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008-1024-70-300
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 567262 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Buckner, Rebecca I Eau Galle, Town of 008-1024-70-300 CST BM Elev: Insp.BM Elev:7 Description� Section/Town/Range/Map No: d� / �J 09.28.16.125A30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 3. 6Z X03.b / Septic r -'+ti 3 Benchmark c s-c-A, F•4., ` /;!b'D /, 3Z /61,,3Z, l Dosing Coµ� 3 �dd Alt. BM r l f �+a Z1�C.7 ' / J Bldg.Sewer �7Z, I Jz. Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P//L WELL BLDG. Verq,to Air Intake ROAD Dt Inlet e� Septic /713 UZ Dt Bottom 1 "_5 40.3 Dosing B, J Header/Man. l 3 z s 3.78 -7, S Aeration Dist. Pipe Holding Bot.System c PUMP/SIPHON INFORMATION Final Grade , Z•-7 AM Manufacturer � Demand GPM Z St Cover �I J >5J • / Model Number � � 3� U ' 3 TDH Lift Friction Loss System Head TDH t 1 S Z. ,6 Forcemain Lengt�/ _ Dia.Z Dist.to well SOIL ABSORP/JTIOc.CN� YSTEM BEDITRENCH Width Length No.MV PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS � — —� SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type tem: A. UNIT l y � 1�� Model Number: DISTRIBUTION SYSTEM / Header/Manifolp ( Distribution Z �� x Hole Size J( x Hole Spacing Ve o Air In ke Pipe(s) !{ t J t I Length__Dia Length 7✓' is Spacing r g Z +O T SOIL COVER 1 x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded hed Bed/Trench Center I Z Bed/Trench Edges Topsoil l L es [g No ] No Y test COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1/1y / / nspection#2: / / Location: 483 233rd Street Ba dwin,WI 54002(NE 1/4 NW 114 9 T28N R1 6W) NA Lot 3 C.�w��'SC� Parc No: 09.28.16.125A30 1.)Alt BM Description= Ga J.<. ,p/o Pi 2.)Bldg sewer length / -amount of cover= /1 CCt ai��t.5 A e4 5 a v` -- -- - i Plan revision Required? 0 Yes ;�No Use other side for additional information. D SBD-6710(R.3/97) Date Insepctor's yture Cert.No. o I r i n r w o y m w � N m b � p O _ 'CS m A, at �" � tC • p r c p 0 r a 4. a 90- RL � o � t h � 0 3 PL O A. Op A too �? m 2", A„ O A pn. y � 0 v b g n tg 0 !14 Q � ► �' -41 Ch QR a A b l II County T / f . Safety and Buildings Division ST //Q/ S_ "� 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) , � p=, � Madison, 53707-7162 �� \ 726'icii; State Transaction Number Sanitary Permit A I' i 3,2� �3 In accordance with SPS 383.21(2),Wis.Adm.Code,submissi,m. is fo o the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:A lica .F'. or state-owned POWTS are submitted to Project Address(if different than mailing address) P g azY Pe PP e J (� B ) the Department of Safety and Professional Servies. Personal i ormation you provide may be used/l%s,econdary L/ purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. @.": _ _J 8 /) �, I. Application Information—Please Print All Information �j (`' • of ''I ST 24��aai Property Owner's Name pew `j re-" Parcel# 5„e.�f� �Gc c fez -_ arC ��� v4) 001-/02y-7a- 306 Property Owner's Address R0 �4,7 Property Location ,J (� / , / 2574-3O) p2 D S t O S '- °0y Govt.Lot l City,State ip Code Phone Number �} All--1/4, y�y, Section f 5 QQ' / //(_circle one A u G w� ( 7/2 T N; R_F-�_Ee II.Type of Building�(c eck all that apply) Lot# Subdivision Name A �r?2,F�a^mily Dwelling-Number of Bedrooms /_vI J t/'I y4i/YA, , /I'i' lit}/ .' . LL. Block# ❑Public/Commercial-I ribe Use / _— CI City of CSM Number ❑Village of ❑State Owned-Describe Use 2- 6 El own A &c)--7 IJ Town of ,�'�re G�c�R 4 Z.to va ► 3 313 III.Type of Permit: (Check only one box on line A. Complete line B if appy ble) A. IH'Nef�w System ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑Permit Renewal CI Permit Revision CI Change of Plumber CI Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: (Check all thatp -- ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade n_ o ,,>2 in. . uita: e . Mound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) _ CI Pretreatment Device(explain) /( mssir!ri. 'Aria , 111111.011/ V.Dispersal/Treatment Area Information: t !A' 1141/1/02 s / Of all ' /�++ Design Flow(gpd) Design Soil Application te(gpdsf) Dispersal Area Requi (sf) Dts Pyed(sf) System Elevati. -G 1 i ct f'� ''D ' ( O0 '"4� `0 6 J.p -C41( /Dvo hog 00 f9• � VI.Tank Info apacity in Total #of Manufacturer Y Gallons Gallons Units 14°47 4d a te 0 � ` c U U 3 N New Tanks Existing Tanks �ArT r w v 4 m n 8 w Septic or Holding Tank f go v /AD t(�' es'P r ✓ Dosing Chamber �J' 'p _— goo goo i f Ai VII.Responsibility Statement-I,the undersigned,assum responsibility for• stallation of the POWTS shown on the attached plans. Plumber's Name(Print),, Plum igna MP/MPRS Number Business Phone Number s .1 i. /1 .I -� � Vg4 '3 /- ‘7o/x.37 Plumber's Address(Street,City,State,Zip Code) V County/Department Use Only Permit Fee Date Issu Iss ng Agent Si atur� IL Approved ❑Disapproved / /z ❑Owner Given Reason for Denial $l(/Z 5-•°' r 7 20/3 J IX.Conditions of Approval/Reasons for Disapproval 0 /1_ d. f '_. ` w^z J��,, d��Q`,V�,'�i. /� ` SYSIFM OWNER: (�UYt Cam,` GYL CU✓LC "e '' ��' 1.Septic tank,effluent filter and �/ru s dispersal cell must be serviced/maintained ���1�/ / , / , / 9/4-1/ `/''e'u.A " G� 'dh as per management plan provided by plumber. ,,/ q/ 2.All setback requirements must be maintained A ' !w A' �' ' t`lt��5 t g9V as per applicablet�l for the system and so.mit to the County ly on paper not i an 8 to x 11 inches cl j 10 SBD-6398(R. 11/11) vtexa f DIVISION OF INDUSTRY SERVICES T 10541N RANCH ROAD \o 8t'y ����,,, \; HAYWARD WI 54843 • D' " a Contact Through Relay • SS K www.dsps.wi.gov/sb/ 9 sl y www.wisconsin.gov x s� V 4O' sslori?