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014-1040-90-050
C) N O ~ y 7 O A fD aC ~ ~ I 'Droi 3 3 I ~ ~1 K~ ~ o I O~ 00 O N Z S w O N y CD O c0 D O N ~ CD ~ N r. . , ~ C ~ €tR ~ '~ ~ O) W ~ E 2 d I N Q~ m w N ~ I CD W 3 3 v~ I °o ~ ~ co cc ~ sp I ~ m ~ c0 3 D o g 7 O ~ ~ ~ o ~ ~ y ~ v I cr% Z D y ~ fU i m a No J~ z D m t; D ~' a ~ ~ o `~ ~ ~ ~ ~ W _ ~ o o ~ W ~:. ~ ~ c o c o s .. N N ~ i .. f~D N p p m W O O O d 0 00'0 I O LU ~ A X C ( N N N F ~ C C o. ~ m v O O I O m N ~• 0 n i ~: 3 ~ ~ ° ~ ~ _ a a ~ Z O D D o ~ I w O 3 O O ~ ? @ d I ~p i ? ~ m `~ ro i I G ~ N C W ~ Q. ~ ~ 7 ~ I ~ Z O O m O_ y C N I ~ 6 y ~ ~ a 3 I o - , _ C y ~ N W LU O a ~ I a ~ a ~ cn o a O O ~ ~ I ~ ~ ~ O I a n3i c I 3 -• d O - o 3 a ' ~ tD ~ ° o ~ ~ N m ~ x ~ 3 m • w N O C ~ CO N N ~ v r: I N ~ ~ • ~ ~ ~ ~ _ ~ ~ I ~ C a I i o ~ m m en O c~ O i O ~ O i ncnO ~ ~~ o m ~ c ~ o rt O ~ '. n A 'B '9 O d A t 3 3 ~: '•< ~ O ~ '. ? ~ j O ~ ~ O ' W (~ y I ~ O ~ ~ I ~ A O O ~ N o ~° ~ ~ o c n W o N N ! O O ~ K C ~ v i ' d ., a ~ I N N F ~ ~ ~ C O C O O W '' y 0 c V 0 V 0 ~ ~ K Q fD ~ d °''~ O O O w 'i CC G CC G ~ fA fB fn ~ li f ~ p ~ !i , m d a ~ o l Ro W d - N N O V ', Q O 3 ~ c ~ ~ .. •• a w D ~ m O ~ ~ ~ CD N N ~ -• N c N CD a '~ j ~ i ~ ..~ -I N ~ A J Z tD ~ r~! 7 a ICI A Z ~ ~ Q 1 0 3 O '' UI Z W 'T1 C a ~ .. '~ C W CO ~< Z A ~J A ~1 0 ~• O • 0 h • fi a fi ~~ OO N O O v A dC ~V ~ O C.,~ I I f? r~ m j N d N ~ N C ~ N N N O- O 0 0 0 T ~I N J C I ~ v ~ (D N ~ C N W ~_ O CO ~p ~ ~ ~ I I ~. z I o O N ~ ~ a z I ~ 0 i ~ I w Q Z i i o N O I I I, I I I I ncnO ',3 ~n d r~ o d c f c ~' ~ o p `i1 7 ~D '0 N ~ p - c D 'p C ~ ~ ~ p d ~k ro 3 ;-• 3 = ~ ~ ~ .. ~ ~ l ~ Zr O Z~ 0 3 ~~ 3 3 ~ Z v, a (n ~. m Z~ o~ ~~ ~~ N Z c a O ~ = ~ ', T ~ A O w~ ~ ~~ ~ C '3 OD y ~ fD p S Z ~ Vs N O N O. ,7°"', N N C N p S Z O fD ~ `za ~ O ~ K ~ p ? „ ,i, ~ C CD ~ O (D ~ N 3 W r W d fpai C N 7 ~ N N ~ N O "~S / l ~ ~ O N 7 u i . ~ ~ N W O ~ O p ~ 1 O O f0 n O O O 0 0 0~~ - ~ O O O [7 N O. 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I ~ d F y0 ~ y y N y y ~ Q ~' ~ p07~ y N N y y O S 7 `G C7 tD S11 ~ 7 `~G n y y N~ N ~ O. fD O. y~ V N ~, O. fD O- CD S O •Z pj ~ fD 7' O~ N p fi y 0 ON ~~ p OfD ~~ A R ca 7 ~ ~ 7~ aOO O ~ y O 7 ~ ~ 7~ OOO O F O~ , O`C d N C'~ O O= . O`G d N n O fi D N N o O N D fD p~j d ° N N ~^~ o~7c~ ' m m~ o a ~7cp v3 0 ~v `<D ~ c ~nci`~ D m c N _ myo a (DyO a '~ ° o O , o V O. o. q ~ ~ I A fD @ QA O O O ~ ~' ~ O b O O O O O O O 0 0 ~ ~ P6. X67 g~-10 Xisaonsin Department of Health sad Soolal Services Division of Health SEPTIC TANK PERMIT APPLICATION ,~ TYPiC or USS BLACK INK ~. OWNER OF PAOPSRTY '^ / ~, " l~ ~~ ~ ~D - Name v ~ Address (Street, City, Zip Cods) , " ~-~~:1,~,~ _ ~i 7~ ,~ i,~,~~= ~-~ ~~' ;~~~f ~~ '` ~ - won B• LOCATION OF PROPERTY W ARE SYSTEM WILL BE CONSTRUCTED ALTERET OR EXTENDED COUNTY ~~ ~/C C ~~ Check Ones CITY PILLAGE LEGAL DESCRIPTION ~ TOWNSHIP ` / / / ~;~ ~~ r : 51 / ~ " < ` 7~~~° ' ~ ~~1 ' / ~ ~ ~~ ~ . .. 1. f , 1 ` r ~. / ~., ' ~. C. ,, _ , IS LOCAL PERPSIT REQUIRED FOR THIS WORK? ~-YES NO PERMIT NUMBER D. .SEPTIC TANK CAPACITY !''O C%' Gallons NEW INSTALLATION / `. RT~PLACEtgNT ADDITION MATSRIALSs Prefab Conorete X~ poured in Place Steel Other NUMBER OF TANKS ?0 BE INSTALLED s (`% /d,~L- E. TYPE OF OCCUPANCY ~ Check Ones Cane or Two Family Residence Cou~mercial Industrial Other f; Speaity ' Number of Persons to be Accommodated /_` = Number of Bedrooms ~ ? : F. APPLIANDES, ETCs Food Waste Grinder. YES ~ NO Automatic Clothes Washer ~ YBS NO Dishwasher YES NO Automatic Potato Peeler YES~ NO ~ Other (Specify) G. MASTER PLUMBER MAKING INSTALLATION _ ~ Hams: ~~.~,~"~~~~,j ~,fa'L~!.G d ~`/ ~ Addresss Irk ~~',/~ r~ .~ •jt 1~~ License Numbers . r/~! Ml! 4 L' ~ '/ i '/ v -~ /,F ~/ ~ Signature. of Appliaar-t: _-~ .' ~` ~C` ~~y c~`~-f'''' MP RSW Addr ss ~~~~ ' ~ l^~ % e s __ ~ ,~~ ~ H. mpleted by Issuing Agesa) (To be C o / Date of Application / ,~ /~ / % ~' Fee Psid = r ~1 ~~ . ~ Permit Issued (date) r / '~ / !Ji ~- Permit Nemtbe r~ / ~~ '~ .. . / ~ i:, ti /, Agent (Name) 1'< i t . ~ -Pti.-G~ ~ /~ `7r,:) ~ ~;~ ~ Fors x ~~': ~h ~::r ~ j ~,% ~ . Toxn, Pillage, City, County, etc. (Specify} Note; The application cannot be considered for filing until all of the above questions are ansxered and the fee paid. Agents xill forcrard application, the fee of 51.00 for each septic tanx sad the third copy of the permit (aanary~ to the Division of Health.. Checks and money orders should be made payable to the Division of Neaith. Do not xrit: in space below ~ FOR DEPARi?IENT USE ONLY I. DATE RECEIVED- ~ '~- I`I ~ ~ ACCEPTED HY ~ ~ RETURNED ~ (Initials) (Date) See Co s.) ~ FEE RECEIVED VALID. No. ~ ~- PERMIT NO. Lt~ es or No REYIELIED BY APPROVED DAT1t _ (Initials) Yes or No COMPLETE OTHER SIDE J • saPTlc TANK PERMIT No. - A=PORT ON SOIL Pa RCOLATION TaST ~ AND SOIL BORINGS - ?0 . DIVISICFi OF HEAL?H • PLUMBING SECTIb~I P.O.Box 309, Madison, Wis. 53701 .~ ,' Purauaerst to H b2.20, itis. Adainistrativs Code P t R C O L A T I 0 N T t S T ' Teat Dspttt Character of Soil Hours Plater Test Time Drop in Plater Level Inches utss Nusher Inches Thielasess in Inches Sines Hole in Hols lhterval Second to Next to Last To Fall 1st Flatted Ovami in Minutes Last Period Last Period Period Ons~Inch axampls p • 0 3b++ To Soil 10+' Cla 26N 23 Yes or Ho 30 1 2 1 2 1 2 60 .1<: ~ w"~~ .x RECORD DATA FROM MINIMUM OF 3 TT~ST HOLES Compute size of absorption area in aoaord with H 62.20 ills. Administrative Code. SOIL BORINGS • Minimum 3b" Balo+- Pro osed Abao tion S etas Boring Total Depth De th to Ground Fiatsr De th to Bedrock Number Inohas Obserrorad astiraated Observed Estimated Character of Soil with Thiolrness in Inches a~aaple B • 0 72" 72" Black To Soil 12" C t8" Sand 18" Gravel 2~++ :~ ay ~~ r ~ /? ; RECORD DAT1 FA0~1 MINIMUfi OF 3 BOAS HOLES PE OF OCCUPANCYt ,~/ RESIDaNCat Number of Bsdroaea _~ OTHER: (Speolfy) Humber of parsons D FIRSTS GRL*IDER: Yes No ~ Diahwashart Tss No ~ Automatic ~Clothss hasher= Yes ~ No ~~ FFWENT DISPOSAL SYSTEMS NEFI u`, aXTENSION ADDITION REPLAI~IENT Tile Size ~ No. Lin.Feet:~ ~/% ~ Trench xidth :~ Depth _"'~ ~'' Number of Lines .7 Depth Tile Size ~„~ No. Lines Seepage Beds Length Width ~_ Seepage Pits Inside Diameter ~ Liquid Depth ~_ I, the underai~ned, hereby eert.'ry that the percolation tests reported ,:n this form were made by me or under s • super--. .vision in sooord xith the procedures and method specified in Chapter H u2.20 (13 ), Fliaoonsin Adsdnistrativs Code, and edge and belief. that the data raeorded and location of test holes are aorreet to the best cf ay knoxl l Nary ~'. /~ / f =/'~ f 1~ Viii. < /i ti' TITLa ~ i%/ `_<: ~= i~ Jai ; ~~'~- ~~ Type or print REGISTRATION N0. or MASTER PLUMBER LICElISE N0. ~~!~~' ~ "'{/~> ~ ~ i 7 % , ADDRESS 1 ~, /~ ~ ,r* ~ . 6 ~ :'T f~ ~-~ // DAiT ~ :~ ~ / ~ / ~' S IGNA?UAa ~ ~ = ?/j,..-. %/.~. i- /' .~ ~` - ' - - _. ~ /`~ .~ cnnsin ~~epartment of Commerce PRIVATE SEWAGE SYSTEM `ety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m11 Permit Holder's Name: City Village X Township Ber , Dar I & Krista Forest, Town of CST BM Elev: Insp. BM Elev: BM Description: L °~ b ~ ~ CST' TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ /, 5 r~ Dosing ~/~ 3 Cast b tO~ A, ~ ~-- F~ ~~, Holding TANK SETBACK INFORMATION TANK TO P/L IJo(-'~ WELL BLDG. Vent to Air Intake ROAD Septic ,7 /~ ~ 117 f / $,S / /eJ5 / -' Dosing ~ /~ ~ / 17 ~ /.3$ ~ / 3.5 ~ Aeration Holding PUMP/SIPHON INFORMATION /~.~ Manufacturer Demand ~p ~` ~.~~ GPM Model Number ~ 5 Z .39 ~1~5 TDH Lift •~ Friction Loss . ~ System Head H.SJ TD ;,~ ~4Ft Forcemain Length ~ Dia. ! Dist. to Well /45 z ~~~ SClll ~RS(1RPTI(~N SYSTEM County: St. CroiX Sanitary Permit No: 499168 0 State Plan ID No: Parcel Tax No: 014-1040-90-050 Section/Town/Range/Map No: 19.31.15.295610 ELEVATION DATA STATION BS HI FS ELEV. Benchmark T.3~ ial. ,'OC3 AIt.BM~'1 ~~ i v\. ,s,~ y~. zt Bldg. Sewe r ~ (~ ~o~.ne,~ ~"'c) tSidrJ ~ . ~ Q~j . 2 S St/Ht Inlet S. zs 9Z . f St/Ht Outlet ~ ~ Dt Inlet Dt Bottom )Z. ~, ~, S 5 Header/Man. . / 97. Z ~ Dist. Pipe ~ 1 47, ZI ti Bot. System ~, ~ 71p, t~ s Final Grade ~ ~ ' Z / St Cover C©~~~.t•- 7.3~ l`~ BED/TRENCH Width / Length i No. Of Trenc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ 1 I Z..• 5 Qe _~ _ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of System: ~ 3a ~ Z!~ / ~F3 ~ ./v T'~~ UNIT Model Number: a~ I~ISTRIRl1TION SYSTEM D,S L.) ~Z Header/Manifold l ~ Distribution tl Pipe(s) .S ~ 5S' ~ ~ x Hole Size !t ~ x Hole Spacing ' ~ ~~~ Ve to Air Intake ~J~ J Length ` Dia _ Spacing Length Dia c3 Z -" SCllt CnVFR ., o.e~~..ro c.,~•e.,,~ n., r., ..,. Mnnnri nr AI_C;rade Svctems ~nlv Depth Over ~ Bed/Trench Center Depth Over Bed/l'rench Edges ~ xx Depth of Topsoil ' ~ xx Seeded/Sodded 1.; N xx Mulched i No ~s /. b b o s i ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~"~ /I 5 / ~~ ~ Inspection #2: / /~ Location: 2075 Highway~63 Deer Park, WI 54007 (SW 1/4 NW 1/4 119 T31N R15W) metes & bounds Lot ~~~'~"' Parcel No: 19.31.15.295610 1.) Alt BM Description = r'~ ~~ Ga `~{'-- ~ ~~`^~'~`^~ ~o I ~'ac]~i/~. 2.) Bldg sewer length = Fi~ri Si`t'' 1 ~~ ~~ ~~ ~\~ -amount of cover = N ~~ ,~ ~ ~.. ~..,~ 7. S5 ok Plan revision Required? ', Yes No ' ~ ~ ~S OLt, ~~3~7 ,other side for additional informati n. I- ~- " Date Insepctor's ignatur Cert. No. - I 0 (R.3/97) ~' Safety and Buildings Division ~ " County .. ` Z ~ " L ' 201 w. wasttington Ave., P.U. 716 t i ~ c S t 1SiCQlI,~/l f M~iison, WI 537~l16 ~ Sanitary Permit Number (to be filled in by Co.) De artment of Commerce tag) ~-31i~-'' `~ `~ Sanitary Permit Application State Pha- LD. Number ~ /~~ ~~ ~ Io arxord with Comm 83.21, Wis. Adm. Code, petsoaal information }rottprovide '- may be used for seeatdary purposes Privacy _ _......._ . ...... ......... . prpj~ Address (if different than trreiling address) I. Apptieatiou Iafor~natioa -Please Print Alt Iaforrnatio ~t~M£ PAY Owirer's Name ~~ .;t ~ !' ";~' i ~ Pared # Lot # Block # Q~Y~~/L ~:RtST~ 8~2~ ~ Df~191 C~`1~~~0- c~ ~ Pmpecty Owner's Mail'atg Address ~ Property Location City, State Zip Co de hone Numb er P t~ `-~ ~`/r ' , /Y ~~~~ I"~t`IL.. Y4'! / ~ ~~C.A.J~~ Q ~ / 9 `I ~~`2L3 ~~Lt`) T ~i N. R ~~eE~) ~i ~~~~ ~ II. Type of Beildiag (check a@ that apply) ~ _~ ~:.~ ~1 or 2 Family Dvnelting - Nwnber of Bedrooms Subdivision Name CSM Number ^ PuWicJCommetcial -Describe Use ~ ^ State Owned -Describe Use ~ ~" //Z , 5d u ^City ^Yi,lage ,~Torwtship of ~a ~. III. T ype of Perm (Check Daly eras bmc oa liae A. Complete tine B if applicable) A' ^ New System ~Replaoerrrerrt Systerrt ^ Treatarerrt/Elolding Tank ~ Onty ^ Other Modification to Existir-g System 8• ^ Permit Rettevrat ^ Permk Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expitntion Plumber Owner ~ N. T of POWTS S - Chsck alt that a ~ ^ N~ -Presaaiaed IzR-Ground ^ Mound ? 24 in. of srri~ble soil " ~Moimd <24 in. of ~itat~e soil ^ At-Garde ^ Single Pass Sand Fitter ^ Coatructed Weiland ^ Pressurised tn-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Tit Unit ^ Recirculating Sand Filter ^ Recirculating S ~ Med~ Filter ^ Leac ' Chamber ^ 'Line ^ Gravel-less Pi ^ Other ( ') ~'" ~ V. reataneat Area Iafermatae: 2 Design Flovr(gpd) Design Swl Dispersal Area ~ (sf) Dispersal Area (sf) SYstan Elevation ~5U ~ ~ O~ ZD 45~ 2250 4Sd ZSb 9'L.S / YI. Task Info Capac' in Tana! Number Manufarxurer' Prefab- Sire Steel Fiber Plastic Gallons Galkars of Units Caste Constructed Glass New Exiatmg Tssdcs Turks sepae err l~bidag Tmak ~ ~ X11/~c>t' ~ aerobic T,eatmea unir > ~ VII. Re~,sibiltty S4tetnsat- T: tits rar+ufersipted, rtssuroe rapoadbiRty ter of tke 1'OWTS sAorva oe ttte atdte6ed platers. Plumber's Name (Prim} bees mbar Business t~-one Plumber ~~'~ ~x ~3z~Z ~ ~s- ass- z~bl Plumber's Address (Street, City, State, Zip P~. (3 eu. ~i~ ~ S~'2 W / ~~1'L~ g VITL Doer rtment iJse Approved ^ Sanitary Permit Fee (tnduaes Groundv Date Issu' Si o ^ Given Reasor ~ r-Denial Surcharge Fee) 5 5 D . D'b cJ ,~ / 6 9 ~} ~ IX. Comas of A rov atz far Disapproval 5'~,0~~ ~ ~ 1. 8Y>;T61~~VVNEa 3,. t..O...~,o ~h`erv~ • ,~•... `` ~~, 1. tank, eflhleM tikes end a C e, ; ,t`. e.~e.~ w ~ d-~. J Pet'v~~ . dispersal cell must all ~g servit;es /maintained (/ as per management plan provided by plumber. 2. All setback requiranents must be maintained ~ per appNcaWe tide / ordittanas. Atheh earephre plan (m the Coaaty os~) kr We sysrm os prper s~ rasa titin 8llt :11 i~cw ~ size SBD-6398 (R.. Ol/03) r~ C O ao ~ ~ ~.~ o `~ o V ~ ~° ~~~z~ ~a a b3~ ~ ~~ ~ ~ ~ ~~H ~ ~ ~ ~L .~ ~ a~ ~ c ,~ ~ ~~w ~~ ~~~ A°a~io ~~ o ~s ~ wavy ~ ~~ o0 3~ ~~ .~ ~ ~ ~ ~~ ~~~ Q N oc[~r ~ ~ H ~ Q ~ ~ ~ ~, ~ h ~ gN .~ h U O~ ti ~ 9 ~ a ~ ~ O +e W ~ m \ a ~ ~ ~ ~ W ~ a ~ ~ ~ ~ ~ ~ M t~ ~°~n U M ~ o h~ W ~ U Q a ~ ~ ~ ~ ~ .°, o V E+r ~+ ~ ~ $ ~' °' ~ ~ a rr U° a ~; a~ h .~ ~ a ~ a a 3 a h~ c N H z w " '~R~ ~u, h fi ~6 ~ ~~ ~ ~ ~^ N~ o~ Q~ ~ ~ w .off. •, commelrce.wi.gov f ~ isconsi Department of:Gomrnerce INSPECTION REPORT cc Date of Inspection: July19, 2006 Project Name: Berg Use: Residential Legal Description: SW, NW, 19, Parcel ID Number; 014-1040-90~ Subdivision: NA Municipality: Town of Forest County: St. Croix Plan Transaction Number: Sanitary Permit Number: Wastewater Flow: 450-600 gpd Persons Present: K. Stoner Certified Soil Tester 1 Name and Address: Gary L. Steel, CST 222353 ,15y~ECElVED JUL 2 4 2006 Ified Soil Tester 2 Name and Address: ith Stoner, CST224059 2 220 Wood Creek Rd sT. cROlx COUNTY ~ren, WI 54872 Owner Name and Address: Daryl & Krista Berg 2075 Hwy 63 Deer Park, WI 54007 An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations by the certified soil tester (CST) relating to the presence or absence. of redoximorphic features in the A horizon and/or subsoil. In-situ soil texture, structure, and consistence factors were also reviewed as they .relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water. hydrology may also be noted and their effects are factors considered in the recommendations and conclusions portion of this report. A typical soil profile at CST B-1 could be described as follows: 00-07" 10YR 3/2 sil, 3mgr, dsh, cw. 07-13" 10YR 4/4 sil, 1 mpl, dsh, cw, w/ c2f 10YR 5/6 rmfs. 9~~~"_7_SYR ~l4_cl~2msbk~dh,-cw, vu/-c2-3d- 7-.