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HomeMy WebLinkAbout040-1303-00-038 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 563866 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Westview Construction, Inc., c/o Aaron Clay Troy, Town of 040-1303-00-038 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 14046 1 /3 m / G5r 22.28.19. '7 3 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 7.5$ /a-7•S /Q2::~ Septic y / /z6O Benchmark 6.5 /as.! /dC:b Dosing T60 Alt. B Go✓ ,3 3 ld•`f , z 071 P. L, owl. r_ 1 b ICS Bldg. Sewe 7.7-9 /6'1.5$ 7.7 99• -Z- Holding i St/Ht Inlet -7. CF TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Ven to Air Intake ROAD Dt Inlet J Septic Dt Bottom / NYC" ~ X / S Dosing / NAHeader/Man. z - s 3,6(p 16 Li - 62 Aeration Dist. Pipe 3 / /6 G Holding Bot. System ~ Z fE 944o mPUMP/SIPHON INFORMATION Final Grade Z . S 16-!5 Manufacturer r Demand St Cove 3,34 /i Y. Z l GPM v p Model Number TDH Li5g nctiop Losss~ System H ad TDI 7I Forcemain Lengt IDia. i 1 Dist. I Well 2 (i -T SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of TJ~nche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 16 / (~(e SETBACK SYSTEM TO c~ v P/L /LBLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: 35 UNIT n I / /L Model Number: DISTRIBUTION SYSTEM ~o Header/Manifold 11 Distribution ! x Hole Size x Hole Spacing Vent it Intake q 1LengthDia Z Pipe(s) Length Z/ Dia Z S Spacing 3-33 Z. 1 7 V SOIL COVER x Pressure Systems Only xx Mound Or At- rade Systems Only 0-1 - /17 Depth Over Depth Over xx Depth of xx Seeded/So ded xx Mulc ed Bed/Trench Center / Bed/Trench Edges \ Topsoil I P- I Yes No es 0 No t tp 7~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 spect- #2: ol->r /ow O..~ Location: 230 Walnut Hill ay River Falls, WI 54022 (SE 1/4 SE 1/4 22 T28N R119-) a ;nut Hill ill P rm aka The Tri to Par 1 No: 22.28.19. 1.) Alt BM Description = U~ SQ,,. 2.) Bldg sewer length = t / 6 amount of cover= C.~~S V,- - Q~ Plan revision Required? ❑ Yes No Z / Use other side for additional information. ~ C, ~ (o~ SBD-6710 (R.3/97) Date Insepctor's 'gnatur Cert. No. 1; Plot -"fO - - - Of Prop rv Owner Wa5r eaju~5Tktle--, I"= , L Dew tax 3c. L : , (aweptwhere nom Or THE 7RW-'FQ OF lowl Bacjbvsm PH Non* ~4:+~Ltdtut~etcY ~ a R~ ~ t~ ~ I 1.4 1 te t.~ \t.ti L#L new, pea itc Locadom: 41 (yam' 4JL°J~ County Safety and Buildings Division ' 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) s Madison, WI 53707-7162 Y \ S1oNP,/ fo~ State Transaction Number yy~~ ermit Application G In accordance with SPS ? W' . dm. Code, submission of this form to the appropriate governmental unit is required prior to obtaini s ary permit. Note: Application forms for state-owned POWTS are submitted to Project Address f different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be ibdfor seconda 2 L2 tit t~~ J~ u oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. J Tl r ( VA Y_ 1. Application Information - Please Print All Infor o 1f Property Owner's Name A/ ~C Parcel # es~ ) 6 L,4) Lo ty 61r U ~q4 c 303 Property Owner's Mailing Address C Property Location 0 SO re Govt. Lot,7,9 C' /-7 7 3) q01/ City, State Zip Code Phone Number , CC /4, Section or I►JGYa'~~ J Z / ?1 0_2 Q d (circle on T N; R. II. Type of Building (check all that apply) ~I PSI- Lot 0 or 2 Family Dwelling - Number of Bedrooms A 14 3 Subdivision Name VWrr PWXC l2- __4A '1 ~a~ !3 -7 -V V ❑ Public/Commerc 1- escribe Use / , , /y ^ D_ , ❑ City of El State Owned - De .tribe Use CSM Number El Village of G ❑ Town of / f a y