& Scott Walker,Governor Dave Ross,Secretary October 29,2013 CUST ID No. 648443 ATTN::POWTS Inspector KEITH E KNUDTSON ZONING OFFICE KNUDTSON PLUMBING ST CROIX COUNTY SPIA 927 150TH ST 1101 CARMICHAEL RD ROBERTS WI 54023 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/29/2015 Identification Numbers Transaction ID No.2326483 SITE: Site ID No. 797074 Becky Buckner Please refer to both identification numbers, 233RD St above,in all correspondence with the agency. Town of Eau Galle St Croix County NE1/4,NE1/4, S9,T28N,R16W Lot: 3, Subdivision:Csm Vol 14 Pg 3923 FOR: Description:Mound,4 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1455877 Maintenance required; 600 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),Pressure Distribution Component Manual- Ver.2.0, SBD-10706-P(N.01/01,R. 10/12), SSWMP Pub. 9.6; Effluent Filter COND The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes AP and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed DEPT OF and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. PROFESS!• The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. DIVISION OF I No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. "` The following conditions shall be met during construction or installation and prior to occupancy or use: SEE CO' Key Item(s) • 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.In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound component manual are complied with.A copy of this information must be given to the owner upon completion of the project. • This system is designed for a concave slope. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15'beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. KEITH E KNUDTSON Page 2 10/29/2013 • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i).Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, � Fee Required$ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf, Please Include a Copy With Your POWTS Plan RevieWer,Integrated Services Payment Submittal. (715)634-7810, Fax: (715)634-5150,M-F 8:00 a.m.-4:45 p.m. WiSMART code:7633! pat.shandorf @wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. I ' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESGN 17 2013 Residential Application i/``')( • INDEX AND TITLE PAGE Rvi C CES Project Name: Becky Buckner Mound System Owner's Name: Becky Buckner Owner's Address: 2170 Ross Ave. St Paul MN Legal Description: NE1/4 of the NW1/4 Sec. 9 T28N-R16W Township: EauGalle County: St. Croix Subdivision Name: Csm Vol. 14 Pg. 3923 Lot Number: 3 Block Number: Na Parcel I.D. Number: 008-1024-70-300 Plan Transaction No.: TIONALLY ROVE Page 1 Index and title SAFETY D AND Page 2 Data entry SNAL SERVICES Page 3 Mound drawings SERVICES Page 4 Lateral and dose tank JUS Page 5 System maintenance specifications Page 6 Management and contingency plan / Page 7 Pump curve and specifications Page 8 Plot Plan RESPOND • Page 9 Concave Mound Calculations Designer: Keith Knudtson icense Number: MPRS#648443 Date: 10/099111 1 Phone Number: 651-470-1737 Signature: - �' _ I_ Designed Pursuant to the Mound Component Manual for POINTS Version 2.0 SDB-10691-P(N.01/01),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) Version 7.0(R. 03/2012) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: 38 fill(0in calculations lattiions assume treatment for a 400.00 Estimated Wastewater Flow(gpd) fecal coliform of<=36 inches. 1.50 Peaking Factor(e.g. 1.5= 150%) 600.00 Design Flow(gpd) 4.00 Site Slope(%) 97.00 Contour Line Elevation(ft) 12.00 Depth to Limiting Factor(in) 0,60 In-situ Soil Application Rate(gpd/ft2) Distrl j ion Cell Information 7(0�5 O ir' al Dispersal Cell Length Along Contour(ft) = 1 8.001Cell Width(ft) '41111117150 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest •'int in the distribution Y Pressure Disribution information network? Enter Y or N (C or E) E Center or End Manifold 4.00 Lateral Spacing(ft) If N above,enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Orifice Diameter(in) 2.00 Estimated Orifice Spacing(ft)= ( 8.11 Ift2/orifice 2.00 Forcemain Diameter(in) 120.00 Forcemain Length(ft) Does the forcemain drain back? 1 Y 1 88.00 Pump Tank Elevation(ft) Enter Y or N 6.50 System Head(ft)x 1.3 19.57 Forcemain Drainback(gal) 10.50 Vertical Lift(ft) 67.38 5x Void Volume(gal) 2.40 Friction Loss(ft) 86.96 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 30.48 System Demand(gpm) 19.40 Total Dynamic Head(ft) Lateral Diameter Selection Manifold Diameter Selection in.dia. options , choice in. dia. options choice 0/5 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank information Total Tank Capacity(gal) 1200.001 Septic Tank Capacity(gal) Total Working Liquid Depth(in) Wieser Concrete 'Manufacturer gal/in(enter result in cell B49) Dose Tank Information Effluent Filter information 800.64 Dose Tank Capacity(gal) PolyLok Filter Manufacturer 16.12 Dose Tank Volume(galfin) PL-525 Filter Model Number Weiser Concrete 1 Manufacturer Project: Becky Buckner Mound System Page 2 of 9 X N rr A II 11 N .r II C 00 N I 1 W •- II I oo d � w � orh �' cig c PP 5P A n 1... 