-5YR- 5/8-r-rr~fs. ___ _ __ _ _ ___ _ ____ _ _ _ _ _ __ 19-26" 7.5YR 4/4 sl till, 1 msbk to Om, mfi, w/cad 7.5YR 5/2 and 5YR 5/8 rmfs. If a mound system is designed to overcome limitations of a high level of seasonal soil saturation and slow permeability, the linear loading rate should not exceed 4.5 gpd/ft and the basal- wastewater application rated should not exceed 0.2 gpd/ft2. The additional basal area will partially compensate for the gentle land slope and prevent wastewater leakage at the mound toe. At least 30 inches of sand lift is recommended when applying septic tank effluent to the distribution cell of the mound to ensure proper treatment. The longest portion of the mound must be orientated along the contour. The upslope mound toe should be shaped to divert surface water east and west away from the mound. The mound shall be constructed to divert surface water around the mound structure as much as possible. In addition, the south driveway ditch should be modified to improve drainage if it is determined that surface or subsurface hydrology is improved by intercepting water and diverting it away from the mound site. Existing tank(s) and piping should be tested for water tightness to make sure that infiltrating groundwater does not overload the new mound. . If there are any questions regarding this report, please contact me. Leroy G. J sky, Wa water S cialist Ljansky@ mmerce tate.wi.u E-mail 715/726-2544 Voice 715/726- 549 Fax SAFETY AND BUILDINGS DIVISION Integ_ rated Services Bureau 13 East Spruce Street Chippewa Falls, WI 54729 www. commerce.wi.gov/sb (715) 726-2544 ^ Plumber ^ Owner ® County ® CST ^ Other _ Page 1 of 1 Pam Quinn From: Jansky, Leroy [Ijansky@commerce.state.wi.us] Sent: Thursday, July 20, 2006 7:33 AM To: Pam Quinn Subject: Onsite The stoner onsite is at 9 a.m. Thur (today). Located at SW, NW, 19, 31, 15W Forest Township (014-1040-90-000) Original test by Gary Steel on 11-2-00. Leroy G. Jansky, PSS Wastewater Specialist 13 E. Spruce Street Chippewa Falls, WI 54729 (715) 726-2544 Voice (715) 828-5902 Cell Leroy.Jansky@Wisconsin.gov 7/20/2006 Wiscxx+sin Department of C SOIL EVALUATION REPORT Division of Safety and Buildings ~ ccordance wilt, Comm 85. Wis. Adm. Code ORIGINAL ,~ Page 1 of 4 Keith Stoner l l Att h m t it n t l th 11 i 8'/ h i i Pl t County ac p e s on r no an : x nc co e e p a ess es n s ze. an mus i cl d t t li it d t i l h l b f St. Croix u u no m o: vert ca and orizonta re n e erence point (BM), direction and e, percent skrpe, scale or dimemsrons, norttl arrow, and locavon and distance to nearest road. Parcel i.D. 014-1040-90000 Please print all information. Reviewed By Date Personal infom~aGOn you provide a ee~s~rivacy , s.15.(14 (1) (m)). Property Owner Property Location Daryl + Krista Ber Govt. Lot SW 1/4 NW 1F4 S 19 T 31 N R IS W Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2075 Hwy. 63 OUNTY City St a Zip Code Phone Number J City ~ Village tf Town Nearest Road Deer Park ~ W 7 715-263-3494 Forest Hwy 63 ~ New Construction WSe: NI Residential / Number of bedrooms 3 Code derived design flow rate 450 d Replacement .J Public or commercial -Describe: Parent material Glacial Tilf ~. Flood plain elevation, if applicable General comments t ` and recommendations: Interpretive Mound Site -See attached job memo page. ~~ ~~/~'~_~ ~ ~,/~' ~.~''~~ ~ GPD NA hs~C'~~~ `- ^ Boring # _.I Boring V' Pit Ground Surface elev 93.51 ft. Depth to limiting factor 0~~ in• Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cor~tence Boundary Raots fR2 in. Munsell Qu. Sz. Conf. Color Gr. Sz. Sh. *Eff#1 'E 1 0-6 10YR2/2 - sil 2mgr/sbk mft/ds cs 3f-co .6 .8 2 6-9 10YR5/3 c1f5YR5/8 sil 1 msbk/1 mpl ds gs 3f-co .4 .6 3 9-14 10YR5/4 c2d5YR5/8 sil 2msbk ds gs 3f-co .6 .8 4 14-20 5YR4/4 c2d5YR5/8 scl 2msbk dh gs 3f-co .4 .6 5 20-48 5YR4/4 m2d5YR5/8 7.SYR6/2 sl 1 msbk/m mfr/mfi - 2f-co .2 .6 Boring # ~ Boring /~ Pit Ground Surface elev. 92.74 ft. Depth to limiting factor 0~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cons'~sterx:e Boundary Roots GP D/ft' in. Murrsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-6 10YR2/2 - sil 2mgr mfr/ds cs 3f-co .6 .8 2 6-7 10YR5/3 - sil 1 msbk/1 mpl ds gs 3f-co .4 .6 3 7-11 10YR5/3 c2d5YR5/8 sit lmsbk/1mpl ds gs 3f--co .4 .6 4 11-23 10YR3/4 c2d5YR5/8 sil 2msbk mfr gs 2f-co .6 .8 5 23-40 5YR4/4 m2d5YR5/8 7.SYR6/2 sl m mfr - 2f-co .2 .6 " Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L uent #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature: _ CST Number Keith E. Stoner 224059 Address Keith Stoner Date Evaluation Conducted Telephone Number 23220 Wood Creek Rd., Siren, WI 54872 7118/06 ?15653-2324 Property Owner Daryl + Krista Berg Parcel ID # 014-1040-90 000 Page 2 of 4 Boring # ~ Boring 1/ Pit Ground Surface elev. 94.04 ft. Depth to limiting factor Q" in. Soil Application Rate Horizon Depth Dominant Color Redox Descripton Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10YR2/2 - sil 2mgr ds cs 3f-co .6 .8 2 7-11 10YR5/3 c1f5YR5/8 sil lmpl ds gs 3f-cb .4 .6 3 11-20 10YR5/4 c2d5YR5/8 sil 2msbk ds gs 3f-co .6 .8 4 20-40 5YR4/4 m2d5YR5/8 7.SYR6/2 sl m mfi - 2f-co .2 .6 Boring # - Boring Y' Pit Ground Surface elev. 89.08 ft. Depth to limiting factor 0" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in, Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 1 ~~ 0-9 10YR2/2 c1d5YR5/6 sil 2msbk ds cs 3f-m .6 .8 2 9-15 10YR6/3 c2d5YR5/8 sil 1 mpl ds - 2f-m .4 .6 Hand dug pit in drainageway to determine ability to see redoximorphic features in Ap horizon. ^ Boring # --~ Boring ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stnucture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont Color Gr. Sz, Sh. •Eff#1 *Eff#2 `Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (IL.07/00) KC1rh $Yor1Er PROPERTY OWNER: Darvt + Krista Ber4: PARCEL J.D.# oio-ioao-9o 000 SOIL AND SITE EVALUATION 1269 Page 3 of a Keith Stoner REPORT MEMO Propose a 4' x 112.50' Interpretive Mound Site. Mound cell located along the 94.00' contour with a system elevation of 96.50' with a 4.0 gpd/ft lineal loading rate and a .2 gpd/ft.sq. basal wastewater application rate. t ~. Kevin Grabau From: Jansky, Leroy [Ijansky@commerce.state.wi.us] Sent: Tuesday, January 09, 2001 x:09 PM To: 'Kevin Grabau' S~ Subject: RE: ~~~ I recommend that they engage a CST soil scientist to conduct a determination under Comm 85.60 (1) or (2), Wis. Adm. Code. The procedure is outlined there. If the choice is for an interpretative determination in lieu of a soil saturation determination (using pipes) I need to conduct an onsite to verify the CST's results. There are separate reviews of this data and associated fees for department review. > -----Original Message----- > From: Kevin Grabau [SMTP:KevinG@CO.Saint-Croix.WI.US] > Sent: Tuesday, January 09, 2001 8:18 AM > To: Leroy Jansky (E-mail) > Subject.: > Hello Leroy, > There is a parcel here that was soil tested in 1993, and found to ave > soil conditions that would not support any type of replacement system, so > a holding tank was installed. Now the people are wanting to sell t e > property, and want to know if there is any possibility for a system ~~~ now. > The parcel has been soil tested again last November and found to only have > an A+4 conditions in one boring, and A+0 for the rest, :with mist borings > having the bare-bones minimum of 6" before mottling is found. The people > are wanting to know what steps they have to take to get the site checked > for A+0 conditions to see if any type of mound, etc. can be installed. > I informed them that state personell had to make the determination on > this. Through some sort of communication breakdown, they thought the ball > was already rolling on this. > She also wanted your phone number, so I am sure she will be calling. I > did tell her I would contact you first, so you could be aware of what > conditions are on the site. I have not been on-site. > Thanks. > Kevin Grabau > Zoning Technician > St. Croix County Zoning Department > 1101 Carmichael Rd. > Hudson, WI 54016 > Ph: (715)386-4680 > Fax: (715)386-4686 > keving@co.saint-croix.wi.us 1 a ., ~~ V~a~ ~ ~~~ w.~' '"^~-- ~} IR. 3 (. I S~. 29S ~ ~~ °`~ -~ea.~' C t /~L~ J ~}C,t-- w-~.~r~ f ,~-- ~ S ~`Q~ }~Pa S...fC ~T ~g ~ sKP~sF,«& (=~~ s~ or ~-l~o - 90 -~ /mot. 3<. r s-, z~rg ~ '~ ~ 3 ~~~~~ ~.. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _of 3 Division of Safety and Buildings rn accordance wren Comm a5, wis. Ham. ~ooe County must i Pl 11 i h i t l th 8 1/2 ze. an nc es n s ess an x Attach complete site plan on paper no include, but not limited to: vertical and horizontaliefarencepoint (BM), direction and Parcel I.D. - OCK '`~ percent slope, scale or dimensions, north ~rovw;eildlocaRign and distance to nearest road. / (J ~ D Q ation. Please prefit~a~~ ~hfor m eviewed te ~ D'a ~ ~ i Personal information you provide may l)k u9gd'for secondfl4y pkr ses (Privacy Law, s. 15.04 (1) (m)). h,(~i ~ / ) ~~ /~, v t/' ~' v'' _ Property Owner ~ -- • ' ; `~ ~ ~ j ° Property Location Brad Hanson "~- ^ ~~+ • Govt. Lot ~ 1/4~ 1/4 S19 T 31 N R 15 f(or) W , ~ Property Owner's Mailing Address ' ~ ~ ~ ` ~ ~ Lot # Block # Subd. Name or CSM# ,` ~~ ~ ,; : ~r ~ ' Ila Ila Ila City e Zip orJe~ Phg~p, ,' -. ~' ^ City ^ V illage ~ Town Nearest Road Deer Park WI 540 /% y ) Forest HY. #63 ^ New Construction Use: ® Residential / Nu•?nbecoLlbedro~tims "~ Code derived design flow rate Lin GPD [~ Replacement ^ Public or commercial -Describe: Parent material ~1 a .i a 1 c]ri ft Flood Plain elevation if applicable - _ ft• General comments and recommendations: Soil borings in area do not show anything other than a A+0" soil condition. At this time the only system available are holding tanks. Further study by Dept, of Comtnercem could allow A+0" mound system. ^ 1 Boring # ~ Boring ® pit Ground surface elev. 97.55 ft. Depth to limiting factor 8 in. Soil lication Rate H i D th l r t C D i Redox Descri tion Texture Structure Consistence Boundary Roots GP D/ft= or zon ep in. o o om nan Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 1 -4 10 3 3 none 2f 5 8 2 -8 10 4 3 - 3 8-20 10 4 20- 2 Boring # ~ Boring ~ pi( Ground surtace elev. 99.05 ft. Depth to limiting factor 6 in. Soil A lication Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 -6 10yr2/2 none L 2msbk mfr gw 2f .5 .8 2 -21 10yr6/3 c2d 7.5yr5/8 sil 2msbk dsh 1f .5 8 3 1-40 5yr4/4 2d 7.5yr5/8 scl 2msbk dsh na na .4 .6 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` tmuent rrz = w ~ su mgrr_ ana ~ ~o = ~~ ~ ~ ~~~ CST Name (Please Print) Signature ~ ~ • CST Number Gar L. Steel 02298 Address Date valuation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 L1-2 2000 715-246-6200 .~ Property Owner Brad HanSOri ParcellD# ~1~-lC~y~4 90.0 Page 2 of 3 3 Boring # ^ Boring ~] pit Ground surface elev. 95.85 ft. Depth to limiting fador 6 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Stnx~ure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 1 0-6 10 3/3 none L 2msbk mfr 2f .5 .8 2 6-20 10 6 2 c2 7 5 5 8 sil 2msbk dsh 1f .5 .8 3 20-40 7.5 4/4 c2d 7 5 5/8 scl 2msbk dsh na na .4 .6 Boring # r^--~ Boring DU Pit Ground surface elev. 98.25 ft. Depth to limiting fador 6 in. Soil lication Rate Horizon Depth Dominant Color Redox Des(iption Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 1 0-6 10yr2/2 none L 2msbk mfr gw 2f .5 .8 2 6-22 10 6/2 c2d 7.5 5/8 sil 2msbk dsh 1f .5 .8 3 22-40 5 4/4 c2 7.5 5/8 sl 2msbk dsh na na .5 .9 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting fador in. Soil lication Rate Horizon th De Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fP p in. Munsell Qu. Sz Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access servrces or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (86/00) ~` STEEL'S SOIL SERVICE Gary L. Steel CSTM2298 MPRSW-3254 N 1 "=40' BM.= top of well Alt. BM.= top of ~i Brad Hanson SW4NW4 S19-T31N-R1W town of Forest @ el. 100.00' step @ el. 101.20' Gary L. Steel 11-2-2000 ~`~ 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 ' Parcel #: 014-1040-90-050 07120/2006 08:19 AM PAGE 1 OF 1 Alt. Parcel #: 19.31.15.295B-10 014 -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 -BERG, DARRELL C &KRISTA K DARRELL C & KRISTA K BERG 2075 HWY 63 DEER PARK WI 54007 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description " 2075 HWY 63 SC 1127 CLEAR LAKE SP 1700 WITC Legal Description: Acres: 8.070 Plat: N/A-NOT AVAILABLE SEC 19 T31N R15W 4A IN SW NW COM INT N LN SW NW WITH E W H W BlocklCondo Bldg: R/ H Y 63, T S ALG R/W 342.5', THE 510', N 342.5' TH W 510' TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) POB FKA 014-1040-90 (2956-10) & INC COM 19-31 N-15W SW NW SE COR SAID PARC; TH 342.5FT TO N LN;TH ELY 517.50FT; TH SLY 342.50FT;TH WLY more... Notes: Parcel History: Date Doc # Vol/Page Type 05/02/2001 644409 1630/635 W D 05/02/2001 644408 1630/633 AFF 05/02/2001 644407 1630/631 W D 07/23/1997 964/552 more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/18/2005 Description Ctass Acres Land Improve Total State Reason RESIDENTIAL G1 8.070 40,000 141,700 181,700 NO Totals for 2006: General Property 8.070 40,000 141,700 181,700 Woodland 0.000 0 0 Totals for 2005: General Property 8.070 40,000 141,700 181,700 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 commerce.wi.gov isconsin Departmentof Commer+re Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 09, 2006 CUST ID No. 224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/09/2008 SITE: Daryl & Krista Berg 2075 St Hwy 63 Town of Forest, St Croix County SW 1/4, NW 1/4, S19, T31N, R15W Identification Numbers Transaction ID No. 1308555 Site ID No. 716603 Please refer to both identification numbers, above, in all corres ondence with the a~enc. . FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1090787 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. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. Approval is hereby granted pursuant to s. Comm 85.60(2), Wis. Adm. Code, to estimate the depth to seasonal soil saturation based on an interpretive determination process. Approval of the interpretive determination negates the requirement in s. Comm 85.30(2)(b), Wis. Adm. Code to designate the ground surface as the highest level of soil saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon. 2. The estimated highest level of prolonged soil saturation approved under this determination is six inches below grade. At least 30 inches of sand lift on top of six inches of unsaturated, in-situ soil is required for adequate treatment and dispersal. 3. The basal soil application rate for the mound shall be 0.20 gpd/sf, and the linear loading rate 4.0 gpd/ft. 4. Chisel plowing to a depth of 12 inches immediately prior to sand placement is required to improve vertical water movement into the soil solum. 5. Landscaping up slope of the mound shall be incorporated into the POWTS design to prevent surface water from concentrating along the up slope edge of the mound and to divert surface water drainage away from the system. The center up slope mound toe must be designed at a 4:1 slope ratio. 6. This approval shall remain valid unless the site is altered in such a way that the depth to soil saturation would change or if saturated conditions are observed for seven consecutive days at depths less than 3 feet below the infiltrative surface of the POWTS distribution component. 