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Home My WebLink About038-1018-95-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St.Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567218 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Simonson, Randel C. &Ann I Star Prairie, Town of 038-1018-95-000 CST BM Elev: Insp.BM Elev: BM Des cri tion: Section/Town/Range/Map No: 00 •D /0 0.-D 7m / 03.31.18.71 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C S� Benchmark j Z_ Dosing Alt.BM Aeration Bldg.Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet jy< ' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt 4AW Septic / 39 1 q �' / Dt Bottom f �� Dosing �� 1/ Header/Man. ,A / Aeration Dist. Pipe /u,z to. Holding Bot.System Final Grade PUMP/SIPHON INFORMATION Manufacturer �„ Demand St Cover GPM Model Number Z1 �v D M 3 TDH Lift Friction Lss /LSystem Head TDH Ft Forcemain Length, Dia. / Dist.to Well g3`tJ' 2.0 ' .4( c 7� (tom.�' SO[L ABSORPTION SYSTEM BED/TRENCH Width f Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. ep DIMENSIONS 761 �- SETBACK SYSTEM TO I P/L JBLDG IWELL LAKE/STREAM LEACHING acturer: INFORMATION Type Of System: f CHAMBER OR (U b u� � ( UNIT Model Number: DISTRIBUTION SYSTEM art I-17�c'i Header/Manifold // I Distribution ` 1� / x Hole Size x Hole Spacing Vent to Air Intake Length Dia 2°o Pipe(s)�o �& Dia /'5-V Spacing 3<33 3 u :. o / SOIL COVER x Pressure Systems Only Mound Or At-Grade Systems Onl Depth Over Depth Over xx a ee ed/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil 0 Yes No Yes No COMMENTS: (Include code di cr pencjes,persons p es e ,etc.) Inspection#1: 16 / ZL/ /3 Inspection#2: 10 L a ion: 1194 Cty. Rd. H New Ric ond,WI 54017(Gov't Lot 6 3 T31 N R1 8W) metes&bounds Lot V ' I No: 03.31.18.71 1.)Alt BM Description= �I�� f` -"'�'"" 2.)Bldg sewer length= �") I�!{�it (�Z 5 (° P/0 amount of cover Plan revision Required? Yes ❑ No LLI- I Use other side for additional information. ___ ________� I SBD 6710 . (R 3/97) Date Insepctor's Signature Cert.No. . Legal Description: NE1/4,SE1/4,S3,T31N, R18W P.I.D: 038-1018-95-000 Subdivision Name: NA Lot#: Govt 6 Township: STAR PRAIRIE Parcel Size: See Map SCALE:1"=20' County: ST.CROIX Contour Line Elevation: 88.33 Cell Dimensions: 10'X 30' 4 inch Sch 40-ASTM D2665 System Elevation 89.16 Mound Dimensions: 50.25'x 34.17' 2 inch Sch 40-ASTM D1785 Slope: 15% 1112 Sch 40-ASTM D1785 A BM1 Elevation: I 100.00' Top of 2"PVC pipe A BM2 Elevation: 100.30' Top of ground rod SW corner of house. ■ Backhoe Pits: Tanks 1000/650 gallon Septic Tank Combo tank with outlet baffle in 1000 gal.compartment,POLYLOK 525 at outlet of 650 gal.compartme nt 1250 gallon Dose/Surge Tank ITime dosed to allow for possible heavier use on weekends. NOTE: End slopes of mound encroach on driveway, and P/L setbacks. End slopes to be retained and insulated with retaining walls and 2"foam. Existin sand point well to be abandoned and new well installed. --ftft RT F- MI_AN�C+Z LI tiC STOP Sugn Z P, WALLS b a w DVVELLING WeLL ' J � Uj Pic. J _ Z jr WOO 5. Z pa dip " "AtN+NG W tL * vv i rii 2-11 FOAM ZNSUi,AT/anti ISO �K'tvEr-W►� �CTI�1ti/N� ,ALL W C IN IV WI D + D ALL � i"1 h/rA Conn _ Safety and Buildings Division / . C k-) 201 W. Washington l Ave., P.O. B2 x 7162 Sanitary Permit Number (to be filled in by Co.) PS Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appr_jgte g. 1 unit Z Z 73 7-SJ is required prior to obtaining a sanitary permit. Note: Application forms for state-owned S are s to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may beAvor sec _t, purposes in accordance with the Privacy Law, s. 15.0 1 m , Stats. , 9 ~ C T 1. Application Information - Please Print All Information C Property Owner's Name C~ Parcel # 015L mvp NN) S rl n4 ©W-SO N lot s -91s-000 Property Owner's Mailing Address Property Location 7 ) )3'Z7 777'" S ~ 6,ci Govt. Lot , / City, State Zip Code Phone Number C , 3 Section U S~/O! rcleE o1 one II. Type of Building (check all that apply) Lot # T 3) N; R 91 or 2 Family Dwelling - Number of Bedrooms ~z J Subdivision Name / ~n 5 ( A Block # N IV b El Public/Commercial -Describe Use ❑ City of ❑ State Owned- Describe Use CSM Number ❑ Village of Im Town of _5,._4,e III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. aNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued < Before Expiration Owner /Vlll7- ~`~~GGy 0 - IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound > 24 in.of tab le soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explaitreatment Device (explain) V. Dis rsaUTreatment Area Information: Design Flow (gpd) Design Soil Application e(gpd f) Dispersal Area Requir (sf) Dispersal Area oposed (sfj System Elevation .300 >7 Ir 75-0 Oa $y oa X390 VI. Tank Info Ca ity in Total # of Manufac er Gallons Gallons Units o a New Tanks Existing Tanks P.1! UU r%~ v~ u. V C4 Septic or Holding Tank Dosing Chamber / ~7©(D a © j 65 ee_ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum i e MP/MPRS Number 17Business Phone Number AI & oo 5cm m i rl 12-7-3 760 is-760_ oc/g Plumber's Address (Street, City, State Zip Code) 61(o /5O~~'Auc Sprvt 5 T C VIII. Court /De artment Use Only ❑ Approved ❑ Disapproved hermit Fee Date Issued Issuing Agent Signature ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval 3 lat Gtir1 / SYSTEM OWNER: - c7G~A~ U 1. Septic tank, effluent filter and dispersal cell must be serviced /.maintained f as per management plan provided by plumber. r VLU 6710, 46 2. All setback re it V;, as per applicabl@tf,RSb*i'ffMJfi for the system and submit to the County only on paper a less than 81n x I1 inches in size SBD-6398 (R. 11/11) ptipnRTAAf4 DIVISION OF INDUSTRY SERVICES - =5~ 3824 N CREEKSIDE LA HOLMEN WI 54636 M Contact Through Relay 5 I S P www.dsps.wi.gov/sb/ www.wisconsin.gov ~O~ssioN pys~4 Scott Walker, Governor Dave Ross, Secretary August 28, 2013 CUST ID No. 223760 A777V.• POWTS Inspector ZONING OFFICE JOHN F SCHMITT ST CROIX COUNTY SPIA 616 150TH AVE 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/28/2015 SITE: Identification Numbers Randel & Ann Simonson Transaction ID No. 2273955 1194 County Road H Site ID No. 793162 Town of Star Prairie Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NEIA, SETA, S3, T3 IN, RI 8W FOR: Description: Two Bedroom Mound System / 15% slope / Time-Dosing / construction of (3) retaining walls Object Type: POWTS Individual Site Design Regulated Object ID No.: 1441496 Maintenance required; 300 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; 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 CONS and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. AP The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code DEPT requirements. PROF SOF No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.0D'V'S'ON OP~O stats. IN13 The following conditions shall be met during construction or installation and prior to occupancy or use, Reminders: E CO *in • This system has been reviewed and approved as an Individual Site Design. The system shall be constructed accordance with the approved plans and ch. SPS 383, Wis. Adm. Code. • The county shall inspect the (3) retaining walls for proper construction prior to installing any of the dispersal cell components. - b Uc~ . y~ s~ ec~~o r I • The time-dose mechanism and the dose volume being delivered to the system shall be field-calibrated before the system can be put into full operation. • Recommend the redundant pump off switch be mounted approx. 8 to 9 inches off of the bottom of the tank and the timer enabler setting shall be 10.9" from bottom of tank. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. JOHN F SCHMITT Page 2 8/28/2013 • 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. • A copy of the approved Mans 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. 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 Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 450.00 This Amount Will Be Invoiced. erard M Swim 0000~~ When You Receive That Invoice, POWTS Plan Reviewer, Integrated Services Please Include a Copy With Your (,600789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. ~v .swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly f a~^ Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Simonson 2 Bedroom Mound Owners Name: Randel & Ann Simonson Owner's Address 1327 27th Street RECEIVED Hudson, WI 54016 JUL 31 2013 Legal Description: NE1/4, SE114, S3, T31N, R18W INDUSTRY SERVICES Township Star Prairie County: St. Croix Subdivision Name: NA Lot Number: Govt. Lot 6 Block Number Parcel I.D. Number 038-1018-95-000 r'OIVALtY` Plan Transaction No. ROVED + i'4FErY q ND Page 1 Index and title SE RV1 CES Page 2 Cover letter USTRyPage 3 Data entry `SERI/L'~$ Page 4 Mound drawings Page 5 Lateral and dose tank 7 Page 6 System maintenance specifications Page 7 Management and contingency plan N~~NGE Page 8 Septic tank specifications Page 9 Effluent filter information Page 10 Dose tank specifications Page 11 & 12 Pump specifications and curve Page 13 Pressure filter information Page 14 Plot plan Page 15-17 Retaining wall information Page 18 Septic tank maintenance agreement Page 19 Warranty deed Page 20 CSM Page 21-24 Soil evaluation report Designer: John Schmitt License Number: 223760 Date: 7/27/2013 Phone Number: 715-760-0486 Signature: + 241 /aG 7 L.c Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01) and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS (10/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 24 Legal Description: PNA /4, SE1/4, S3, T31N, R18W P. 1. D: 038-1018-95-000 ! v Subdivision Name: Lot Govt . 6 Township: R PRAIRIE Parcel Size: See Map SCALE: 1 20' County: CROIX Contour Line Elevation: 88.33 Cell Dimensions: 10'X 30' 4 inch Sch 40 -ASTM D2665 System Elevation 89.16 Mound Dimensions: L50.25' x 34.17' 2 inch Sch 40 -ASTM D1785 Slope: 15% 11/2 Sch 40 -ASTM D1785 A BM1 Elevation: 100.00' Top of 2" PVC pipe 0 BM2 Elevation: 100.30' Top of round rod SW corner of house. ■ Backhoe Pits: Tanks 1000/650 allon Septic Tank Combo tank with outlet baffle in 1000 al.com artment, POLYLOK 525 at outlet of 650 al.com artment. 1250 allon Dose/Surge Tank Time dosed to allow for possible heavier use on weekends. NOTE: End slopes of mound encroach on driveway, and P/L setbacks. End slopes to be retained and insulated with retaining walls and 2" foam. Existin sand point well to be abandoned and new well installed. 4.A. t: L) G E 1 r I_ I Iv C STOWyC~ ~ elcn wit ni z R rmo UW tI1FAUS 0VVa b - N i - - N W f ~ r f J PVC Z-;C PC C IZ q Cn Arrv,N(, W tL , yv,Tii ZL" FoAdi~„~{-j _i f 3'1°11 _ ALL_ W S - - - - - = C j\ ►rI 7 h)Su LATICN ~ErAiNiNG CTy' t~ %4 h /vt./ w ALt- Jahn Schmitt Septic System ✓ Design Septic System Services ✓ Evaluations ✓ Maintenance 616150"' Ave. Cell Phone: 715-760-0486 Somerset, W154025 Email: jschmitt@somteLnet June 30, 2013 The design for the Randel Simonson mound at 1194 County Road H, Town of Star Prairie, St. Croix County was designed pursuant to the Mound Component Manual for POWTS Version 2.0 and both SSWMP Publication 9.6 and Pressure Distribution Component Manual Version 2.0. Due to the space constraints of this small lake lot the end slopes and one small portion of the toe encroach on the driveway and property line setbacks. During an onsite visit Charlie Bratz suggested retaining the portions of the end slopes with insulated retaining walls. This solution allows for more than enough basal area for the two bedroom mound soil absorption area. If this is an Individual Site Design, bill me accordingly. The system will have a 1000/650 gallon combination septic tank that would allow for a pretreatment unit in the future. The effluent will be filtered out of the combination septic tank by a Polylok 525 effluent filter and by a Sim/Tech STF-100 on the force main. Due to expected heavier use of the septic system on weekend and holidays a 1250 gallon surge dose tank with time dosing will be installed. Sincerely, L V, John Schmitt Mound and Pressure Distribution Component Design Site Information _ R Residential or Commercial Design Note: Sand fill (D) calculations assume a 200.00-; Estimated Wastewater Flow (gpd) Table 383-143 in-situ soil treatment for 1.50; Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 300.00 Design Flow (gpd) 15.00! Site Slope V 3 Contour Line Elevation (ft) - 26.00 Depth to Limiting Factor (in) t 0.40; In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 30.00` Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00! Dispersal Cell Design Loading Rate (gpd/ftz) 1Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? - - - E'- Center or End Manifold -37331 Lateral Spacing (ft) If N above, enter the elevation (ft) _ 31 - Number of Laterals of the highest point. 