4 da - - coo cbo 6 o a r4 b b c q ' a: O n Z Z CD 0 0 0 0 tz„ !\ II vo CD gl. co co ti - b 0 a" o- = o a H 0 , II co ^, — ..., a \ k ion' A N o /-■• CI to h °h `�^+� Q �., ti N tv M k o' b � o Ct L.„ o d ". es. N -4.co x k II k ~ a � O CA , ° co o Ct O. F \ \ :11 co otg o, o 0 Mound Plan and Cross Section Views 1/i- 1a!::;:;: : : . . . . . . . . . . . :Observation Pipe : . .-. . . : :-.-.-:• �' 1 4+L•L;4•L•L�L"4 L:•a°.L.4rL.L•4•L•4.4:4.4.4.4.1•R•4.4.4.4x4°'..°.•L•4.4.4•L•L.4. •.4.4.4 ,.,.,•.r',i- i.x4r4141411.1 41Li4:y2. r1 L1 ti�4:4'.�11..*.^:yL�ti, .4�4?L:L.ve..•r*.,... A r•r•r•r. 1•+,'•°r: r•r.r.:•r• 1•r•:.°•r•.%.,r•.'•.r.r•.•r•r•.•r-r•r•r• :•r•r' L+1+4.4�a.4 4°S.'ti;4�4.L=e••L•L.'�5 L.L.L;L.4+L,Y•4•Ln4,4,4,L.4,4+L•4.4 4 e 1�1 t.4 4 1.7.e.7;A°+4.41;Al..;-,•L...zps;A:7..4..Av e x4 1..;°,1e'4.:S 1y 1L'ra•:';..v.:trtir'.r4•Lrti•41L14r.4 —ti .• °.r.r.r•r•r•:•r•r•r.r•r•r.r•r•r•r•r•r•r• r•r•• J•r•,•r••^r•}•r•r•r•.•r•r•r•. • i\ L riot e paw 9 of 9 for chanrc s • Mound Component Dimension to the mound dimensions due to tlh concave slope deflection. A 8.00 ft E 27.84 in H 1.00 ft rise ft -76,.-cat B 75.00 ft F 9.50 in I 12.31 ft L 98.71 ft D 24.00 in✓ G 0.50 ft J 8.82 ft W 29.13 ft 600.00 (ft2)Dispersal Cell Area 1523.44 (ft2) Basal Area Available 8.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.79 (ft) ,..4.9 .w.,,,. G t H I. ._...... ......._. F Dispersal Cell 99.50 (ft)Lateral 99.00 (ft)--► :; Invert Dispersal Cell ( : Elevation D ,A.?.{. `7 `,� -).-, f!Y ,n}}, } > ->,. ....1• it 1�7 Yu;► 7.i►` 1, ?� . . x .?A,- t T)4� .1.L). t il'4. . ° `fi . L... 4 97.00 (ft)Contour Elevation 4.0 %Site Slope –11--- Geotextile Fabric Cover Shading Key 1 a '- -' Dispersal Cell See lateral details on 0 Topsoil Cap c a 1.5 ft ' 4; 4;s ..4 4 L:4r4r..Lx4 Page 4 for number,size, r r r^}x•1'1 r• C ..'y�.ti•S 4x4 4.L 4 4s�xer,4 Subsoil Cap a o �; �r;•°' C and spacing of laterals. ® •;,;.:1 i -31;::-.4.1 er . .y.,.4e4 Laterals equally WSW ASTM C33 Sand Z ‘..9:;-....:,-.-4,...,-,.:A5.:••. 4 4 L L L 4x'4 ais are °a 4 L 4 ti F spaced from the �� >� Tilled Layer o ft ^; T i Lac i 4 441 4 4 4x4 4 L".4 4 4 L ,• distribution Dell's © .:LS1;4 a epe ;rre.e.e: .ti?ti Aggregate °r:1�.s f:1�'?1: :: . centerline in the •.� 1, �. 4 1 x4�4�Lx vi 40 A ----10 distribution cell(AxB). Project: Becky Buckner Mound System Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over P tive Atrt B dimension •.Turn-up wr ball valve or alesnoutplug 4 AN laterals we identical IF X—>) Holes drilled on the bottom or the lateral a s . *qua!spaced -4r • "Force main connection via N.a Cross to manifold at any point. - Laterals&forcemain Sch 40 PVC per SPS Table 384.30.6 Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing(X) 2.04 ft Lateral Length(P) 73.44 ft Orifices per Lateral 37 Lateral Spacing(S) 4.00 ft Orifice Density 8.11 ft2/orifice Lateral Flow Rate 15.24 gpm Manifold Length 4.00 ft System Flow Rate 30.48 gpm Manifold Diameter 1.50 in Total Dynamic Head 19.40 ft Forcemain Velocity 3.11 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --' l SPS 316.300 WAC I' I I- I- 4 in.min. .--/-...-- 1! I Disconnect Tank component is properly vented %.1. :: E--- Alternate outlet location 1 I' Forcemain diameter Weiser Con crete Manufacturer :-:.:. I 2 in. Capacity 800.64 Gallons —io— Volume 16.12 gaVinch A d Weep hole or anti- Dimension Inches Gallons B (ii' siphon device A 30.27 488.00 B 2.00 32.24 C d Pump off elevation(ft) C 5.39 86.96 t ( 89.00 D 12.00 193.44 D Total 49.67 800.64 ... Dom se tank elevation(ft) 3"Bedding under tank. 1 88.001 Alarm Manuafacturer SJE. Rhombus I Note: Switches Alarm Model Number Tank Alert I containing mercury may not be used in Pump Manufacturer Goulds I this system. Pump Model Number EPO5 Pump Must Deliver 1 30.481gpm at 1 19.401ft TDH Project Becky Buckner Mound System Page 4 of 9 Page 7 of n you LDS PUMPS Submersible Effluent Pump MODEL 3871 EEPp0045 . gi ''n. APPLICATIONS •Fully submerged in high ■EPO5 Impeller:Thermoplas- •Bearings:Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. •Casing and Base:Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation.Auto- resistance. • Canadian standards Association • Heavy duty sump matic models include Motor Housing:Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch for efficient heat transfer, in"C"or"F".) facsembled • Dewatering assembled and preset at the strength,and durability. tory. SPECIFICATIONS •Motor Cover:Thermoplastic cards Pimps is ISO 9001 layered. FEATURES cover with integral handle and •Solids handling capability: float switch attachment points. 