7. This approval in no way relinquishes the use of color patterns to estimate the depth to high groundwater on any other parcels or portions of parcels. 8. A copy of this approval letter and attachments must accompany the mound system design for this site for purposes of plan approval and sanitary permit issuance. If the Interpretive Determination Report was accompanied with a plan and an expiration date is shown on this letter, the expiration date only applies to the plans for the design, not to the decision on the Interpretive Determination Report. KEITH E STONER Page 2 8/9/2006 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. If plan index sheets were submitted in lieu of additional full plansets, a copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. All permits required by the state or the7ocal municipality shall be obtained prior to commencement of construction/installation/operation. If this construction project will disturb one or more acres of land, an Erosion Control Notice of Intent (NOI) shall be filed with the department 14 days prior to any earth disturbing activities. In granting this approval the Division of Safety & Buildings reserves theright 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. Sincerely, ~' Leroy Jansky, P , Wast ter Specialist Integrated Services Bureau (715)726-2544 Voice lj ansky@commerce. state.wi.us Fee Required $ 100.00 Fee Received $ 100.00 Balance Due $ 0.00 WiSMART code: 7633 Indez Page for the Interpretive Determination Report 130~~5~ Owners Name Daryl and Krista Berg Address 2075 Hwy 63 P,Q,~U,T.~. Deer Park WI 54007 !'~p~tC~ltlOjlCu' ~ ~~,~ Parcel ID# 014-1040-90 000 ® 1i ~ ~ ' ~b Legal Description ~.",ENT OF COMM t Parcel in the - saFeTYaNU ,~~E,ss SW1/4 NW1/4 Sec. 19 T31N-R15W ESpO :NCE Township and County Township ofForest - St. Croix Co. Page 1 Introduction, Local Hydrology and Local Geomorphology. page 2 Landscape Position, Soil Disturbances and Previous Reports Page 3 Site Analysis Page 4 Conclusion and Site Recommendations Attachment #1 Soil and Site Evaluation Report Attachment #2 State Wastewater Specialists Onsite Report Attachment #3 Copies of Soil Survey Maps and Soil Series Descriptions Attachment #4 Topographic Map of Area CST Keith E. Stoner CSTM# 224059 Address 23220 Wood Creek .Siren WI 54872 Signature Date INTERPRETIVE DETERMINATION REPORT IN LIEU OF GROUNDWATER MONITORING INTRODUCTION The following is an interpretive determination report completed for Daryl and Krista Berg. The Berg property is located in the SW,'-a - NW4 Sec. 19 T31N - R15W Town of Forest in St. Croix County. My goal is to conclusively demonstrate that the soil conditions at this location are suitable for the placement of athree-bedroom mound sanitary system that will not contaminate the ground water supply and will treat and disperse the wastewater for this structure. LOCAL HYDROLOGY Forest Township is located in the northeast corner of St. Croix County and is located in the St. Croix River Watershed. Surface hydrology of the site consists of water moving north-northwest across the property line to an open agricultural field with a drainage way bisecting the field. This drainage way travels down slope to the field's edge to a road culvert discharging to Wolf Creek and the North Fork of the Willow River approximately 2000 feet to the northwest. There is a shallow drainage way located twenty-two feet east of the mounds proposed end slope with an elevation of 93.74' based on a local benchmark. This drainage way is approx. three feet wide and is connected upstream to a culvert going under the drive. This culvert and a shallow ditch located along the south side of the driveway will divert the surface water flow from a drainage area approximately one acre in size located above the proposed mound site. The ditch located upslope or south of the drive has a continuous slope of 1% out to the road ditch of U.S. Hwy 63. The ground elevation at the culverts outlet is 90.04'. The primary source of water available to this site will be from precipitation (with a mean annual precipitation from 28" -33") ®and the subsequent runoff received from heavy rains or melting snow. The water table onsite would be considered perched primarily due to a dense sandy loam glacial till within the profile exhibiting a weak sub-angulaz blocky to massive structure. LOCAL GEOMORPHOLOGY The soils of St. Croix County are mostly loamy and gently sloping or sloping. They are well drained to somewhat poorly drained and surface drainage is in a southerly direction. Glaciation is chiefly responsible for the many kinds of soils formed. It affected formation of the soils by depositing several kinds of glacial drift and by sculpturing a wide variety of landforms. In most places the glacial drift is many feet thick over bedrock. The bedrock consists of dolomitic limestone0. 4 St. Croix County Soil Survey -United States Dept. of Agriculture July 1978 page 1 ®Santiago Series description ortho.ftw.nres.usda.gov The soil-mapping unit for this site is Magnor silt loam (MaB)©. The Magnor series consists of very deep, some what poorly drained soils which are deep to densic contact. They formed in loess or silty lacustrine deposits and in the underlying dense sandy loam till mostly on ground moraines, end moraines, disintegration moraines, drumlins and ice walled glacial lake plains. Permeability is moderate in the silty mantle, moderately slow or slow in the till subh~laan~d~very~ riow'inpeth hedb ater table at as depth of 1-3 feet OO percent. ®Tlus soi ~ LANDSCAPE POSITION /LOCAL TOPOGRAPHY The site is located on a side slope with a slope gradient of 3% and a northwesterly aspect. There is approximately 140' of contour on which the proposed mound cell will be located. The land surface shape configuration of the site shows a shape parallel to the contours as linear to slightly convex and the surface shape perpendicular to the contours as linear. The tested area is located down slope of an existing driveway on the edge of a mowed yard with Burr Oak, Elm and Basswood trees on the perimeter of the site. As previously discussed there is a ditch on the south edge of the drive that will divert water either east or west through culverts to a drainage way or road ditch. SOIL DISTURBANCES Soil disturbances for this proposed mound location has been limited. It appears that this site has been kept as a woodlot adjacent to an existing home. The property has a woven wire fence around the perimeter indicating it may have been pastured previously. The depth of the A horizon along with the size and age of existing tree cover would indicate that this site may not have been plowed. Manmade disturbances to the soil would be the creation of a driveway with a shallow ditch and drainage way east of the mound site. (See soil test for elevations and location.) PREVIOUSLY APPROVED INTERPRETIVE SOIL SATURATION DETERMINATIONS Transaction ID# 1184516 -Chris Huppert -Santiago Series SW4 -SE4 Sec. 13 T35N-R15W Town of Johnstown -Polk County Transaction ID# 980154 -Bernie Seidling -Santiago Series NE4 -NE4 Sec 9 T31N-R15W Town of Forest - St. Croix County OSt. Croix County Soil Survey -United States Dept. of Agriculture July 1978 page 39 ®Santiago Series description ortho.ftw.nres.usda.gov 2 ANALYSIS OF THE SITE To determine the depth of seasonal saturation for an interpretive mound site we typically look very closely at the following characteristics: - Soils (Texture, Structure and Consistence) - Landscape Position - Vegetation Type The soil textwe for this site consists of a moderately permeable A horizon with a strong to moderate, medium granular structure 6 to 7 inches in depth. No redoximorphic features were visible in the A horizons of soil pits 1-3. To spot check ourselves as to the visibility of redox features in the darker A horizon it has become procedure to construct a shallow pit in an assumed or known wet area to verify of redox features can be discerned. For this site B#4 was hand dug on the edge of the fields drainage way. Redox features were readily seen in the Ap horizon and the subsoil. This gives us confidence that the observations and conclusions drawn from the upslope soil pits to be accurate. Landscape position is very important to a sites ability to deal with the forms of precipitation and associated surface water flow. This site is situated on a 3% side slope, which allows surface water to run across and down slope. Unique to this site is the location of the driveway upslope with a shallow ditch on the upslope side. This ditch will assist drainage for the proposed mound site by intercepting surface water from upslope and directing it easterly to a culvert and shallow drainage way or west to the main ditch of U.S. Highway 63. The type of vegetation onsite is another indicator of soil wetness. This site is partly open yard but is fringed by a wooded area. Tree types consist of American Elm, American Basswood, and Burr Oak. Shrubs consisted of Buckthorn and Pin cherry with grass growing on the surface areas where light penetrated. I found no plants in the tested area which would be considered wetland species however wetland obligates as Bull Rushes and Reeds Canary Grass were identified in the drainage way. Root depth was shallow with the highest density in the one to three foot range with a gradual reduction in number and size with depth. This density typically indicates an unsaturated soil condition with an available oxygen supply in the profile to sustain plant growth throughout the growing season. I believe we have beneficial site indicators that will justify the use of this site for a three bedroom sanitary system. They are as follows: ® A moderately well drained A horizon with a moderate medium granular structure, which will assist in integrating wastewater into the natural soil. ® A water shedding landscape position assisted by a driveway ditch, which will divert surface water around the site. ® Vegetation onsite indicating unsaturated soil conditions to allow for plant growth. Based on these soil and site characteristics Ibelieve apredicted depth to seasonal saturation of 6 inches is justified. 3 Conclusion and Site Recommendations In conclusion, and as stated previously, a predicted depth of seasonal saturation of 6 inches can be applied to this site with confidence after a detailed soil and site review of this property. The purpose of this in depth review is to site athree-bedroom replacement sanitary system. In designing a sanitary system for this site I would recommend the following design parameters: / 4.0 gal. /ft./day linear loading rate / .20 gal. /ft. sq. basal loading rate / 30 inches of ASTM C33 sand fill / Proposed upslope mound contour of 94.00' / System Elevation of 96.50' / Expand upslope toe using a 4:1 ratio at cells center tapering to end slopes. / Pressure test existing building sewer to insure there are no groundwater leaks / Test existing tanks if used should be tested for water tightness. / Modify existing driveway ditch to improve drainage if necessary Site preparation should include typical mowing and vegetation removal along with plowing to re-orient any platy structure and incorporate sand into the substratum. By following the conditions set forth, I believe this system design will adequately treat and disperse the wastewater for this existing three bedroom home. 4 Wisconsin Department of Commerce Division of Safetv and Buiidinas SOIL EVALUATION REPORT ...a-innn ,.,itti rnmm Ar. rn/ic erim r`nfr0 `„~ ~.:. ^ 1269 Page 1 of 4 KeRh Stoner County Attach complete site plan on paper not less than 8'/ x 11 inches in s¢e. Plan must St. Croix include, but not limited to: vertical and horizontal refe2nce point (BM), directron and Parcel I D percent slope, scale or dimensions, north arrow, and location and distance to nearest road. . . 014-1040-90 000 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Daryl + Krista Ber Govt. Lot SW 1/4 NW 1/4 S 19 T 31 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2075 Hwy. 63 `~ ___._____ ____ City State Zip Code Phone Number _! City _ j Village / Town Nearest Road Deer Park ~ WI 54007 715-263-3494 Forest Hwy 63 i New Construction Use: yI Residential /Number of bedrooms 3 Code derived design flow rate /I Replacement _J Public or commercial -Describe: Parent material Glacial Till Flood plain elevation, if applicable General comments and recommendations: Interpretive Mound Site -See attached job memo page. 450 GPD NA ^ Boring # _- Boring Pit Ground Surface elev. 93.51 ft . Depth to limiting factor 0~~ in . Soil A lication Rate pp Horizon Depth in. Dominant Color Munself Redox Description Qu. Sz. Cont. Color Texture 5tnuture Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'Eff#1 'Eff#2 1 0-6 10YR2/2 - sil 2mgr/sbk mfr/ds cs 3f-co .6 .8 2 6-9 1 OYRS/3 c1 f5YR5/8 sil 1 msbk/1 mpl ds gs 3f-co .4 .6 3 9-14 ~ 10YR5/4 c2d5YR5/8 sil 2msbk ds gs 3f-co .6 ~ .8 4 14-20 ~ 5YR4/4 c2d5YR5/8 sct 2msbk dh gs 3f-co .4 .6 5 20-48 5YR4/4 ' m2d5YR5/8 7.SYR6/2 sl 1 msbk/m mfr/mfi - 2f-co .2 .6 ^ Boring # Boring /! Pit Ground Surface elev. 92.74 ft. Depth to limiting factor ~~~ in. Soil Application Rate Horizon Depth Dominant Color in. Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GP `Eff#1 D/ft= •Eff#2 1 0-6 10YR2/2 - sil 2mgr mfr/ds cs 3f-co .6 .8 2 6-7 10YR5/3 - sil 1 msbk/1 mpl ds gs 3f-co .4 .6 3 7-11 10YR5/3 c2d5YR5/8 sil 1 msbk/1 mpl ds gs 3f-co .4 .6 4 11-23 i0YR3/4 c2d5YR5/8 sil 2msbk mfr gs 2f-co ~ --- .6 -- _8 5 23-40 5YR4/4 ____ ~~ m2d5YR5/8 7.5YR6/2 sl m - mfr ~ - ~~ 2f-co -- -- .2 .6 _~ i ~ ~ ~ ` Effluent #1 = BOD 5> 30 <_ 220 mg/L and TSS >30 < 150 mg/L uent #2 = BODS < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature: CST Number Keith E. Stoner ~~ 224059 Address Keith Stoner Date Evaluation Conducted Telephone Number 23220 wood Creek Rd., Siren, wl 541372 7/18/06 715-653-2324 Property Owner Daryl + Krista Berg Parcel ID # 014-1040-90 000 Page 2 of 4 Boring # _ !Boring /J Pit Ground Surface elev. 94.04 ft. Depth to limiting factor 0" in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Strtkture Gr. Sz. Sh. Consistence Boundary Roots P *Eff#1 *Eff#2 1 0-7 10YR2l2 - sil 2mgr ds cs 3f-co .6 .8 2 7-11 10YR5/3 c1f5YR5/8 sil 1mpf ds gs 3f-co .4 .6 3 11-20 10YR5/4 c2d5YR5/8 sil 2msbk ds gs 3f-co .6 .8 4 20-40 5YR4/4 m2d5YR5/8 7.SYR6/2 sl m mfi - 2f-co .2 .6 Boring ^ Boring # - _/_,~ Pit Ground Surface elev. 8g•O8 n. Depth to limiting factor 0" in. Horizon Depth Dominant Color Redox Description Texture StnKture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. Soil Application Rate P `Eff#1 *Eff#2 1 {~~ 0-9 10YR2/2 c1 d5YR5/6 sil 2msbk ds cs 3f-m .6 .8 2 9-15 10YR6/3 c2d5YR5/8 sil 1 mpl ds - 2f-m .4 .6 - ~--- - rt' -- ~---- ___ __ - - --- -- -~-~- - - -- ---_ I _ - }- I , Hand dug pit in drainageway to determine ability to see redoximorphic features in Ap horizon. ^ Boring # !Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Stricture Gr. Sz. Sh. Consistence Boundary Roofs `Eff#1 `Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L `Effluent #2 = BODS < 30 mgJL 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. Keith Stoner SBD-8330 (R.07/00) SOIL AND SITE EVALUATION 1269 Page 3 of 4 PROPERTY OWNER: Darv1 + Krista Berk PARCEL I.D.# 014-1040-90 000 Keith Stoner REPORT MEMO Propose a 4' x 112.50' Interpretive Mound Site. Mound cell located along the 94.00' contour with a system elevation of 96.50' with a 4.0 gpd/ft lineal loading rate and a .2 gpd/ft.sq. basal wastewater application rate. ~~ ppb l=1 O. h ~~ tp ~~~~~ wN--•t II II II II ~ N W O °~~~d _~ - II ~g~ ~~ ~~ q~ ~ Q) ~j b7" ~ ~' ~ ~ ~ `~ II ~, ~ w ~ b t~ N o „ b ~ ~ ~ p x ~ r ~ ~~ ~ M o c ~ ~ ~ (I O x {p c A 'f ~ ~J o i ~` w o \° ~ o n ~ ~, ~i 0 II ~ o ti ~ ~ A n ~~ r ~m r w ~. 0 ~g ti -~ ~ ~ tVn ~~ ~'~ N~ w ~° W b pp Np ~ A O O A p O o `~ i a s w 0 - `s~ td xt W Q b w ~A j ~o~~~d OO a ~b 0 y~ ~ ~ ~~ ~ ~W ~~ a ~ „ ° ~ ~~~ ~ ~ A V ~~ ~ ~ ~ , .y ~ ~ c~ ~+. ~ o0 ee ~ y b ~ ~~ O b ~ ~~~ Rr~ 0 -~*,n ~,d ~+ ~ `-~ ° `° ~ ~ ~ ~ w~~ ~ ~ --- ~ a ~ ~z~ ~. ~ V ~ 1~ 0 ~ ~ ~e'~~~p ('1 ~ o0 O c r, ~ n h m w x A ~. 5'a° a~ ui p f~ $ ~ .' A i O A comrnerce.wl.gov ^. r ~~~on~~n -Department of Comm®rce INSPECTION REPORT Date of Inspection: July19, 2006 Project Name: Berg Use: Residential Legal Description: SW, NW, 19, 31, 15W Parcel ID Number: 014-1040-90-000 Subdivision: NA Municipality: Town of Forest County: St. Croix Plan Transaction Number: S93-02813 Sanitary Permit Number: Wastewater Flow: 450-600 gpd Persons Present: K. Stoner SAFETY AND BUILDINGS DIVISION Integrated Services Bureau 13 East Spruce Street Chippewa Falls, WI 54729 www. com me roe. wi. gov/sb (715) 726-2544 Certified Soil Tester 1 Name and Address: Gary L. Steel, CST 222353 Certified Soil Tester 2 Name and Address: Keith Stoner, CST224059 23220 Wood Creek Rd Siren, WI 54872 Owner Name and Address: Daryl & Krista Berg 2075 Hwy 63 Deer Park, WI 54007 An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations by the certified soil tester (CST) relating to the. presence or absence of redoximorphic features in the A horizon and/or subsoil. In-situ soil texture, structure, and consistence factors were also reviewed as they relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water hydrology may also be noted and their effects are factors considered in the recommendations and conclusions portion of this report. A typical soil profile at CST B-1 could be described as follows: 00-07" 10YR'3/2 sil, 3mgr, dsh, cw. 07-13" 10YR 4/4 sil, 1mpl, dsh, cw, w/ c2f 10YR 5/6 rmfs. 13-19" 7.5YR-4I4 cl, 2msbk,-dh, cwf w/ c2-3d-7.5YR~/8 rmfs.- - 19-26" 7.5YR 414 sl till, 1 msbk to Om, mfi, wlc3d 7.5YR 5/2 and 5YR 5/8 rmfs. If a mound system is designed to overcome limitations of a high (eve/ of seasonal soil saturation and slow permeability, the linear loading rate should not exceed 4.5 gpd/ft and the basal wastewater application rated should not exceed 0.2 gpd/ftz. The additional basal area will partially compensate for the gentle land slope and prevent wastewater leakage at the mound toe. At least 30 inches of sand lift is recommended when applying septic tank effluent to the distribution cell of the mound to ensure proper treatment. The longest portion of the mound must be orientated along the contour. ,The upslope mound toe should be shaped to divert surface water east and west away from the mound. The mound shall be constructed to divert surface water around the mound structure as much as possible. In addition, the south driveway ditch should be modified to improve drainage if it is determined that surface or subsurface hydrology is improved by intercepting water and diverting it away from the mound site. Existing tank{s) and piping should be tested for water tightness to make sure that infiltrating groundwater does not overload the new mound. If there are any questions regarding this report, please contact me. Leroy G. J sky, Wa water S cialist cc: Ljansky@ mmerce tate.wi.u E-mail 715/726-2544 Voice 715/726- 549 Fax ® County ® CST ^ Other _ ^ Plumber ^ Owner ~g ~ . 0 0 0 0 N 0 ~. z 0 ~~ o ~ ~o ~. ~ ~~ ~~ o, ,~ ~ '" ~t O N O O A O O O O N O O O ~ O ~p m ~ ~ oa w ~ ., `~ N "y O W O~ 0 c m v ~ ~ ~ ~ ~ 3 a ~ ~ N x f~D n ~ C (~D. Z ' ~ ' • Soil Survey of St. Cmix County, Wisconsin Daryl and Krista Berg Site Map Unit. Legend Summary St. Croix County, Wisconsin Map Unit Symbol Map Unit Name Acres in AOI Percent of AOI Ao$ Amigo silt loam,2 to 6 percent slopes 24.6 10.2 BpA Brill silt loam, 0 to 3 percent slopes 2.4 1.0 CoC2 Chetek-Onamia complex, 6 to 12 4.4 1.8 percent slopes, eroded. Fe Fluvaquents 9.4 3.9 Fm Fluvaquents, wet 11.4 4.7 FnB Freeon silt loam, 2 to 6 percent slopes 76.4 31.8 FoB Freeon silt loam, heavy substratum, 2 11.5 4.8 to 6 percent slopes. HaA Haider silt loam, 0 to 3 percent slopes 13.6 5.6 MaB Magnor silt loam., 1 to 6 percent. slopes 39.6 16.5 RhA Rib silt loam, 0 to 3 percent slopes 2.8 1.2 SaB Santiago silt loam, 2 to 6 percent 27.8 11.5 slopes ShB Sattre loam, 2 to 6 percent slopes 1.0 0.4 SrA Slcyberg silt loam, 0 to 3 percent slopes 8.6 3.6 VaB Vlasaty silt loam, 2 to 6 percent slopes 7.0 2.9 USDA Naaral R Web Soil Survey 1.1 7/3 i/20Qb ~ Co~eervatia~ Serdce National Cooperative Soil Survey Page 3 of 3 -_--t.... ........a - .....a -..,.....,...u. ~v t I v.aM/ uuv ltil ltll7 V 1 \ V l\.11 Llll . a > ~_ LOCATION MAGNOR WI+MN Established Series HEL-HFG-DJH 04/2006 MAGNOR SERIES The Magnor series consists of very deep, somewhat poorly drained soils which are deep to a densic contact. They formed in loess or silty lacustrine deposits and in the underlying dense sandy loam tit[ mostly on ground moraines, end moraines, disintegration moraines, drumlins, and ice-walled glacial lake plains. Permeability is moderate in the silty mantle, moderately slow or slow in the till subsoil, and very slow in the substratum. Scopes nir-ge from 0 to 6 percent. Mean annual precipitation is about 30 inches. Mean annual air temperature is about 42 degrees F. TAXONOMIC CLASS: Coarse-loamy, mixed, superactive, frigid Aquic Glossudalfs TYPICAL PEDON: Magnor silt loam - on a nontheast-facing concave slope oft percent in a hardwood forest at an elevation of about 1,500 feet. (Colors are for moist soil unless otherwise stated.) A--O to 4 inches; very dark brown (1 OYR 2/2) silt loam, dark grayish brown (] OYR 4/2) dry; moderate medium subangular blocky structure; friable; many fine and medium roots; about 2 percent gravel; extremely acid; abrupt wavy boundary. (1 to 6 inches thick) E1--4 to 7 inches; brown (]OYR 4/3) silt loam, pale brown (lOYR 6/3) dry; moderate very fine subangular blocky structure; friable; common fine and medium roots; about 2 percent gravel; very strongly acid; clear wavy boundary. E2--7 to 11 inches; brown (l OYR 5/3) silt loam, very pale brown (lOYR 7/3) dry; moderate fine platy structure; friable; common fine and medium roots; common medium prominent strong brown (7.SYR 5/6) masses of iron accumulations; about 2 percent gravel; extremely acid; clear wavy boundary. (Combined thickness of E horizons ranges from 0 to 7 inches thick) E/8--11 to 16 inches; 70 percent brown (IOYR 5/3) silt loam, very pale bmwn (l OYR 7/3) dry; (E); moderate coarse platy structure; friable; moderate medium subangular blocky structure; friable; extends into or surrounds remnants of dark yellowish brown (1 OYR 4/4) silt loam (Bt); moderate medium subangular blocky structure; friable; common fine and medium roots; few fine faint and distinct grayish brown (1 OYR 5/2) iron depletions; common medium prominent strong brown (7.SY4 5/6) masses of iron accumulation; about 1 percent gravel; very strongly acid; gradual wavy boundary. B/E-16 to 21 inches; 70 percent dark yellowish brown (lOYR 4/4) silt loam (Bt); moderate medium subangular blocky structure; friable; few distinct brown (7.SYR 4/2) clay films on faces of peds; penetrated by tongues of brown (1 OYR 5/3) silt loam (E); very pale brown (1 OYR 7/3) dry; moderate coarse platy structure; friable; common fine and medium roots; common medium distinct and faint grayish brown (lOYR 512) iron depletions and common medium prominent strong brown (7.SYR 5/6) masses of iron accumulations; about 4 percent gravel; very strongly acid; gradual wavy boundary. (The glossic horizon ranges from 2 to 30 inches thick.) 2Bt1--21 to 29 inches; reddish brown (SYR 4/4) sandy loam; moderate medium subangular blocky structure; firm; few fine and medium roots; common distinct reddish brown (SYR 413) clay films on faces of pads; few fine distinct reddish gray (SYR 5/2) iron depletions and common medium distinct yellowish red (SYR 5/8) masses of iron accumulations; about 9 percent gravel; very strongly acid; gradual wavy boundary. 2Bt2--29 to 39 inches; reddish brown (SYR 4/4) sandy loam; moderate medium subangular blocky structure; firm; common distinct dark reddish gray (SYR 4/2) clay films on faces of pads; few fine distinct reddish gray (SYR 5/2) iron depletions and many medium distinct yellowish red (SYR 5/8) masses of iron accumulation; about 10 percent gravel; strongly acid; gradual wavy boundary. 2Bt3--39 to 58 inches; reddish brown (SYR 4/4) fine sandy loam; moderate medium subangular blocky structure; firm; few distinct dark reddish gray (SYR 412) clay films on faces of pads; few fine distinct yellowish red (SYR 5/8) masses of iron accumulations; about l2 percent gravel; moderately acid; gradual wary boundary. (Combined thickness of the 2Bt horizons ranges from 6 to 45 inches.) 7/31/06 6:17 PM Official,Series Description - MAGNOR Series L w ' oY ' http://www2. ftw.nres.usda. gov/osd/dat/M/MAGNOR.html 2Cd--S8 to 60 inches; reddish brown (SYR 4/4) fine sandy loam; massive tending to part along horizontal cleavage planes to weak thin plates; firm; dense and compact; about ] 0 percent gravel; moderately acid. TYPE LOCATION: Taylor County, Wisconsin; about 9 miles east of Medford; 2750 feet north and 100 feet west of the southeast corner of sec. 31, T.31N., R.3E. Rib River Lookout Tower USGS quadrangle; NAD27. RANGE IN CHARACTERISTICS: Thickness of the silty mantle ranges from 12 to 36 inches. Depth to the base of the argillic horizon and to densic contact ranges from 40 to 60 inches. Content of clay averages from 7 to 17 percent in the particle-size control section and the content of fine sand or coarser averages 1 S to 70 percent. The base saturation (by sum of cations) is less than 60 percent in some part of the argillic horizon. Volume of gravel ranges from 0 to 10 percent in the silty mantle and from S to 3S percent in the till. Volume of cobbles ranges from 0 to 3 percent in the silty mantle and from 0 to 5 percent in the till. Volume of stones ranges from 0 to 1 percent in the silty mantle and from 0 to 3 percent in the till. Surface stones have coverage ranging from 0 to 3 percent. Reaction ranges from extremely acid to slightly acid in the solum, except that it ranges to neutral in the Ap horizon where the soil is limed. Reaction ranges from strongly acid to neutral in the till. Redox concentrations are typically throughout the pedon below the Ap or A horizon. Redox depletions with chroma of 2 or less are in the upper 10 inches of the argillic and aquic conditions occur there at some time in most years. The A horizon has value of 2 or 3, and chroma of 1 or 2. Cultivated areas have an Ap horizon, 6 to 9 inches thick, with hue of 7.SYR or l OYR, value of 3 or 4, and chroma of 2 or 3. Ap horizons with color value moist of 3 have value dry of 6 or more, The E horizon has hue of 7.SYR or l OYR, value of 4 to 6, and chroma of 2 or 3. Colors of 4/3 or S/3 have value dry of 7 or more. The E horizon is silt loam or silt. Magnor soils have a glossic horizon. Horizonation has a wide range depending on thickness of the silty mantle and the extent to which eluviation has occurred. Therefore, there can be E/B, B/E, 2EB, or 2BB horizons singly or in combination. The E part of the EB or B/E horizon has color and texture like the E horizon described above. The Bt part has hue of 7.SYR or l OYR, value of 4 to 6, and chroma of 3 to 6. Some pedons have a Bt horizon with color and texture like the Bt part described above. Some pedons have a Btg horizon, with dominant chroma of 2, below the upper 10 inches ofthe argillic horizon. The 2E part of the 2EB or 2B/E horizon has hue of 2.SYR, SYR, 7.SYR, or l OYR; value of 4 to 6; and chroma of 2 or 3 Colors of 4/3 or S/3 have value dry of 7 or more. The 2E part is typically sandy loam, fine sandy loam, loam, or their gravelly analogs, but in some pedons it is loamy sand or gravelly loamy sand. The 2Bt part has color and texture like the 2Bt horizon described below. The 2Bt horizon has hue of 2.SYR, SYR, 7.SYR, or l OYR; value of 3 to S; and chroma of 3 to 6. It is typically sandy loam, fine sandy loam, loam, or their gravelly analogs. Bulk density ranges from 1.65 to 1.90. Some pedons have pockets or thin strata of loamy sand or gravelly loamy sand. Some pedons have a 2BCd horizon with hue of 2.SYR, SYR, or 7.SYR; value of 3 to S; and chroma of 3 to 6. It is typically sandy loam, fine sandy loam, or their gravelly analogs. Clay content averages more than 7 percent. Bulk density ranges from 1.8 to 2.0. Some pedons have pockets or strata of loamy sand or gravelly loamy sand. The 2Cd horizon has hue of 2.SYR, SYR, or 7.SYR; value of 3 to S; and chroma of 3 to 6. It is typically sandy loam, fine sandy loam or their gravelly analogs. Clay content averages more than 7 percent. Bulk density ranges from 1.8 to 2.0. Some pedons have pockets or thin strata of loamy sand or gravelly loamy sand. COMPETING SERIES: These are the Brennyville, Fallcreek, Hatley, Maroc, Oesterle, Plover, Rosy, and Stinnett series. Brennyville soils have base saturation greater than 60 percent in all parts of the argillic horizon. Fallcreek soils do not have a silty 12 to 36 inch thick mantle or it is less than 12 inches thick that is more than SO percent silt. Hatley,, Oesterle, Plover, and Rosv soils do not have a Cd horizon do not have a densic contact within the series control section. 