Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
026-1160-15-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croi Safety and Building Division INSPECTION REPORT sanitary Permit No _ 569511 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID o' r 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. Dalton, Steven M. Richmond, Town of - -15-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 160 , 0 /0 0 . 0 Q mt 23.30.18.1221 TANK INFORMATION ELEVATTON DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z Benchmark f) Dosing - 41 Alt. BM Aeration Bldg.Sewer� or, Holding S Ht Inlet'_ �, arc- < 7Y 7 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent o Air Intake OAD Dt Inlet Dr Septic > / ,L 70 1 N 301 Dt Bottom ` 1 S: 3 3 . Z Dosing y / Header/ an. t ® �� _ o . Aeration Dist. Pipe ( S, .5 Q vJ Holding Bot.System fve- 7. Final Grade S'E' 2• PUMP/SIPHON INFORMATION �I�i S¢e Lt-�t1vJ ! 3 Manufacturer DeP Rand St Cover Model Number C-p b�& 3 l AtAA'" TDH Lift .� Fribion�OSs System Heal DH r Ft Fop'ain Lengt / Dia. y Dist.to Wei S-04LAI§SORPTION SYSTEM 15- 1101ldl 2 BED/TRENCH Width Length -, No.O Trencheg PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 vak4Ae SETBACK SYSTEM TO P/L BLDG WELL LAKE/ EAM EACHING Manufacturer INFORMATION CHAMBER R L2.TD'sI/ 4' 7 Ty f System: �� 1-t-'�� � �a�� UN Model Number: D RIBUTION SYSTEM Head /Manifold Distrb ti n/ Q/� 7 /L 7 2 i a� r x Hole Size x Hole Spacing Vent to Air Intake , {� t/ Pipe(s) V T a :/ — Length If 9 Dia_ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Jy Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 'V /� Bed/Trench Edges Topsoil [] Yes 0 No E,4] Yes No COMMENTS: 46(I clu( de discrepencies,persons present,etc.) Inspection#1:�/ Inspection#2: Location: 1304 146th Ave ILRichm d,WI 54017(SW 1/4 NW 1/4 23 T30N R18W) Whitetail Meadows Lot 15 Parcel No: 23.30.18.1221 1.)Alt BM Description= ! r`I�CJ�`Yt�L(/11 G��t,Q.Ei� �O 'k[A� 2.)Bldg sewer length= X 303`{ ,pc'�C.- � o f j J yt -amount of cover= f r " Plan revision Required? Yes Use other side for additional information. _'3 11_ Date Insepctor's Sign ure Cert.No. SBD-6710(R.3/97) }9 v_ 6 � v In 13 a h s 4 ? w w County �l Safety and Buildings Division �f ttis 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) Madison,WI 53707-7162 �6F�'a�loaav'� ary Permit Application State Transaction Number loft In accordance with SPS 3.21(2),Wis.Alm.Code,submission of this form to a appropriate governmental unit /�/ ` is required prior to obtaining a sanitary permit. Note:Application forms for state POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you pr°°°°°°o������ sed for secondary y A+,6 purposes in accordance with the Privacy Law,s.15.04(1)(m),Slats. I. Application Information—Please Print All Informa ' /`fd-11, a V C Property Owner's Name S 0� Parcel# +tV f ��d 04'lM T 9YO 2014 02-6 Property Owner's Mailing Address��QQ 0' (�H� Property Location Z� ' /�Q VA--Ct v 'r D&° B OA Govt.Lot City,State Zip Code Phone Number t Z3 1 , . S �1`„Nw /<, Section 1 1,170 f e,5ed Vv J <1 z•� �li' ' (,a '7—8 Y 7 v (circle one) H.Type of Building(check all that apply) Lot# T 3 N; R_ E or W El 1 or 2 Family Dwelling—Number of Bedrooms /S Subdivision Name /�f .� Bloc l /L'�•t daw 3' ❑Public/Commercial—Describe Use El city of 11 State Own d—Describe Use � CSM Number 11 Village of �^ 'Town of n ck,' 0 old Ai i I C4 l Ct w�. III.Type of Permit: (Check only one box on line A. lomplete line B if applicable) A_ �Vew System ❑ Replacement System ❑Treatment/Holding Tank Replacement Only El Other Modification to Existing System(explain) B. ❑Permit Renewal El Permit Revision ❑ Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that apply) on-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dispersal/Trea&ent Area Information: Design Flow(gpd) Design Soil Application Rate(gp 0 rsal Area Required(sf) Dispersal Area Prop ed(sf) System Elevation I_,06 _v�b . 