3/4"maximum, •EPO4 Impeller:Thermoplas- •Power Cable:Severe duty •Capacities:up to 60 GPM. tic Semi-open design with rated oil and water resistant. •Total heads:up to 31 feet. pump out vanes for mechanical •Discharge size: 1112'NPT. seal protection. •Mechanical seal:carbon- rotary/ceramic-stationary, BUNA-N elastomers. •Temperature: 104°F(40`C)continuous METERS FEET 140°F(60°C)intermittent. . . lo_ •Fasteners:300 series ' stainless steel. 9- 30 2s FT 5 ........ •Capable of running _. .. dry without damage to a- components. 25 Gs 7 Motor: u s 20 •EPO4 Single phase:0.4 HP, 115 or 230 V,60 Hz,1550 5_ RPM,built in overload with c 15 automatic reset. a 4- epos •EPO5 Single phase:0.5 HP, o 115 V or 230V,60 Hz, 1550 " 3 10 RPM,built in overload with EPO4 automatic reset. 2 •Power cord:10 foot 5 standard length, 1613 1 SJTOW with three grounding plug.Optional 20 a- 00 10 20 30 40 ___ 50 GPM foot length,16/3 SJTW with three prong grounding plug o z 4 s a 10 12 m3/n (standard on EP05). CAPACITY Goulds Pumps c 2001 Goulds Pumps ITT Industries Effective May,2001 B3871 • Mound System_Maindbenance and Operation Specifications Service Provider's Name Powers Sanitation Phone 715-246-5738 POWTS Regulator's Name St.Croix County Zoning Phone 725-386-4680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 0E4 mg//I mL Type of Wastewater Domestic Maximum Fecal Coliform Service Freauencv. 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 monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect forponding and seepage once every 3 years Other 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 1 6-8" Diameter Lawn : ' : = • • Threaded Cleanout•Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Becky Buckner Mound System Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code Rost This system shall be operated in accordance Publication S 6 382-84 a 881 Wis. ode and Component Manor Vera 2.0 with its'SBD-component 0�P(N. manuals[SBf?-10691-P(N.01I01),SSWMP 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 Bede soundness. defective,openings used for service failure and assessment shall be wale watertight openings greater completion than inches in diameter shall�be secured by an effective locking subject to failure must be replaced. Exposed 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 of the tank e contents outlet filter she�ic tank shall be disposed of in accordance with NR 113,Wis.Mm.Code. The operating condition 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. Intermittentfllter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and sown in the tank exceeds 1/3 the lktuid 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. such products The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, p 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. wand and Pressure Dfstrtbuttan SvsISTA 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 BONS,30 mg/L T85,10 mg/L FOG,and 10'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 tare 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. Coindnasncv 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 mananagament 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: Page 6 of 9 o ^^ , , M 1+ `J N w V �� CA 0 © _N'-'_._._x x x 1 / ti c h ..... iii r!11. s,c), Z o b S $ A. m d e to a. E UI r I,-0-0 o Q. ii 3oc, b Ito o b�•�y . ft. et Dl A7 q 3 D o Q. o a Cy r.. R o �• m •b qg a o N g tv p+ y O ti , CO n y Lt o Zir r) o O a oo g tico. y t""4 ii i 1 to K., ch b o ell t' s h M k7 to & Vi os a \ t� A c0 Co NO , Wisconsin Department of Commerce SOIL EVALUATION REPORT Page \ of se- Division of Safety and Buildings in accordance with Comm 85,Wis. Adm. Code .. County cj 1 , e-SZ-0 \x Attach complete site plan on paper not less than 8 1/2 x 11 inches n size i include,but not limited to:vertical and horizontal reference point(BM),dir IV E Par.-I I.D. percent slope,scale or dimensions,north arrow,and location and c istance to nearest road. O0 - 1.0 g_i o —100 Please print all information. OCT 1 6 ?002 Rev-wed • by Date '7 Personal information you provide may be used for secondary purposes(Prn acy Law.s.15.04(1)(m)). \ /� ri6�Yt�'j"L.-/L/- Property Owner \2`-f 1�tJ sli-►.� C.G�y - w S fMtt ion �+� CIO `�V Q f (-�` fl-k S l i J oN sm - W 1/4 S CI T 12 N R I 6 E(or€V) Propeasitetwases Mailing Address Lot# :lock# Subd.Name or CSM# Z 3 31 SD ni- iftNe 3 - GSri .V o(-- L q 1 R) a9 'La City State Zip Code Phone Number as ❑Village B Town Nearest Roach 3fJrttjliQ)►mil I W 1 I Sq 0 021.( -1 is 68-V- 3-lSO G FY1..LE 1 2-3 3 ‘•'l ST, fa New Construction Use:g Residential/Number of bedrooms 3 Code derived design flow rate Ll S (-) GPD ❑Replacement ❑ Public or commercial-Describe: Parent material -I—ILL Flood Plain elevation if applicable K3 11 ft. General comments M.0 L) - '�J\--1-)4 C " <.S p` Cl)N1 t�'N\)�. �j`� -�-1-L s J`i�3 o , and recommendations: w U 0/o -\-D Lt ,C`T.1K7. )sv. ZL` OF Sft).,) , R t..t �--.) v2 1_4 Boring# El Boring ® pit Ground surface elev. CI-7-3 ft. Depth to limiting factor > i 6 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 / o--) 10`1 (2_3/7.. — S). 