2 7/31/06 6:17 PM ~ Official Series Description - MAGNOR Series http://www2. ftw.nres.usda.gov/osd/dat/M/MAGNQR. html y,. Maroc soils have a lithic contact with igneous or metamorphic bedrock at a depth of 40 to 60 inches. Stinnett soils average less than 7 percent clay in the dense till. GEOGRAPHIC SETTING: Parent material: Formed in loess or silty lacustrine and in the underlying dense sandy loam till of Late Wisconsinan Age. Landform: Flats, footslopes, and toe slopes of ground moraines, disintegration moraines, end moraines, drumlins, and ice-walled glacial take plains. Slope: 0 to 6 percent. Elevation: 800 to 1950 feet. Mean annual air temperature: 39 to 45 degrees F. Mean annual precipitation: 28 to 33 inches. Frost-free days: 120 to 135 days. GEOGRAPHICALLY ASSOCIATED SOILS: These are Adolph, Amery, Auburndale, Cable, Capitola, Cebana, Freeon, Haugen, Newood, Newot, and Santiago series. The well drained Santia o soils, the moderately well drained Freeon soils, the poorly drained Auburndale and Cebana soils, and the very poorly and poorly drained Adolph and Capitola soils are in a drainage sequence with the Magnor soils. Santiago and Freeon soils are on steeper landscape positions. Auburndale, Cebana, Adolph, and Capitola soils are in depressions and drainageways. The somewhat poorly drained Almena soils are on similar landfonns to Magnor soils where the silty mantle is greater than 36 inches thick. The well drained Amery, and Newot soils and the moderately well drained Hau~;en and Newood soils are in on higher or more sloping landcape positions where the silty mantle is less than 12 inches thick, or is absent. DRAINAGE AND PERMEABILITY: Somewhat poorly drained. Surface runoff is medium to very low. Permeability is moderate in the silty mantle, moderately slow or slow in the till subsoil, and very slow in the substratum. Magnor soils have a perched seasonal high water table at a depth of 1 to 2.5+ feet for 1 month or more per year at some time during the period of September to June in normal years. USE AND VEGETATION: Many areas of this soil are cleared and used for cropland or pastureland. Common crops are corn, small grains, and hay. Many areas remain in woodland. Native vegetation is deciduous forest with red maple, sugar maple, quaking aspen, yellow birch, and white ash predominating and with some balsam fir, American basswood, northern red oak, and American hophornbeam. DISTRIBUTION AND EXTENT: North-central and northwestern Wisconsin. LRR K, MLRA 90A, and MLRA 90B. This soil is of large extent. MLRA OFFICE RESPONSIBLE: St. Paul, Minnesota SERIES ESTABLISHED: St. Croix County, Wisconsin, 1975. Type location moved to Taylor County, Wisconsin with the correlation of the soil survey in 2000. The source of the name is a lake in southeastern Polk County, Wisconsin. REMARKS: Diagnostic horizons and features recognized in this pedon are: Particle size control section -the zone from 16 to 36 inches. Ochric epipedon -the zone from 0 to 16 inches (A, El, E2, EB). Albic horizon -the zone from 7 to 16 inches (E2 and E part of the EB). Glossic horizon -the zone from 1 1 to 21 inches (EB, B/E). Argillic horizon -the zone from 16 to 58 inches (B/E, 2Bt1, 2Bt2, 2Bt3). Densic contact -the contact with dense till (2Cd) at 58 inches. Redoximorphic concentrations -oxidized color featwes in the zone from 7 to 58 inches. Redoximorphic depletions -depleted color features in the zone from 11 to 58 inches. Lithologic discontinuity - at the upper boundary of the 2Bt1 horizon at 21 inches. Aquic conditions in the upper ]0 inches of the argillic horizon. The bulk density and platyness of the argillic horizon is considered to be relict of the till, but studies are needed to determine whether or not these horizons meet criteria for fragipans or fragic soil properties. 3 7/31/06 6:17 PM ~ TopoZone -The Web's Topographic Map c, ~:-~ ~r http:J/www.topozone.com/print.asp?z= 15&n=5001278&... fol. ~ ~~ ~~~ y~w.~,~ _ ~ ~ ~ t ,.. . - - - ~ ~ ~ - t ~~ ~ ~/ , ~;~- , ~~~• .,. ~~ ~ ~, ~.:_.•.f ° r~~---Vic-""`" - f ~ a ~"'.~ t _ - , ~,} r-~ ., .. F w r r°~ . del _ .`~S ~. -'-~`7 ' _/ ..1f ~ ~~ . . ',, jam,.- _ ,_ ~~ ,', ~n "~...~"'"``'_.~.,~ ~ t~ f',~.~~ 5 ~ ~ 1 r ~_ 149 _ - --~ . -=-"~..~'~~' ~--.r~ --..r- _ r ~ i 1 ,1 rte.: \\ ~c - _ . ~ i ~-, ~,~,~ r~.f . ~, ` ~ ~ ~ 4' . -- -- _. 0 0.3 0.6 4.9 1.2 1.5 km ~ 0 0.2 0.4 0,6 0.8 1 mi Map center is UTM 15 556680E 5001278N (WGS84/NAD83) Forest quadrangle M=0.512 Projection is UTM Zone 15 NAD83 Datum G=0.511 1 of 1 7/31/06 5:54 PM ~•-- ((, ~± ` YGL .~C)c_I~pAGEU~J • STATE BAR OF WISCONSIN FORM 1 - 1999 6e~44Q9 WARRANTY DEED KATHLEEN H. WgLSti Document Number REGISTER OF DEEDS HF ST. CRQIX CO.. This Deed, made between Bradley D . Hanson and Mary _ Ann Hanson husband and wife RECEIVED FOR RECORD 05-02-2001 1:00 PM Grantor, and Darrell C Barg and Krista K. Beres, husband_ YpRRpH?Y DEED 'T 11 and wife as survivorshi marital ro rt - EXEM.t CEkT COPY fEE: COPY FEE: Grantee. TRANSFER FEE: X56.60 00 2 for a valuable consideration, conveys to Grantee the following Grantor . kECORDING FEE: 1 PAGES: ~ , described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Legal Description Addendum Attached Recording Area Name and Return Address Title One Premier Group 706 19th St. S Hudson, wT 54016 014-1040-80-0000 (part ~1--f 014-1040-90-0000 Parcel Identitication Number (PIN) This is #temestead property. Together with all appurtenant rights, title and interests. (is) (is-wet) antor warrants that the title to the Property is good, ind G efeasible in fee simple and free and cleaz of encumbrances except nin r Reservations, restrictions and easements of g record, if' any, and public highways, zo and building regulations. Dated this des April 2001 Bradle H on • Ann H son * >« ACKNOWLEDGMENT ALJTHEIYT[CATiON STATE OF WISCONSIN ) ss. Signature(s) s~Croix _ County. ) Personally came before me this ~~t?' -day of authenticated this day of Atoril _ '~',_ the above named ~ _ ~ and Bradley D Hanson __jrr ] 7 . S !T y n ns n ~ ; ~ TITLE: MEMBER STATE BAR OF WISCONSIN '"~ t ~' ~ (If not, authorized by §706.Ob, Wis. Stets.) to me known to be the person the fore oin rostra n d ackn d the samdi~~ ; ~ • ~ W ~ ~ ~~• ~'••- • •' ;' Q • r~ THtS INSTRUMENT WAS DRAFTED By *• gidne n s Michael H. Foracki Notary Public, State of Wisconsin Eau Claire wI 54701 My Commission is permanent. (If not, state expiration date: Au st 30 20 3 (Si natures ma be authenticated or acknowled ed. Both are not necessary.) WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-1999 'Names orpersans signing in any capacity must be typed or printed below their signature. entury 2I Premier Group PO Box 56, Saint Croix Falls WI 54024-U056 '1'7576147.7FX Phone. (715)483-3244 Fax: RogerPanek Produced with ZpForm'" t•Y RE FormeNet. LLC 18025 Fineen Mile Road. Ctityon Townsh4. µ~~'$en ~8p35, tettOY 383-9805 asy5 s VOL .~~~QPAGE UJ~ LLGt~I, l~L•',SCRIP"I~IUN AUDI:NDUf~i Parcel 1 : fart oC the Southwest Quarter of the Nurthwest Quarter (SW i/4 of NW 1/4), Section 19, `I"uwnship 3 l North, Range 15 West, 'l'awn of Purest, dcscribcd as follows: Beginning at the intcrscctiun of the North tine ul~ said S W I/4 ul N W 114 with Last right of way of State 1lighway "G3"; thence South aluug said Gast right uf' wary line a distance of 342.5 feet; thence Last parallel with sail Nurllti line a distance of 51 U.UU lcct; thence North parallei with said right of way line a distance of 342.5 [ect; thence Wcsl along sail North line a distance of 510.0 feet to the point of beginning. Parcel 2: fart of the Southwest Quarter of the Nurthwest Quaricr (SW 1/4 of NW 1/4), Section 19, '1'uwnship 31 North, Mange I S West, Town of Forest, dcscribcd as follows: Commencing at the intersection of the North line of said SW 1 /4 of N W 1 /4 with the easterly right of way of State 'trunk I ligiiway "G3"; ihcn~c suutha-ly along said easterly right of way line a distance of 342.5 Lect; thcuce easterly parallel with said north line a distance of S 10.00 feet to the point of beginning; tltiis being the southeast corner of the land dcscribcd in Warranty Deed recorded in Volume 9G4 on page 552 in the St. Croix County Registry; thence northerly; parallel with said right of way line a distance of 342.5 feet to said north tine of the SW1/4 of NW1/4; thence easterly along said north line a distance of 517.50 feet; thence southerly, parallel with said easterly right of way a distance of 342.50 feet; thence westerly, parallel with said north Line of the SW 1/4 vi'N W 1/4 a distance of 517.50 feet to t(tic point of beginning. s ST. 4'>t~QiX COUN'T'X' SEP?[C TANK MAINTENANCE AGREEME RECEIVED AND GWNERSHIP CEItTiFICATION kORM q~~ 2 4 2006 OwntrBuyer ~ I~ RYL ~ ~ t21S?`A ~~K L3 Mailing Add~retts ~ 7 ~ 5T ~ hl y la3 ' Property At3dress U~ R r~tl2 K 1~t/' 1 5 q 00`7 (Veriftcaticue re:quitYd frcun Planning e4c Zottiug motet for teew consttuctivn.) City/State ~l~~r'~ '~'F~~1~ 1/~ 1 Parcel Identification plumber bl~ °-iC~~l b- 9b - bD~ ~cAI, nESCRIPTION Property I.t~cation ~ ~ , ~~ ~/ ,Sec. ~ `~ , T~ 1 N R }~~ W, Town of ~Gt2><ST Subdivision ~ ,Lot # Certified Sgrrvey Map # ,Volume ,Page # Warranty Died # Volume ,Page # spec house: a yes a no t.ot linen ide~atihable r.l yes O nn SYSTEM MAINTENANCE AND OWNER CERTIFI~ATInN Itnpropcr flee: aad t~aint,onance of your sceptic system could ezsntt is its P~ '~~ to handle waste. Pro'Per mainteutat~c esonsists of pumping out the septic tank every tbtex years or sooeter, if isctded, by a licensed putgper. Wlmt yen put into file System con affect the funetioa of the septic tan]c as a treatment stage is the waste dir~posat system. Owner maintcoeace rc~pcre>sibitities ate Specified in Comm. 83.52(!) and in Chapter i2 - St. Croix t;ounty Sanitary thditrance. The property owner agree'~K w submit to St. Groix Caenty Plaaaittg & 7.Jnnin$ Ueparanent a c:ertifieation fore", Sig>xxl by flit owetex and by s master plumbex,,nuatscymau phunbex, testtiete:d pNunber or a Iiceosed pamper vesifjristg that (1) the on-rite wastewater dispoSaE syxtemt is in pmper operating condition aneltar (2) apex inspection and peuapittg (if ttecexesery), flit Septic ttotk is less than U3 full of sludge. l/we, the uttdersigtted have read the: above requirements and agree to maintain the prfvate sewage disposal system with the standards set fottb., !retain, ae set by t!~ [hpatt+vcnt of Commerce and the Departtt~nt of Nateeal Ke:sout+ees, State of Wisconsin. Gertiftcation stating that yow septic systcpt bas been eneintninesl must be compieocd sad returned to the st. Croix County Plannutg & 7tueing Deparm~t within 3o days of rise three year eatpitatiost date. i/wt certify that all statctnertta em this form arc true to the beret of my/oeu kniowe. Uwe am/are the own+~(s) of the property dosetibed above:, by virtue of a waaaaty deed resceuded in Re,, lefts of Tkeds Ufftea. Number pf bedrooms r c~ e_ ~iz~.~ SIGNATURE F APPLICANT(S) DATE sstAny infoemation that is misrepre>aettted tn8y resttlt in the. sanitary permit being rcwoked by the Planning & Zoning Department. *•" [nclttde with this t-pptiCUtion a ree:orde:d warranty dtxxl from the Register of I)Qeds Office sad a copy of the certified survey map if rc:ktxmce is made in tlu: warranty eieed. t `, r ~ i Mound System Maintenance and Operation Saecifications Service Provider's Name Cassellius Sanitation Phone 715 265-4623 POWTS Regulator's Name St. Croix Coun Zonin Phone (715 386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum 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 Contro{s Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ct for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials 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 Bati Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Daryl and Krista Berg Interpretive Mound Page 5 of 8 . ~ Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated fn accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and k>cat or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance wfth Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall lie disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fiker is equipped with an alarm, the finer shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical addkives 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. Pumo Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarr-s, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dilate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mglL FOG for septic tank effluent or 30 mg/L BODSi 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the pemrlt for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed lt should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell, Observation pipes within the dispersal cell shall be checked fnr 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. Continaencv Ptan If the septic tank or any of its components become defective the tank or component shat) be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal perfommance. if the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project Daryl and Krista Berg Interpretive Mound Page 6 of 8 I commerce.wi.gov ^ ^ ~sconsin . Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. commerce.wi.govlsb! www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 09, 2006 OUST ID No. 224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/09/2008 SITE: Daryl & Krista Berg 2075 St Hwy 63 Town of Forest, St Croix County SW 1/4, NW 1/4, S19, T31N, R15W Identification Numbers Transaction ID No. 1308565 Site ID No. 716603 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1090800 Maintenance required; Replacement system; 450 GPD Flow Rate System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.01/O1),and Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/01) 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 the 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 Dept. per s.145.46, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This approval is based in part on an interpretive determination approved pursuant to s. Comm 85.60(2), Wis. Adm. Code and recorded under transaction number 1308555. It is subject to the conditions set forth in that approval. • Proper landscaping of the mound and land surface up slope of the mound is critical to proper operation. See the approved plans for details. • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods ofpublication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". 