0.188' Orifice Diameter (in) 2.00 Orifice Spacing (ft) = 6.67 ffz/orifice 1W Forcemain Diameter (in) 30.00= Forcemain Length (ft) Does the forcemain drain back? Y 78.00' Pump Tank Elevation (ft) 3.25 System Head (ft) x 1.3 1 4.89 Forcemain Drainback (gal) 10.76 Vertical Lift (ft) 39.31 5x Void Volume (gal) 0.56 Friction Loss (ft) 44.20 Minimum Dose Volume (gal) 0.00: In-line Filter Loss (ft)'g 29.49 System Demand (gpm) 14.57 Total Dynamic Head (ft) I Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x 1.25 x 2.00 x x 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator _ Treatment Tank Information Total Tank Capacity (gal) •_1650 00_ Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1250.004 Dose Tank Capacity (gal) PolyLok Commercial Filter Manufacturer 26.81 Dose Tank Volume (gal/in) 625 Filter Model Number Weiser Manufacturer Project: Simonson 2 Bedroom Mound Mound Plan and Cross Section Views T 1/10 B J Observation Pipe - K'l . O A B z 3 . ..We, L Mound Component Dimensions A 10.00 ft E 28.00 in H [A4.40 ft K 10.13 ft B 30.00 ft F 9.50 in 1 ft L 50.25 ft ✓D 10.00 in G 0.50 ft J ft W 34.17 ft 300.00 (ft) Dispersal Cell Area 893.18 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 3.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 90.96 (ft) H G •I F Dispersal cen ` 89.66 (ft) Lateral -i - ft $x.16 O Invert Dispersal Cell t Elevation E D 3 4 88.33 (ft) Contour Elevation 15.0 % Site Slope Geotextile Fabric Cover Shading Key W . I - Dispersal Cell See lateral details on 10 0 Topsoil Cap o = 115 ft Page 4 for number, size, Subsoil Cap 0) o O and spacing of laterals. © ASTM C33 Sand F Laterals are equally ®0 Tilled Layer y 0.5 ft Typical Lateral spaced from the f Aggregate c distribution cell's -j- centerline in the - A distribution cell (AxB). Project: Simonson 2 Bedroom Mound End Connection Lateral Layout Diagram Center the laterals over the A & B dimension Turn-u p wi ball valve, or of on n out plu g E P All laterals are identical IF X 1 Hol es drilled on the bottom of the lateral s equally spaced Laterals aforcemain Soh 40 PVC per SPS -rabic 384.30-6 g Forov main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.04 ft Lateral Length (P) 28.56 ft Orifices per Lateral 15 Lateral Spacing (S) 3.33 ft Orifice Density 6.67 ft2/orifice Lateral Flow Rate 9.83 gpm Manifold Length 6.67 ft System Flow Rate 29.49 gpm Manifold Diameter 2.00 in Total Dynamic Head 14.57 ft Forcemain Velocity 3.01 ft/sec Dose Tank Information Locking cover with warning lat:iel and locking device and _ sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented E- Alternate outlet location Forcemain diameter Weiser Concrete Manufacturer 2 in- capacityl 1250.00 Gallons volume 26.81 gal/inch - Hight :eater Alarm Ivv 'x5 inc hac Weep hole or anti- I. ern, ne c:a-~ siphon device Timer Enable 10.9 inches ed Pump off elevation (ft) Redundant Off 78,911 (Mount-Redundant Off Float slightly SE ftiftMoat) Dose tank elevation (ft) 3" Bedding un er tank. 78.00 Alarm Manuafacturer SJE Rhombus Alarm Model Number Tank Alert AB Pump Manufacturer Zoeller Pump Model Number 98.~-.__. Pump Must Deliver 29.49 gpm at 14.57 ft T D H IS,o7 s Zy Project: Simonson 2 Bedroom Mound Page 4: of 0 Randal and Ann Simonson Lake Dwelling The Simonson Lake Home/Cabin will be serviced by a 300 gpd Mound POWTS. The Dwelling will normally be occupied by2 people(2 X 50 gallons/ Day-- 100 gallons / day Estimated Wastewater Flow. It is expected that often times on weekends The Estimated Wastewater Flow will increase due to guest. The estimated Wastewater flow is expected to increase to 200 gallons / day on Friday and 400 gallons / day on both Saturday and Sunday. Average Dail Design Wastewater Flow 100 gallons estimated flow X 4 days= 400 gpd 200 gallons estimated flow X 1 days = 200 gpd 400 gallons estimated flow X 2 days = 800 gpd 1400 gpd X 1.5 = 2100gallons/week 2100gallons/week + 7 days/ week = 300gpd Design Flow Sunday Monday Tuesday Wednesday Thursday Friday Saturday Carryover 200 400 300 200 100 0 0 Daily s'lmo estimated 400 100 100 100 100 200 400 flow 24 hr. pump volume 200 200 200 200 200 200 200 Remaining surge 400 300 200 100 0 0 200 volume Surge Volume= 300 gallons Surge Capacity Needed= 400 gal.(largest carryover) x 150% = 600 gallons Minimum Dose Volume = 44.20gallons Maximun Dose Volume = 300gal/ 5 doses/day+(,163)(30) = 64.89 gallons Pump will deliver 46gpm at 14.57ft TDH SURGE TANK TIME DOSE FLOAT SETTINGS Redundant Off Float 10.9" off bottom of tank SEE CORRESPONDENCE High Water Alarm 35" off bottom of tank Reserve Capacity 4T'- 35 " = 12" x 26.81 gal/inch = 321.72gallons Sure Capacity 35"-10.9" = 24.1" x 26.81 galfinch = 646.12 gallons Dose Volume 50 gallons Timer Setting Dose timer to activate pump at 4hr intervals for 1.09 Minutes. Wieser Concrete: W1250-MR (4T'@ 26.81 galCnch) All timer settings and dose volumes to be field calibrated S A of Z'~ Mound System Maintenance and Operation Specifications Service Provider's Name ; John Schmitt Phone) 715-760-0486 POWTS Regulator's Name St. Croix County Zoning Phone`: 715-386-4680 System Flow and Load Parameters Design Flow - Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1650 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Other¢ Inspect retaining wall (See Retaining wall information) Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral 6 214 Project: Simonson 2 Bedroom Mound Pagel of 4' Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local 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 with SPS 383.33, 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 be 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 filter is equipped with an alarm, the filter 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 additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and 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) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it 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 for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating 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 performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: D Z to 542t„ AS 84" X A REQO m 43" z z m C D w 0 21 m d o UP 42"~ a m 4" CAS 0 D m N i 3„ 464,. 5., ~ I O0 D Wm ~1 N I D m 38" O M:; m 1 < rn ° < m F g i UP 40" N V ;u 1:4" CAS g X z c 0 m v 41 ? D D ° m N n I N m D r g >O > r r n zr 0 D Oc m m m D uci v _ z Z 00 •10 X~ D G7 D Onz D Z QmoZ--ZO<ODo x ;um =po IoO R7-4 rz x ~ z d nd (/),,a ' L4 0o Nm m0 m N Q ~°z° ~(D n ° -+r~.. ~-~o~~ 0 V) O _S Co _ m 4~ 1-n "'iy ZQ 0rn N z -AZm O >m ~Am .4 ? 4s m O r (n a) (n ? r -1 O ~ Z nh N e d OD ~ N I ~N O~ =n D O 0. (nmD I(D ~C4W9ON_ Cn D O V) (n = O N cn m D r co d (J1 D N Ap Z Z 0o mmm N~ N o 0-0 D O °v A v X 0 Cwt n N > > nDD DO m z2 °°o 0 -n :E z O H n D~ c D 00~ Z ~7 on o o m co Z m m c mr -(m C7 D N 9 a) ° ~ m° ( z < m/! z 0 m r X 0 C 3 z N DH m z X r~ rn m 0 \ N WLP1000/650-MR m DRAWN BY WCP SCALE: 1/4'=l'-O" PRE-POUR: 0 REV. SEPTIC MANUAL MIENER CDtICRETE DATE: 00/00/00 DATE:. POST-POUR: \ Z W3716 US HWY 10 MAIDEN ROCK, WI 54750 ° 800-325-8456 FILE: MIPIODO/650-MR INSTALLATION INSTRUCTIONS PL-525/PL-625 FILTER '"r`F-AL..LILATI •N INSTRUCTIONS Center fitter with opening i 0 ~ L~ ~ U) W J a LL= e e Additional pipe or Polylok Extend & Lok' Glue for centering. Step 1: Step 2: Step 3: (A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the (B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. =±."Ri Ole. C T1 Akii Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back li 1 if necessary into the the housing making sure DO NOT USE PLUMBING {B} Pull the filter out of the housing, the filter is properly alighed WHEN FILTER IS REMOV (C) Hose off the fiter over the septic tank. and completely inserted. ItiiSE RUSBM GLOVES Make sure all solids fall back into the (B) Replace septic tank cover Wli~l CLEA0046 FILTER septic tank. D Z x U) 644" AS REQUIRED D 86" rn m 53" D Z Z c r m m D 0 N :Ll nM-. M ° ~ I UP 52" I / s N 1 m 4" CAS / l _pt ~ 41 M - kl) / I 3" 47" I O I m~ N rn 5" i n o m A D a ° D N N UP 49" v J 4" CAS I I \ m r/ n 1 I N V m L2 O m 50 Ip ~ m n z a N ~ D I cn D r 0 > 0 r _n 0 A 7ZC D r0 O rZ- o~ o v ~ ~ m nrn xx m a nC~ 0 `SD G7AD Arm,*mrrl>0 0yN Z q T vvi~ rrnID ~ a) m° Cma v ° ;K" _L0 y * 0:0 C) mxA -_--I z 0Z eNN - m N r~x o XZ0 MEnO -tr...-4r- K.. 1n , ~A Z0 c Z 0m' NNE VmZ~~ V mA N Dcn ajz O rn DZm DDm NArn apNN 'xm\ M N r v m -i -i N+ _ O N U1 X 0 0 ONi Mrrn~ -~-1N O \ b~ a " 0 N Z c Nrn-n Da ~ 0 O mm n Z crn Z 0 G7 m-im NCo O n Tj :E 0- ~ D0~D DO C7 m D -4 CD m 3 D p -rI 'd 0 D0 Z° m 0 Z r --q z o7.er.. V) 0 0 ;v r a a `i O 1 0 A ° z D (/1 m r- r ..fm m aJ cn v 0 M 0 0 W (n TJ C/) ;v ~ = cn ( A > 0 ° ;o c: c7 O O rn r A r- 0 W O z r O rn ° < 3 > m a D -f M m m 0 rn DRAWN BY: WCP SCALE: 1 41'-0" PRE-POUR: V W1250-MR IU~ESER conceETE ~ SEPTIC MANUAL REV. \ o W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: 00 00/00 DATE:. POST-POUR: 800-325-8456 PILE: m2W-rat 1.11.111 ~V4LlTY,PLIUAS SINCE 99 SECTION: FMO973 des 0312 Z e Product information presented @ Supersedes here reflects conditions at time f7(/ 0310 of publication. Consult factory ` ,Gr/V/ L regarding discrepancies or visit our web site: inconsistencies. 941L TO. P.O. BOX 16347 - Louisville. KY 40256-0347 SHIP TO. 3649 Cane Run Road - Louisv&, KY 40211-1961 www,zoeller com (502) 77&2731. 1(800) 91&PUW - FAX (502) 774-3624 COMPARE THESE FEATURES Non-clogging engineered plastic vortex ~8 Mast Iron Series impeller design l~ ..MATE 4 ~ Corrosion resistant powder coated epoxy finish (FOR PUMP PREFIX IDEN77RCA77ON SEE NEWS & VIEWS 0052) Durable cast construction. Cast switch FOR SEPTIC TANK case, motor, pump housing and base. No LOW PRESSURE PIPE (LPP) sheet metal parts to rust or corrode. AND ENHANCED FLOW STEP SYSTEMS Castings -All cast iron class 25-30 25000# tensile strength EFFLUENT Stainless steel screws, guard, handle, arm OR CEWATERING PUMP and seal assembly SUBMERSIBLE Float operated submersible (NEMA 6) 1'/2a NPT DISCHARGE ~..v 2-pole mechanical switch Motor - Permanent split capacitor, 60 Hz, 1725 RPM, oil-filled, hermetically sealed, U` CPO automatic reset thermal overload protection T..d on M SW"d d UL778 Bearings - Upper & lower oil fed cast iron .ndC nW dW Oak stmwd c222 Na. Oa , Carbon and ceramic shaft seal Entire unit pressure tested after assembly. M 15 c Watertight neoprene "0" ring between Automatic r or Nonautomatic motor and pump housing % HP,1 Ph., 115V or 230V Maximum temperature for effluent or Available with Piggyback dewatering 130°F - 54°C Variable Level Float Switch. Passes'/ inch spherical solids No screens to clog Standard cord length 15 ft. (UL Listed) S5M NPT Discharge (112" X 2" PVC Adapter included with BN & BE Models) On point - 91/2" Off point - 3" Major width -10 = Height - 12" SIMPLEX AND DUPLEX POWDER COATED SYSTEMS AVAILABLE TouoN~ PACKAGED SYSTEMS AVAILABLE Note: The sizing of effluent systems normally requires variable level float(s) controls and property sized MODEL BN9~ basins to achieve required pumping cycles or dosing timers with nonautomatic pumps. @ Copyright 2012 Zoeher Co. All rights reserved. TOTAL DYNAMIC HEADIFLOW W' PUMP PERFORMANCE CURVE PER MINUTE U- MODEL 98 EFFLUENT AND DEWATERING MODEL 98 25 Feet Meters Gal. Liters i 5 1.5 72 273 1 6 20 10 3.0 61 231 1_ _ 15 4.6 45 170 20 7.1 25 95 \ 1 __l± } 4 1 Shut-off Head: 23 ft.(7.0m) v J 009971 Fa- 10 2 5 i I i Z+nE 0 10 20 3 40 50 60 70 80 ii GALLON i '2;12 LITERS 0 80 160 240 ut i FLOW PER MINUTE SK+102 Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm and three phase systems Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches are available for with or without alarm switches variable level long cycle controls Refer to FM 1922 and FM0806 for temperatures above 130°F 98 Series Control Selection Model Volts-Ph Mode Amps Simplex Duplex M98 115 1 Auto 9.4 1 N98 N 5 t Non 9.4 2 or 3 4 vK D98 230 1 Auto 4.7 1 4 Easy assembly' (MM 8 discharge pipe E98 230 1 Non 4.7 2 or 3 4 \ not included.) 1. Integral float operated mechanical switch, no external control required. 2. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FMO477. 3. See FM1228 for correct model of simplex control panel. 4. See FM0712 for correct model of duplex control panel or FM1663 fora w n, residential alternator system. Reduces potential dogging by debris. For information on additional Zoeller products refer to catalog on Piggyback Variable Level Replaces rocks or bricks under the pump. Switches, FM0477; Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump/ Made of durable. noncorrosive ABS. Sewage Basins, FMO487: Single Phase Simplex Pump Control, FM1596; Alarm Systems, Raises pump 2" off bottom of basin. FM0732 Provides the ability to raise intake by adding sections of 1 O CAUTION or 2" PVC piping. Attaches securely to pump. Accommodates sump, dewatering and effluent applications. NOTE: Make sure float is free from obstruction. ,S -RAE P E ,M. w For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. _ MNLTO, P0. BOX 16347 Louisville, KY 40256-0347 Manulacturgs of . Roaad Sl~ATO: 49 Ca 3 6ne Run 61 Louisvile, KY 40211-1961 Qv4urrPat'as SxcE /~9'9~9" (502/ 778-2731. 1 (800) 928-PUMP www.zoollercom PUMP !O. Fax(502)774-3624 © Copyright 2012 Zoeller Co. All rights reserved. PRESSURE FILTER INSTALLATION & SERVICE INSTRUCTIONS hk.