III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. &I New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B_ ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner / IV. Type of POWTS System/Component/Device: Check all that apply) O~ ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) y V. Dis ersal/Treat ent Area Inform ion: ^ 1 Design Flow (gpd) Design Soil Applic tion Rate(gpdsf) Dispersal Area Requir sf) Dispersal Area Propos (sf) System Elevation / (/J boo Ibo boa ►5 r~~ 3 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks a' p w 0 in va w C7 Li Il o /o ~k 5Z ° Septic or Holding Tank 1,:200 - di3 Dosing Chamber © 0G ( )1 VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum 60LYr's Name (Print) ff Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip 71V A ) ~o?i7r 1a ofi e (Z% )1 L4 VIII. Count /De artment Use Only pproved roved Permit Fee Daaatte- I ued Issuing t Signature l'al $ (P~~ ' (l I IX. Conditions of Approval/Reasons for Disapproval J~ 6 t/ he, exrL r ti d . o,r~,b r SYSTEM OWNER: 1. Septic tank, effluent filter and ` dispersal cell must be serviced / maintained as per management plan provided by plumber. d Q 1 p must be maintained ) W+l p Y~o ~0✓1 >1 ~ow~townP~r W 2A-11 sethar-k re ,irpmpnts as per applicable C( &MM"a ft plans for the system and submit to the County only n paper not 1 s than 8 1n x ll inches in size SBD-6398 (R. 11/11) 9~NRTMENT Safety and Buildings >y~ ° n 3824 N CREEKSIDE LA HOLMEN WI 54636 3 S a 1 Contact Through Relay P S~~~ l l~ 1 www.dsps.wi.gov/sb/ cw www.wisconsin.gov I ~OssroNAScott Walker, Governor Dave Ross, Secretary May 10, 2012 CUST ID No. 224832 ATTN.• POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022-4011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/10/2014 SITE: Identification Numbers Westview Construction Transaction ID No. 2079112 230 Walnut Hill Way #38 Site ID No. 778735 Town of Troy Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SE1/4, SETA, S22, T28N, R19W Lot: 38, Subdivision: Walnut Hill Farm (Tribute) FOR: Description: Four Bedroom Mound System / 5% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1368731 Maintenance required; 600 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/O1), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. PRIVATE SEA The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code®~it requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stars. P R The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION P" OF SAF Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE CORRE • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. MARY JO HUPPERT Page 2 5/10/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 &erard Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MARY JO HUPPERT Page 2 5/10/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 &erm~ M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jen-y.swim@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. z ~Vh MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIdWA.~ -::7,-):-:7,,_ INDEX AND TITLE PAGE Project Name: WESTVIEW CONSTRUCTION Owner's Name: (same) Owner's Address: 20 Serenity Court River Falls, WI 54022 Legal Description: SE 1/4 of the SE 1/4, S 22, T28N, R19W Township: Troy County: St. Croix Subdivision Name: Walnut Hill Farm (Tribute) Lot Number: 38 Block Number: NA Parcel I.D. Number: 040 -1303 - 00 - 038 AGE Sys s F- Plan Transaction No.: tonally Page 1 Index and title 0u~Ullgllglllt/'!