3 l Zdl3 zr•o 981 94-•6 96.3 VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units 9 L o New Tanks Existing Tanks c v C y ti v in rn w c7 i~ Septic r Holding Tank Dosing Cham ?�� I V VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. 1 tuber's Name(Prt t) Plumber's Signature REHO Number Business Phone Number A. Plumber's Address(Street,City,State,Zip Code) P. Z �_ucr 5Y 0,,5 VIIL Count /De artment Use Only' Approved ❑Di Permit Fee Date Issued Issuing nt Signatur ❑O eason for Denial $ `�5 � 5 ►zj e en IX.Condi"T'M9W.t treasons for Disapproval f.. ` 3, 0 a l (6LA n Y e j J 0A&C c tank,effluent fter end dispersal cell.must all be services/maintained Li 4k1 ,ti� L'tcc /1,1'U!'/V�3.��n as per management plan provided by plumber. 2. ±Ail setback requ ements<mtlst be`.maintaJh6d Attach to complete plans for the system and submit to the County only on paper not less than 1/2 x 11 inches in size SBD-6398(R. 11/11) CONVENTIONAL IN-GROUND POWTS DESIGN With DOSE CHAMBER Residential Application Index and Title page Owner's name: SW L £ J)a J4d t,) Owner's address: 930 Z a Site Address: / 30 Legal Description: c��c-ppZ T f3a Town: l�-� G� oti�J County: Subdivision Name: �h��L1/ / /�a�� Lot No. Zr Block No. Parcel Identification Number: U Z(a —I/GO /J_ + 04 Pate Index Page 1 Index and Title Page 2 Plot Plan Page 3 Distribution Cell(s) Cross Section Page 4 Dose Chamber Cross Section (with ST & filter specs) Page 5 Pump Curve and Specs Page 6 Maintenance,Management and Contingency Plans Plumber Name: a C. k_jr aw Credential No. Z 7-L 7z-- Plumber Address: f y Z- �. Signature: Date: S �l J '� Phone No. 7/ Deslened Pursuant to the: 1n-eround Soii Absomnon Manual for POWTS Version 2.0 SBD-10705-P(N.01/01). and SSWMP Publication 9.6 Design of Pressure Distribution Nenvorss for ST-SAS(01/Sl Page 1 of `1 b 3 1 � +Y � � V J v � 4 0 s I� � h n a h w 1 .+2 TT- S S 3 3 3� 3 ' 3 i Page of PUMP CHAMBER CROSS SECTION r.irn.2"vent Pipe withCap 2 10 ft.from door,v in-ow Approved locking manhole or freeh air irMake _.: er w!warning 11 J 'A/e.q her•prr t"F vent Cap I Air Tiyl.t Cap Jun;;Cron Bc?:: I 12"MIN F i n a l ` q. ' —�-4-"MIN Grade % � � Inspection R15er 1F3"J.+ihJ r i \ 18"MIN 1/.W'Weep I-icle 1 /� ?r�.•v 1;-12 ' I rueL _ , A+rGlgfrG T I ?;rruve� — Joim. rApoprr- If ved Alarm 6+ �B es outlet- Fil`_er Yan»facturer it mad °approved maic:.riai under Lank SPECIFICATIONS Note: Pump and alarm are on separate Number of Doses: Per aaY I circuits a5 per ILHR 16.28 RNs. Adm. Code Gallons Per Day /# of Doses: /j - Gallons Volw-ne of Back-flow: '/ d Gallons Tank Manufacturer: _� J �'" Total Dose Volume: l A Gallons Tank Si: _ /7-L _ a _ - Gallons i I Alarm Manufacturer: VCcf0A- Capacities: A �� inches or39&-I- Gallons Model Number: B 2' inches or 31- f Gallons C [ 2- inches or dZ .te Gallons Purnp Manufacturer: v u D inches or/7,8'f Gallons Model Number: f--Po Total........ inches or 75'0 Gallons Minimum Discharqe Rate: 3zF- GPM Verrlcal Difference Between Pump Off and Distribution wine: ............ =- lvlinlmum Required Supply Pressure: ................. ... .................. - _ U(> rt. of f=orce Main x . aSa�^ri CZ]on =acl.G= . ................ - ice/ intcrndi i�U17iG 1 ai1K. Dlmen510nS: '?nQt ` lY r /`�IG:i': �' ' /' °^.t u irliet Gallons/inch i ! Sionature. �— License Number L L Z 9 7 7-- Date Page 7 of 8 HGOULDS PUMPS Submersible Effluent Pump _ EP04 3871 EP05 APPLICATIONS •Fully submerged in high ■EP05 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. `;w Sri AssocMan • Heavy duty sump matic models include 0 Motor Housing:Cast iron (CSA listed model numbers end •Water transfer Mechanical Float Switch for efficient heat transfer, in"C"or • Dewatering assembled and preset at the strength,and durability. SPECIFICATIONS factory. ■Motor Cover.Thermoplastic Goulds ftTP is ISO WM FEATURES cover with integral handle and •Solids handling capability: float switch attachment points. 