1 Z-_s b k wrfi,- c-s z- -5 -S Z 7- I V 1D`12.5!`,' — s i 1 Z 6n 3b k 1n e1,- as t-P .3 -8 3 114-1$ 1.3 Ya_ VA - s1 \cgIjIz m — - LL • 6 1'3OTE .: T 1.5 .21 T w t113 -Ev'Nu 91D 1/ lc-Wok) 114-e. }i Qu 1.0 'SE Lo o_Pr )-S S w o.) o.1 -1'\6t Z d a ∎ )3 z Prn,t, .133 w -s Ev RI-U n-?-q;) 12,1/41 -T'tiOW1 F',S L1 L.LS O N CST ON \?--) e d9 5 I:c.D R.. V.TO 1J S'Itct/L .• Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 T NZ��0�..T S 5� LO1-2,F 1�Pc C N l Yv c a L or 3 < •Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BODs<30 mg/L and TSS<30 mg/L CST Name(Please Print) Signature CST Number Arthur. L . Wegerer (® ` o.Z-l2.- 3 220254 Address Wegerer Soil T S ¢ Date Evaluation Conducted Telephone Number 421 N. Main St . River Falls , IiIg54022vice 7 _2-9 -OZ 715-425-0165 - PLOT PLAN Page Z- of 2. Scale l ' = 10 ' ID - -3r . Jm . G Z -025L P(j o v , _ _ Li; Jam cg f: x ' ex /%1E c/) c g.3 - p 337' . 1 � t31 / c,s • r// ? b� /„..,/, il / b) 1. i il i - I iii II J : ��°�o/ � tc�ON I ' I Li I (J p ►J o T H Pfl-t,T- 3 4 I Sri- i °� \S 97 LA�a s 33, -- S.ZJ �S e� ��� >>ZDh1 \ ) - Lo - LiJ T\Z 5 DoT cR+��-( h6q. s6 ,, 3r1 -Q.1--.)C) :0 t O J Ki 1 L. )hl- C -_P-O-sT,_.__ .- Prt-7.ark -_.. L 100.4 3 0k1 IUPt1 L-- 1,td v'hl t POLL_________-__k __________._71 aps2164.4,40‘d -1 -2-R-DZ 715-425-0165 220254 p2-).63-3 CST Signature Date Telephone No. CST No . P Job NO. bULDIJ r Lb 6, niu r • 11...) ■....KJ,i- ..J.A.,4-.4- 1 .7• . . FROM,: TOM0andeiSTRCISYSIOLSON • PHONE NO. : 00emegenaeefrdowee DEC. 16 199E 09:24Fd1 1 . . : .. Vim *Oapaltrand - c•,.-4.:.. , ... ..-.... 'tgril-AND SITE EVALUATION . . Page 1 at....). . • 6141kiii Or sopa oi* ..•,, ' H- •.•. . ••••••:•..-•'•: iolii‘(ii with Coinm 83.05,%Me.Adm.!Code Etnensmarual fiyi.)sien , Minh oomplMaJkif:.';',' .., .',.:,: titiiiiiiP!ar,_1 iii 01 1;M":haa In dim Men'Iwo . County • lode*but not IMItiol-air:ottrW, ., '11WM~.1 refirtne011WeIR(11t4),dr•ollon end __. _ $y,,Croix . .. . . permed elope,well or airtssmaleali,north arrow,and looadog_and.doe to merest rood. . WIWWiiii , • 1 1 ''-; . .--... APPLICANT INFOIOMOION- iPiesso froinijfklii . —7-.-— . -.--.--- 1 Orsoral Wellston you Weal Ifirebo rod* erlwar Lif.4.i6 O44 cam. Reviewed By Date "mew Owner 1 APANINn — ' Location ' • '-- P'_1:, Sta'Le .It0n ---..i .3.. \ t?•oiit.- . NE 1/4 NW 1/4 S 9 T 211 N.R 16 W Properly Owner's Mailing Add reep 4-. O tht.11 I Block ii—likibd.Name or cSIM 2337 50th Av i -' c "' ik "' ',... .''. '' '.'I, -4000.1,—,,,,AAPi` i., ,..... OW Stain Zip-..:•'‘,..Phone Nt-Afort ,,., . 1 C.Iryi :II Wive zj Town Nearest Road . • Baldwin W1 ,- .,j Eau Gab 233 Rd Sr - - New Construction uee: Rasidiift*mberof bedOe mss . -lAddon to existing building d "Cede Derived doly flow 450 gpd Recommended design loading rate 1.2 bed,gptle--12,...-_.Wench,gpdfitt Absorption eraa required.111--bed,Ill 375. ,Muck III Maximum design loading rate 1.2 bet1 gpdfir 1.2 rend.9Pdiff Recommended infitradon surface avalion(s) 100.58 ft(as referred to site plan banchmar Additional design/sae considerations . _______________..., Patent material ......, . Flood -lain elevation,ir,;.ficabie ft S*Suitablet for system 1 Conuentimsl Mound 10-Giound Pressure ' AT-Grade : System In FRI , Holding Tank LIgUnsultable f o r s Y s l o r n S I d U I S S 0 u , C 3 s 0 u 0 2 0 u - i" s 1 U - t.1 S J U SOIL DESCRIPTION RE T Depth 6' 1 ■ ' Cella- ; Motdes 1 Texture! SINOttint iv, 1 Bounder Y, Roots i GPD/F • Boring* Iloilo" in. Munsell , Ou.Sz.Cont.C.okx Gr.SL Sn. :Consiste.r..e i.......,...m., . ”Ciola .--,.................,—.---... • C Dad . Tome) 1 0-41 i 10yrd13 ; . ' I sit : 2rnebk . - infr cs 2f ' .5 .6 T-- . ?'x' 2 (lin 1 OyrV4 - sil 2insbk , mfr ca lr : .5 -....-.., ---I-- 7 Ground 3 16-411 L 10yr5/5 c2d7.5yr5/8 all • I msbk i mfi , dee • . •-■ Ma ft I ' • • • T-- . , . --4.— .„....... Dpt° 1 . ___T_____ .—.._ 'Mang i fader - Is r - -------- --1--- 7 .1-- • I• _____. • ii,• 1 1 , •... 4 : 0.7 : 1004/3 - Sit I 2msbk I mfr ; cs i 2f .5 : .6-.4. .1. •Ii .:.,„ ..-.. 2 7-1'2 i 101/15/4 . all 1 2rnsbk air . es I If .5 .6 %turd 1 — 3 12-44 1 10yr514 2ocISyrS/11 ' sil - i Imsbk rntl • - -t - — .4 5 &PI .-‘ : •953". 1 . I WPM ta ----.--1.------ ' --F limiting 1 wax i ; . h • • . I ; • ---- , Remote:AISAISit- . .--— . —---------- • . r CST Ilams(Pleas Wird) itlattstint. .........____.>< 2 ( . i . i , , Teleptsnat No. Thomas C.Notion ,,,-...--- --7- ., -,, 715-246-2454 oirsi;, Saviroameasal By Design ---,-.e.....-::::•IX-...e•--.1 - 174.,'" t.....-- ate ' CST Number Ref 4 1432 120th Stott New Richmond.wl.,5401/" 1V4/98 2605 171 . • • - . . . , DULL)1 o r LEA.) a 1-i i u I 0.A • I J.._., •_,.."..-r ....,.--r-r .