//10 Page 2 Data entry ~0 ~®2/1iV*, Page 3 Mound drawings 441 f AND BUJ1)It4i;S Page 4 Lateral and dose tank e • MARS JO Page 5 System maintenance specifications IiUFP RT Page 6 Management and contingency plan ®1 1 Page 7 Pump curve and specifications NDE=NCE ~•RBVE LSt,, Page 8 Plot Plan V1l ei Designer: Mary Jo Huppert License Number: 1859-007 Date: 05/09/12 Phone Number: (715) 426-1775 Signature: kd444.1x~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 8 MOUND AND PRESSURE DISTRIBUTION COMPONENT EP~34 Residential Application lldM AND TITLE PAGE t ~pJ_ Project Name. WEST/IEW CONSTRUCTION CG`S, Owners Name: (same) Owners Address 20 Seraniky Court River Fails, Wi 54= Legal Deecripion: SE 114 of the SE 114, 8 22, T26K R19W Townstap: Troy Camty: St crak Subdivision Name: Wa nut HE Farm UnU te) Lot Number. 38 Block Number: NA Parcel 1. D. Number 040 -1303 - 00 - 038 Plan Transaction No.: Page 1 kwkK and file Page 2 Dart entry At Page 33 Wwr d drafts ~y P;k ~ ......0 • Latsrat and dose tank : Page 5 System mak*mw e specificadom a I J0 Page B Mwwgaffwt and cor wy plait Page 7 Purrs curve and qxcFwalione Page 8 Plot Plan Desrgrter: Mwy Jo Huppert Ltcwm Number 1 -007 Dale 04r11n2 Phone Number: (715) 426-1775 Soma". Ded9ned Pr num t is the Mound Corttparm t Wino 3l for PC1WS Va ndon 2.0 SDB-106®'1-P (N. 011M). and both SSWMP Puifte6on 9.6 Dead of Pnassure 01obta >jon Nekwft for ST-SAS (DW) and Pressure Disbltution C n iporrer# Manual Ver. 2-0 SBD-10706-P (N. 01101) Version 5.1 (R. 06106) Page 1of 8 Mound and Ptr®ssure Distribution Component Design Design Worksheet Site informadon alarMions ~ (R or C) ~ _ R`; RetiderAial or Commercial Design NdW Sind•t% aswme• X100.00 ~ Estimated Wastewater Flaw (gpd} Table 8&44-3 M-00 aoi deadr►antfor „w._ 1.50,. Pedit Factor (e g.1.5 = IW%) tealtweetd 3e indres fi00.00 Design Flow (gpd) 5"0:: S0e Slope ___..-.101.80= Cwbxw Lin Ele A ion (fy j 18.80 Depth to Limiting Factor (n) r 0.18 k"W Sol AppIcOon Rate (gp&%?) D m Cal i oa j___ 8O.l0 Dhowsel Cal Length Along Contour (1) = 1Q00 Cal 1AfM (ft) t 1.A0? Depm-sat Celt Design Loadng Rate (gpdM) tdDkwt Waateweler QUORY (1 or 2) Are the In 1, i's the-highest post In the ution # _Y Presets rtatMbrit?Enter Y or N (C or E) C~ Center or End WkwAold 3.33 Lateral Spacing (ft) If N abom enter the elevation (R) 8 Number of Laterals of the erg W point i O.i25 Orifice Diameter (n) Spacing (1h 7 14 fl lor 2.12 Estimated OtRoe = aifice 2.00 Foroemait Diameter ('n) i, ...._._.88M Forcemain Length (0) Does the for+cemom drain back? Y_ "AO' Pump Tank awailion (ft) Enter Y or N 6. System Head 00 x 1.3 7.83 Foroenlain Drairgdc (gal) 9.15 Vertical Ltit (ft) M 5x void Voltune (ga!) 1.21 Friction Loss (fQ 83.83 luh *n mn Dose VoJtnne (gsn 0.00 = #;n-die Filler Lass (ft) 34.60 System Demand (gpm) 16.86 TOW DYINmv a bead (It) Lateaal DbwAMw Selectioe MmdftM Dkwmatsr Selection in. die. choice in. d'ia aptims choice 0.75 1.25 x x 1.00 x 1.50 x 1.25 x i x 2.00 x ! 1.50 x 00 2.00 x 3.00 x _ Gallon fneh Calve hdor (optional) Treatment Tank infemation Total Tarts Capacity (gal) 1200-()O~ Septic _ Tank Capacity (gal) _ - < Total Working L.iq id Depth (in) Wiser ilAarn ddurer gaft (enter result in C" 849) Dose Tank ttrIbnraldon EAMMat FOw tnfonnadm 800.00'; Dose Tank Capacity (gel) Paifiok 2224; Dose Tank Votl>ane (gaiAn) 525 Fifer lioclel Number War Project WESTVIEW C ONSTRt1CTlON Page 2 bf 8 I Mound Phan and Cross Section V'wm t K Q A E W t F _ L Mound tamponent Dbusn:ioo Down We extension made. A 10100 E 2300 m H 1.00 it K 10,31 ft B 60.00 F 9.25 in 1 15 000 L 80.63 0 17.00 in G 0. J 7.01 W 3201 ft B00.00 (ft) Dispersal Cel! Area 150000 (R) Basal Area Avalable 10.00 (gpdNO Unew Loack* Race 6.00 (ft) 1/10 B Obs. Pipe Placement MOUnd Cross Section VIM Aggregate Dispersal Area F'mished Carafe 105.09 (ft) 'dIIIhy ~ H~ - . i .