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. s . ` ` p s KEITH E STONER Page 2 8/9/2006 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Leroy G. nsky, PS , Wastew a Specialist Integrated Services Bureau (715)726-2544 Voice lj ansky@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 s i ~ i ~ ~ ) ~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Daryl and Krista Berg Interpretive Mound Owner's Name: Daryl and Krista Berg Owner's Address: 2075 Hwy 63 Deer Park WI 54007 715-263-3494 Legal Description: SW1/4-NW1/4 Sec. 19 T31N-R15W Township: Forest County: St.Croix Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: 014-104~,0-90 000 Plan Transaction No.: ~ ~' ®~ ~ ~ ~ r O 1~.T•~• P Page 1 Index and title . . ~n12dt ~t 011 Cl~t! V Page 2 Data entry Page 3 Mound drawings s Page 4 Lateral and dose tank DEPARTMENT ai= GCiMMERCE Page 5 System maintenance specifications DIVtS oN OF SAFETY AND 815iLDtNGS 7 P plan e age e and specifi ations Pump curv Page 8 Plot Plan SEE C REST' pf:~JCE Designer: Keith E. Sto ner * ...... ~ ~R+1V~6+ '•., icl~se Number: Designer# 1575-007 Date: 07/31/06 ~ R 'PPI6~ Number: (715) 653-2324 ~' 1575 Signature: C s~~, Mound Component Manual for PYi 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 8 i i ~ Y r Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 3.00 Site Slope (%) 94.00 Contour Line Elevation (ft) 6.00 Depth to Limiting Factor (in) 0.20 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 112.50 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 (c or e) C Center or End Manifold 0.00 Lateral Spacing (ft) 2 Number of Laterals 0.156 Orifice Diameter (in) (e.g. 0.25) 1.50 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 145.00 Forcemain Length (ft) 86.40 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 9.68 Vertical Lift (ft) 4.75 Friction Loss (ft) 18.99 Total Dynamic Mead (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. 4.00 Cell Width (ft) Are the laterals the highest oint in the distribution Y network? Enter Y or N If N above, enter the elevation (ft of the highest point. 6.08 ftz/orifice Does the forcemain drain back? Y Enter Y or N 23.65 Forcemain DrainbaGc (gal) 50.90 5x Void Volume (gal) 74.56 Minimum Dose Volume (gal) 39.85 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 1.50 2.00 3.00 Gallonsllnch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Manufacturer gal/in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 603.36 Dose Tank Capacity (gal) Best Filter Manufacturer 16.76 Dose Tank Volume (gal/in) BTGF-10-8 Filter Model Number Wieser Concrete Manufacturer Project: Daryl and Krista Berg Interpretive Mound Page 2 of 8 , , ~ / ~ Mound Plan View 1_ ..................................... ~~~1/1~0~B`• ~ 'Observation Pipe 'Q' K . . •~ .g -- - ~~;. ~: . . -t Jl - T A z ~-- I - L _ _~ Mound Component Dimensions Note : Upslope J = 13.90' using Down slo a toe extension made. a ~: 1 ratio @ Mounds Center A 4.00 ft E 31.44 in H 1.00 ft K 13.06 ft tapering to 3:1. 8 112.50 ft F 9.50 in z 16.00 ft L 138.61 ft D 30.00 in G 0.50 ft J 10.44 ft W 30.44 ft 450.00 (ft2) Dispersal Cell Area 2250.00 (ftZ) Basal Area Available 4.00 (gpd/ft) Linear Loading Rate 11.25 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 98.29 (ft) ..,,},,. F 96.50 (ft) --- Dispersal Cell : '~ :::: Elevation ~I I~ ~ispersai cell :::: ; :::::::: 97.00 (ft) Lateral • Invert ~p ~ t 9~ Shading Key 10 _ Topsoil Cap © ~}~f~ Subsoil Cap ©~ ASTM C33 Sand ® •`~~ ~~ ~,~~ Tilled Layer ^5 Aggregate 3.0 % Site Slope '~ Q. ~ Dispersal Cell ~ ~~ 1.5 ft c = Y~ ; m o 4~. ~aR aZi 0.5 ft Typical Lateral F ~- A -~ 00 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Project: Daryl and Krista Berg Interpretive Mound Page 3 of 8 t ~ ~ ~ Center Connection Lateral Layout Daigram IE,C-~IE~xI2 ( xl2~l Laterals & Force main of PVC Seh 40 [per COMM Table 84.30-5) Holes drilled on the bottom of the lateral, • ¢ Turn-up+m'ballvalueorcleancrutplug equally spaced Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 2 1.50 in 55.48 ft 0.00 ft 19.92 gpm 39.85 gpm 18.99 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and ----- Comm 16.28 WAC ~ Disconnect Tank component is properly vented Wieser Concrete Ca c' 603.36 Volume 16.76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.55 310.92 B 2.00 33.52 C 4.45 74.56 D 11.00 184.36 Total 36.00 603.36 A B C D 0.156 in 1.52 ft 37 6.08 ftz/orifice 0.00 ft 0.00 in 4.07 ft/sec Locking cover with warning label and locking device and sealed watertight 4 in. min. -1„_ E--- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~off elevation (ft) 87.32 ~ elevation (ft) 86.40 Alarm Manuafacturer Septronics MJJ1 Alarm Model Number MJJ1-2501 Pump Manufacturer Zoeller Pump Mode! Number Model #152 Pump Must Deliver 39.85 gpm at 18.99 ft TDH Project: Daryl and Krista Berg Interpretive Mound Page 4 of 8 r w PUMP PERFORM CURVE f MODELS 5 15 153 45 12 40 35 10 30 ¢0¢ u! = 8 ~ 25 ° 6 20 0 15 4 10 2 5 57 152 153 0 10 20 30 40 50 60 70 80 GALLONS LITERS 0 40 60 120 160 200 240 280 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS These systems are not designed for Explosion Proof Environments. Please consult factory for special options and requirements. Maximum operating temperature range: Pump: 130° (54°C) Switch: 170° (76°C) Page 7 of 8 TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 57 152 153 Feet Meters Gal. Liters Gal. Liters Gal. Liters 5 1.5 43 163 69 261 77 291 10 3.0 34 129 61 231 70 265 15 4.6 19 72 53 201 61 231 20 6.1 - - 44 167 52 197 25 7.6 - - 34 129 42 159 30 9.1 23 87 33 125 35 t0.7 -- - -- 22 83 40 12.2 - - - -- 11 42 Shut-0H Head: 19.25ft(5.9m) 38ft(11.6m) 44ft(73,4m) 016369 CHOOSE A PREPACKAGED SYSTEM: Includes Pump, 10-1526 and 10-1528 (see below) 940-0005 N57 Pump .3 HP 940-0006 N152 Pump .4 HP 940-0007 N153 Pump .5 HP ISUiLD YOUR OWN SYSTEM: N57 Pump .3 HP N152 Pump .4 HP N153 Pump .5 HP 10-1527 Oil Smarl® Pump Switch - 10 ft. cord with Relay. 10-1528 Oil Smart® Pump Switch - 20 ft. cord with Relay. 10-1676 Oil Smart® Pump Switch - 20 ft. cord without Relay (requires Control Panel). 10-1526 Oil Smart®Alarm System with Lights, Audible Alarms and Dry Contacts 3 27132 1z va 1 __~_ 2 z SK7015 A CAUTION qi; :nstaii2tiq~~ of controls, protection devices and wir+ng should be none Gy a qua{ified licensed eiectncian AI'.eieclnca~andsaietyroUesshouldosfollowed~ndudingthemo5trecentNationai sKZOe4 tiect+c Code jNEC~ and tY+e Occupational Safer; and Health Act (OSNAj. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ©Copyright 2Q05 Zoeller Co. All rights reserved. t_ ~_ ao h ~ ~ ~~ ~O ~~ ~ x ~~ ~ o ~, ~~ U b ~ ~a~3.~ ~ ~ o ~ ~~ ~ ~~~v ~ ~ ~ . ~ ~~ ~z~ ~~ M +~+ ~ o ~ ~~~ O U ~~ ~ w ~~ s ~~ ~ ~a~ ~ ,~~~ OQ 3~ H ~ •~ ~---- ~~ ~ ~~ N O q ~ h ~ eV ,,.~~~ ~ e KW 3 n ~ ~ ~ a~ ~~ ~ ~ w ~ ~ M ~ M ~; ~ °° ~~ ~,/ ~ " ~ W L~ ~ as ~ a ~ ,~ g h ~ U $ a ~` .~yVy~ ayg ~ e~j 8 `~ Q I~ ~ l.i °' a e 3 ~ ~ .~ ~~ a ~~ o a a Z ~ II ~ h b ~ q ~ ~ ~+ ~ ~~~ ~ C3 ~~~~~ .,. a STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER h'y,o~ ~.ev /~a~-Se.v. ADDRESS p~~ ] 5 /'~y~,~y ~~ 1,~--~-~U. r~. W 1. J~'y6D 7 SUBDIVISION / CSM# ~tf l }~ LOT ~ /~ ~ SECTION~~T ,3l N-R 1S W, Town of ~d r~ 5 f• ST. CROIX COUNTY, WISCONSIN Provide 2 dimensions to center of septic tank manhole cover. Provide setback and elevation information on reverse of this form. /~ t, ~ 9 ~, 6~ ~, 9 ~- 1" ~a ~~~ 5 ~ BENCHMARK : J~J W (~,,,,r„ ~ ~ ~./ ALTERNATE BM: r j ' Qr r ~~ ~$T~' m~~-TA'/ z ~. / OLDIIdG..TANK INFOF2MATION r Li id Ca acit ~rsr`~ ~ Manufacturer: (,~) ~~~+ qu p y: _ / .~:u- Setback from: Well /~ ~ House /~ ~ ~ Other ~at.,t~fldr~ Pump: Manufacturer t1//~4-- Model# -" Size -- T Float seperation --~ Gallons/cycle: Alarm Location :SOIL ABSORPTION SYSTEM Width: Number of trenches Distance & Direction to nearest prop . 1 ine from: well: House Other ELEVATIONS Buildin-c~ Sewer ST -Inlet : ~ r~ N~ ~C in et , PC bottom ST outlet 9~- ~~° Pump Off Header/Manifold ~- Bottom of system Existing Grade '-~ Final grade DATE OF INSTALLATION: /' S- ` v PLUMBER ON JOB: ' LICENSE NUMBER: Jj' (off INSPECTOR: 3/93 : j t Length_ SC~ASIQ APPLICATION FOR REVIEW °~"`""~d`~"~°° -Complete all pages. POWTS Safety & Buildings Division { )Check if Confirmation is Desired: ( )faxed, ()mailed Bureau of Integrated Services NOTE: Personal information yo P i u provide may be used for secondary Confirmation of assignment to a reviewer purposes [ r vacy Laws. 15.04( 1)(m), Stats.j . 1. Private Sewasre Submittal 2. T YPe of Submittal: Transaction ID: S stem T y yPe ( )New Previous Related Trans. ID: ( } Soif Saturation Determination Report ( )Revision, previous transaction Estimated Completion Date: ( )Interpretive number Determination ( )Replacement Assigned Reviewer: ( 3 POWTS System ( )Petition (attach form SBD-9890) Assigned Office: ( ) At Grade ( )Experiment, experiment approval ( )Holding Tank number Circle your choice of offices below: ( ) Nonpressurized In- Ground ( }Component Manual Next available appointment in any office, 2. Green Bay 3 Hayward ( )Pressurized In- Number SBD- (R--_~ , . , 4. LaCrosse, 5. Madison, 6. Shawano, 7. Waukesha Ground ( )Engineered Design ( )Mound ( )Aerobic Treatment Unit 3. Project Information - Filt in all known information. { ) Sard Fi!ter Project/Site Name -single pass Location, Number 8 Street of project (if unknown, indicated nearest road) -recirculating ( )Constructed Wetland Legal Description: ( )Drip Line Coun Ci Villa a Town of ( )Other: Other buildings served by this system: Building Type (check one): ( )Dwelling, 1 or 2 family Other systems on this project/site: ( ) Public/Commercial Building ( )State-owned Building 4. After plans are reviewed, please: (check all that apply) Call customer 1, 2, 3, 4 (circle number)' 'Refers to customer number from below _ Requesting party will pick up Gallons per Day _ Mail plans to customer 1, 2, 3, 4 (circle number)' 5. Complete the following designerlowneHrequesting information. Utilize the check boxes when designer, owner or requesting party is the same to avoid re atin infor mation. Desl ner Intornatlon Customer 1 Re uestin 'Pa 'if differeht than des' ner Customer 3 First Name Last Name Customer Number First Name Last Name Customer Number Company Name Company Name Address Address Cky State Zip+4 (9digits) City State Zip+4 (9digits) Phone Number (area code) Fax or Internet cell phone Phone Number (area code) Fax or Internet Check others ff applicable Check others if applicable Owner Pa er Re uestin art Owner Pa er <Owner~InfonnaUon Customer2 Other Please ' Customer 4 First Name Last Name Customer Number First Name Last Name Customer Number Company Name Company Name Address Address City State Zip+4 (9digits) City • State Zip+4 (9digits) Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Internet Check others ff applicable Check others ff applicable ( )Payer ( )Payer ( )Other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUNT DUE $ Attach check here Review Code 7633 enn ~ne~~ in •f inn. uuai-av/ i i ~a~ iiw~ 6. Plan Review Fees for Private Onsite Wastewater Treatment Systems Type of Project Fee 1. All treatment components are previously approved under s. Comm 84.10 (2) or (3): Design wastewater flow of the proposed system: 1,000 gpd or tess ............................................................................................................................$175.00 1,001 - 2,000 gpd ...........................................................................................................................$225.00 2.001 - 5,000 gpd ......................................... .$275.00 ................................................................................. greater than 5,000 gpd .................................................................................................................... $300.00 plus $0.05/g/d 2. One or more treatment components are not previously approved under s. Comm 84.10 (2) or (3): Design wastewater flow of the proposed system: 1,000 gpd or less .............................................................................................................................$300.00 1,001 - 2,000 gpd ...........................................................................................................................$400.00 2,001 - 5,000 gpd ............................................................................................................................$500.00 greater than 5,000 gpd ..................................................................................................................... $600.00 plus $0.05/g/d 3. Holding tanks previously approved under s. Comm B4.10 (2) (3) Design wastewater flow of the proposed system: 5,000 gpd or less .............................................................................................................................$60.00 5,001 -10,000 gpd .........................................................................................................................$100.00 greater than 10,000 gpd ..................................................................................................................$150.00 4. Holding tanks not previously approved under s. Comm 84.10 (2) or (3j and site constructed tanks Design wastewater flow of the proposed system: 5,000 gpd or less ............................................................................................................................$120.00 5,001 -10,000 gpd .......................................................................................................................... $200.00 greater than 10,000 gpd .................................................................................................................... $300.00 Experimental System (additional one time fee) ........................................................................................................$300.00 Revisions to Approved Plan ...................................................................................................................................$60.00 Petition for Variance (InGude form SBD-9890) .....................................................................................................$225.00 Soil Saturation Determination Repoli -Per Site (other than a proposed subdivision) ...................... $100 00 Interpretive Determmat+on Report .............................................................................................................................$100.00 Lot Restriction Waiver ............................................................................................................................................$80.00 S u btota I .................................... Priority Review: Enter same amount as subtotal .................................... Prior approval from a section chief is required for a priority review, If approval is granted, the priority will be reviewed within 5 days of receipt. Enter TOT,+~L (rounded to the nearest doiiar) here ~ and on bottom of FRONT PAGE Note: Fees are pursuant to Ch. Comm 2 and are subject to change annually; please contact any of the offices listed below for the most recent copy of this form. Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days of receipt of all required information. 7. Appointment, Scheduling Information, and Plan Submittal Checklists. POWTS scheduling is not available. Plans will be assigned to a reviewer after receipt of plans. If you wish to receive confirmation of the assigned reviewer and estimated completion date please check the box in the upper right comer of the front page. Also note in the same location that you can designate a specific office for review. If you select a speck office your estimated completion date may be considerably greater than what would be possible in another office. Submittals received without a specific office indicated on the form may be assigned to offices other than the receiving office depending on reviewer availability. To obtain a submittal checklist call the material order unit at 608-266-1818 or one of the full service offices listed below. Madison S&BD Hayward S86D LaCrosse SBBD. Shawano S&BD Green Bay S8<BD Waukesha SS<BD 201 W Washington Ave 10541 N Ranch Rd 4003 N Kinney 1340 E Green Bay 2331 San Luis Place 401 Pilot Court 53703 Hayward WI 54843 Coulee Rd Shawano WI 54166 Green Bay, WI 54304 Waukesha WI 53188 PO Box 7162 Lacrosse WI 54601- Madison WI 53707-7162 715-634-4870 1831 715-524-3626 920-492-5601 262-548-8600 608-266-3151 Fax: 715-634-5150 Fax:715-524-3633 FAX: 920-492-5604 Fax:262-548-8614 Fax: 608.267-9566 Email: haywardsch@ 608-785-9334 Email: shawanosch@ Email: greenbaysch@ Emaii: waukeshasch@ TDD608-264-8777 oommeroe.state.wi.us Fax: 608-785-9330 commerce.state.wi.us commerce.state.wi.us commerce.state.wi.us Email: madisonsch@ Email: lacrossesch@ commerce.state.wi.us commerce.state.wi.us ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 May 24, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of Brad Hanson property, located in the SW;NW;, S.19, T.31N., R.15W., Town of Forest, St. Croix County, WI., has been conducted with the assistance of Gary Steel, CSTM# 2298. This onsite revealed unsuitable soil for onsite sewage disposal as there was not sufficient depth to seasonally saturated soil to meet the requirements of the A + 4" rule. This site is only suitable for a holding tank system by current WI. Administrative Code standards. Should you have any questions, please feel free to contact me at this office. ~yince~rely, 1 ,.~, ~~~~G~,,~~'~J '!~ ~~. J ~--- mes K. Thompson ~ '" Assistant Zoning Administrator cc: file ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 May 24, 1993 Division of Safety Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 and Building To whom it may concern: An onsite soil investigation of the 5W;NW;, S. 19, T. 31N. , R. 15W. , WI., has been conducted with the 2298. Brad Hanson property, located in Town of Forest, St. Croix County, assistance of Gary Steel, CSTM# This onsite revealed unsuitable soil for onsite sewage disposal as there was not sufficient depth to seasonally saturated soil to meet the requirements of the A + 4" rule. This site is only suitable for a holding tank system by current WI. Administrative Code standards. Should you have any questions, please feel free to contact me at this office. Sinc ely, l ~~~~ ~~ mes K. Thompson Assistant Zoning Administrator cc: file ~,Qpa~{p~,~u~r~.31.15.29~VATE SEWAGE SYSTEM Laporand.H;~rnan Relations INSPECTION REPORT ' Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: ^ City ^ Village ~ Town of: I v.: / nsp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septi Dosing Aeration Holding ~; !U ~'~ ' Lc.~~' s .tee ' TANK SETBACK INFORMATION ~ `~ TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic NA Dosing N Aeration NA Holding Manufacturer Demand Mod I Number TDH Lift Lriction S TDH F Forcemain Lengt Did. Dist. To Well PUMP /SIPHON INFORMATION SOIL ABSORPTION SYSTEM nty: n NO.: ELEVATION DATA A9300235 STATION BS HI FS ELEV. Benchmark a ~ ~Jl~, Bldg. Sewer / Ht Inlet ~ 9a ~ ~ ~ ~ ~/ Ht Outlet o /~6 y !~ ~ /+~s i ~~ Dt Inlet Dt Bottom Header /Man. Dist. Pipe Bot. System Fina de , BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN 1 N DIMEN I N SYSTEM TO P/ L BLDG WELL LA M LEACHING u adurer: SETBAC INFOR TION TypeO CHAMBER Mode Numb System: OR UNIT DISTR16L1TION SYSTEM ~ ~ ~ Header J Manifold ution Pipe(s) x Hole Size x Hole Spacing ent To Air Intake Length Dia. Length Dia. Spacing SOI ER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) ~ '` LOCATION : FOREST 19.31.15.2 5B r~ ~ '~ rn .~ ~ J ~df~~ t~y~-;~, ._,~ - .,•G ~' ~ ~-~ ~ -~„ ` ci" ~ ~ ~~' ,~ , ; / -~ l i:,r ,r ( i ~~ ~ ~/ ~._k.~,~- ~ ~ ~ _~ ~~ `1 Plan revision required? ^ Yes LJ'No Use other side for additional information. ~---~ SBD-b710 (R 05/91) Date Inspector's Signature Cert. No. ~~__ _ SONITORY PERMiT ~PPLIC~TIIAN ~"MR In accord with ILHR 83.05, Wis. Adm. Code Cou~~ EgMIT # STATES N -Attach complete plans (to the county copy only) for the system, on paper not-less than ~ ~`/~.~ 11 8'fl x 11 inches in size. - ~ ~ ec ff revision to previous application -See reVer3e Side for In3trUCtiOrIS fOr COmpleting this appllCatlOn. STATE PLAN LD. NUMBER 1. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION. ~ ~ -;~ ~,~) PAO TY OW R PROPERTY LOCATION w'/a W Zt,~`'/a, S 9' T ' ,1~f, R ~,sE (o W PROPERTY OWNER'S AILING ADDRESS `y LOT # > ~ BLOCK #A' ~ ? ,~ t / v C TY, STA ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER >` ~r r f*~ II. TYPE OF BUILDING: (Check one CITY ~ NEARE T ROAD • j ) ^ State Owned ,~ VILLAGE ~ ~ ~ - fF ^ = Public 1 or 2 Fam. Dwelling-¢~ of bedrooms- ! ) III. BUILDING USE: (If building type is public, check all that apply) ~ ~!/ _~ Q ~,(a _ 9a 7 1 ^ Apt/Condo 2 ^ Assembly Hall 6 ^ Medical Facility/Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 11 ^ RestauranUBar/Dining 4 ^ Church/School 8 ^ Mobile Home Park 12 ^ Service Station/Car Wash 5 ^ Hotel/Motel 9 ^ Office/Factory 13 ^ Other: Specify IY. TYPE OF PERMIT: (Check only one in line A. Check Tine B if applicable) A) 1. ^ New 2. ~ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5. ^ Repair of an System System Tank Only Existing System Existing System B) ^ A Sanitary Permit was previously issued. Permit # - Date Issued Y, TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 ^ Mound 30 ^ Specify Type 41 ®Holding Tank 42 ^^ Pit Privy 12 ^ Seepage. Trench. 22 ^ In-Ground _ 13 ^ Seepage Pit Pressure 43 ^ Vault Privy 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATIONS 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE . / -, REQUIRED (sq. ftJ PROPOSED (sq. ft.) (Gals/dayJsq. ftJ (Min.finch) ELEVATION ~~ ~- / T /`t' /11 I'T ~ ~ Feet ~~ Feet VII. TANK PACITY in allons Total # of ' Prefab. Site Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer s Name oncret Con- Steel 91ass Plastic App. Tanks Tanks structed Se tic Tank or Holdin Tank ,.G itJ ~+~-' t'~ Lift Pum TanWSi hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the or-site sewage system shown on the attached plans. Plumber's Nam 'nt): Plumber's Signat ~ No Sta ps) ~/MPRSW No.: mber Business Phon e Nu p W ¢y` g js~ ~ // e rr .~ /~ tP "J~ Plumber s Address (Street, City, Statg~7rip Code): 1 s 7~. try, ! .S~OI IX. COUNTY/DEPARTMENT USE ONLY ^ Disapproved Sanitary Permit Fee (Includes Groundwater a e s e Issuing Agent Si (N ps ^Approved ^ Owner Given Initial surcharge Feet' A verse D t rmination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8 Buildings Division, Owner, Plumber F INSTREICTI4NS ~ - 1. A sanitary permit is valid for two (2)-years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new - criteria in the Wisconsin Administrative Code will be applicable. 3; All revisions to this permit must be approved by the permit issuing authority. - 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onste sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this. sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s). of where the system Is to be Installed. ' il. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. IIL Building. use: If building type is Public, check al! appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallops, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIIL Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8i~ x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications fior pumps and controls; dose volume; elevation differences; friction;. loss; pump performance curve; pump model and pump manufacturer; D) cross section of the 'soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHAR7aE '~ 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. .,; The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398. (R.11 /RS) --NfiecCnsin Department of Industry, SOIL AND SITE EVALUATION REPORT 'Page 1 of 3 ° LabCr and t•!u^han Rslaeons __ Division of Salery 8 Buildings in accord with ILHR t33.05, Wis. Adm. Code COUNTY ~,_ ~ _ G t . Cro1X Attach complete site plan on paper not less than 8 1 /2 x 11 inches in size. Plan must include, but PARCEL I.D. # not limited to vertical and Horizontal reference point (BM), direction• and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION PROPERTY OWNER: PROPERTY LOCATION r~radlP Hanson G0~/T. LOT Sid ••1l4 p,t~ tr4,S1~ T31 ,N.R 15 ~S (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 2075 T-?v • 463 n/a n/a n/a CITY, STATE ZIP CODE PHONE FJUMBER CITY ^`~1LLAGE ®f'OWN NEAREST ROAD Ti'eer Park, ITT . 54007 (175) ?.h3-?1+42. F rest tt fh3 (J New Construction Use #:xj Residential /Number of bedrooms 3 (J Addition to existing building ~}; Replacement (j Public or commercial describe 450 Recommended design loading rate 0 bed, gpd/tit 0 trench, gpd/ft2 Code derived daily Bow gpd Absorption area required n ~ bed, ft2 nln trench, h2 Maximum design loading rate 0 bed, gpolft2 0 trench, gpdm2 Recommended infilVation surface elevation(s) rt/P tt (as referred to site plan benchmark} Additional design !site considerations n a Parent material ~1 acial t~ J 1 -Flood plain elevation, if applicable n/A ft S =Suitable for system CONVENTIONAL -- U =Unsuitable tors stem O S ~tU Boring # 1 ~:< Ground elev. rt ~- ft. Depth to limiting factor ~„ ~ Boring # _~ i .~. Ground elev. ft. Depth to limiting factor Depth Horizon in 1, 0-fi 7 h-].~ 3 119-3 MOUND IN•GROUND PRESSURE ADT- $ DE~ ^ S I~ULL ~ ~'^ UK O S ~U ^ S ba~t1 .... r~re~ne71r1T1~'161 RGD(1RT .~v~~ v...vv.... . .~.. .-- - GPD/ft Dominant Color Munself Monies Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary / Roots /f ? Bed rerxit 5 .h 1f~yr3/?. none L. 2/m/~*r r~fr w c . . ~ 1('STrS/~ cmd 7.5yr5/6 sit. 2Ir.+/~! mfr 1;lte 1/f. .S . ' 7.5gr4/4 v cmc? 5yrt+rf fi s).. t4 n/~t na/ n/a .3r: r Remarks : _- hor np, 2- show tre s e a fl-]., none •tiil'ah1 _ fro inst 1].ation f. s s em. Remarks: Phone; 7 Name:-Please Print Gary L. Steel ess: 15 54 2~t?,tfi . Ave . , Nec•~ F,ie'tmoncl , t•1~ . 51+~1 i ._- ,..,___ Date: r ~i , •~•~ ?Qt' 1 1 I ~ ~~ }- -~ ---~ --- i I -~ 7 - - -- - ~ ~ -- 1 ~t w ~ - t ---~. ~ / ~ ~ I -- ~ - . ,--~ i ---~ --- ..--~ ~ ---t ~ -- ~ - -I -i - - ~ - ~ --~ - -- , I , ~ - I i ~ -~ -- ~ I s~ _ _ _ _ I ~ - I ~ ~ i I - - ~- ~' %~ `'-i p' --a ~ --I ~ - I ; i ~ ~ ~ 1 I i ~ - I I I ~ --~ -- i -~ --' I --~ ~ ' ! - -- I ~ ----I ---~ - I 4 ~ --- I r-- - I ~ -I -- I- - - _ - - -- ~ -- - I ~ -- _~ ~ ~ I \ ~ i - -~ I i ~ -~ --' --+ ~ ~ - ~ ~ - - I_ _ ~ - ~ , I ~ I I ' --- It ~ i i , - - I ~ i I ~ I ' - ~ _ ~ C ~ ~ 4S ~_ ( -~ - ~ ' ~ ~ ~ -- -- - ~ --I t ~ - -- -3- - o~ __ -- - ~ --- --- --~ ~ E----, -j a - - - d - - #s , ~ - -._ - - I I ~ ' e -~a 't ~,-, Y~ - ~ - - -- - ---- -- ~ --.. - - - - - - L~ T/ ~' S - - FA .~ rr • i ~~ 1 - - ., -- ,~T ~,' ~Y., :; r - - ~- ~ . __ ~~ S~, ~~~ T,. ~ ~ - - --- -- - --~ ~ ~ -- ---- --- - - + N ~, ~ - - -- - ---+ ---- -- ~- I 1---- ~ ~- i - .,~ ) ~---- ,C~c ~ I - -- - -- - ~ I---~ ~ -- - __ -- _ - _ _ _ " 'I SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations August 25, 1993 CALVIN POWERS JR 1969 - 185TH AVENUE NEW RICHMOND WI 54017 RE: PLAN S93-02813 HANSON, BRADLEY SW,NW,19,31,15W TOWN OF FOREST HOLDING TANK 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 FEE RECEIVED: COUNTY OF ST CROIX 60.OD The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, ""~ ~"~ ~~ Duane Steiner Wastewater Specialist Sr. Section of Private Sewage (608) 355-3159 SBD-7887 ~ R. 01/fll i i~ I 1 ~ -- E f --~ - ~ I --r ----1 ~ ---~ I --1 -{- ~ , ~ --- I . 1 ~ -~ -~ --? _ ~ ~ --+ -I -~-- --~ --~ 1 -1 ~ -~ - ~ ~ ~ ~ j I 1 ~_- I ~ 1 ` i _ ~ f 1 _ 1 ~ ~ ~ 1 1 y 4 4 _ - - ~ i ~- p 1 x---~ I - --i ~ ---+ 1 -- i ' ~. ~ i ~ ---- i ~ ~ ~ -~ - _ 1 --- - - ~ ~ ~ _ ~ ---f ---1 I j -r ----- i -j --- I ~ -rf --- ~ l A ~' i .~ ~. r-- -~ - -~ -- -} -- - -1 -- V --- - r ~ _ _ 1 --~ _ i --- ~ -~ _ -{ - ! ~ I ---t L --- I ---I ---~ - --- ~ ~(~ ~ 1 ---~ ~ -I - ---~ ~~ -----~ ~ --- ! --- j ---i --- -- - - -~ - I -- ~-- - ~ - ~ ~ ---+ I __ --- -- ~ ---j . -~I - - ---t 1 V~ - -- - - - ~ - -~ --- ~ -- - I ~ ~ ~ -- . b ' --~ I --- _. I __ ` --f ` -- - I T - ' ~1 - -~ - ~ ~ i - 4- ~ -- - -..~ - I -._---~ - - ' ~ - ~ i - ~ `~ ` ~ I 1 -* -- I i i - ~ ~ - -- -~ _ -- I I ~ i - j _ i ~_--j -- ~{ am. ~`i ~ - 1 ----i --` ----- _ -~ f -- --i -- - - ~ ~ ~ h -- -j i -} ~- " -- -i --- - - -- ~-- ~ / ~ t ~ YYYYY~~~~~ - ~ _- ~ _-_ -_ I~ -Q ~ _- ____ _~_ _-_ ~ I - __ .. _ _-_ ~ __ _.- ._ ~ ~ ~. ~ ' - -- - - - - --- - 1- - ----- - ---- -_ ' - -_ - - _ - --- - --- -- - -~ r- ~ ~ _ --_ _ - - _ _ _ _-- -___ . - - _. -~.~- __ -- - -- - -- r- --- - - _ ~ I ~' -- -- 1 --, -~ P -- - --- --I - - ` ' I i ~ T ~ C~ `' ,: Mr. ~~~ I ~ ~ ' _ _ ~ „ ~ _ _ ~ 1 _~ ~~ --k~ - __ - j - _ ~ _ ~ ~ ---- I __ -- ~ _ --_- __ _~... 1 _...- ----- ~ _. -- - -- - ----- ~ I- __ +_ I - ~ ! 4 ' -- - I - i - -_ ~ i {- a-_ I - --- I l ~ -- .~ ~ ~ 4 ~ I ~ I . r: ~~, ' _~ W ~ --- ~ 1 1 ~ I ' ~ 1 ~ j ~ 1 1 ~_ - ~- -- 4--~- ~ -- t---. .. , --- - - - , -- . . - _ - ~ I _ , 1__ ..-- I ~ , ~-_ - - ~_-- ' i .~_ __ .I. ~ ~ ~ - - ~ _ _ ;~ •J. .. ~ ` --- ~.~ y ~ ~ ~ ' I~ i 1 ~ 1 _ I ' ~ ; . ~ ~ ` ~ ~ ___ ~ ~ • ~ ~ ~ I ~ I ~~~ ~ ~ ~ to -- - i y 1 ~ -- ~ ~ I 1 -- I - I ~ 1 -- --- ~ I ~ , - I I - i ~ _~__ , _ ___ , ~.___ I ,..._- ~_.___ I ____ ~ -_.- _ _ __..._ ____ -_._ ~ ___ ~ _... _ _ _ , ~_ _ ; ,_ __.. j ___ .1_.._ .__ _ - I__ _ , _..__... ___ ~ .~_._ . j ~ .__ l .__ ~ ~__ ~~ _ .__ -L__ +_ __ _..._. ~_ _ ~ I _.... ; ----- ~---__ -- - _ . t - -- ~ - I-- i. __. .--- - ~ ~ ~----- ...-__ ~ ~ __._ __.._ ~ __- I 7_...... t..__. I- _.. - ~ - ~- ~ - -.-, -- I - _~__ -- L. j-- - 1 ~-- - - _r--_- -~_ _ I --- r F~ j ._-~ ~ .__ _ l f -- -- f-_ - HOLDING TANK SERVICING CONTRACT '~ _._..._.Y_:._.1 _:_._... CoMr~s", SIN ` •• q ~~ ~ ~~ / ~~ This contract is made between the_ _ ^ ` _ ~ - r - - ^ _ .+ _ - - r Violdtnp 1ankO0wnerpi Namta(a) . U'7 ~ r-` . s. r'*r^,' GJ and +( rumper'e Name ~c~2 r ~c.X-f!C, !.