~ .J 1455 L.examar Drive 'l'oll Free 888-999-3290 OQice 231-S82-1020 Boyne City, ML 49712 Fox 231-582-7324 /:'mail Web INSTALLATION: When installing an STF-100, screw filter into discharge port of any pump that has a 2" National Pipe Thread. Pumps with a smaller discharge port maybe adapted to fit. When installing an STF-100A2 a tailpiece and male adapter will need to be added to the inlet end of the filter (end opposite of the cap) to the desired height and a 2" union will need to be added to the outlet end (the end closest to the cap & on the side of the filter). Always install the filters in a position where they can be easily serviced. *"Always use caution when starting threads to avoid cross threading". Plumb force main into the 2" sch 80 PVC union. "We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O-ring or sealing surface*". 3 rye _ SERVICE: Service of filter screen is dependent on usage as every system is unique. For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our STF-101 service alarm switch has been installed and adjusted properly it will alarm when the filter requires service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks (600 micron, 150-190 micron, and 100 micron). Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a "pump on light" that stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the 4" cap. Pull filter screen from canister and wash out thoroughly in appropriate location with proper protection. In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop. Nate bW in cold candSims Os XWr cap nW be dW" Jo, remove. Keep ftwpi in a wwm area or pour warm water over ft cap hakm nwxw rrg. Owe ft Ow is msftW in the Mvyk it nu*4am a su6b llartiperawm and ramowfg Me cap wilt trot be a probiem. If the system is equipped with our Service Alarm Switch, the filter screen does not need service until the Service Alarm Switch activates a light or audio alarm. We still recommend that the filter be inspected once a year for damage or corrosion. NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of head to overcome friction loss through the filter. SERVICE ALARM SWITCH The alarm switch is available in three pressure ranges, low head, medium head, and high head. Installation is simple, on SIM/TECH FILTER systems, remove W plug from base of filter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm. Pressure adjustment is made by removing the end plug, and inserting the 7/32 alien. Clockwise increases pressure. One turn equals approximately 3 PSI. The low head alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range (3 to 24 PSI). We recommend the use of a ball valve when using an alarm switch. Once you have installed the filter and alarm switch, the ball valve can be closed off to simulate a plugged filter so that you can make sure the alarm switch is working correctly. """"TRY OUR LID/SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks screen for easy removal and installation. Made of PVC plastic. WARRANTY All products are warranted against defects in material and workmanship for a period of two years from the date of purchase. In no event shall GAG SIM/TECH FILTER, INC. be liable for any consequential damages or any labor, material, freight or expenses required to replace, correct or reinstall the product. GAG SIM/TECH FILTER, INC.'s liability is limited to repair or replacement of the part. All warranties are void if the product has been improperly modified, applied or installed, subjected to misuse or abuse. Except as stated herein, there are no warranties expressed or implied, including the warranty of merchantability or warranty of fitness for a specific purpose. EFFECTIVE Seotember 13.2005 Mound / Retaining Wall Cross Section Not to scale C A p C IN P f WALL ~5TM C33 8ccct;s AvGQc~At 5AN D GIZ ~~wo LrvcL 3/y P~yw'c cp C0 eAPACr BASE Z'' Syeo,~,a.n 4X~! POST aEMTONifi: 13 A C K=I LL ~RESQ~NpENCE w M ~ ? r X J~4 D i5 PEP-:AL CG LL l~ r A-STM 5ANDc~ N t~ a 7 T ~c Retaining Wall Material List 1. 4"x4" AC2 Green Treated Posts 2. Granular Bentonite 3. Plywood 4. 2 inch Foam 5. 3/4" Aggregate 6. 6"x6" Green treated timbers 7. 12 inch Concrete Retaining Wall System. Retaining Wall Maintenance The retaining wall is an essential part of this dispersal cell and must be maintained 1. Make a thorough annual inspection of the wall. 2. Correct any settling or grading problems around the wall. 3. Take notice of any wall movement - settling, bulging or rotation, and then take proper corrective measures. 4. Control any random weed growth as necessary. 5. Avoid use of salts as deicers around the wall. With proper installation and maintenance the retaining wall should last the lifetime of the mound. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address t/Z Property Address Lc t~ (Verification required from Planning & Zoning Department for new construction.) w, Parcel Identification Number ©3f -/0/ - 000 City/State LEGAL DESCRIPTION Property Location 1 ~ ('0' 1/4 , Sec. , T, 3 _N R~W, Town of -Prat r~ Subdivision Plat: Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 26 LI 7 LI (before 2007)Volume , Page # Spec house /yes ❑ no Lot lines identifiable o yes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(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 a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) If f~ll1llllll~H~III~lI IHI STATE BAR OF WISCONSIN FORM I - 2000 8 Tx? 4009220 2 Document Number WARRANTY DEED 926444 BETH PABST THIS DEED, made between John G. Tuttle and Lynn E. Tuttle, REGISTER OF DEEDS husband and wife, Grantor, and Randel C. Simonson and Ann M. Simonson, ST. CROIX CO., WI husband and wife as survivorship marital property, Grantee. RECEIVED FOR RECORD 11/08/2010 4:16 PM EXEMPT N/A Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 30.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 270.00 "Property'): PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Together with all appurtenant rights, title and interests. 038-1018-95-000 Parcel Identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, easements and restrictions of record. Dated this 4th day of November, 2010. * ohn G. Tuttle * Lynn re'ruttle * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST.CROIX COUNTY. ) ss. authenticated this 4th day of November, 2010 Personally came before me this 4th day of November, 2010 the above named John G. Tuttle and Lynn E. Tuttle, husband * and wife to me known to be the person(s) who executed the TITLE: MEMBER STATE BAR OF WISCONSIN foregoi ins n d acknowled the same. (If not, authorized by § 706.06, Wis. Slats.) PEG tA THIS INSTRUMENT WAS DRAFTED BY ~\1 gta O k Publ' , State ofWisconsin' a% Wtsc My commission is permanent. (If not, state expiration date: ) Michael H. Forecki, Attorney 8/26/2012 (Signatures may be authenticated or acknowledged. Both are not necessary) 'Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 EXHIBIT A A strip of land extending 66 feet Eastward and Westward, and between the South shore of Cedar Lake and road, now located in Section 3, Township 31 North, Range 18 West, meaning to convey a strip of land extending from said South shore of Cedar Lake to roadway and extending Eastward from the East line of land conveyed by warranty deed bearing date of August 6, 1914, to one Harry M. Williams, 66 feet; same being located in Lot 6 of the SE'/. of said Section 3. ALSO, Part of Government Lot 6, Section 3, Township 31 North, Range 18 West described as follows: Commencing on North line of County Trunk Highway H, 210 feet West of the East line of said Section 3; thence West to a point on the North line of County Trunk Highway H which said point is the Southeast corner of land above described; thence North to the South shore of Cedar Lake; thence East on lake 30 feet, more or less, to a point North of place of beginning; thence South to beginning. Meaning in all to convey a strip of land 96 feet in width, Eastward and Westward between the South shore of Cedar Lake and the North line of County Highway H. I 2 of 2 Q o Z N i n `A + C m 00 ;Q ?t 6 Rpm°T 9 If c 1 j o~ g 05~ ~ R fit 0 C, M, smm C~ t~ngcmi>O a~ tip Fn - 0-.Ac zz w c-{r 'IC0 °°m G m ~mr' -c m N 8 mZ ~8~ ~S~ < _ GM) m m Z ~o ZcM~ r, C. !n <OO Q~ o m O )m" ii-- ! I Z r ~ r 'm - -4 r ~ r r r m = j (R SOUTH 227.70') + r w + r ! 227.73' p r + N01.02'27'E 158.78' + 65 77 38.56' 68.89 54.56 CIO ~7 I : u + IJ -Ni 4 1 ~ l ~m co 0+~ ' O y R'r ~ -D N +r m r R SOUTH 86.0(Y) Z m p S00.33'1sw 86.35 + + 61.79' 55,71' 37.14' c m i r S00.31'44w 156.64' v Z r I O O z p O CO) i i Q< b m+ 1` z C r r vim: ~r z muo ~r it z : UO + Z r 't r r vi p f7T~ r, ? v 129 1 40 r r i z ~O r r t I r ~~r 1119VIS3 Oz`zzz zmz?z vIS3M + r I ~QQgQ Q_grnQ M.z1,9£.ZON T 8 ,>o-av nn oo,s~•wN to to v, v, co .9E M.L749°40N (WtX-40N'!) ~x %api a ~i ~az00 Z. z 0 O zp 2 ZOO p Z .'O r 1+2 P~ / 0 O^"Nc~ m n I T i~ ~2 R1 `vIsconS SOIL EVALUATION REPORT #1646 ` Department of Com erce CEIVEDin a rdance with Comm 85,, V j'#[iCjeD Page 1 of 6 Division of Safety an Build jt Schmitt Soil Testing, Inc. Attach complete site pla on paper not less than 8%: x 11 riches in size. Plan must County St. Croix include, but not limited t : verticalla~d XjogJr'~lT¢feren point (BM), direction and percent slope, scale or mensiOONs'' offtthh rr h d loca ion and distance to nearest road. Parcel I.D. 7::/)] 038-1018-95-000 ~ Ieas6lo" AWShbat* PLANN G & Z NING OFFICE Reviewed By~ Dat Personal information you p ses (Privacy Law, s. 15.04 (1) (m)). ~.CX Property Owner ~~~pp Property Location Simonson, Randel C & Ann M f nyYlQh'Ta'tk0-1 Govt. Lot 6 NE1/4, SE1/4, S3, T31 N, R18W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1327 27th St. 71 City State Zip Code Ph Me Number City Village X Town Nearest Road Hudson WI 54016 715-549-9182 Star Prairie Cty Rd. H ❑ New Construction Use: [A Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD Replacement ❑ Public or commercial - Describe: Parent material Glacial till (Amery-Cromwell Flood plain elevation, if applicable 78.0 tt. General comments and recommendations: Pits A thru D are described in this report. Pits 1 thru 6 are described in the attached report by CST Donna Stark dated 9/29/2010. A] Boring # Boring Pit Ground surface elev. 90.07 ft. Depth to limiting factor 57 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 10yr3/4 FILL sl 2mgr mfr as 2f,1vf .6 1.0 2 3-16 10yr4/4 FILL sl 2msbk mfr gw lvf .6 1.0 3 16-57 10yr4/4 FILL sl imsbk mfr 1vf .4 .7 All horizons are FILL, useability of FILL material for a septic system was verified by Leroy Jansky of the Dept. of Commerce on 5-24-2011. Fill Fi-I N Boring # E] Boring Pit Ground surface elev. 92.66 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-2 10yr4/3 FILL sl 2mgr mfr as 2f,ivf .6 1.0--- 2 2-25 10yr4/6 FILL sl 2msbk mfr as 2f,ivf .6 1.0 3 25-29 10yr5/4 none sil imsbk mfr Cs 2c,if .4c .6 4 29-36 7.5yr5/4 none scl 2fsck mfr gw 2m,if .4 .6 5 36-42 7.5yr5/4 f1f 7.5yr6/8 sl 2msbk mfr if .6 1.0 0-25 inches is FILL, useability of FILL material for a septic system was verified by Leroy Iansky of the Dept of Commerce on 5-24-2011. FILL * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <.30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 5/2012011 715-247-2941 SBD-8330 (K07/00) Property Owner Simonson, Randel C & Ann M Parcel ID # 038-1018-95-000 Page 2 of 6 a Boring # El Boring Pit Ground surface elev. 94.32 ft. Depth to limiting factor 42 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 10ye4/3 FILL sl 2mgr mfr as 2f,2vf .6 1.0 2 3-13 10yr4/6 FILL sl 2msbk mvfr gw 2f,ivf .6 1.0 3 13-22 10yr3/4 FILL sl imsbk mfr as ivf .4 .7 4 22-33 10yr5/3 none fsl lmsbk mfr cs 1c,1f .2 .6 5 33-42 7.5yr5/4 none scl lfsbk mfr if .2 .3 0-22 inches is FILL, useability of the FILL material for a septic system was verified by Leroy ]ansky, Dept of Commerce, on 5-24-2011. FILL material has moderate to weak structure and is friable to very friable. D] Boring # Boring ® Pit Ground surface elev. 93.2 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-1 10yr4/3 FILL sl 2mgr mfr as 2vf .6 1.0 2 1-12 10yr4/6 FILL sl 2fsbk mvfr gw 1vf .6 1.0 3 12-22 10yr4/4 FILL sl 2fsbk mfr as 1vf .6 1.0 4 22-26 7.5yr5/6 none scl 2fsbk mfr gw 2m,if .4 .6 5 26-36 7.5yr5/4 none scl imsbk mfr cw 2m,lf .2 .6 0-22 inches is FILL, useability of FILL material for a septic system was verified by Leroy ]ansky, Dept of Commerceon, 5-24-2011. Structure of fill material is moderate and ranges from friable to very friable. 6 36-41 7.5yr4/4 cid 7.5yr6/8 scl Om mfi 0.0 0.0 ❑ Boring # El Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The 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. SB"330 (R.07/00) Schmitt Soil Testing, Inc. „ WA 7Z~~ S77#0203i 3or r STORAGE SHED T WALLS DWELLING r•. Uji _ 5 Lo ED- Po ov _ a - n _ _ L c4l Page 3 of 6 Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Randel C & Ann M Simonson Thomas J. Schmitt, CST 227429 Address: 1327 27th St 1595 72nd St. City, State, Zip: Hudson, W154016 New Richmond, WI 54017 Phone: 715-7 0-1978 Address: 1194 Cty Rd H signature A~+r"'+~-~ Lot No. 71 (Gov't Lot 6) Uate - <~I/ Legal Description: NE1/4 SE1/4 S3 T31N R18W e Backhoe Pit Township, County: Star Prairie, St. Craig County Shovel Pit Bench Mark 1 El. 100.00' Top of 2" PVC pipe Q Bench Mark 2 El. 100.3' top of ground rod SW comer of house Slope= 29% Scale V=20' NOTE: Existing sand point well to be abandoned 1 11:: - well to be installed. 12~ ley) ;f? J Pit Elevations _ - - A: 90.07' B: 92.66' ` C: 94.32 D: 93.20' / 1: 94.44' I 2: 98.55' ►1 t~/I / 3: 93.38' 4: 92.30' 5: 89.40' ' 6: 86.85' Af , LJL .r Community Development Department Page 2 1. The sanitary permit has been issued for the POWTS. The applicant's agent will schedule the required county inspections for compliance with SPS 383. 