------/I/!I// VIIHI/ I/HHI///IH//JJ 103,92 (fl) L&WW 103.32 (ft)-s - : _ = - - - invert C~ - D Eievalaon - - - - - - - - - - - - - - - - - - 4 - 101.90 (ft) Cof*" Elam Wn 5.0 % Site Slope Ge06eA7e Fabric C•mw Shadkig Key I -t- Dispemal con See dew on TOPSON Cap 1.3 a Page4 for~r, abe, Cap so ■J• o /-*o Ow Of 6l , TTT T We LSYW Sand 4 0 R Tvnial Lalsrai F steed *Om equay #w ASM Idb&ftAmCmFS O D AWag'aft camel m in ft A fah", Ii oW (Affi). Project WESTVIEW CONSTRUCUM Pape 310f B t Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold atany point Laterals are identical S s P s or- a 4* 4) = Turn-up whorl valve or I~ )(-iIE~l2 I xl2 Laterals & force main of PVC Sch 40 clesnaut plug per COMM Table 84 30,5 Holes driled on the bottom of the lateral. Number of Laterals 6 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.17 ft Lateral Length (P) 29.30 ft Orifices per Lateral 14 Lateral Spacing (S) 3.33 ft Orifice Density 7.14 fe/orifice Lateral Flow Rate 5gpm Manifold Length 6.67 ft System Flow Rate gpm Manifold Diameter 1.25 in Total Dynamic Head Forcemain Velocity 3.53 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented E- Altemste outlet location Foroemain diameter Wieser Manufacturer 2 in. Ca 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.10 513.77 B 2.00 44.48 C P~ ump off elevation, ft C 2.87 63.83 64.67 D 8.00 177.92 D Total 35.97 800.00 Dose tank. elevation (ft) 3" Bedding un er tank. 94.00 Alarm Manuafacuurer Tank Alert Alarm Model Number HW101 Pump Manufacturer Zoeller Pump Model Number 98 Pump Must Deliver 34.60 gpm at 16.86 ft TDH Project: WESTVIEW CONSTRUCTION Page 4 of 8 - 1 AIo-u- d On m- 11ait!1r anCe and Quendion AM Service Provider's Name rs S!p!!C service Phoneli15) 273-5811 POWTS RegulaWs Name St. Croix C ,a,e 713) 2734747 Svstitm Flow and LA-ad Paraabos flees Flaw - Peak 600 gpd Mwdr rum k0ma t Particle Size MO Est coaled Ficut - Average 400 gpd MaooMIM HODS 220 mo& Septic Tarilc Capacity 1200 gal whefturn ?SS 150 M91L Soil Absorption Component Size 600 ~ FOG 30 mgR Type of Waslewater, Domestic Maximum Fecal Cofdc m ?10E4 dtd100 mL SKVJC* Frearmrrcw Septic and Purr♦p Tank kniped andkir service once every 3 years Effluent Filter Shmold ' inspect and dean at feast one every 3 VMS Pump and Cmnireft Test once every 3 years Alarm Should test monthly Pressure System Latemis shodd be flushed and pressure tested evefy 1.5 Inn Mound inspect for ponduM and seep"s once every 3 iil neoi~ Co Hon and ff s Shadank 1. Observation pipes are slotted and materials conform to Table Comm 84.34.1, have a vet cap, and are sertred in as shown in Ga rrxm d component menuaL 2. Dispersal c el agglregele conforrns b Comm 84.30 (6)(1). 1Ni& Adm. Code. 3. AN gravity and pressure piping rnalierials conform b t1he r+egtiiremerft in Comm 84, Wis. Adm. Code. 4. Tillage of the bssnl eras is accompliashod with a mold bosod or chisel plow. S. The mound shuclure and other drsturhed areas will be seeded and mulched to p wie t sol erosion and help rage boat pin Lail Turn-rip l 1'i Wmd ,f+ffafafaasaff ♦fffflaaafsffaa Grade ` L nu 64 i.lWY*t Y Lilt Oeer Wt Sprinkler valve mace Plug or Batt Valve Di tcilntion _i Long Sweep 90 or Two 45 Degree Bends Same Dianu der as Lateral Project WESTVIEW CONS MLCTIC N Page 5 of 8 - - ~FMW FM UNUM' aeoe~. J8 as t»aE raat re~eus rims f ~ as nQ r s. a. a. ss es as o~ as m a ,s 12 w. w.s ar aa~n 4.3/16 Sena CONS€ LT FACTORY FOR SPECS APPLICATK*ffq ' Becliftel r for duplerc , are araia6iteand - ~faria6le k vd 2M swclres are ava1Ab for to g sire suppled uft inalarm and Bros Ph=* bftdre dCd afiwaftors. kv d*i= qjsleRls, are wma oe - Double yadra " ienrj fast ser1s3ess are able MO ornrffiod arena aroma. farveda6ie level long cys c5onI Am srLECTror MME Standard ag nwdrds - we-q*t 39 gs. ll l? i a.