114"maximum, ■EP04 Impeller.Thermoplas- s 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:11/2"NPT. seal protection. •Mechanical seal:carbon- rotary/ceramic-stationary, BUNA-N elastomers. •Temperature: 104°F(OC)continuous METERS FEET 140°F(60°C}intermittent 10 •Fasteners:300 series stainless steel. 9 30 sGpM •Capable of running dry without damage to a 2.s rr COmpOnen[S. • 25 Motor: •EP04 Single phase:0.4 HP, U s 20 -� 115 or 230 V,60 Hz, 1550 RPM,built in overload with o 5 15 automatic reset. a q EPOS •EP05 Single phase:0.5 HP, o 115 V or 230V,60 Hz, 1550 '' 3 10 RPM,built in overload with EP04 automatic reset. 2 •Power cord:10 foot s standard length,16/3 s SJTOW with three prong grounding plug.Optional 20 0 00 10 20 . . ... 30 40 50 GPM foot length,1613 SJTW with three prong grounding plug o z a s a 110 12 mein (standard on EP05). CAPACITY -Goulds Pumps 2001 Goulds pumps _ I??Industries Eff fective May,2001 83871 f Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipe's; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and-pits shall be disconnected aril the abandoned-pipe openings Seale - • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon bN(( required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wiP, result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ,x w A, S -i',' C Name Phone -71 _Y 9/_S 59 S Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name u S/r Name �-�. e.1_0 x Zoti;ti Phone ?1 ` 7,S,r ' y yL Phone 7 S-3 This document was drafted in compliance with chapter Comm 83.22(2)(b)(11(d)&(f)and 83.54(1), (2) &(3),Wisconsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner �'.�. d Septic Tank Capacity ) Z YO gal ❑ NA srmit ## Septic Tank Manufacturer J'/f ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Cc a y ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model �� ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity -2:5-4) gal ❑ NA Estimated flow (average) („o A gal/day Pump Tank Manufacturer � �v.) ❑ NA Design flow (peak), (Estimated x 1.5) 1?o0 gal/day Pump Manufacturer �d kl4 S b NA Soil Application Rate a, gal/day/ftz Pump Model f PU ❑ANA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil & Grease (FOG) :530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) <_220 mg/L ET"NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other: Pretreated,Effluent_Qualrty - _Monthly average Dispersal Cell(s)__ ❑ NA Biochemical Oxygen Demand (BODS) <_30 mg/L Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L GP<A' ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) <_104 cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Yg in dia. ©.,iA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA 'AINTENANCE SCHEDULE Service Event I Service Frequency Inspect condition of tank(s) At least once ever / ❑ month(s) (Maximum 3 ears) ❑ NA p y: 1 �ear(s) y Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 ears) ❑ NA p p 8-year(s) y Clean effluent filter At least once every: ❑ month(s) ❑ NA ,/ / _U-I-ear(s) Inspect pump, pump controls & alarm At least once every: �� ❑ month(s) ❑ NA �"year(s) Flush laterals and pressure test At least once every: ❑ m ) ❑ yeaarr((ss)) ❑ NA Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW(4/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipe's; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sad itary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All-piping to tanks and pits shall be disconnected and the`aabandoned pipe openings seale --- - = • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon bj required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wi, result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS p�technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site ` evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name e'-a', w y,A- S �f f,` Name Phone 1 -21 _ g�_S 8$ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name a %� Name �--�• �iC,v )C �oti;ti Phone ?) " 7,53' _ q2- Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1), (2) &(3),Wisconsin Administrative Code. Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with SPS 385,Wis. Adm. Code County j"-f. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. ° percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 0" — /(Q -/J--06 Please print all information. Rev' ed by Date Personal information you provide may be used for secondary purpos rivacy Law,s.15.04(1)(m)). /L Property Owner Property Location Govt.Lot S�Z /V 1/4 v3 T j� N R /8 E(or)W Property Owner's Mailing Address Lot# I Block# I Subd.Name or CSM# ljee 411-S City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road )�66 -29IY7 11i el►rn�o�� New Construction Use: Residential/Number of bedrooms Code derived design flow rate GPD ❑Replacement ❑ Public or commercial-Describe: Parent material Flood Plain elevation if app4' ble ft• General comments �� f f�,� �/t f/, ti t,,��, / p� `"'��jj1161 9��C 5��� and recommendations: OG�� </ as 3 O,o ❑ tiT Boring# Boring Pit Ground surface elev./d 2- • ft. Depth to limiting factor / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 *#2 3 18,3/ /d b� /Y � S� t'rrn3lf�C.. ,/ �c.— w t to�' • `� • to El Boring ❑ Boring# �� Pit Ground surface elev. ft. Depth to limiting factor ���_in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 3 °-33 /oy.�y�� s l / K �� w /✓1 33 83 AO Y/(P - .S oSa - s 1 *Effluent#1 =BOD >30<220 mg/L and TSS>30 _150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L CST Nam ( lease Print) Signature CST Number Address Date Evaluation Conducted Telephone Number pd . _ 14 C ZA,, Y- z8-/� ?/or Y9/-S3$ SBD-8330(RI 1/11) Property Owner Parcel ID# Page of F31 Boring# r�� Boring LT Pit Ground surface elev. ft. Depth to limiting factor ,8'J" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPDlft Z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -ff#1 ff#2 C9 'Z t �.S �y/y — !? l �.w,S ✓7�� w ' Z 3 3 2i�o /oy� y/� S/ /rn �� ��. /v • q - LP 1 R] Boring# Boring pit�-pit Ground surface elev. 98' � ft. Depth to limiting factor > !/ LI in. Soil—Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Donsistence Boundary Roots GPD/ft Z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 " ff#2 3 Z3,l /,4 Y/ -T 5b t Boring c� Boring# Ground surface elev. /�' 3 ft. Depth to limiting factor 7 in. I 9Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 102 � . z- '�� *Effluent#1 =BOD 5>30<220 mg/L and TSS>30 <150 mg/L "Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(R11/1 l) Property Owner Parcel ID# Page of Boring# ❑ Boring 7 Pit Ground surface elev. �� ft. Depth to limiting factor �n Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 z- ,S�2 yip 1 s x e>11✓A- • Z •3 F-1 Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 ff#2 Boring Boring# Ground surface elev. ft. Depth to limiting factor in. El n Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "1.01 02 Effluent#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L 'Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. M-8330(RI 1/11) w b a W d QL— W h W �c4~ o QL NA w � � z O' s � r7 W I� V � C � ran,�T Count let Buildings Division , W. gton Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) Madison 1 53707-7162 °A A 5675/1 Sanitary Permit Application state Transaction In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this fo the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms foftd POWTS are submitted to Project Address(if djlt'eren�than mailing address) the Department of Safety and Professional Servies. Personal information you p used for secondary F O H �!3 purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. y 1 ,+ I. Application Information-Please Print All Informa ' / Property Owner's Name 5 Parcel# r a z( 9 — LP P /J�-a I d a�aj J Property Owner's Mailing Address M Property Location Q 3 6 1,q,v G 7>`- Govt.Lot City,State Zip Code Phone Number" , /a, Section Z D rYa-, "rG,5-17� ✓�'� T 4/U 2- 7" `7/ �` `7 t o �z 8� jo (circle one) T N; R EorW II.Type of Building(check all that apply) L?