• .4 -- DL. 10 J.7 PL.' ,••••••••-•'""'' ' • . . , . PHONE NO ; MegiaMeeeMWM° 4f-fial': TOMetardaSTIAMY ,01 ,,041, . '• ,.....". • .,...r.,',....:, .., . • WORT. • , _r-TFrp Pap 2 of...2.__ RellaVrii0P14/.4: --,. . . -• sou.oescRIPTIoN • .,-.--.r7*.',X-,- : : ...'. , • -..,_......p.. pAi..!:„..";„:_L,.___—..... ..-...___ ' - .___.. it I',• . . . . , . . — , , ...„„ ,..... .i (406;i . WO I ,MONIS Talusi GiALsh, : • 1 Roots I._---- . II"CtiAe. FAINisllifiCe emidgrY 1 1 Bed ! Tench ' .'' * '' 'N ..CIU•t CM*Cobr . • I ' •••":•-•- ------_.- ___ -_ .___---------------- — , si , • , . '''.;•:. . 1 I 0-7 i 1fra - 1 l . 2miblv. mfr f al 2f ; .5 .6 , • ... 3 ,.k . 1 ..::.„,... :',.... ,..---:_____. .-..... 6 2 ! 7.10 )0,15i4 4_211______ ,..... .... ___________-----:--t •• - I , Goma • ! A i .5 Ow 3 19-30 100US ' • c7.417.5515/8 a I. lmebk rel _ I — - .-.... , : I 1 . I , WM ti I ..•■■.........---......•..- 1.•- 1 ' .;.,.., ..... DIP to biting I , . ___1.......—_....--------- . I • ; , I ! ! ___L-_.__,- • _.• I farka 1 i I 19" ! ! ........ 1 • -I- • • . • I 1 . . -- I i . I • : _rim: • ......_._._ .._ ,, p,i.-.-.:,11:. re■•=1+1 . r""1"...." I 18•19■1•MIMP -: 1 I t i ., • i i .41 .■....-.1.___--- ; T-- i I I t I I : Ground : • • . I aiav i —• - .: . --..-- -I— -• . I . • . , . 1 I . • th DeP id : . I . : . . : . . . . lialitiftg 1 _ .-1.....— . ......_ ..- _—.... I • factor , .. , • - . -■ —■.....••■ ••••,•..•.--1—•.'...... .r".........—.-.-"•" r••••......• •••.:'.....,••.1. . 1...........-■.....—.4.--_______t_.. -....••--f-•-___...._. ..........7---....-■— i I 1 ! i .L. ___ I Rem s: _ _ ... . ............ ,,.,:•••,...;•„4; , 1 • $ . ,:. • ... . I ■ . : I I^ • ...--.,--.......... _ ---■ -1- •• .-•....----i— . ., I : . I . I I I ■ .... 1 ...m.....- -4.---. GIOUnd a..... .......-... .-- t 1 ! . . . elery L_ •, —, — _ , .... i. . . . • . i i i 1 . i _4_• . . Depth to ! 1 , ___.. : _.! .__. . WIN . I I I I ..• , —--•". ----i-----------;------.......-... I . I i • 4 ............:-..... . ,, . • , 1--- 1 i Remarks: ,......;._...... _ _ .... .___._________. I . • ..,. „At I -.•.... •• ...• ■■••••-•■•• ........................ ...•:. ''..•:.,:i.• i "."-- . I 1 ••••- I••- - ------- --- ---•-•••. I 01004 .....m--...•r•ho.... 1 .......-4....• _±. elev •..1...-: .... • 1._ I 1 . . . .... i.....---- 1 ___4_—___. ___: - _4_---.1-- ; r , _. , ,-- --4--- ; I -4.-----.-- DePth 10 • . 1 kinking ! i ! . . __ ••- •-----i--- ■ .... _ _I--. _H.-- ..._ fador 1 1 1 --_ I ..• I. _____ ,r___ ..4______;.__-:-..--- 1 I ___ ----I 1 I . ; 1 ---•• — . --• . . . . , Wisconsin Department of Commerce SOIL EVALUATION REPORT Pepe 1 of 3 Division of Safety and BuNdi ge in accordance with Comm 85.1Ms. Adm. Code Cos Attach complete site plan on paper not lass than 8112 x 11 inches In size.Plan must 6r' Go?- include.but not Sided to:vertical and horizontal reference point(BM),direction and Parcel t,D. -,, percent slope,seminar dimensions,north arrow,and location and distance to nearest road. QQO " IO Z�"�d (lv - Please print all Information. Reviewed by J��/� r ,A 4. A 1102 P e r s o n a l infonndon You Provide maybe used for secondary purposes(Privacy law,s.15.04(1)(m)1. 'l RAN , Property Owner Property Location ir -G• 9 a Ron Stave Curt. NE 114 NW 1/4 S 28 N R 16 0r1 W Property Owner's Mat irg Address # Mont#tSubd.Nerve or :-' . 2337 50th Avenue 3 - Stave )7'/,"y23 qty State Zip Code Phone Number (]VNlage Town Nearest la0oifd Baldwin 1 WI I 54002 1( ) Eau Galls I 50th Avenue . Cl New Consbudian 0 Residential 1 Number of bedrooms 3 Code deftred design lbw rate 450 GPD o Replacement Q Pubic at commercial-Describe: Parent material Flood Plain elevation if applicable NA ft. emend cc""Plena �Tbis is an update of the soils report dated 1 t' ': , , been done so as the original report is not ledgable and�: Updated to ,,, : -e . requirement Of#1 1 Boring Pitt Ground surface elev. 9133 it. Depth to Smiting factor 1 in. Rate Horizon Depth Dominant Color Redox Desalpdon Texture Sluc4xe Consistence Boundary Roots GPDM' In. Muneetl Qu.Sz. Cont Color Gr.Sz Sh. '_ 'E1 1 0-8 10yr4/3 - au 2msbk mfr ow 2f .5 .8 2 8-16 10yr5/4 - sil 2msbk mfr cw If .5 .8 3 16-43 10yr5/3 t2a5yr5/8 sit Imabk mfi - - .2 .3 2 U Boring Bcwkig l l # Pit Ground surface elev. 94.68 R � In. Soil Appiostion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots , GPD/111 In. Mureei Co.Sz. Cart.Color Gr.Sz.Sh. "13#11 Efir2 1 0-7 10yr4/3 - ail 2msbk mfr cw 2f .5 .8 2 7-12 loyr5/4 - sit 2msbk mfr cw If .5 .8 3 12-44 10yr5/3 f2d5yr5/8 sit 1 msbk mfi - - .2 .3 Me.;#1=BOO,>30<220 mgt are TSS>3O< mgt. `Effluent#2-BODE;30 mpg-and Ms 30 mot CST Name(Please Prbhg Signature CST Number Thomas C Nelson 227387 Address Data Evaluation Conducted Telephone Number 1432120th Street,New Richmond,WI 12/04/98 715-246.2454 Ply Owner Stave Petal ID# Page 2 et 3 3 Bodng# D pit Ground surface elev. 94.48 ft. Depth b factor 19 in. Sal Application Refs Horizon Depth Dominant Color Redox Description Texture Sbu gore Cannhlmoe Boundary Roots QPDDIE In. Morsel Cm.Sz. Cont.Color Gr.Sz.Sh. _ 'E1101 •EIlIR2 1 0-7 10yr4/3 - ait 2msbk mfr cw 2f .5 .8 2 7-19 lOvrS/4 - sal 2msbk mfr cw If .5 .8 3 19-30 IOyr3/3 f2dSyrS/8 sill lmsbk mfi - - .2 .3 Uiaaay ognea ,,, •, Itr;u t Nelson '`;_ I Nelson, ` _,. onlinvironmentai By Design,erRUS Boring# 8 eon ELI x'. aG , :'220002.10.07 Pit mound surface elev. ► t ,• Horizon Depth Dominant Color Redo: Bi/uiMtisn /11 1' f :I's!'"". :':- OPDIW in. Mime Qu.Sz.art.Color .,'' 1r.St Sb. Verified BaMg# 9 Pit Ground surface else. 1t. Deptl�to limiting(odor b. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots l3PDDB M. Mosel Ou.Sz. Cont.Color tar.Sz.Sh. 'EV 1 'Eff#2 'Mont#1=BOD6>30<220 mglL and TSS>30<150 mgIL •Effluent#2=BOO.<30 mgll.rid TSS<30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need meter isl in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. geze% . . lir Stave 2 3 Property Owner Parcel ID# Page of 3 Borin # 0 Boring g Pit Ground surface elev._ 94.48 _ft. Depth to limiting factor 19Cn• 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 0-7 10yr4/3 - sil 2msbk mfr cw 2f .5 .8 2 7-19 10yr5/4 - sil 2msbk mfr cw if .5 .8 3 19-30 10yr5/3 f2d5yr5/8 sil lmsbk mfi - - .2 .3 Digitally signed I by Thomas Nelson Nelson, — c-F.nvaccnmantal Boring By Design,c=US Boring# J Date:2002.10.07 0 pit Ground surface elev. __ _ p • 45:36:16-06'9�'otl Application Rate cc30 I'115�'��' Horizon Depth Dominant Color Redox Bigrarldien ee si nce Bount � trt GPD/ff in. Munsell Qu.Sz. i nt.Color Sr.Sz.Sh. 1 *Eff#2 Q ready for orov Verified �' y p 0 Boring Boring# Ground surface elev.____ft. Depth to limiting factor in. Li Pit 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 *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<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-8330Test(R.07/00) I DULV I O r LDu 0, mu 1 u i an • 1 i.. vv-* -. ,-' -- r ` l , ru' PF�01 DEC. 16 1998 06:25 41 P4 r 1 t, , 1 1 . .T t I 5IGN , . 1,. r. L ' -' . '■ FROM,: TOM rrI0ST-4• ., 'a, NO. • X0000000060 ... (� WISCONSIN �'�Q�.'� NEW RICHMOND,''�,�� 12(Y" iV�rli+•f 715.246-2454 . t PAGE//ms�ss ' w a '�+, PAV'i. 3 4 va, t " ON_9_„__T 28 N, R t W TOWNS iP e COUNTY Wisconsin I. 1 i I !- N ;; 2 M 0 vp , c-4 6I p. ate 4r8(112 0 49- -..-'0//6 X / SCALE 1" Toga Nelson 8 f 1. Corner Post Nail w/ Ribbon ELEV. 1W 227387 RM 2. Nail w/Ribbon in utility pole Ele" 100.43' AVE EAt D It 7ith ifirOit e443.01 wiimeti.viavi,stehtittyiittaSivetts - W W/ I/4, siecTiow $ T 1, EIS► mow Digitally signed by Thomas Nelson DN:cn=Thomas Thomas Nelson, s o=Environmental By Design,c=US J Date:2002.10.07 Nelson 06:41:24-06'00' Reason: Signature Document is Not Verified certified X1104- mss `�' r JJ , \s' f6 1 q '\- \V • FILED -NOV 3 2( 62Y628 AU G 0 4 2000 • 3) KATHLEEN H Re^d s e1 of Deeds 10•S1.COX t et crolxCo..Wt 1 R S p C?D-a.- • \'1.1 � � ��-" �..__ CERTIFIED SURVEY MAP LOCATED IN TOWN OF EAU ALLE,E N � � R. 16W. ST. CROIX COUNTY, WI N SCONS . THE PREPARED FOR FOUND, BUT APPEAR TO HAVE BEEN RONALD STAVE DISTURBED. NORTH LINE OF THE NW 1/4 UNPLATTED LANDS NORTHWEST CORNER NORTH QUARTER CORNER SECTION 9 - FOUND SECTION 9 - FOUND ALUMINUM CAPPED MON ALUMINUM CAPPED MON 1 i (2613.68' ) NW COR. 2613. 97' (S89°35'24"E) I I I NE-NW (S89°35'24'E) S86°48' 05"E 1517. 301 f� -- S86°48' 05"E 1096. 67' I C. S. M. I I I Clsz w 586°48' 05"E 70096570' I z0 I VOL. 9 .`6 S DR 1 VE1 ( SHED HIGHWAY SETBACK LINE (h ON F/L SOUTH I PG. 2439 I I` I ¢ i.8.. � I � ' I O 1 . HOUSE-'j, -.1 . a \-MOUND I I ?►"m L� C. SS�I=, I i I A -a. SHEDS I .Y..Q4,...13 I I °i m �� '',80 z I .QO..... .Oe1. I I a - I (S89°35'24'E) 0 1 S86°48' 05"E I I G'- LOT ' N co r- 2 10. 32' I S86°48' 05"E 27. 53 ACRES N CO _ I 33. 05' • 177.27 0 1, 199, 198 S0. FT. Z 392. 3 7' I to zI I o 602. 69' w 26. 70 ACRES EXC. R/W w m A C7 L _ _ _ _ o—0,.... 0,0 z LOT 2 w o I, 163,008 SO. FT. ;ol• .°- . 4.56 ACRES w p (Al Z to,,,-14. R 198,815 SO. FT. 0 0 r C7 „' 1" -s 4.31 AC. EXC. R/W %0 1 m -c 187,900 SO. FT. N O 04 m (n o1B 6' tml k_S86°52' 21"E 0 . 65' C 33.05' 569.60' -0 Z I 1 N w -0 m r• rn . Io01 s 4.56 ACRES w al 2' E OF F/L NORTH v OO 83E N w ,,.I 1v ,9:- C x 198,818 S0. FT. CA V r 4.31 AC. EXC. R/W •1 m SW COR. I I 100' z 187.903 SO. FT. 2 w 6.5' N OF SE COR. n E/W F/L NE-NW � yi NE-NW 4-33.05' 6 569 56' � O 1275. 17' 7 r 705.61' b Z I I 1186°56' 38"W 1308.22' SW-NE Z ^i 6.5' N OF CD 0 Im 1 E/W F/L I I SOUTH L INE OF THE NEI/4 - NW 1/4 Iz �,m UNPLATTED LANDS o m,_ i z z� I, °v° o �i> �^ wr �1- 1w n 8 C r`NI:41 41 I SOUTH QUARTER CORNER n?I oo c to f� c" . SECT ION 9 FOUND °;I a O `.. z ALUMINUM CAPPED MON 1 nti ?. t{ . a X I a s C c rn � �nnuIIIMO N/�,��� CI C� '.1 gCOIVS � BEARINGS ARE REFERENCED TO �� /� CT o Y THE NORTH LINE OF THE NW 1/4 i `� LEGEND (ST. CROIXSCO.S86°48' COORD. SYSTEM). ( JAMES M. o - SET I" X 24" IRON PIPE WEIGHING WEBER I I 1. 13 LBS. PER L INEAR FOOT. - VALLEY, .4 o • SET P. K NA IL IN TOP OF FENCE POST ,Q1804 VA AO • - WELL A��`��\ es ( ) - RECORD DATA •1 =3 004� eS U Rv ����� " -'III ITMCirTnniiii JAMES M. 