~rar*oatc~+~rdioare..dr.eYesla~rlde an.+.~e/m~orrrp~i~d 9es~trs ~Al~••iYeLwrieda~ldtar~eeilep~irl~+aiirer.Mer. c..rer sires.. are~radLwee.sF~rurr_ Void vrriiw ■e+~ rr.ple: 3lr.e~..re.rau.wer~~sYtPtt~aaeaeG un Ila i A Mb '8A t art &7 - ! SraR~~.free~3~oiiereMeliviANNOMlrr. N96 t 1 AS s!t 26r 1.3 r< tOOd Mak% ISIMS Umd: s ar*ar 0900 r. qM* dWIMK (M or (q ooa 298 f A,- 17 'I arl A7 _ asar I L dM" EM Mo i Noe V 2cr2a6 3ar4&5 4 Pasr~g rsGbr ii~tmwerAasor rs 7. -ftmfWhdwJfWtrr1 [fle~werso~erpias Fartpfo~efafaoaiirorimrierfoiracwirlaaWb'oP d[IAedellUrwlB~i~iwr. AH %Mdb&a dMICM mudu*+~9sr►oWdbfdoafbyaquaNkd MUZ- 13 8oeezaek.lYialas6intsadsaiersr~lasa4ddleteMeeraiietlri~~eae~ ~ ~A1~1lIrer4,R11P9Z aaeaaetrmio~rc~rteplegaotl~eneey~.srraarel~a8drirrlsActlOSrUy. RESERVE POWERED DESIGN For urltlsttal Mrdit MS a reserve saftlyta mis erg'sleered loth the 63slgn of evaty Zoeier pump. axalarr~o.eorsatr - t - 1•wi•1R~ac ~1e~e _ - _ o alar.ancaaaor Plot P&W - - e $ 0,x'8 Prpe der r f if-Al, CO.Ak5 '44XCI Legal lD ow L49t_~~ t~~~: h~+Trfl ~f~ict~) wkere new Sf: t~t7C ~#tr-Y, t~.'esx~36t► r AGE Nor& 'u. 13 ie 00 mot. Aft ~Z1f to Z ore iok Oct-19-2010 01:59 PM St. Crcix County Plan/Zon ng 715-386-4686 1;1 ST. CROIX COUNTY SE'PTIC' TANK MAINTENANCE AGREEMENT AND /-OWNERSHIP CERTIFICATION FORM Owner/Buyer - l~ rJ-~~~ Mailing Address 2 r V U ((6 U. 02 ~d Property Acltlrc;ss 23 ~ 1/Ua l n u~ ~-l ~ Gl WAV ___4 (Varification required from Planning & Zoning p artment for now construction,) City/State LI ucr ~ e_ lI S ~E 1'ltrce] Identification Number O VO / 36 3 -~(j--Q 3 LEGAL DE PTION (.1-7-73) Property LocationSt '/q . , Sec. , T2 NR~W, Town of 7~ Subdivision Plat: _1 Lot #,Y2. ~G Certified Survey Map # , Volume, Page # Warranty Deed # (before 2007)Volume Page # Spec house es tno Lot lines identiliablo yes 110 SYSTEM MAINTENANCE AND OWNER CERTIFXCATIQN Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the @tnctiotn of the septic tank as a treatment stage in the waste disposal system. owner maintenance responsibilities arc specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, sighed by the owner and by a master plumber. journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposol system is in proper operating condition ennd/vr (2) after inspection and pumping Ur necessary), the septic lank N less than t!3 11111 of sludge. l/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set fortis, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintain must be completed and renamed to the St. Croix County Planning & Zoning Department within 30 days of the three year expirati date. I/we certify that all statements on this form are to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue or a warranty deed corded in Register of Deeds Office. Number o edrooms SIG A URE PPLZCANT(S//~~ / DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and it copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) ion iE e i 8 OTx54040841 9 STATE BAR OF WISCONSIN FORM 3 - 2000 954891 Document Number QUIT CLAIM DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Gran or, ST. CROIX CO., WI and Westview Construction, Inc., a Wisconsin Corporation Grantee. 