2. The sanitary permit issued for installation of the POWTS contains a condition that requires compliance with all conditions of the land use permit and contractors must be made aware of the conditions regarding stabilization of disturbed areas upon completion of the mound. 3. No phosphorous fertilizers shall be used on the disturbed areas of the site, unless a soil test confirms that phosphorous is needed for establishing permanent vegetative cover. 4. Within 30 days of completing the project, the applicant shall submit to the Zoning Administrator photos of the disturbed areas for documentation of compliance with conditions. Photos may be sent electronically via e-mail attachment. This approval does not allow for any additional construction, structures or structural changes, grading, filling, or clearing of vegetation beyond the limits of this request. Your information will remain on file in the St. Croix County Community Development Department. It is your responsibility to ensure compliance with any other local, state, or federal rules or regulations, including obtaining a building permit from the Town of Somerset. Please feel free to contact me with any questions or concerns. (:amela , Quinn Land Use Specialist/Zoning Administrator Enc: Land Use Permit LU88065 Cc: Brian Wert, Building Inspector, Town of Warren Mike Wenholz, Wisconsin Department of Natural Resources Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, WI 54016 Fax 715.386 4 686 www.sccwi.us/cdd www.facebook.com/stcroixcountywi cdd @co.saint-croix.wi.us ST. C I - C` U'�1 T Y Land Use Planning&Land Information "Ca/ `SIVI, Resource Management Community Development Department October 11, 2013 File#: LU88065 Randel &Ann Simonson 1327 27"' Street Hudson, WI 54016 Re: Land Use Permit, Filling & Grading < 10,000 sq. ft. in the Shoreland District 1194 Cty. Rd. H, Parcel #03.31.18.71, Town of Star Prairie Dear Ms. Rubis: This letter confirms zoning approval according to the plans you have submitted for filling and grading an area of >1000 square feet within 300 feet of the Ordinary High Water Mark (OHWM) of Cedar Lake to construct a private on-site wastewater treatment system (POWTS) on the property referenced above. Staff finds that the proposed project meets the spirit and intent of the St. Croix County Zoning Ordinance and Shoreland District with the following findings: 1. Filling and grading less than 10,000 square feet <300 feet from the lake OHWM on slopes >12 percent is allowed with a land use permit in the Shoreland Overlay zoning district pursuant to Section 17.29(2)(c) of the St. Croix County Zoning Ordinance; 2. The filling and grading will consist of excavating —1000 sq. ft. for the basal area of the mound POWTS and installation of tanks and retaining walls that will be connected to an existing two-bedroom cabin on Cedar Lake. The POWTS will meet the 75'setback from OHWM and other required setbacks and dimensional standards contained in the St. Croix County Zoning Ordinance; 3. The applicant's agent, John Schmitt, will install the POWTS in an area that slopes away from the lake, so there is limited potential for erosion or sediment issues. With conditions to establish permanent vegetation on all disturbed areas and prohibit the use of phosphorous fertilizer to maintain a lawn, negative impacts to the water quality of the lake will be minimized; 4. The lake shore is N 40 ft. from the existing house and the owner will be required to maintain existing vegetative cover within a 35'shoreline buffer zone; and 5. The Wisconsin Department of Natural Resources staff was sent the application for review on October 1, 2013. A DNR grading permit will not be required for land disturbance less than 10,000 sq. ft. and outside the 75'OHWM setback. Based on these findings, approval of the land use permit is subject to the following conditions: Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, Wl 54016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountvwi cdd(@co.saint-croix.wi.us C W ` z � d w ° M zx W cam d V o O u lfl d y 6S b 07 d � 7 �A � f' A. an d = d p dip y V O q 6 I�1 d O Cc, Or- °� b0a+ 3myv`Q .. O aC6 d' ��z dr _ � 40 z � � r w � A � a � w a O aF � N J M -� �::- O CO)(D � CD '� Co _ Jw FOOL o, -a ' _ b Z Or oSIMO. , mal 1%vim < C O -1 = o n p� O CL Z U) a CD _ —1 F) CD n � CD �Z :r�, mall CD a O C CO) d � C7 . — —. CD �. ke" N y O o0 CD O C � -f, dMft POOL L* mmomml (D O N CL =r momal O " ' 0 r C C -h Cl) C —. =r_. Via r. M 0 0 cr _ CL n -p 0 (a y, � an � foolk CL to —. N ' NEOL CL O 00 1 03/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 02r-02 Page of a property owner Parcel ID# (� a Boring# Boring R, Depth to fimiting factor _ in Soil A lication Rate Pit Ground surface elev._,____.__ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *EfF#1 *E in. Munsell Qu.Sz. Cont.Color Gr.$z.Sh. r 'I 0 w aM yl L I Boring# Boring m y 7 pit Ground surface elev.�ft, Deem to limiting factor � Soil APpl lcatlon Rate Horizon Depth Dominant Color RedoxDesorlptlon Texture Gtr9z Sh ConsistcnGe Boundary noota *Fff#1 ft*Eff#2 In. Munsell Qu.Sz. Cont.Color L- QL M4 • - 10 3 n� ' SYRY Olt Y t-7 Boring Ll Boring# Ground surface elev. ft. Depth to limiting factor In. pit Soil A001cation Rate Horizvn DcNlh ppminarvt Color Redox IDoecri Munsell Texture Rtnicture Consistence Boundary Roots GPDIfI� Qu.Sz. Cont.Color Gr,Sz.Sh. *Eff#1 Eff#2 "Effluent#1 SOD, 30.<220 mg/L and T55 x30 100 n WIL "CfFluent#2=@ODD_30 mSA-and TSS<'in m©A The Department of Commerce is an,equal opportunity scrviee provider and employer. if you need assistance lu a"Q55 Scrviees or need material in an altcmate format, please contact the department at 608-266-3.151 or TTY 608-264-8777, SBDA130 T07100) 03/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 01/02 r R�C�e Wisconsin Department of Commerce 4PR18,0 55V QUA ION REPORT Page of Division of Safety.and Sulldinys p ST. i jFeb m 8 �is. m. Code County Attach complete site plan on paper not less than 8112 x 2 /V� -PI must X include,but not limited to:vertical and horizontal reference porn c nand Parcel I,i}. _en percent slope,scale or dimensions,north arrow,and location and dista nearest road. Please lari,nf all informati[►n. R¢+1wed by Date , I Perewnl Information you provide may lee used for secondary purposes(Privacy LAW,!].15.04(1)(m)). Pr erty Owner Property Location Govt,_Lot 114 114 S J T3! N K e # Black# Subd,N ama or CSM# lah ty Owner' ailing Ad ress Lot - / �^^ Gz'�d � 3 a 7 a� City State zip Code Phone Number ❑City Q Village IN Town Nearest Road oN WZ S ay c �lS 3 y9- 9�g S-to- Pr,`,,r;c. Co. [� New Construction Use:l.Residential 1 Number of bedrooms c2_3 Code derived design flow rate 3120 ° y '+� � GIRD P,Replacemerrt E"ubilc or eommarelal-Doacribe: Parent material 1/ +� ` n F.lolo►d Plain elevation i applicable R- General comments = S u t c,_r hpl Or+ y1� 1 &tj k�� rc,,r �'•5 Irc AIa�.tx lNth and recommendations' 'g S� ` tr,,5 ov1' house. ��tsallvt. E, +1-►a„r �nsu ;� �blc So. Ls s 5 10 cs 0 "Ps I \% A rC.a w. S ® Boring Q Baring# Pit Grouno 9urFace elev. 'ft. Depth to limlting factor 7 v In Sall A iM tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/fP In. Munsell Ru,Sz. Cont.Color (,I r.Sz.Sh. *Bff#1 *E02 s L a f5 b k ra w 4 w i tvi 1. 1. 3-)b r S `f R'! --------- SL FSS K n C 1 YM to 1 7r5 L I M5bV- rnF► — . jBoring# "—I Boring I �t Pit Ground surface el®v. ft. Depth to Ilmiting factar �a in, Soil Application.Rate_ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM _ In. Munseil Qu-Sz, Cont.Color Gr.Sz.$h. *Eff#t VNIQ 1 `(tR� - s L 19FS bit , q w a M - 6 i d 101- —F-------. L_ Ins fr C w . q . 10 7syQl ) Fs L IFS bv�. "Effluent 1f 9 Q BOD 30=220 mg/L.and TS8 w30:154 mg/L "Efli rant#7.m SOD,:s 30 m41L.and TSS<30 mg/l. CST Name (Please Print Signature CST Number o Yt t7 y dress 6L 0(;O-tv S-+,. 0�1*15"luation Conducted Telephono hlumbor a-7� T 5 03/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 02/02 R ��y Page If-3- � 5p� ParceLlD# prapany owner--., Boring d m. a sing# � — ft, Depth to 1'rtniting factor Soil A fire Rate Pit Ground surface elev.�_ GPDAf Horizon Depth Dominant Color Redox Description Texture Structure. Consistence Boundary nRoot$ *Eff#1 "off in. Munsell Qu,Sz. Cont.Color t n- 1 -f 3 ----"' S L a F55 k m w t � `i RAJ v fa C? -� -r s/ ir It F2.s rA. 1 L Boring ,n_ Boring# around surface elev.—ft, Depth to limiting factor Soil A 6DI kaiion Rate y' EA Pit GPDIfl� Horizon Depth Dominant Color Redox Description Texture Structure Gansistarice Boundary rRoot3 "Etf#1 "Eff#2 In. Munsell Qu,Sz, Cont.Color Gr,Sz.Sh. if 7 � a Boring in. Baring# I--1 Ground surface elev..r ft. Depth to limiting factor^ Soil A Ication Hate LI l� Pit Roots GPD/ff Horizon Dcyth pom Texture Stricture Consistence Boundary rnarrt Color Redox pgacription Gr.Sz.Sh- "Et�1 "8�2 in. Munsell Qu.Sz, Cont_Color " Effluent#1 BOD,:3o<22o mg/t,and T55 a30 180 ritwIL "couent#2=BODE=3a mgA.,and TSS<311 rngA The Department of Commerce is to an.equal opport 1m sorvice pTovider and departtmentlat 08-266 3151 or TTXt608 264-8777,services or need material in tttl aitcmAte format,p SH0.r4136(0.07J00) A. S'Y r+n hYJ s o Pa e 3 3 ar . 5<c.3�131 N� l. C c 'A 1-7 `r to C> eed oar Jo- ® r _ - d v o ►ck R� Ccr Y r r� r.unu�r�r .-t— `T --- --------- -----=---------- --------------- ------------- ----------------------------------------- ----- 0 cl, k5 .......... .........-.. 64 63 58 $ .� b � 20 i 68A 1470/275 Ati� i LOT3/i — _ — __ 70 c _ 65B 248 66 -- tO 74A 1 J 69B 72 °--- LOT2 - d qq 1 14 .20 I i = M O cANn cc vi 225A-21 ENT LOT6 65A C: I / / 351.86 I � / •/ / N 73B m cl.i i r— — _..._..._..— — — Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567218 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Simonson, Randel C. &Ann Star Prairie, Town of 038-1018-95-000 CST BM Elev: Insp.BM Elev: BM Descriptiion� SectionlTown/RangelMap No: 00 .4 /00-D J!L/,I / 03.31.18.71 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i✓ �� S� Benchmark / Z_ 160 r ad Li c �e r Dosing _ Alt.BM Aeration Bldg. Sewer Holding St/Ht Inlet I3 Z St/Ht Outlet �y TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt dalot Septic 4, Dosing �� . �,�/ �µ Header/Man. ,A Aeration 1 Dist. Pipe L Holding Bot.System Final Grade PUMPISIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number 2� e: () M 3 _I Dw TDH Lift/ Friction Lis ISystern Head TDH Z/ Ft T j o5— j oo.d '" Forcemain Length, r 5 D(iiaa. // Dist.to Well i C, 3� 2.0 , l SOIL ABSORPTION SYSTEM BED/TRENCH Width Length r No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. ep DIMENSIONS j �C, SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING acturer: INFORMATION CHAMBER OR Type Of System: (U 4> i �/ UNIT Model Number: '47' b � DISTRIBUTION SYSTEM L7�v 'x„c�' .4 Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake u / 11 cL Length Dia °� Le gth a�I Dia ''5V Spacing 3.33 3 �' C 1 SOIL COVER x Pressure Systems Only Mound Or At-Grade Systems On Depth Over Depth Over x xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil O Yes [R No I [A Yes No C ENTS: (Include code di cr penges,persons pxesen,etc.) Inspection#1: �6 / 2Z/ �3 Inspection#2: /� ��Z V-Z 5�,-7 r. �"C,t�) �. LCation: 1194 Cty. Rd.H New Riccond,WI 54017(Gov't Lot 6 3 T31 N R1 8W) metes&bounds Lot I No: 03.311.18.71 5'�>CiI�,:�n��C.° �.�IC�.'"S C`U2'.,�,�.c•;,�C / �ovJ CJ 1.)Alt BM Description 2.)Bldg sewer length -amount of cover Plan revision Required? F Yes H No Use other side for additional information. — — — -- Cert.No. Date Insepctor's Signature SBD 6710,(,R.3/97) County 6 . fir' Safety and Buildings Division 57, C�©l x { D$ ! 201 W.Washington Ave.,P.O. Box 7162 Sanitary P/e-rmi`t�Number(to be filled in by Co.) Ps r ,.I�Aary!VVi -7162 L� / f ` w State Transaction Number Sanitary Permit Application Iy/� Z Z y3 4 S�- In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the apprp to goo 1 unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned S are s to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may beAwor sec / (J I f ses in accordance with the Privacy Law,s.15.04(l m,Slats. 19 y C T 17 I. Application Information-Please Print All Information C Property Owner's Name C Parcel# � 0151- rJ 51610foso N M� C36?-/0/ Property Owner's Mailing Address Property Location ' 1 3-Z-7 27 l f'f s/�6 E T Govt.Lot _ J City,State Zip Code // Phone Number C y, s Jt Y<, Section3 Ud o � Syo� t0 T 3) N; R J rciE one II.Type of Building(check all that apply) Lot# Subdivision Name 91 or 2 Family Dwelling-Number of Bedrooms �r-ooyooms A / 1 S: 01 A I Block# ti � b ❑Public/Commercial-Describe Use ❑City of CSM Number ❑Village of ❑State Owned-Describe Use ®Town of OeW lle ft' III.Type of Permit: (Check only one box on line A. Complete line B if applicable) A' X New System ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) List Previous Permit Number and Date Issued < B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New yw Before Expiration Owner IV.lvpe of POWTS S stem/Com onent/Device: Check all that a 1 ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑ At-Grade OR Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) Pretreatment Device(explain) V.Dispersalflrrea tment Area Information: Design Flow(gpd) Design Soil Application te(gpd f) Dispersal Area Requir (sf) nDispe�rsal Area oposed(sf) System Elevation ©� D. /,_, �� 75 oa as VI.Tank Info Ca ity in Total #of Mac er o Gallons Gallons Units w ° U N New Tanks Existing Tanks o w' ` rn w C7 0+ Septic or Holding Tank I�� p 0 ��pQ p � ! G S :TEE Dosing Chamber �� © /z o .