�/ El or 2 Family Dwelling-Number of Bedrooms Lot r Subdivision Nam-ee CSk a.� El Public/Commercial-Describe Use El city of ❑State Owned-Describe Use OsM.P�� CSM Number ❑Village of 5 (`1 S f, ®`Town of , C k .e— 0 L III.Type of Permit: (Check or0ly one box on line A. Complete line B if applicable A. w System y El Replacement System ❑ Treatme ding T nly El Other Modification to Existing System(explain) B. ❑ Permit Renewal El Permit Revision El Change of er ermit Transfer to New List Previous Permit Number and Date Issued Before Expiration wner IV.Type of POWTS Sys tem/Com onent/Device: Check all that a YNon-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound 124 in.of suitable soil ❑Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) retreatment Device(explain) V.Dispersal/Treatm nt Area Information: S- >L J ,1 J.0 D 0-'n i L 5 O b Design Flow(gpd) Design Soil Application Rate(g f) Dispersal Area Require Dispersal Area Proposed(sf) System Elevation i- 3 s ?,3 vo t,6 0 -3 z,ad o 2-d 3 > %/-r 9&. 9 VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units o a New Tanks Existing Tanks c d� " Y R � a` U v1 ti rn iw C7 eptic Holding Tank Dosing Chamber l /` VII esponsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS show the attached plans. P er's Name(Print) Plumber's Signature MP P Business Phone Number Plu ber's Address(Street,City,State,Zip Code) 7"j 7Gb— Lg147 0 ZC. 5 16-6 -;�`' 3-t Ga YeL5 3 VIII. ount /De artment Use Only pproved ��. Permit Fee Date sued Issuing A e Signature Reason for enial $ �� bb 2 IX.Condition Disa prov :dispersal cell must al be services 7 mamtalned as per management plan provided by plumber, 2: Ah sett eck requirements must bs;malintainW as per aipplic"code 1 orders: 0" Z . v s 64) —/0 70,E PIA1.01 e 1 Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x 11 inches in size SBD-6398(R. 11/11) Feb-06-2014 03:45 PM St. Croix County Plan/Zoning 715-386-4686 1/11 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: �`� £ J l d N Owner's Address: 93 p k,a y C SY Z5- Legal Description; f c . Z 3 o Township: County; ,,,a ; k Subdiviaion Name: 4V Lot Number: f Parcel ID Number: O z-1. — 1 1).0 -I --0 a 0 Page 1 Index and title Page 2 Plot Plan Page 3 S_ ystem Sizin &Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management plan Page 7 St CroIX CtY Septic Tank Maintenance Form Page 8 Warranty Dead Page 9 CSM or Plat Attachments:Soil Test&House plans , Deslgner/Plumber; G et w4,, Lloense Number: Z Z Z P7Z Date: d- 7- Phone Number Slgnatu Designed pu t=he Ground Soil Absorptlon Component Manual for nwTs version 2,0 8130-10706-P(N.01101). Page 1 V Y 3 \ 1 9 � o ifV -±- 3 Q- lb w � \kJ 2 x J r 2-a - 0 > �� � r 6 � —j J %� � r N � i I AV M ro v N. rn CU LA .'e—p v 5 LE Fl t; Li aj D y v O y ry aj w LJ C) E; ai ej ".4now Q -W IV cj U M d M fi tj tj > CJ lu tj = - 0 E m Fv— tj ul rz 44, ci ci '7- PC E� POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner f d �76 l-'� Septic Tank Capacity Z gal ❑ NA srmit r Septic Tank Manufacturer 37 r avv ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 6C S. ❑ NA Number of Bedrooms 7 ❑ NA Effluent Filter Model d ❑ NA Number of Public Facility Units a-NA Pump Tank Capacity gal --2'IqA Estimated flow (average) (06 V gal/day Pump Tank Manufacturer -Q-NA Design flow (peak), (Estimated x 1.5) 9e)0 gal/day Pump Manufacturer ..8'NA zz Sdih J Application Rate - gal/day/ftz Pump Model Standard Influent/Effluent Quality Monthly average* Pretreatment Unit 