04/23/2012 11:31 AM EXEMPT#: NA Grantor.quit claims to Grantee the following described real estate in St. REC FEE: 30.00 Croix County, State of Wisconsin (the "Property"): TRANS FEE: 204.00 PAGES: 1 Lots '1 and 39 of Walnut Hill Farm, Town of Troy, St. Croix County, Wisconsin. Recording Area SOLD AS IS WITHOUT FAULTS Name and Return Address: Title One Premier Group File # 17851 Together with all appurtenant rights, title and interests. 0~tcationn 040-1303-00-039 er (PIN) Thi s is not homestead property. Dated this 17th day of April, 2012. Citizen S to Bank * Gene Haberman, its Vice Chairman * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) COUNTY ST. CROIX ss. authenticated this Personally came before me this 17th day of April, 2012 the above named Citizens State Banks by Gene Haberman, its * Vice Chairman to me known to be the person(s) who executed TITLE: MEMBER STATE BAR OF WISCONSIN th ego ng i trume t an c o v dged the same. (If not, authorized by § 706.06;~~1,h~?§ ~S~t~) pp,,* m Palett THIS INSTRUN N~~LA<DR4FFEDBS'., Mich Por ~'rtY Notary Public, to of Wisconsin = Q : 2 ? My commission is permanent. (If not, state expiration date: 10/27/2013 ) (Signatures may be authenticatib or acknoA Bot" riot necessary.) *Names of persons signing in any kacity 1nuSt be•typed ~y3ted below their signature ~'''•.STATE OF1- 0~._~ 1 of 1 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3-2000 Parcel 040-1303-00-038 06/05/2012 12:26 PM PAGE 1 OF 1 Alt. Parcel M 22.28.19.1773 040 - TOWN OF TROY Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner CITIZENS STATE BANK O -CITIZENS STATE BANK 375 STAGELINE RD PO BOX 247 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 230 WALNUT HILL WAY SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.050 Plat: 09-092-WALNUT HILL FARM 1/75 040-03 SEC 22 T28N R19W PT SE SE WALNUT HILL Block/Condo Bldg: LOT 038 FARM LOT 38 (1.050AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-28N-19W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 03/05/2010 912825 SD 03/28/2006 821266 WD 12/10/2003 748768 2471/594 WD 11/19/2003 747018 9/92 PLAT 2012 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.050 52,000 0 52,000 NO Totals for 2012: General Property 1.050 52,000 0 52,000 Woodland 0.000 0 0 Totals for 2011: General Property 1.050 52,000 0 52,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 dLb PA1 VYlacerrsh Department of Cormrler" I~ EVALUATION REPORT pap t of3 DMlslon of Ssf* and 8uldinpa o AUG r0 JA Adm. Code Courk Altach earnplele site plan on pepa~E M 11 I eke. Man must ST. f~itOlX Include. but W knVad to: vertical and lark o~), dRSction and Pat+OUl l.DQ 040 - 1303 -00- 038 pen:entelope,acaleordkoanslons,northanow,and twratnoolo neareatroad. P/oase print an Ink mmoon. Cad` , DaN Pe sww inknnreaoo rod Pw" n y be used icrceconday Purposes (Priwcy tea. , s. 15.w tl) t~N)• (J S PropertyCMrner Propeltirlocalon ~ WEST VIEW CONBTRUt,Tit?N govt. Lot 813 114 SE 114 8 22 T 28 N R 19 a Properly 0wner'a Awing Address Lct / Mock fl Subd. Now or CSIX 20 Serenity Court 38 Walnut Hill Form CMUte) CRY State Z Phone Number OD4 Whge • own Nearest Road River Fe114 WI 54022 1 ) WI&M Hill Way D New cm*uc%n U"[q ReaiderlMal / trlsnber a bedrooms 4 Coda doNed doftn now rate 600 GPO p Replacement p Public or coamnerctat - Describe: Parent material loess overtill Flood PWn sleveft NappHeabie NA t. General COMM* Mound System 1.42 ft. sand fill 0.4c loading rate and