�t✓` VII.Responsibility Statement-I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plum i e J1 MP/MPRS Number Business Phone Number oN ScN M rl z 2z37�0 �s�76o Plumber's Address(Street,City,State Zip Code) _ VIII oun /De artment Use Onl Permit Fee Da�[ssue Is ing Agent S a Approved ❑Disapproved ❑Owner Given Reason for Denial $ 6 IX.Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1.Septic tank,effluent filter and 7 ( - dispersal cell must be serviced/.maintain ed %� /�G�G� � as per management plan provided by plumber. L(J��Q�o 2.All setback requirements hp as per appllcablMW&M�1�5.for'the system and submit to the County only on paper not less than 81/2 a 11 inches in size SBD-6398(R. 11/11) Legal Description: NE1/4,SE1/4,S3,T31N,R18W P.I.D: 038-1018-95-000 Subdivision Name: NA Lot#: Govt 6 Township: STAR PRAIRIE Parcel Size: See Map SCALE:1•'=20' County: ST.CROIX Contour Line Elevation: 88.33 Cell Dimensions:I 10'X 30' 4 inch Sch 40-ASTM D2665 System Elevation 89.16 Mound Dimensions: 50.25'x 34.17' 2 inch Sch 40-ASTM D1785 Slope: 15% 11/2 Sch 40-ASTM D1785 A BM1 Elevation: 100.00' Top of 2"PVC pipe 0 BM2 Elevation: 100.30' Top of iround rod SW corner of house. ■ Backhoe Pits: Tanks 1000/650 gallon Septic Tank Combo tank with outlet baffle in 1000 al.com artment,POLYLOK 525 at outlet of 65D al.com artment 1250 gallon Dose/Sure Tank Time dosed to allow for possible heavier use on weekends. NOTE: End slopes of mound encroach on driveway, and P/L setbacks. End slopes to be retained and insulated with retaining walls and 2"foam. Existin sand point well to be abandoned and new well installed. • 7r.— PtT i tZ !9 Mr=ANDE,� 4 LItiC r STORE c TA" R WALLS �.: weLL — do _ W q PVC .- L 01 6 c� U RE-,AtN1AiC W tL Vv FOAM r � iNSi,fir�T/�"ti -5 Np 15 ic LO T�-TNI ti I ivL W iNkLL W Z1' lz C I\ tiff tybULAT1CN W ALL c�-y h 0 ;a 1,A vErnaTntF` DIVISION OF INDUSTRY SERVICES Z" �0A 3824 N CREEKSIDE LA HOLMEN WI 54636 Contact Through Relay p www.dsps.wi.gov/sb/ y� S www.wisconsin.gov :......... A+P' 5�4 �SSION Scott Walker,Governor Dave Ross,Secretary August 28,2013 CUST ID No. 223760 ATTN:POWTS Inspector ZONING OFFICE JOHN F SCHMITT ST CROIX COUNTY SPIA 616 150TH AVE 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/28/2015 SITE: Identification Numbers Randel&Ann Simonson Transaction ID No.2273955 1194 County Road H Site ID No. 793162 Town of Star Prairie Please refer to both identification numbers, St Croix County above,in all correspondence with the agency. NE1/4, SETA, S3,T3 IN,RI 8W FOR: Description:Two Bedroom Mound System/15%slope/Time-Dosing/construction of(3)retaining walls Object Type:POWTS Individual Site Design Regulated Object ID No.: 1441496 Maintenance required; 300 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; 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 CONE and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. AP The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code DEPT OF requirements. PROFESSIO No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.0'DN'S'ON OF IN stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders: • This system has been reviewed and approved as an Individual Site Design.The system shall be constructed in 4SZle'Co Y PP � Y accordance with the approved plans and ch.SPS 383,Wis.Adm. Code. • The county shall inspect the(3)retaining walls for proper construction prior to installing any of the dispersal cell components. — b IA , • The time-dose mechanism and the dose volume being delivered to the system shall be field-calibrated before the system can be put into full operation. • Recommend the redundant pump off switch be mounted approx. 8 to 9 inches off of the bottom of the tank and the timer enabler setting shall be 10.9"from bottom of tank. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis.Stats. • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. JOHN F SCHMITT Page 2 8/28/2013 • 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. • 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. 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 purp6ses. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 450.00 This Amount Will Be Invoiced. r _ erard M Swim When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (600789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. � $rol V� ',.,.�".swim@wisconsin.gov WiSMART code:7633 cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm : ... Effective January 1,2012,all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. r1, MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Simonson 2 Bedroom Mound Owners Name: Randel &Ann Simonson Owner's Address 1327 27th Street RECEIVED Hudson, WI 54016 JUL 31 2013 Legal Description: NE1/4, SE1/4, S3, T31 N, R18W INDUSTRY SERVICES Township Star Prairie County: St. Croix Subdivision Name: NA Lot Number: Govt. Lot 6 Block Number Parcel I.D. Number 038-1018-95-000 R OIV LLY Plan Transaction No. jAF Q '��ANQ Page 1 Index and title 4AL SERVICES Page 2 Cover letter Page 3 Data entry ST RY SE VI CE S Page 4 Mound drawings Page 5 Lateral and dose tank 7 Page 6 System maintenance specifications Page 7 Management and contingency plan D�NCL Page 8 Septic tank specifications Page 9 Effluent filter information Page 10 Dose tank specifications Page 11 & 12 Pump specifications and curve Page 13 Pressure filter information Page 14 Plot plan Page 15-17 Retaining wall information Page 18 Septic tank maintenance agreement Page 19 Warranty deed Page 20 CSM Page 21-24 Soil evaluation report Designer: John Schmitt License Number: 223760 Date: 7/27/2013 Phone Number: 715-760-0486 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P(N.01/01)and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS(10/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) Version 7.0(R. 03/2012) Page 1 of 24 Legal Description: NE1/4,SE1/4,S3,T31N,R18W P.I.D:V 018-95-000 Subdivision Name: NA Lot#: 6 Township: STAR PRAIRIE Parcel Size: ap County: ST.CROIX SCALE:1"=20' Contour Line Elevation: 88.33 Cell Dimensions: 10'X 30' 4 inch Sch 40-ASTM D2665 System Elevation 89.16 Mound Dimensions: 50.25'x 34.17' 2 inch Sch 40-ASTM D1785 Slope: 150% 11/2 Sch 40-ASTM D1785 AL BM1 Elevation: I 100.00' Top of 2"PVC pipe BM2 Elevation: 100.30' Top of ground rod SW corner of house. ■ Backhoe Pits: Tanks 10001650 gallon Septic Tank lCornbo tank with outlet baffle in 1000 gal.compartment,POLYLOK 525 at outlet of 650 al.com rtment. 1250 allon Dose/Surge Tank Time dosed to allow for ssible heavier use on weekends. NOTE: End slopes of mound encroach on driveway, and P/L setbacks. End slopes to be retained and insulated with retaining walls and 2"foam. Existin sand point well to be abandoned and new well installed. loft Iftft-- EoLG Or 1 M AN1)EK, STO�R�GE SAW 2- R T�N�iG DVVaUNG WAU-S b do N WcIL T !ft+ W Ll 5CN Pvc C 01 3n th V � k'E;'AlN',n1G w' LL � 11 w,rti z,. Foam Z!NS U tA T/t"IJ LO RcT-Nt 2-11 IZCI\Iv�y -�8uLATION -' `. RrrrlrN�NV John Schmitt Septic System ✓ Design Septic System Services Evaluations ✓ Maintenance 616 150`"Ave. Cell Phone:715-760-0486 Somerset,W154025 Email:jschmitt @somtel.net June 30, 2013 The design for the Randel Simonson mound at 1194 County Road H, Town of Star Prairie, St. Croix County was designed pursuant to the Mound Component Manual for POWTS Version 2.0 and both SSWMP Publication 9.6 and Pressure Distribution Component Manual Version 2.0. Due to the space constraints of this small lake lot the end slopes and one small portion of the toe encroach on the driveway and property line setbacks. During an onsite visit Charlie Bratz suggested retaining the portions of the end slopes with insulated retaining walls. This solution allows for more than enough basal area for the two bedroom mound soil absorption area. If this is an Individual Site Design, bill me accordingly. The system will have a 1000/650 gallon combination septic tank that would allow for a pretreatment unit in the future. The effluent will be filtered out of the combination septic tank by a Polylok 525 effluent filter and by a Sim/Tech STF-100 on the force main. Due to expected heavier use of the septic system on weekend and holidays a 1250 gallon surge dose tank with time dosing will be installed. Sincerely, John Schmitt Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand fill(D)calculations assume a 200.00; Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for 1.W Peaking Factor(e.g. 1.5 = 150%) fecal coliform of—36 inches. 300.00 Design Flow(gpd) 15.001 Site Slope (%) V 8 Contour Line Elevation (ft) 26.00' Depth to Limiting Factor(in) 0.40' In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 30.W Dispersal Cell Length Along Contour(ft) F 10.00 lCell Width (ft) _ 1.00! Dispersal Cell Design Loading Rate(gpd/ft) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? E'= Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.188 Orifice Diameter(in) 2.00; Orifice Spacing (ft)= 6.67 ft2/orifice 2.00a Forcemain Diameter(in) _ 30.001 Forcemain Length (ft) Does the forcemain drain back? Y 0 Pump Tank Elevation (ft) - 3.25 System Head (ft) x 1.3 t 4.89 Forcemain Drainback(gal) 10.76 Vertical Lift(ft) 39.31 5x Void Volume(gal) 0.56 Friction Loss(ft) '6 44.20 Minimum Dose Volume(gal) In-line Filter Loss 29.49 System Demand (gpm) U`3i —1,f.-571 Total Dynamic Head (ft) Lateral Diameter Selection I Manifold Diameter Selection in. dia. options choice I in. dia. options choice 0.75 1.25 1.00 1.50 x 1.25 x 2.00 x x 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator Treatment Tank Information Total Tank Capacity(gal) 165010; Septic Tank Capacity(gal) Total Working Liquid Depth (in) _____, Wieser Manufacturer r gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1250.00° Dose Tank Capacity(gal) PolyLok Commercial Filter Manufacturer 26.81 Dose Tank Volume(gal/in) 625 Filter Model Number Weiser Manufacturer Project: Simonson 2 Bedroom Mound Mound Plan and Cross Section Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T 1110 B -: J Observation Pipe ; 30: : : K ' . . . . . _1 T O 081 A w - B. 3 :;:: : : : . . . . . . . . L Mound Component Dimensions A 10.00 ft E 28.00 in H 1.00 ft K 10.13 ft B 30.00 ft F 9.50 in z 19.77 ft L 50.25 ft ✓b 10.00 in G 0.50 ft J 4.40 ft W 34.17 ft 300.00 (ft2) Dispersal Cell Area 893.18 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 1 3.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 90.96 (ft) --i ,,,,,,,,,, ,,,,,,,,, •j _ :- F Dispersal cell 89.66 (ft) Lateral ft -♦ — $�� O . . .. .� .:::. .: ::: ::::: : : Invert Dispersal Cell E D •....... Elevation a , 88.33 (ft) Contour Elevation 15.0 % Site Slope -�— Geotextile Fabric Cover Shading Key c. I - Dispersal Cell See lateral details on Q Topsoil Cap c 1.5 ft Page 4 for number, size,H Subsoil Cap a, o .0 and spacing of laterals. ASTM C33 Sand :o Z 1 F Laterals are equally 4 Tilled Layer H 0.5 ft Typical Lateral spaced from the 05 0 Aggregate �r c 5[] I distribution cell's -} centerline in the A distribution cell(AxB). Project: Simonson 2 Bedroom Mound End Connection Lateral Layout Diagram Center the laterals over the A6',Bdimension •Turn-upwlbolIvalveorolonn out piug FF.r..,m'..airnr,*c.-0nnection P dentical J6X...�l Holes drillod on the bottom of the lateral s equally spaced Laterals&forcemain Sch 40 PVC per SPS Table 384.30-6 via tee of cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.04 ft Lateral Length (P) 28.56 ft Orifices per Lateral 15 Lateral Spacing (S) 3.33 ft Orifice Density 6.67 fe/orifice Lateral Flow Rate 9.83 gpm Manifold Length 6.67 ft System Flow Rate 29.49 gpm Manifold Diameter 2.00 in Total Dynamic Head 14.57 ft Forcemain Velocity 3.01 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --1 SPS 316.300 WAC 4 in.min. Disconnect Tank component is properly vented E:Forcaemain Alternate outlet location diameter Weiser Concrete Manufacturer 2 in. Capacity 1250.00 Gallons Volume F 26.81 gal/inch High Water Alarm 35 inches Weep hole or anti- 1••��,. Iw rnw�ci� �j► siphon device Timer Enable 10.9 inches O'Y Pump off elevation(ft) Redundant Off (Mount Redundant Off Float slightly 78'91 SJEE 4V!( g?M"oat) –7 a Dose tank elevation(ft) ,-J----37"—Bedding un er tank. — 78.00 Alarm Manuafacturer SJE Rhombus Alarm Model Number Tank Alert AB _....._. __.