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City/State Baldwin Wi. 54002 Parcel Identification Number 008-1024-70-300 LEGAL DESCRIPTION Property Location NE 'A, NW �'A,Sec. 9 T 28 N R 16 W, Town of Eau Galle Subdivision Plat: , Lot# Certified Survey Map# 2 6 ,Volume 14 ,Page# 3923 Warranty Deed # / f) Z69 (before 2007)Volume 2 ( f'7 ,Page# (p01 Spec house DyesIZto Lot lines identifiable Q yesOno 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. Uwe,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 4 Attetedu X031/ 13 SIGNATU 0 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) Parcel #: 008-1024-70-300 11/07/2013 01:31 PM PAGE 1 OF Alt. Parcel#: 09.28.16.125A-30 008-TOWN OF EAU GALLE Current rXi ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner O-BUCKNER, REBECCA K REBECCA K BUCKNER 2170 ROSS AVE ST PAUL MN 55119 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *483 233RD ST SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 4.560 Plat: 3923-CSM 14-3923 008-2000 SEC 9 T28N R16W PT NE NW BEING CSM Block/Condo Bldg: LOT 3 14/3923 LOT 3 4.560AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 09-28N-16W NE NW Notes: Parcel History: Date Doc# Vol/Page Type 01/12/2004 751268 2489/609 WD 01/12/2004 751267 2489/608 WD 07/20/2001 651738 1684/489 LC 07/23/1997 954/527 more... 2013 SUMMARY Bill#: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/06/2012 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 4.560 900 0 900 NO Totals for 2013: General Property 4.560 900 0 900 Woodland 0.000 0 0 Totals for 2012: General Property 4.560 900 0 900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: 513 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 U 2989P 609 7512E. KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2-2000 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD This Deed,made between Ryan N.Peterson,a single person -- -- 01/12/2009 09:50AN WARRANTY DEED EXEMPT # 8M Grantor,and Rebecca K.Buckner,f/k/a Rebecca K.Peterson,a single REC FEE: 11.00 person TRANS FEE: COPY FEE: -- - — --- CC FEE: PAGES: 1 Grantee. Grantor,for a valuable consideration,conveys and warrants to Grantee the following described real estate in St.Croix County,State of Wisconsin(if more space is needed,please attach addendum:) Part of the Northeast Quarter of the Northwest Quarter(NE 1/4 of NW 1/4)of Section Nine(9),Township Twenty-eight(28)North,Range Recording Area Sixteen(16)West,Town of Eau Galle,St.Croix County,Wisconsin, Name and Return Address more particularly described as follows: Lot 3 of Certified Survey Map filed April 4,2001,in Volume 14 of Certified Survey Maps,at Page 3923,as Document No.627628,office of 6 fre- Q-4,•„ the Register of Deeds for St.Croix County,Wisconsin. This deed is given pursuant to a judgment of divorce. 008-1024-70 Parcel Identification Number(PIN) This is not homestead property. ■ta) (is not) Exceptions to warranties: Easements and restrictions of record. Dated this ( day of cG,■ c O �— * yan N.Peterson AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) -- ``,�tt11111111p�� C )SS. GU(4•A t rout —._.- _.__ County ) authenticated this day of :.01 • ' ' • • • '+d0'' C Personally came before me this ( day of 0 : _R)" •'_z 3at�ual`7 2004 the above named =U R avn N.Peterson 7k - — TITLE:MEMBER STATE BAR OF WISCONSIg'9i� , • •SGo-e know t be the erson(s)who x.' ted the foregoing oF authorized not, _---_- �'��y maw0st°�instrumen ndacknowled_-di et-j authorized by§706.06,Wis. Stats.)THIS INSTRUMENT WAS DRAFTED BY * — •I v r _ -- Thomas A.McCormack Notary Public.State of WISCONSIN Baldwin,WI 54002 My Commission is permanent.(If not,state expirationn date: (Signatures may be authenticated or acknowledged.Both are not necessary.) --._ . •_s e2.6h . *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO-PRO FORM No.2-2000 (800)655-2021 www.infoproforms.com Z6. F \ V' - .1 \ 1L- 2-- (zx 17- . A, , i -- ( Z 7 ...73,11-i-f-P-te-ft( \ N , , '73:- , , \c) 1)/10"b-- 441 z' ° , .vc t _,,f I vJ • ,t E) * ,.;) imm •k.'-\ - 4 - ) _\ \J‘ \-c \r-, ,t ,\1_ - L e �1 1 e► 1 (5.1t;,1, zy / 1 4 • • Parcel #: 008-1024-70-300 03/28/2007 03:48 PM PAGE 1 OF 1 Alt. Parcel#: 9.28.16.125A-30 008-TOWN OF EAU GALLE Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner O-BUCKNER, REBECCA K REBECCA K BUCKNER 1200 MISSISSIPPI ST NE FRIDLEY MN 55432 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *483 233RD ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 4.560 Plat: 3923-CSM 14/3923 SEC 9 T28N R16W PT NE NW BEING CSM Block/Condo Bldg: LOT 3 14/3923 LOT 3 4.560AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 09-28N-16W NE NW Notes: Parcel History: Date Doc# Vol/Page Type 01/12/2004 751268 2489/609 WD 01/12/2004 751267 2489/608 WD 07/20/2001 651738 1684/489 LC 07/23/1997 954/527 more... 2007 SUMMARY Bill#: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 4.310 400 0 400 NO UNDEVELOPED G5 0.250 50 0 50 NO Totals for 2007: General Property 4.560 450 0 450 Woodland 0.000 0 0 Totals for 2006: General Property 4.560 450 0 450 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: 513 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00