rooomrnandatlons: Property Address: 230 Walnut Hill Way 5011 O11~tr1` W IW rJ l+~ro EC1Rll6T. a Boring r El Ptt Ground surface elev. 101.88 ft. Depth to IlmM M bcW 19 In. SOl &pMft Rate Horkon Depth D m*mnt Color Redox Description Texture 8tnabae Corslatence Boundary Roots GPOW In. M1rrlsel Qu. Sz. Cont Color Or, Sa. Sh 'EMI 'E11112 1 0-7 10YR2f2 - sil 2fgr&sbk mvfr as 3vf-co 0.6 0.8 2 7-12 10YR4/14 - ail lfpl mvfr Cw 2vf-co 0.4c 0,6 3 12-19 10YR4/4 - ail 2fgr&sbk ra& ow 2vf-m 0,6 0.8 4 19-24 10YR4/4 c2fl0Yft416&I0YR6d2 sil 1 &sbk mft ow lvf--m 0.4c 0.6 5 24-36 7.SYR416 c2d 7-SYP-V6 al Om dh lvf-m 02 0.7 Horizon 5 has some Sr/cobs Boft# ❑ Borir~ 2 .28 24 ❑ 101 Q Pit Ground surface elev. ft. Depth to Ilmling tailor In 801 Rate Horkon Depth Dominant Color Redox Dendplion Texture Structure COraktence Boundary Roots GPOW In. Munsel Qu. St. Cont Color Car: Ss. Sh *01101 'E02 1 0-6 10YR212 ail 3fgr mvfr ow 3vf-co 0.6 02 2 6-12 10YR3/3 - ail Bill mvfr cw 2vf-co 0.4o 0.6 3 12-24 10YR3/4 - sit 2fa&sbk mfr cw 2vf-m 0.6 0.8 4 2430 7.5YR416 c2f 10YR4/4 0m dh 0.2 0.7 orizon 4 bas some Srleolm ' Effluent tt1 a > 30 < 220 mpll. and 758 >30 < 1t10 nWL ' ESuw t ft2 = BOD < 3D ma and 788 c 3o mplt CST Name (Ptease Prim) S CST Number Mary Jo H rt llister's Soil Testa & Desi 224832 - A Address Data Evaluiffiffi Conducted Telephone Number W987S 690th Avenue, River Falls, WI 54022 03 - 27 - 12 (715) 426 -177S l,.1n M1I~TMNM Property Owner WBSTVlB W Construction (Lot 38) 040 -1303 - 00 - 038 2 0f 3 Perot ID # Q # Pn around surface elev. 103.28 ft. Depth to Mow factor 21 In. Pap tlom Sol R~ Deawtptbn rextuie stnichae Co Horton fn ont Cobr Redox Boundary Roots OPOdfF In. Mur"I Qu. Sz. Cont. Caton or. Sz. Sh MV 'E#M2 1 0-7 10YR2/2 ail 3fgr mvi} as 3vf-co 0.6 0.8 2 7-12 1OYR 3 ail 2 mfr aw 2vf-co 0.6 0.8 3 12-18 10YR414 ail 2fshk rnfr cw 24-co 0.6 0.8 q 18-27 76YR3/4 91 lfsblc mv& aw 24m OA 0,7 S 27-30 7.5YR3/4 c2f7.SYR4/4 al Om mfr Ivf-f 0.2 0.6 orIzon 4 has some gr/cobs. F] soft Borina H pg Ground surface elev. ft. Depth to I MNIng factor In. Horizon Depth Dondnent Color Redox De 801 tlon Rete k MunseN scripaon Texture SM1cblre Conatstence BMaary Roots OPDV(F Qu. Sz. Con. Color Or. Sz. SR MINI 'EM2 Boring # 886*4 E Ground surface elev. It. Depth to WAI&V factor h P Horizon Depth Dominant Color Redox Deaad SoN Rem piton Texture Stnxdure, Corpdenc, Boundary Roots GPD& In. Munsel Qu. Sz. Cont. Color Or. $2. Sh 'EH#1 - - . J-= ' EMum t #1 a 900e a 301220 my& and TS8 >30 < IW nVL ' Effluent 02 ®ODi < 30 nvk and T$S < 30 nwptt. The Department of Commerce is an equal opportunity service provider and employer. If yon need assistance to access services or aced material in an altmieto format, please contact the dep utnent at 608-266.3151 or TTY 608-264-8777. sa~suarstam~ Plot Plan for Site and Soil Evaluadon Page 3 of'3 Property Owner 1N*_-T VW-0) `OA%5Tj2ucn 0) _ Legal Description h-,& e Bu+~) (except where not SPA PIE 42E,. nV / Z 2gA) fib, owm -OF 20, a = Backhoe pit CRax YAV, wtsem11aW • 1.05 .AcOgr.-A North a 3g ~ 0. le 4Q'K~D 6~" t0r 3x? y7' ~So+ Ptc 7- , _ l~ R N'SsdD t ite Location: ,.ter IAR I- 12 -8 , I ~ I I &Ox59 SLIDER R.O. 5'-Olt" x 4 =Il'~5" - - - c 0 Full Vlew, , , Y 1 4GINEERED FLOOR TRUSSES ® IS.2" o c ' I1fi 1~ 1 I ~ Fut. Family ROOM C/, m UnNnfehed V ' 8• clg ~ - 1- CV , , 2 Ply. 2x10 • - Q 23~-~n Flush Header I 1 I, O N I I, ~ Handframe For b- Stalr Headroom. 