__....._..._.w Pump Manufacturer Zoeller Pump Model Number Pump Must Deliver I 29.49 gpm at 14.57 ft TDH IS.o7 5 Zy Project: Simonson 2 Bedroom Mound Page r7 0 of Randel and Ann Simonson Lake Dwelling The Simonson Lake Home/Cabin will be serviced by a 300 gpd Mound POWTS.The Dwelling will normally be occupied by 2 people(2 X 50 gallons/Day=100 gallons/day Estimated Wastewater Flow. It is expected that.often times on weekends The Estimated Wastewater Flow will increase due to guest.The estimated Wastewater flow is expected to increase to 200 gallons 1 day on Friday and 400 gallons/day on both Saturday and Sunday. Average Daily Design Wastewater Flow 100 gallons estimated flow X 4 days,=400 gpd 200 gallons estimated flow X 1 days=200 gpd 400 gallons estimated flow X 2 days=800 gpd 1400 gpd X 1.5=2100gallons/week 2100gallons/week 7 days/week=300gpd Design Flow Sunday Monday Tuesday Wednesday Thursday Friday Saturday Carryover 200 400 300 200 100 0 0 Daily estimated 400 100 100 100 100 200 400 flow 24 hr.pump volume 200 200 200 200 200 200 200 Remaining surge 400 300 200 100 0 0 200 volume Surge Volume=300 gallons Surge Capacity Needed=400 gal.(largest carryover)x 150%=600 gallons. Minimum Dose Volume=44.20gallons Maximun Dose Volume=300gal/5 doses/day+(.163)(30)=64.89 gallons Pump will deliver 46gpm at 14.57ft TDH SURGE TANK TIME DOSE FLOAT SETTINGS Redundant Off Float 10.9" off bottom of tank SEE CORRESPONDENCE High Water Alarm 35" off bottom of tank Reserve Capacity 4T'-35"=12"x 26.81 gal/inch=321.72gallons Sure Capacity 35"-10.9"=24.1"x 26.81gaUnch=646.12 gallons Dose Volume 50 gallons Timer Setting Dose timer to activate pump at 4hr intervals for 1.09 Minutes. Wieser Concrete:W1250-MR(47"@ 26.81 gal/inch) All timer settings and dose volumes to be field calibrated 5 A of 7.4 Mound System Maintenance and Operation Specifications Service Provider's Name I John Schmitt Phoned 715-760-0486 POWTS Regulator's Name St. Croix County Zoning Phonei 715-386-4680 I System Flow and Load Parameters Design Flow-Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1650 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Inspect retaining wall (See Retaining wall information) Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30(6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 .• Grade4 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral — Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral 6 24 Project: Simonson 2 Bedroom Mound Page's of#' Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[SBD-10691-P(N.01/01),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P (N.01/01)j and local 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 with SPS 383.33,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 be 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 filter is equipped with an alarm, the filter 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 additives to enhance septic tank performance is generally not required. However,if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and 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)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODE,, 150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BODE,,30 mg/L TSS, 10 mg/L FOG,and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it 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 for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating 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 performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its'present location by increasing basal 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: D z X N 54 AS 84° A REQD m 43" z cmI D w 0 rn m v � 0 UP 42" \ro m 4" CAS D m � 3". 464" � 5"" O a7� D X Dm -+ m — 38" p m A b v < < rn N — m 0 i ^' UP 40" N V A 4"' CAS D c X O m z c (/1 �p O m A 41" __q __4 D o m I D I m m D r >0 > r r 0 z z O z z D A c m m m U) o z z ON D 0 0 �D 47?D Qm�mmD00G0DN I+ O xX � _ Z O > �n0 woo =0o-Io0z 14rZ ON my m0 m m �ZO m�0 �r�.. -1O�0w�n 0 to vvio Z50 �N c z cnzr� i r-a �,m��Am '�+ O �N 0coo =p D O ow twmD �D °WC�,•°or.�_ Tl (7) ➢ .-.rte O N fn ' O N Ln v'� D> W : o O O U 1 v D N Ap zmD Z �� mom rnm cn O dv D O c= o °v D AW n D \\ 2F> >0 O (m7 _{ � oo< Tl � z �� \ � zz � O WO N O m oo Z r m c m m n L.n o m < C ?t O m° D V"1 v '�D ,iZ,7 Z N O _v mr X .. -� m " r m C O co 0 r ;1 C 3 z m DH ; A r � F4 m 0 \ cn WLP1000/650-MR X DRAWN BY WCP SCALE: 1/4'=l'-O. PRE-POUR: ° SEPTIC MANUAL MIERER culCRETE REV. \ z W3716 US HWY 10 MAIDEN ROCK" WI 54750 DATE: 00/00/00 DATE:. POST-POUR: ° 800-325-8456 FILE: 1101000/650-MR INSTALLATION INSTRUCTIONS z �goo PL-525/PL-625 FILTER NISITALIATION INSTRUCTIONS AIL L""wh Center filter with opening t� t9 to J a LLO x e e Additional pipe or Polylok Extend&Lok° Glue for centering. Step 1: Step 2: Step 3: (A)Locate the outlet of the septic tank. (A)Before installation, place the (A)Glue the filter housing on the (B)Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary. (B)Make sure that the housing (B)Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. Ma, Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back if necessary. into the the housing making sure 00 NOT PLUMBING� (B)Pull the filter out of the housing. the filter is properly alighed WHEN FILTER IS REMOVED (C)Hose off the filter over the septic tank, A completely inserted. II !' Make sure all solids fall back into the (B) Replace septic tank cover 'A°VJIANM ALM septic tank. D z x U) 64�" AS REQUIRED D 86" m K 53" D z Z - m D N i rn Of° � UP 52" � N 1 m o" CAS 4 / l m \ ;o — O x A D I 3" 47" 5" � O (A m 5 v ° m co I N UP 49" a 4.. AS 1 � � I N N v m 50" 1 rn m Im+ D z cn N 1 D i m D r 2 V n N z� D r0 = r 2 Z p m0 � x o o �_ m m D Am 3: U) D z DOZ p D G7?D (��ggg***iiit_W g.xmO< p�� z cCi>v mp CA m 0mD DO mCN�° AC�° pOG�=S(+t Orz an NN o m N r-Az n �Z° mN0 :-c -+0� to Kx Z0 \ C z c-) -1 NNE �-i� v-ZOU m� N _a �N Z 2 m y0 ;C .�Z)r^ C)Dm NAM .8N '=U)\ M N o v n N Z z cnC Oo �m> D� r��C��O?- Zn TI o A° \ C �� 47 mpr*mrm- ( : BOO �Ca n D z c-� v z m m CD -4 m v' vv D �7 tin r '� --4 n CD C N W C) r (�D D D° i7 z o o ;o C� ° Z D p Co y D o m X Z r O O ;u O° U) p 0 "� m Foo v p o 1 o p o o V) "o V) A 2 to U) D n O r O co °z z Q ,rm G 3 m > ;o m DH f m m m = W1 25O-MR MIENERIBRINETE m DRAWN BY: WCP SCALE: 1/4'=l'-O" PRE-POUR: ° -4 SEPTIC MANUAL ReV. " \ o W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE 00/00/00 DATE:. POST-POUR: \ 800-325-8456 FILE: W1250-ISM �U41/TY/—UMP6�NCE �c�i�,9 SECTION: ZFMO973 [7 0312 Product information resented f� Supersedes here retlects conditiapns at time / CJl V/ �G L/ 0310 of publication.Consult factory regarding discrepancies or visit our web site: inconsistencies. MAIL TO: P.O. BOX 16347-Loukvib.KY 40256-0347 SHIP TO: 3649 Cane Rum Road-Louisto4s,KY 40211-1961 www.zoeller total (502)778-2731.1(800)92 8-PUMP-FAX(502)774-3624 COMPARE THESE FEATURES Non-clogging engineered plastic vortex 98 Cast Iron Series impeller design " FLOW—MATE" Corrosion resistant powder coated epoxy finish (FOR PUMP PREFIX IDENTIRCA77ON SEE NEWS&VIEWS 0052) Durable cast construction. Cast switch FOR SEPTIC TANK case, motor, pump housing and base. No LOW PRESSURE PIPE (LPP) sheet metal parts to rust or corrode. AND ENHANCED FLOW STEP SYSTEMS Castings-All cast iron class 25-30 25000# tensile strength EFFLUENT Stainless steel screws, guard, handle, arm OR DEWA,TEIRING PUMP and seal assembly SUBMERSIBLE Float operated submersible(NEMA 6) 11/2" NPT DISCHARGE 2-pole mechanical switch Motor-Permanent split capacitor, 60 Hz, 1725 RPM, oil-filled, hermetically sealed, UL IP 0 - automatic reset thermal overload protection Tealed to lA$bndard Ui778 Bearings-Upper&lower oil fed cast iron -dCeO6 WGSA St o Wd c221 au.1 oa -- Carbon and ceramic shaft seal Entire unit pressure tested after assembly. f MC Watertight neoprene"0"ring between Auto Automatic aYc L PG or N `. o Autoonautomatic motor and pump housing %HP,1 Ph., 115V or 230V Maximum temperature for effluent or Available with Piggyback dewatering 130°F-54°C Variable Level Float SvAtch. Passes 1/2 inch spherical solids No screens to clog Standard cord length 15 ft. (UL Listed) SSM 11/2" NPT Discharge(1'/Z'X 2"PVC Adapter included with BN & BE Models) On point-9'/" Off point-3" Major width-101/8" Height- 12" POWDER SIMPLE)( AND DUPLEX COATED SYSTEMS AVAILABLE TOUGH, PACKAGED SYSTEMS AVAILABLE Note: The sizing of effluent systems normally requires variable level float(s) controls and propedy sized MODEL N9 basins to achieve required pumping cycles or dosin g timers with nonautomatic pumps. ©Copyright 2012 Zoeller Co.All rights reserved. (n TOTAL DYNAMIC HEADIFLOW X LU ul PER MINUTE PUMP PERFORMANCE CURVE U- EFFLUENT AND DEWATERING 7s 6 1"4 MODEL 98 r._ A 5M '- MODEL 98 25- Feet Meters Gal. Liters 5 1.5 72 273 Z6 6- 20-- 10 3.0 61 231 15 4.6 45 170 S2 7.1 25 95 2 20 < % z hut-off Head: 23ft(7.0m) 4- 1 5 20 Shut-off�Sh� ff 009971 1 0 2- 0 10 23 3 40 50 60 70 80 GALLONS t .21M LITERS 1 80 160 240 FLOW PER MINUTE SK1102 Electrical alternators,for duplex systems,are available and Variable level float switches are available for controlling single supplied with an alarm and three phase systems Mechanical alternators,for duplex systems, are available Double piggyback variable level float switches are available for with or without alarm switches variable level long cycle controls Refer to FM 1922 and FM0806 for temperatures above 130°F 98 Series Control Selection Model - Volts-Ph Mode Amps Simplex Duplex M98 - 115 1 —Auto 9.4 1 4 15-1 "Easy assembly" N98 9A 2 or 3 4 4 D98 -230 1 4.7 1 (MM g discharge pipe 4.7 E98 -230 2 or 4 not included.) E 1.Integral float operated mechanical switch,no external control required, 2.For automatic use single piggyback variable level float switch or double piggyback variable level float switch.Refer to FMO477. 3.See FM1228 for correct model of simplex control panel. 4.See FM0712 for correct model of duplex control panel or FM1663 fora ; residential alternator system. Reduces potential dogging by debris. For information on additional Zoeller products refer to catalog on Piggyback Variable Level Replaces rocks or bricks under the pump. Switches,FM0477;Electrical Alternator,FM0486;Mechanical Alternator,FM0495;Sump/ Made of durable.noncorrosive ABS. Sewage Basins,FM0487;Single Phase Simplex Pump Control,FM1596;Alarm Systems, Raises pump 2"off tt of basin. Provides the ability to bo r om aise intake by adding sections of 1112" FM0732. or 2'PVC piping. JA CAUTION] Attaches securely to pump. Accommodates sump,dewatering and effluent applications. NOTE:Make sure float is free from obstruct ion. RE,SE.RVE POWEREI-� D E S For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. A#AJL TO:P.O.BOX 16347 Louisville,KY 40256-0347 Manufacturers of SNP TO, 3649 Cane Run Road Louisville,Ky 40211-1961 502)778-2731-1(800)928-PUMP PUM II www.200110r,com FAX t502)774-3624 Copyright 2012 Zoeller Co.All rights reserved. Yft; /_ PRESSURE FILTER INSTALLATION & SERVICE INSTRUCTIONS Jj L 1455 Lexamar Drive Toll 1-'ee 888-999-3290 Ojice 231-582-1020 Boyne City,MI 49712 Fax 231-582-7324 Email .. _ Web INSTALLATION: When installing an STF-100, screw filter into discharge port of any pump that has a 2" National Pipe Thread. Pumps with a smaller discharge port may be adapted to fit. When installing an STF-100A2 a tailpiece and male adapter will need to be added to the inlet end of the filter(end opposite of the cap)to the desired height and a 2"union will need to be added to the outlet end (the end closest to the cap&on the side of the filter). Always install the filters in a position where they can be easily serviced. **Always use caution when starting threads to avoid cross threading**. Plumb force main into the 2"sch 80 PVC union. **We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O-ring or sealing surface*". R rtes SERVICE: Service of filter screen is dependent on usage as every system is unique. For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our STF-101 service alarm switch has been installed and adjusted properly it will alarm when the filter requires service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks(600 micron, 150-190 micron, and 100 micron). Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a"pump on light"that stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the 4"cap. Pull filter screen from canister and wash out thoroughly in appropriate location with proper protection. In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop. lash #�r a[ b ,EtSlt lllc at t a3lt�ae or pour +err' " � �ilk � i�r too it�a�r�a�arm ,�eulne and Aw"MAW,taty�r rM1E f If the system is equipped with our Service Alarm Switch, the filter screen does not need service until the Service Alarm Switch activates a light or audio alarm. We still recommend that the filter be inspected once a year for damage or corrosion. NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of head to overcome friction loss through the filter. SERVICE ALARM SWITCH The alarm switch is available in three pressure ranges, low head, medium head, and high head. Installation is simple, on SIM/TECH FILTER systems, remove%"plug from base of filter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm. Pressure adjustment is made by removing the end plug, and inserting the 7/32 alien. Clockwise increases pressure. One turn equals approximately 3 PSI. The low head alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range(3 to 24 PSI). We recommend the use of a ball valve when using an alarm switch. Once you have installed the filter and alarm switch, the ball valve can be closed off to simulate a plugged filter so that you can make sure the alarm switch is working correctly. ****TRY OUR LID/SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks screen for easy removal and installation. Made of PVC plastic. WARRANTY All products are warranted against defects in material and workmanship for a period of two years from the date of purchase. In no event shall GAG SIM/TECH FILTER, INC. be liable for any consequential damages or any labor, material, freight or expenses required to replace, correct or reinstall the product. GAG SIM/TECH FILTER, INC.'s liability is limited to repair or replacement of the part. All warranties are void if the product has been improperly modified, applied or installed, subjected to misuse or abuse. Except as stated herein, there are no warranties expressed or implied, including the warranty of merchantability or warranty of fitness for a specific purpose. EFFECTIVE September 13. 