~ S~GZ17 I W acknov'vtedge the inatatlatlon of a) holding tank(s) on the following property: (P ovlde legal description:) II,, S (,,~ ~~~ o -~ ~ t~ 7'~ v ~- ~Q G'~' ; v --r i ~, ~cR-its r S ~i : (~' 3 / _,.. _ - ~ •C T 6/\t~ y~ _ •~ /t' ~ /~ ~ /U Gti- `O'ff ~o r-[ h~ /C. a,, f,~ 1 S ~ ~{~, S 1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality", which has signed the pumping agreement renquired in Ch. ILHR 83.18 (4) (b), Wis. Adm. Code and ' with the County of _-~'~ `! ~ ~ X . 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the ail-weather access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18 (4) (b), .Adm. Code. and to the county, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further ary to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The-dates on which the holding tank was serviced; f. The volumes in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect unfit the owner or pumper terminates this contract. In the event of a change in this coy the owner agrees to fife a copy of any changes to this service contract or a copy of a new service contract with the munic and the County named above within ten (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print} ~ Owner's Signature( ) ~- ~ i Pumper'a Name (Print) ~ Pumper'a Signature 7 Pumoar'a Registration Number .S a 593-02g 13 Subscribed and sworn to before me on this date: ~, laq My commission expires: 10- s8o-~s7a (N. tt~as) This instrument was drafted by the State of Wisconsin Department _e 1_.1.._x_.. 1 s-.... and LJ,.men Qelalinnc Rura~u of Plllmhinn HOLDING TANK AGREEMENT Agreement Oate ~~ 1 _R~ - - This agreement is made between the - r County or Local Governmental Unit (Holding Tank(s) Owner(e) ~/ ~ar¢~~' ~ ~r,~ ~. v 1-l,~I~ Ira-d(r`~ lJ, -~ l-~a~y /~• /-lahsv~ I acs? s cC. f-r'wy (0 3 (Called Munlclpallry below) i V ~~Y i~c~r~i ~~ " Y Qa'T We acknowledge that application is being made for the installation of (a) holding tank(s) on the following property, (Provide Legal land description:) space referred for reeordln9 data _ Retum To ''~-/-~ wit/ Sr,~ N%J--- .~v.ti.. __.~n.f _,r_C1_..C-%U _S1A1!v - '3~a, 5 ,' _T~ .~ S~v,' ~~ 3~ a . ~' ~~ lJ S/D ~ /o X013 or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment o sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private sewage system as permitted unde Ch. ILHR 83, Wis. Adm. Code, or Ch. 145, Slats. As an inducement to the County of S~-. ~ ~ v ~ x to issue a sanitary permit for the above described property we agree to the following: 1. Owner agrees to conform to all applicable requirements of Ch. ILHR 83, Wis. Adm. Code re{ating to holding tanks. If the owner tails to have t holding tank properly serviced in response to orders issued by the municipality to prevent or abate a nuisance as described.in ss. 146.13 a 146.14, Stats. the municipality may enter upon the property and service the tank or cause to have the tank serviced and charge the owner placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed s. 66.60, Stats. - 2. Owner agrees to pay aU charges and costs incurred-by the municipality for inspection, pumping, hauling or otherwise servicing and matntaini the holding tank in such a manner as to prevent or abate any nuisance or health hazard caused by the holding tank. The municipality shall not the owner of any costs which shall be paid by the owner within thirty (30) days trom the date of notice. In the event the owner does not pays costs within thirty (30) days, the owher specifically agrees that alt of the costs and charges may be placed on the tax roll as a special asses ment for the abatement of a nuisance, and the tax shall be collected as provided by taw. 3. The owner, except as provided by s. 146.20 (30) (d), Stats., agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code t have the holding tank serviced and to file a copy of the contract or the owner's registration with the municipality and with the county. The owne further agrees to fife a copy of any changes to the service contract or a copy of a new service contract with the municipality and the county withi ten (10) business days from the date of change to the service contract. 4. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code who shall submit to the municipality and to the county report in accord with s. ILHR 83.18 (4) (a) 2., Wis. Adm. Code for the servicing on a semiannual basis. In the case of registration unde s. 146.20 (3) (d), Slats., the awnershall submit the report to the municipality and the county. 5. this agreement will remain in effect only until the local governmental unit responsible for the regulation of private sewage systems certifies tha the property is served by either a municipal sewer or a soil absorption system that complies with Ch. ILHR 83, Wis. Adm. Code. In addition, thi agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permi the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner and assignees of the owner. The owner shall submit the agreement t the register of deeds and the agreement shalt be recorded by the register of deeds in a manner which will permit the existence of the agreemen to be determined by reference to the property where the holding tank is installed. S 9 3 - 0 ~, ~ 2 81-~- ~) Namg(s) (Print - I pwn ) Sign t ~~JJ p , I • - i , ..---- .. _.._ ._.._ ----_.. ___.-_.. _~L ~ . -~ S O•r ~/ ~ . Q bl SU Y'~ I t~'-:'~-~ ~ Subscribed and sworn-to before me on this d Municipal OtiiEial Name (Print) I Municipal Official Signa re ~ ~ o N l~~f ~.) ~ e ~ c 1J ic~~`Y`- Municipal Official Title (Print) ) G)~Qihl~i~N i ____=~ i ~ _ ~~.a3 „ ~ Notary Public My commission expires: ~-" ~ `~ _.. .. _.... ,.. ... ... ~. .. - . -.. _. - _..... _ ~__.._ ~ ~.. .~ _ c._... .., ,11 f: ............. Il.......f.......! ..1 In./....,... f .. 1. r...•nA L.~....nn Dnl.,,~r•nn D...n ~., ni DI..Thin.. i _• , ~~ ,.. ,. ~ ~. i S93 "' O~ ~7 ~ V . .. .. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ROUTE/BOX NUMBER CITY/ST i ~.cQ ~ Y~ Q'w~ C~ V $ ~ ~~ ~~7~ ~~5~ ~1~ lL~ _ FIRE N0. 0~~7 _ ZIP ~'~) PROPERTY LOCATION: S ~~ 1/4 ~ ~ 1/4, Section ~ ~ , T .~t N, R 7 ~ W, Town ~~~)~ o ~ ~ a~I Q S-{- , St. Croix County, Subdivision , Lot No. 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 SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning 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 (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County oning Off' -within 30 days of the three year expiration date. ~ _ 'cam, SIGNED /~//~1., ~~i.-~Y~ DATE ~~~ ~ - / St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) T96-2239 or (T15) 425-8363 Sign, Date, and Return to above address " ~, ., + APPLICATION FOR SANITARY PERMIT 3TC- 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the. permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second. form should be retained and completed when the. property is sold and submitted to this office with the. appropriate deed recording. --------------------------^ --------------------------------------------- ~-~-, ~ l Owner of property 6 G ~ 9L /1~r~~ c l Location of property S ~ 1/9 ~ 1/9, Section ~, T~N-R f5 W Towna h i p ~' ~ -F-c; v-~ C "~" Mailing address ~" ~ ~ o ~ ~ ~-- Address of site ~~ w~Q. Subdivision name Lot number previous owner of property 71 O f~ G.,~ ( ,r'' ~j ~ )'lam ~4~`r Total size of parcel "T G..c r~S ~' ~ Date parcel was created - )r.~ rr j/ ~ Are .all corners and lot lines identifiable? ~~Yes No Is this. property being developed for resale .(spec house)? Yes ~_No Volume and Page Number ~ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A y~aiuw ^°' which includes a DOCUMENT NUMBER, VOLUKE AND PAGE NUMBBR, and the SBAL OF TNB REGLSTER OF DBSDS. In addition, a certified survey, if available, would be helpful sous toe ~aa~~,,~~,,iid ~1_a_,_vs_ a reviewing process. If the deed description references to a~~fied Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (out) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. 'S~~`k• S~f~'S~C/7 and that I (We) presently own the proposed site. for the sewage disvosal system (or I (we) have '~ z DOCUMENT NO. STATE BAR OI? WISCONSIN FORM 1- WARRANTY DEED 48'744'7 •-- n~ ~ ~.~-~, mans Deed, mesa between ,Kendall M. Winegar, a single ---... .. ...... Gr tor. ans.. ~radl:ey::tf:_:_Hansgri•-and-~Mary:_A:7ri_ Haiisori:; ~1iu-sband and .__---wife,-•as. survivorsfip..marital propert~i _ .:.:::::::::: .: w t SSe h~ Th the aid raptor, or sluable lderat'on- ~.. .._-__One._~o~~ar__-~~I-.OQ~--an~-ot~er va~ua~_ ~_e cans`~~erat~on _ conveys to Grantee the following described real estate in ... $~ .. ~rGiX Countq, State of Wisconsin: TNIf fMCi Rt1[RVLD -OR RLCOROINO DATA REGISTER'S OFFICE sr. coax co~vw - ~ Reed for Record AUG 211992 ~ 8:30 A. M ~RdLO Finvti+~aeerica.~l Bank W. 104 West Maple Street Ta: Parcel No: Part of tha SWl/4 of NW1/4 of Section 19, Township 31 North, Range 15 West, St. Croix County, Wisconsin described as follows: 'ginning at the intersection of the North tine of said SW~/4 of NW1/4 with Easy right-of-way of 5TH "63"; thence South a"long said East right-of-way line a distance of 342.5 feet; thence East parallel with said North line a distance of 510.0 feet; thence North aarallel with said right-of-way line a distance of 342.5 feet; thence West along said North line a distance of 510.0 feet to the point of beginning. a sr f'~+ This .._...-_ig!_~~:_°.•-._ homestead property. (~+) Q~~N Together with all and singular the hereditaments and appurtenances thereunto belonging; Ana.._ Kendal 1_ M. _ Yii negar---•---------•----- ---•----• ........................ warrants that the title is good. indefeasible in fee aim Ie snd free and clear of encumbrances ezce t easements, reservations and restrictions of record, and except applicable municipal and zoning ordinances, and wilt warrant snd defend the same. Dated this ------•-•---•---•----~.`~.rJl!.----•---......_ day of ---••----.....AU~USt ..............................•--•----•--~ 19.g2... .....................•----.._._.._....---..._....... (SEAL) ...:.................--...--•----------•---...__......---....-----._. (SEAL) s AIIT88NTICATION . __Kendall- M.__Winegar ................~i' ..._..--••-----• .................•-•----•--••--•-•---..._........... (SEAL) ACSNOWIi.BI)(iMSNT Signatnre(e) authenticated this _..._.__day of_______________________... 19__..__ TITLE: MEMBER STATP; BAA OF WISCONSIN (If not- ---------------------------------------------------• authorized by ~ 706.06. Wia. Stata.) STATE OF WISCONSIN POL K------------------------------County. ~~ P}ersonally came before me this .__1.J~x__dsy of A~uS S~ ............................. 18 y~ named -------------------------------------- a- ---- --------_--.. be the pars ~-- _p~~3l~: egoing i meat and Oa _.~~: 1-08-1996 0-40AM FROM ~, ~Dayartrr-ehf~ot arcs SOIL EVALUATION REPORT T 9f`refAblN.a " ,r f~..w..w Or. 1Mw AJr r_l~ P. 1 page 1 of_ .3' iY1~Q1 mrrglss~ nl~® ~ ~ _.... - --- p depot not Iess than 8112 x 11 indres in size. Plan roust indu4e, but not Nrrdted to: vertkai anA hofEzelltal rdererrea point (BM), idh and Parcel I.D. psraent slope. scale ar dimensiohs, norflr arrow, And lor~ebr- sod dfsfanoe to nean>ts[ naafi. ~'leese print a/! In/orn-stion_ Rerlie~w~gd by ~ Dale Pereonei inlormepen you provide mrtr ire need for termnatnlr tru-poeee (Priwcy Lew. ^.15.oe (i) (m))• Prapee{yOWnet Prepelty l4cag4n ~L"dd Govt. (At $yJ 114 1!4 S ~ 9 T 31 N R 't ra ~ tat j yy Property Owner's Mairrrp address i.ot * 9ivrlc d Shrl5~1. fYsrne a CSt+lit) !1'el IYd t1e1 City Zip Code one Humber ^ ~Y ^ Vdlege Town Nearest Road D~ E~ark 4 _ F~'est ~ i IiY, 163 O New t~onsbuaion ljse: ® R~derrtial / NusrDsr d Nedreoms ~~ sods, derNsd design Aow taut, __ A ~ [~ i7eplacertrerr[ ~ P'uolic ar corlrmerdd - Dselbe' ~0 GPD Peron[ maul gl ae~i al cb-i ft Flood f?lek- elevation -f+ipp(ieetrls + -+ tL C+ensral aorm~erds ~~ and reCWnrrrerldfstlons: so~.l bCririgt~ in area d0 nt~t show anythi.n9 CtLI)p-Z' tha73 d A~rQ" soil vonditian. At this time the only system ava.flable are holding tanks. ~ btu that study by ~, of ooaaerc~slt caula alYcsw A+o~r rrt~u>fa system. Boring d ~ QOM ~ I~ o,t GroundsuKaee ekw_ 97.55 a no.nr. -., e...rrr.,., t~.,,.. R Ha[izon Depht- Dominant Redorc Desatption Texture Stnrdwe Corrsistenoe 94tM+dary Roofs Soil lion Rai tn. Murree! Qu. $z. Coal. Color 6-. SZ. Sh. 'r=tffl!1 '~Pll12 1 -4 1 3 .3. ~ 2 -8 1 ~ -a 4 F3orirrp q ~ B°'k[g L=-J ®Pit GroNnd surtsae elw. • 99,_ OS , R. Depth to Iimlpng fapr# ._ 6 " in, Soi) 'Rats Horizon Depth Domineht Color RsdoY Dercrip6on Texhrre StrucWo Cwr:sistence t;tourtdary Rests GPDr'tE irr. MWtsetl Qu. Ss. Corn Cotat Gr. SZ Sh. 'Eflil7 •EtTtll2 y ,6 10yrZ 2 none L 2tltt'ak tnfr gw 2f .5 .8, 2 -Z7 10yz 6/3 c2d 7, SyrS/i3 siI 2ittgbk fish 7 f 5 3 1-40 Syr4/9 2d 7_5yr5/8 scl Zglsbk ash na na .4 :6 • CYL.~~. Y. _. !.n _ ~- ~~ ~ .. oft Of IY 1 r1i ~.T! r \~11,I CST Name (Plessa pant) ~ ,_~- etc = w ~ ~ regrt, ana Tss ~ 30 7 .. r l . CST Num 1554 200th. Ave., Nt7ta R~.chmond, ~z_ 5gOX7 ~ ~nnn 715-24b-6200 ~Jey.~.~,.~.~ ~(S'~ x-2(0 ~ 2 S~`f 1-88-1996 O.41AM FROM P.3 .~ .~~ ~. Propett~r owner add ~ Pateel tD ~ p~ Z d 3 ., ~r] Prt tae elev. .95.85 R oapAl to gmit(ng tamr 6 in. Sall ~ MoriZan ~t Oarriirtartt Goiol' Reao: DesQipfjort TetnWe 8~ Cg11~1de Beufxf~- Rasta CiP gME tn. Mun9e/ Qu. 3x. t;orrt, t:cior GY. 5z Sfi. •~1 'EIR82 1 0-6 10 3 3 ~ rune L Zak ~ 2f .5. .8 2 2 7 5 i 1f .8 3 20--40 7.5 4/4 c2d 7 5 5/8 sc7. Zrtlsbk , dsh na na .4 ..6 I ~ 1 ~~~ a ~~ ~ .~_...~e_~_~~. OtQ 'fie e --ter w ~~. ---~-..___..~~_._ ---- - ..qr•~.-q.w~wwn ,... WII Rini Ffori~on ~ Doniaant Color Ftsdax Oescrlp6on Texture S4ti,cattre Consi~hcs BoutlOary Roots C3P Dl1!' ih. Muneel Glu. Sz Corn. Dolor Car. Sz. Sh. •EfR~1 •f?I'Ap~2 1 0-6 10yr2/2 >t~ L 2a~hk mfr gw 2f .5 .8 2 5-22 10 /2 c2d 7, 5 5/8 sil ~ 2ttesb~k dsh 1 f .5 .8 3 22-~0 5 ~4 4 c 7.5 8 sl 2Rrsbk dsh tea . 5 , 9 '-` -'-`r ~ ~ w,r~ P~~~r..Tdu~as..e -fie.. a n:.~ ~ r~ur__ ~y~ ~ L SOA R@te I"~~ ~~ Color Re4o~c Oeaaipion TaxWre Strurbee Co>afstanoe 9ots+dsry Roes G In. Nl4t~o1 Gu. 5z. Cont. Cotor Gr. 3z Sit- 'E'~1 'kfl'l~ E146,ent !21 = BODs > 90 c aZ0 rngl~ end T53 y30 c 750 mglL ' ER0.~ent tit = BClD~ ~ 30 rtgA. and TSJ < 3D n~gA. The pepartroent trf Cantimercc is an squat opportunity service provider and natployor. if you tt~ed assistance to acrxss services or need ma~triai is an alternate format, please eoRltdct tlat depatttacat at 608.266.3151 or TTY 608-264-8777. eiDalw(It4go) 1-08-1996 0.41 AM f j, f ~. FROM S .SOiL S~RViCE P_ 2 Gary L. Steel CSTM2298 Brad Idar~.son MPRSW3254 ~ si 9•-T37N-R7 SW taan of Poorest N 1"z40' ~-~f.. _ 'top of we].1 @ el . 100.00' Alt. HM. = t~ of step @ el . 101.20' ~~ G3ty L. Stems 11-2-2000 1554 200th Ave. New Richmpnd, WE 54017 (715) 246-6200 ~ti