1 Wall (This Area Only ` 'tfny ~I 2 Ply. WO 'n l X Flueh Header 4 4 v v v 4 v.4 1 i Wisconsin Departrnent of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code County ST CA 0/)(-- Attach complete si • " L vT H include, but not Off ed NTROL PLAN must be 1D~1 1.13 percent slope. sca re sanitary permit issuance 4061 Rofiew~W Date rso" for secondary purposes (Privacy Law. s.15.04 (Wm)). (0 (z4a3 Property owner 7'OP-P Property A 1 l~ Q CJ 'r'oPP B3ER5 Te7fa T- %v 4110A) A&I Govt. Lot 1/4 S ~L T ~lJ N R & (or) W ~0. Property Owner's Malling Address Lot # Block # Subd. Name or, CSM# City --CMWR State Zip Code Phone Number ❑ City ❑ Village W Town Nearest Road 6-POVE TT MN SSOWe ( CSI) zyY• toff -rRIDY so. 6-1ovER li~F New C0nSMxtw Use: M Residential / Number of bedrooms Code derived design flow rate 0 r D~ GPD ❑ Replacement ❑ Public or commercial - Describe: tA Parent material 10ESf OVA- P-4?0, = IKS Flood Mai, elevation if applicable ft General conwrients and recormftefndations: • ,+Atif- 7~sT~o Svi~7 pie i9- /~lavvo ❑ Botrng 6 S.S. S F/ Boring # ® Pit Ground surface elev. ft. Depth to wrov factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDf'ff= b in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 TOM l 6-& /oYR 313 L sb/4-- fR cs 2 • 5 . 3 W.Zg V1'2 Y16 F G z xo S/ L f5 'k n47CR c S SGL d ~ e r' d ~ 0 # ❑ Boring ~l 70 S.S. s • ® Pit Ground surface elev. ft. Depth to wnft factor in. SoN Application Rate Hortmn Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM in. Muansell Qu. Sz. Cont. Cola Gr. Sz. Sh. -Eff#1 -EfM2 IN f 0.5, /0 he 313 -24Jh c N-F/? w 3 f- .3 fT N 2- -12- /o R L Z ShK caj Z f- S /10 I Cz4 Mo r S C /Nf • Z 3 7• s ~2 s/ y • Effluent #1 = BOD > W < 220 Trot and TSS >30 1150 nV& ' Effluent #2 = BOD < 30 rn%& and TSS 130 mglL csT Name (Please Pr#rt) R , -ALB tz i c c7` S~ otu1 22 3 5 Address Ulbricht & Ass9ciates Date Evaluation Conducted Telephone Numbw Private S T • 15 • O 7U. • 7-7A • 3 yy 2- 2812 10th Ave. Spring Valley, WI 54767 PINS' FOR 4 PRO X , 2 Yo ~4 s . oya • /085 • so • t~ /0 - OW dyo • /t,~l~ • 2-0- CIVIC` 0 yo•/04?(/- &a•m oyo•/0 *1-70•0m o yo . /o~~ g'p • X0, 1 a - T4Dl? 1.31E ~ S TED?- Proper(yowner # Z Parcel ID Par Z 3 of ~ U Z sss . I I Ground surface elev. Depth to Wnwng factor tn. ors Depth Dominant Cokm Redox Sod Rate Desa~teat Texture Strudure Consistence Boundary Roots GfPlfr in. Munsel Qu. 5z Cont. Color Gr. Sz. Sh. `EffA1 ~Ety 0-9 io Of J/3 ~ 9• l /D Si L Z S ~ cS - s g 3 • Z ~o ~i L 2 fSh~ fi' CS s 2-5 Me .3 Pit Ground surface elev 'ft. Depth to limiting factor Sod Appldan Race ' Horizon tJon MMCZV Redox f3escription Texture Struckn-e Consistence Boundary Roots GPDdff? kti Munsett Qu., Sz. Con Color Efr. Sz Sh. `EitN1 'Eft i Bonng # ❑ pit Ground surface elev. fl. Depth to limiting factor lrL 4- Horizon Depth Dominant Color Redtnc St~lf Rate Description- Texture Structure isterece 130lXidaRy Roots G Sw- in. MunseN Qu. Sz. Cont. Cofer Gl. Sz Sh. •Etf#1 'i=ttJE2 l R t 3 Boring #f Boring F-1 Q pit Ground surface elev. #t. Depth to WTftng fader in. Sod Rate Hortzon Depth Dominant Redox Descd Texture Structure Cor s enee Boundary Roots GPON in Munsell Qa. Sz Cont. Gr. Sz. Sh. °EfW1 `Eff#2 Efftuerd #1 = BODS> 30:S 220 tag& and TSS >30,c 150 P)WL ° EffkmA #2 = BODs < 30 mgA, and TSS 130 n%VL The Department of Commerce is an squat opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3159 or TTY 608-264-9777. seoaz3a rRQnxst • PLOT PLAN WALNUT HILLS FARM. LOT 3 # Pg. 3 of 3 = Contour elevation lines. • = Backhoe Soil pits. O = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. I SCALE : Vt = 30 E 7 70 f IY& 5 Te-p /4/,Oavo 7e--,t4 ' gllb O f s $2. • f ~o j~ r f 3 _ -