2005 Mound / Retaining Wall Cross Section Not to scale C ►�(P CAP { WALL ��rM C33 B[E'CN5 AG6U6ATk 5AN D LTV t L 31y P�ywcacp M C0M PA Ct-E0 l3AsF- yxLt f OST Ni0N T,: tBACK =�c� ��,�R�SQONpENC Q SSA 3 X CA= LL ,t A,STM 5 /A a T x Retaining Wall Material List 1. 4"x4" AC2 Green Treated Posts 2. Granular Bentonite 3. %" Plywood 4. 2 inch Foam 5. 3/4" Aggregate 6. 6"x6" Green treated timbers 7. 12 inch Concrete Retaining Wall System. Retaining Wall Maintenance The retaining wall is an essential part of this dispersal cell and must be maintained 1. Make a thorough annual inspection of the wall. 2. Correct any settling or grading problems around the wall. 3. Take notice of any wall movement— settling, bulging or rotation, and then take proper corrective measures. 4. Control any random weed growth as necessary. 5. Avoid use of salts as deicers around the wall. With proper installation and maintenance the retaining wall should last the lifetime of the mound. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer J Mailing Address /-�,_�t7 Property Address (Verification required from Planning&Zoning Department for new construction.) City/State /lf s kd_m< �j wi Parcel Identification Number ©.3f- Ol f - 9 5 - d� LEGAL DESCRIPTION Property Location �'I4 1/4 , Sec.3 , T 3L_N R�W, Town of A--c i a, Subdivision Plat: bm/no() , Lot# Certified Survey Map # , Volume , Page # Warranty Deed # 2� �7 7 _ (before 2007)Volume , Page # Spec house yes D no Lot lines identifiable❑yes[I no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning&Zoning Department a certification form, signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning&Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _1.2 7/ 3 / 13 SIGNATURE OF APPLICANT(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 a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) L STATE BAR OF WISCONSIN FORM 1 -2000 8 Tx? 4009220 2 WARRANTY DEED 926444 Document Number BETH PABST THIS DEED, made between John G. Tuttle and Lynn E. Tuttle, REGISTER OF DEEDS husband ' sband and wife,Grantor,and Randel C. Simonson and Ann M.Simonson, ST. CROIX CO., WI husband and wife as survivorship marital property,Grantee. RECEIVED FOR RECORD 11/08/2010 4:16 PM EXEMPT #: N/A Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 30.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 270.00 "Property"): PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: —T—I+ Le O'er. .? Together with all appurtenant rights,title and interests. 038-1018-95-000 Parcel Identification Number(PIN) This is not homestead property. Grantor wan-ants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways,easements and restrictions of record. Dated this 4th day of November,2010. * ohn G.Tuttle * Lynn gftuttle * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST.CROIX COUNTY. )ss. authenticated this 4th day of November,2010 Personally came before me this 4th day of November,2010 the above named John G. Tuttle and Lynn E. Tuttle, husband and wife to me known to be the person(s) who executed the TITLE:MEMBER STATE BAR OF WISCONSIN fore=0s' nand acknowled the same. (If not, authorized by§706.06,Wis.Stats.) PEG THIS INSTRUMENT WAS DRAFTED 8Y E\IE�^V �aH PUb�cn Publ' ,State of Wisconsin S aye of Wts. My commission is permanent. (If not,state expiration date: 8/26/2012 ) Michael H.Forecki,Attorney (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.1-2000 /] �Y& EXHIBIT A A strip of land extending 66 feet Eastward and Westward,and between the South shore of Cedar Lake and road,now located in Section 3,Township 31 North,Range 18 West,meaning to convey a strip of land extending from said South shore of Cedar Lake to roadway and extending Eastward from the East line of land conveyed by warranty deed bearing date of August 6, 1914,to one Harry M.Williams,66 feet;same being located in Lot 6 of the SE'/.of said Section 3. ALSO, Part of Government Lot 6,Section 3,Township 31 North,Range 18 West described as follows: Commencing on North line of County Trunk Highway H,210 feet West of the East line of said Section 3;thence West to a point on the North line of County Trunk Highway H which said point is the Southeast comer of land above described;thence North to the South shore of Cedar Lake;thence East on lake 30 feet,more or less,to a point North of place of beginning;thence South to beginning. Meaning in all to convey a strip of land 96 feet in width,Eastward and Westward between the South shore of Cedar Lake and the North line of County Highway H. 2of2 o z � a o c� CO)OR m ! gam ' po �n p � r Z O S �n O CO)g5-0� gc t 2 yx rt') 9m mE r z �j +�+ _'z 'z w u ~ 51 m SO N <� �+ O ' � m �i ;,cc Cir- mCA $ ��ii ; m :S -4 220 ;aCm '�I zz o ; nr' OpT -r mm v -0, Cn O 71 T 0 f-.. n {Ti� � O m � 0 � �V p! MI T f w 1 � u' P -y ! � Z 1 W Ei R SOUTH 227.70') r 0 1 I L61.79' 1.OZ'27?E 158.78' 1 M 65 77 66.89' 54.55 Cb Co � � ! n O (R SOUTH 86.W) g '�SOO'33'15'W 86.35' r _ r m p D 55.71' 37.14' r i :'� c, z m 1 1 S00'31'441W 156.64' r '� i r �' o •.V� n � Z �l 1 0 J'rr rr , g U uU O Z O O m ao;� fr cpr O co ; y z:_g:IWa3� ! Z- 4 m * --q Z r' 1 c� r rr n O O-� 1 r r l 40 1� Q-------------- x - 0 Ii r 1 / t4tZ'Jd 111 Ill �r • • O n-LS3M _ /r / � zzzz zMzsz r / 0 Q � QZQ ' I - AAA {{�� AA M.ZtX.ZON _s�T --------- -9£.WN g r�r rt� rt�r�i r-1r z £9'ZEt M 00, / � co (n v�cn to p N uM.LZ,s►.VoN (Mgt .aoN a) o `� x oazooz ; z 0 // ;u co zC - n z zOp ., I _r :� i O �Z p �`*SCO/1S SOIL EVALUATION REPORT #1646 Department of Com[ee C E IV E D m a rdance with Comm s d�C�e� Page 1 of 6 Division of Safety a tl Schmitt Soil Testing,Inc. Attach compl ete site pla r not less than 8%x 11 nches in size. Plan must - Cou St.Croix include,but not limited ppd r or�tgl�gferen point(BM),direction and percent slope,scale or 4+0 �rr6J�,bad loca'on and distance to nearest road. Parcel I.D. -7 038-1018-95-000 , /�G 8 Z NING OFFICE Reviewed By ` y Dat Personal information you p ses(Privacy Law,S.15.04(1)(m)). Property Owner ��pp Property Location Simonson, Randel C&Ann M (.(t�C�- Govt.Lot 6 NE1/4, SE1/4,S3,T31N, R18W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 1327 27th St. `` 71 4 City State Zip Code Ph6Ke Number City ❑Village F] Town Nearest Road Hudson WI 1 54016 1 715-549-9182 Star Prairie I Cty Rd. H ❑New Construction Use: M Residential/Number of bedrooms 2 Code derived design flow rate 300 GPD N Replacement ❑ Public or commercial-Describe: Parent material Glacial till (Amery-Cromwell Flood plain elevation,if applicable 78.0 ft. General comments and recommendations: Pits A thru D are described in this report. Pits 1 thru 6 are described in the attached report by CST Donna Stark dated 9/29/2010. A]Boring# Boring Pit Ground surface elev. 90.07 ft. Depth to limiting factor 57 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure 7sisten Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 1 0-3 10yr3/4 FILL sl 2mgr as 2f,1vf .6 1.0 2 3-16 10yr4/4 FILL sl 2msbk gw ivf 6 1.0 3 16-57 10yr4/4 FILL sl lmsbk mfr ---- ivf .4 .7 All horizons are FILL,useability of FILL material for a septic system was verified by Leroy]ansky of the Dept.of Commerce on 5-24-2011. Fill Boring# [I Boring Z Pit Ground surface elev. 92.66 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 `Eff#2 1 0-2 10yr4/3 FILL sl 2mgr mfr as 2f,ivf .6 1.0 2 2-25 10yr4/6 FILL sl 2msbk mfr as 2f,1vf .6 1.0 3 25-29 10yr5/4 none sil lmsbk mfr a 2c,lf .4c .6 4 29-36 7.5yr5/4 none scl 2fsck mfr gw 2m,lf .4 .6 5 36-42 7.5yr5/4 fif 7.5yr6/8 sl 2msbk mfr ---- if .6 1.0 0-25 inches is FILL,useability of FILL material for a septic system was verified by Leroy]ansky of the Dept of Commerce on 5-24-2011. FILL L— --- I I I i I I I I I "Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD5 s30 mg/L and TSS<_30 mg/L CST Name(Please Print) Signature: 7 CST Number Thomas J.Schmitt SY � L_ 227429 Address Schmitt Soil Testing,Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond,WI 54017 5/20/2011 715-247-2941 SBD-8330(R.07/00) Property Owner Simonson, Randel C&Ann M Parcel ID# 038-1018-95-000 Page 2 of 6 r i Boring# [] Boring Pit Ground surface elev. 94.32 ft. Depth to limiting factor 42 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 1 0-3 10ye4/3 FILL sl 2mgr mfr as 2f,2vf .6 1.0 2 3-13 10yr4/6 FILL sl 2msbk mvfr gw 2f,ivf .6 1.0 3 13-22 10yr3/4 FILL sl lmsbk mfr as 1vf .4 .7 4 22-33 10yr5/3 none fsi imsbk mfr Cs 1c,1f .2 .6 5 33-42 7.5yr5/4 none sel ifsbk mfr --- if .2 .3 0-22 inches is FILL,useability of the FILL material for a septic system was verified by Leroy Jansky,Dept of Commerce,on 5-24-2011. FILL material has moderate to weak structure and is friable to very friable. F Boring# Boring pit Ground surface elev. 93.2 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 1 0-1 10yr4/3 FILL sl 2mgr mfr as 2vf .6 1.0 2 1-12 10yr4/6 FILL sl 2fsbk mvfr gw lvf .6 1.0 3 12-22 10yr4/4 FILL sl 2fsbk mfr as ivf .6 1.0 4 22-26 7.5yr5/6 none scl 2fsbk mfr gw 2m,if .4 .6 5 26-36 7.5yr5/4 none scl imsbk mfr Cw 2m,lf 2 .6 0-22 inches is FILL,useability of FILL material for a septic system was verified by Leroy Jansky,Dept of Commerceon,5-24-2011. Structure of fill material is moderate and ranges from friable to very friable. 6 36-41 7.5yr4/4 cld 7.5yr6/8 scl Om mfi --- ----- 0.0 no F] Boring# El Boring El pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 Effluent#1 =BOD?30<220 mg/L and TSS>30<150 mg/L "Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) Schmitt Sod Testirg,Inc. �s �. Eoap TER *0203i i STORAGE t� c� t�% DWELLING WALLS WaLL ui SLOP lb AMPLA 96 ov_ -- �► `:` sli3 ;£ AN 77R�6s Page 3 of 6 Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Randel C&Ann M Simonson Thomas J. Schmitt, CST 227429 Address: 1327 27th St 1595 72nd St. City, State, Zip: Hudson,WI 54016 New Richmond, WI 54017 Phone: 715-7 0-1978 Address: 1194 Cty Rd H signature +-+s^�+,-ate -- Lot NO. : 71(Gov't Lot 6) 0!/ Legal Description: NE1/4 SE1/4 S3 T31N R18W ■ Backhoe Pit Township, County: Star Prairie,St.Croix County Shovel Pit Bench Mark 1 El. 100.00'Top of 2"PVC pipe Q Bench Mark 2 El. 100.3'top of ground rod SW comer of house Slope= 29% Scale V=20' NOTE: Existing sand point well to be abandoned w well to be installed. 0C—) xn/ TIM)f, Pit Elevations A: 9o.m' `t B: 92.66' l C: 94.32 D: 93.20' 1: 94.44' 2: 98.55' x r`/I 3: 93.38' 4: 92.30' r,✓E-Ll�� 5: 89.40' 6: 86.85' 4 / �'� ■ 0 ?u f Q� �, f �� ' �, i i 1 I � , �� , i . , _--- 1 � . \ '� �.__1 � � , �, : -.� _ ,i \ _� ,.�: • ., ... ,\ ® - I'�� - __ _ _ I i �� `_ � -. -, �� V �� - - _ � _ � ,_ A Land Use ST. planning&Land Information �------ Resource Management Community Development Department October 11, 2013 File#: LU88065 Randel &Ann Simonson 1327 27th Street Hudson, WI 54016 Re: Land Use Permit, Filling &Grading < 10,000 sq. ft. in the Shoreland District 1194 Cty. Rd. H, Parcel #03.31.18.71, Town of Star Prairie Dear Ms. Rubis: This letter confirms zoning approval according to the plans you have submitted for filling and grading an area of >1000 square feet within 300 feet of the Ordinary High Water Mark (OHWM) of Cedar Lake to construct a private on-site wastewater treatment system (POWYS) on the property referenced above. Staff finds that the proposed project meets the spirit and intent of the St. Croix County Zoning Ordinance and Shoreland District with the following findings: 1. Filling and grading less than 10,000 square feet <300 feet from the lake OHWM on slopes >12 percent is allowed with a land use permit in the Shoreland Overlay zoning district pursuant to Section 17.29(2)(c) of the St. Croix County Zoning Ordinance; 2. The filling and grading will consist of excavating —1000 sq. ft. for the basal area of the mound POWTS and installation of tanks and retaining walls that will be connected to an existing two-bedroom cabin on Cedar Lake. The POWTS will meet the 75'setback from OHWM and other required setbacks and dimensional standards contained in the St. Croix County Zoning Ordinance; 3. The applicant's agent, John Schmitt, will install the POWTS in an area that slopes away from the lake, so there is limited potential for erosion or sediment issues. With conditions to establish permanent vegetation on all disturbed areas and prohibit the use of phosphorous fertilizer to maintain a lawn, negative impacts to the water quality of the lake will be minimized; 4. The lake shore is N 40 ft. from the existing house and the owner will be required to maintain existing vegetative cover within a 35'shoreline buffer zone; and 5. The Wisconsin Department of Natural Resources staff was sent the application for review on October 1, 2013. A DNR grading permit will not be required for land disturbance less than 10,000 sq. ft. and outside the 75'OHWM setback. Based on these findings, approval of the land use permit is subject to the following conditions: Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, W154016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountyw cdd@co.saint-croix.wi.us Community Development Department Page 2 1. The sanitary permit has been issued for the POWTS. The applicant's agent will schedule the required county inspections for compliance with SPS 383. 2. The sanitary permit issued for installation of the POWTS contains a condition that requires compliance with all conditions of the land use permit and contractors must be made aware of the conditions regarding stabilization of disturbed areas upon completion of the mound. 3. No phosphorous fertilizers shall be used on the disturbed areas of the site, unless a soil test confirms that phosphorous is needed for establishing permanent vegetative cover. 4. Within 30 days of completing the project, the applicant shall submit to the Zoning Administrator photos of the disturbed areas for documentation of compliance with conditions. Photos may be sent electronically via e-mail attachment. This approval does not allow for any additional construction, structures or structural changes, grading, filling, or clearing of vegetation beyond the limits of this request. Your information will remain on file in the St. Croix County Community Development Department. It is your responsibility to ensure compliance with any other local, state, or federal rules or regulations, including obtaining a building permit from the Town of Somerset. Please feel free to contact me with any questions or concerns. (:amela , i Quinn Land Use Specialist/Zoning Administrator Eric: Land Use Permit LU88065 Cc: Brian Wert, Building Inspector, Town of Warren Mike Wenholz, Wisconsin Department of Natural Resources Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, Wi 54016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountywi cdd(@co.soint-croix.wi.us n 0., Or. �t5 VEIL C oll rM fm4L� C. y z � � d o �■ , OWNED t� o �' �, o n O,0 CL .4;3 v, O Mft3 13 CD - = CD (D o o, y c to y CD z � Z oo 0 � rMIL WINES X -h MINE m �D CL N CD P 0• O (D a CL O O � -h O MINES Cl) Q ■"� -■ U) o Cr Vim c = Q •� zu CD C fmilL Cl) CL _ rMIL y N 'N CD �;. • C. O � V . O 0 W o N Z Q a W q •p o ° c 9 a c o r L > M p 1++ O co -� � ^ d a � m L1/ W �"' "yam d m C', y s � aEmbq '3 �'sE " ID4 1_' � o � 7 � � e °,� « U w T 1 L d v W �m O anQ. ,� C L � �J� x s C = orbs o.°i •° br w E \ �� rC V m a .��. oo F' �'' '-' ,`, j� ��iii�.r o c z z d ^ I/ �"� b0 •a� C 00 O y O d h�l VC xi 7. a=.+ Z A.� N A No J \ 0 XMMc k §ƒ k U3 3 w$ U) a \ cc LL « om-mom 0-- 0 k @/j-rk & -== 02 � Qa E � m§7{ c ; J m§2{2 oE ± - > 7t� m � l� § 77m tffm LL $ 27kkn § �__ 2 §2t0 < = 2f� k o � k {�t/ n ' \ $=k\ o E \ k k § C/ > 4) , \0o§ / am $ § � SSA 0) � § = §22 2z f 77) CL m � k 7 d, \/ % 2 E-m \ CL`\ ! / O)_ - / } LO CL Q . o < < 3SJ/ k# � Ln G � \ 2 a § 0 2 .0 § � ) � \ k ~ � � � ■ ■ 3 � � � ' $ $ 2 2 2 CL { 2 ] q ) 0 / § £ / / 2 ) ƒ © U) U) el § / \ ) 2 Q § © i s (D 7 ( § ƒ ; k _) k ZE . 2 ob � $ 2 D 'o ' k d / 4 0 2 $ } } 2 2 g k 2 - , e ,IL w E & .2 k f / J a \ 3 $ J i Ryan Xarrington From: Bratz, Charles L- DSPS <Charles.Bratz @Wisconsin.gov> Sent: Thursday,April 04, 2013 11:06 AM To: 'John Schmitt' Cc: Ryan Yarrington Subject: RE: Difficult Site Looking at the soil profiles it is apparent that this site does not have an "A" plus 4 profile. This condition will require a Soil Saturation Determination Report. If the fill material is proposed to be used for treatment and dispersal it will require an on- site to assign a load rate and suitability assessment. It might be possible to use the site with removal of the fill soil material and replace with sand. That could be ASTM C-33 sand but not necessarily so. Medium sand may be acceptable with the WWS review of the material. The soil report for the last three pits where done under dry conditions. The soil report shall indicate the consistence in a moist condition. That is required so as to make a reasonable assessment of the suitability of the soil and a more accurate description of the structure. New pits will be required with a size suitable to make the assessment of the horizons. Shovel pits are not suitable for Soil Saturation Determination Reports. Call or e-mail if you plan on revisiting the site. Hopefully the snow will be gone and the soil is not frozen. From: John Schmitt [mailtoJschmitt @somtel.net] Sent: Tuesday, April 02, 2013 8:42 AM To: Bratz, Charles L- DSPS Cc: Ryan Yarrington Subject: Difficult Site Hi Charlie am attaching a soil evaluation for a lot on Cedar Lake in St. Croix County. Here's a little information and history to go with the site.The lot has a cabin on it, that the owner would like to demo and replace with a year round residence.There does not appear to have been any sort of septic system on the lot, so St. Croix County has told past prospective buyers that holding tanks are not an option. The soil and the site were originally evaluated by Donna Stark. The owner was not satisfied with Donna's site and soil evaluation, so Tom Schmitt was contacted and he had Leroy Jansky do an onsite along with Ryan Yarrington and Kevin Grabau from St. Croix County Zoning. Leroy was going to write a report after doing an onsite, but retired before he wrote the report. During the onsite Leroy thought a mound or drip system would be feasible after evaluating 4 shovel pits within Donna Starks evaluated area on the west side of the driveway. Tom Schmitt has since then evaluated the east side of the driveway and found there still to be fill, but the slope is much less and a recent survey has revealed that there is less area on the west side of the driveway than what had been indicated by the owner. I have included a plot plan with a proposed 2 bedroom pretreated mound on the east side of the driveway that is on the new survey map. I understand this would be a Individual Site Design because of the fill, but I don't know what an ISD all entails. Please let me know if you think a mound or something else is feasible on this site or if you need to do an onsite. The owner does not want an aerobic treatment unit but I don't see any way around pretreatment. Thank You John Schmitt 715-760-0486 3)/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 01/02 r RFcE�� D Wisconsin Department of Commerce Ap% 'vALUA ION REPORT Page of Division of Safety and Bulldirnys p p S i m. Code County Attach complete site plan on paper not less than S 1/2 x U ry .Pi must S� x include,but not limited to:vertical and horizontal reference porn c n and parcel 1,D. ,.OD percent slope,scale or dimensions,north arrow,and location and dista nearest road, - please plant all irtformatlon, R¢Glewed by [?ate • ' Personal information you provide may he used for socondary purpose:(PrlvaCy Lew,s.15.04(1)(In)). { Pr9kerty owner Property Location SGOVT-Lot 1/4 114 S 3 T3 I N M � E Property Owner ailing Ad ress Lot# Block# .Subd,Name or CSM# ^^d 13 A 7 a y(�/Get" dw City State zip Code Phone Number ❑City Q Village ;M Town Nearest Road Q New Construction Use: Residential I Number of bedrooms-,n7—3 Code derived design flow rate y.'; ® GP'D ,Replacemarrt ❑ Public or commercial-t�oocrlba: . Parent material �� Flood Plain elevation.if applicable R ants Q General comm = L) e 0.. h S&s r%C.Ta N k F��t' h•5 C. t•Q rA N S s-4� �P i and recommendations. 'g J � � s+: In S o . fiso 1V'1 . ��+ee 5 ION., < or '.1! �� a eot aii. 5 F ® Boring 41 Boring# Depth to limiting factor / 0 In 'r 9 macs elev. n. P 9 — U ounC U all A lic'�tbn Rate Pit ----°--- 9 Horizon Depth Dominant Color Redax DescrlRtlon Texture Structure Consistence Boundary Roots PD/f 2 In. Munsoll Qu,F:. Cont.Color C,'r.Sz.Sh. *121M NEW — 1 0.3 / b R a -- SL aMk MFw 4w aM !, 3-Ib '1 Is `fRy 5 L FSSK rr Lv — r" 1 . S G w W'F . -7 , e Boring# "-I Boring Pit Ground surface elev. ft. Depth to limiting factor_a in, Soil Application Rate_ Horizon Depth Dominant Color Radox Description Texture Structure Consistence Boundary Roots GPD1fF I _ In. Mun/nsell Qu.Sz, Cont.Color Gr.Sz.Sh. *Efi#1 *EfW2 3 Al- yal D YA IN ScL I MS lo W- N w 7.SYQ. - V F5i. SbVL EfilUent 41 c BQD v 30 Zi 220 mg1L and TSC x30:160 mg/L "EfAnon#42 m BOD c 30 mgA-and TSS<30 mg/L CST Name (Please Print Signature CST Number o h �-�- 17 73dress ^ bb-,v S i. Da#e Evaluation Conducted Tetephono Number c9'7(0 T 9-a -ao 15-2 - sV S to 03/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 0P"02 �RQllJyi.-An4 a � Parcel ID# Page properly Owner i �� 0 R M L [l Boring _ 0 Boring# rn Ground surface elev. R• Depth to 1"rtniting factor�_ in. Soil A lication Rate �4 Pit Horizon Depth Dominant Color Redox Desarlption Texture Structure Consistence Boundary Roots *E�GFDIffr� 2 in. Munsell Qu.Sz. Cont.Color Gr,$z Sh. l o- 1 y 3 ----- S L F61,11 a w IM yl L 3 _y o-� y/ L, C to t J -6 O <7 Boring 1� boring# � g, Depth to limiting factor �in. i�! 1 Pit Ground surface elev. Soil A1201cation RatE Horizon Depth Dominant Color Redox De9crlptlon Texture GrrSz Sh Gonsislcnce Saundary f2oarta *Fff#1 1*Eff#2 In, Munsell Qu.Sz, Cont.Color a- Y a s-c s h ..a � 3 - y p Boring In. t' Baring# Ground surface elev. ft. Depth to limiting factor pit Soil ApOICafion Rate tiorizon Dzvth ppminard Color Redox poecription Texture Stnrctur2 Consistence Boundary Roots "B GPD�ff#2 In: Munsell Qu.Sz, Cont.Color Gr.Sz.Sh. I Effluent#1 150D.:1,30.<z2o mg/L and T55 x30 I M rn4/f. "effluent#2=BODE:30 mg/l-and TSS.e-30 moll I The Department of Commerce is an.equal opportunity service provider and employer, If you.need assistance to acuoss services or need material in an alternate format,please contact the department at 608-266-3.151 or TTY 608-264-8777, seo-s,ae lao�roa) 03/15/2011 11:58 7154859246 POLK ZONING FAX PAGE 02/02 Page Property Owner �M a> Q ParCeI.ID# [] Boring a 51 Boring# � — Depth to lxniting factor�tBoundaWl; 7-Er*1 -EfW7 Pit Ground surface®lev. ft• Horizon Depth Dominant Color Ruadox Description Texture St picture Consistence oots in. Munsell Qu.Sz. Cont.Color I o- I �f 3 ------ S L a F5.5 k m L_ L b 101 . 3 w t Jr± )C n Boring# Boring '�J 1 I I +�+ 'n Soil A Ication Rate 7 Pit Ground surface elev. ft. Depth to limiting factor • Horizon Depth Dominant Color Redox Description Texture G r$tune Gansisicrtue Boundary ('2oata �ff#1 rEf#2 In. Munsell Qu.Sz, Cont.Color F Boring Baring# Ground Surface elev. ft. Depth to limiting factor in. Pit Sod A lgllon Rate Fiorl=on DcNllt pomfnent Color Rodox poecription Texture Structure Consistence Boundary Roots GPD�f2 in. Munsell Qu,Sz, CDnt Color Gr.Sz.Sh_ " Effluent#1 ^SOD,a 30,<220 mg/L and TSS?.3Q 100 riV. "Cfiluent#2=DODS=30 mgll,and TSS 1311 m©A T fte Department of Co....merce is an.equal opportunity service provider and employer, if you.need asststane- to-8777.services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. sren-R.M(Rmroa) R a. � in S "^D wsc tit PQ �C + A e 3 3 7 < �Qcr� �ar►�14! � � �ar�. 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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 O-SIMONSON, RANDEL C&ANN M RANDEL C&ANN M SIMONSON G� �C,� h' .y. �- e -f-4t2 1327 27TH ST S° HUDSON WI 54016 ScG��e �Y t'`�V� C• C�h r q'�,vrh et r`�� ) Districts: SC=School SP= Special Property Address(es): *=Primary Type Dist# Description *1194 CTY RD H SC 3962 SCH DIST NEW RICHMOND SP 1700 WITC ya 2 - 559- s t'",4 erte" SP 8050 CEDAR LAKE/N R � ✓1, 1�►,Q Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 3 T31 N R18W PT GL 6 A STRIP 66 FT Block/Condo Bldg: WIDE EXTENDING FROM SHORE OF LAKE TO RDWY&EXTENDINGLE FROM E LINE OF LAND Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) �- CONVEYED W /6 COM N LINE OF 03-31N-18W �a HNINE F OF SEC 'D DESC 41D s more Notes: S(� n t/4(�t. / �1`� . + Parcel History: " �1 1q I q (//v Su)2 vr� Date Doc# Vol/Page Type 6 I P�d N��y` " 2 i �aW.� cf 11/08/2010 926444 W D fi'� � �� 04/29/1985 401578 711/127 WD �f W�{_�oir J �,Q,--��/,�-LOir� I A- �Vacj 04/29/1985 401577 711/126 WD a,vi yd aj / �ypyy ov o 03/26/1985 40 Q19 .08/248 moLC 2011 SUMMARY CI'av Bill M P Fair Market Value: Assessed wit : /VO1N Valuations: Last Changed: 10/13/2004 Description 4/ Class Acres Land Improve Total State Reason RESIDENTIAL w�I y -�JA,G 1 0.000 l 118,800 24,600 143,400 NO U f�j jy t / 1 l�Ci w ' 4 i Vin( -�t� ��a t ry y3� (o07 / ;� ��l?o" d �Cr,-� o hv�y Totals for 2011: General Property 0.000 118,800 24,600 143,400 Woodland 0.000 0 0 Totals for 2010: General Property 0.000 118,800 24,600 143,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code R/ Category Amount Su�Aw -a n�1.lh D 5w-vir(lo �( ---o W-1 0'mf 4-'' 20 VO4, x #S rowf �n �a,s.. S'Je t V00d 40 ItL4x. (3,� ,V,-7 1123 Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Jas , � �-4W -Fw, , V, �J 11 jo r Parcel #: 038-1018-95-000 04/27/2011 07 33 AM PAGE 2 OF 2 Parcel History: cont. 367/547 Legal Description: cont. S- ABOVE. 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