2<A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BCD.) _5220 mg/L ANA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) _5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average, Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (SODS) _530 mg/L 2'T'n-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L e'NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) :5104 ofu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y, in dia. e'NA Other: ❑ NA Other: ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA AINTENANCE SCHEDULE Service Event I Service Frequency Inspect condition of tank(s) At least once every: 11 month(sl I / 4R—year(s) 3 years) E:, NA Pump out contents of tank(s) I When combined sludge and scum equals one-third (Y;) of tank volume ❑ NA Inspect dispersal cell(s) I At least once every: ❑ month(s) -5 year(s) (Maximum 3 years) 7, NA Clean effluent filter I At least once every: ❑ month(s) ❑ NA f!�'ears) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ��A ❑ year(s) Flush laterals and pressure test I At least once every: ❑ month(s) -E'IVA ❑ year(s) Other: ❑ manth(s) At least once every; ❑ year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing,,Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify ari-y,cracks or leaks, measure the volume of combined sludge and scum and to check fcr anv back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of erluent on the ground surface. The ponding of effluent on the ground surrace may indicate a Taiiine condition and requires the immediate notification of the local regulatory authority. When the Combined accumulation or sludge ano scum in an4 :Sn< ecuaiS :me-Miro jS; or mare oT :„e t-a.< volume, °e ent;re contents DT the tank snail be removed Dv a S eptaee Servicing l.cerator and Disposed of In ac'-crdanc° L^Jill Chapter i�J= Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of:512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW('./01) Page of START UP AND OPERATION presence of painting products or other chemicals For new construction, prior to use of the POWTS check treatment tank(s) for the ess and/or damage the dispersal cell(s). If high concentrations are detected have the contents that ma y impede the treatment proc a septage servicing operator prior to use of the tank(s) removed by System start up shall not occur when soil conditions are frozen at the infiltrative surface.e is restored the excess wastewater will be power outages pump tanks may fill above normal highwater levels. When p or surface discharge of During P Operator prior to restoring tae Servicing P controls to discharged to the dispers l cell(s) the contents of the pump tankc elmoveddby a Sepulgin the backup effluent. To avoid this situation power to the effluent pump or contact a plumber or POWTS Maintainer to as in manually operating the pump restore normal levels within the pump tank. ark over, or otherwise disturb or compact, the area Do not drive or park vehicles over tanks and dispersal cells. Do not drive or p of an mound or at-grade soil absorption area. prolong the life of the within 15 feet dawn slope Y Reduction or elimination of the following arette butte condomst2cotton swabs;)degreasers; dental floss; diapers, disinfectants; fat; ics• baby wipes, cigarette grease; herbicides; meat scraps; medications; oil; POWTS: antibiotics; gasoline; foundation drain (sump pump) water; fruit and vegetable peelings; g painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT steps shall be taken to insure that the system is When the POWTS fails and/or is permanently compliance with Comm 83h33�IWis Ionsin Administrative Code: properly and safely abandoned in P o openings sealed. • All piping to tanks and pits shall be disconnected and the abandoned pipe p a Septage Servicing Operator. • The contents of all tanks and pits shall be removed and properly disposed of by in all tanks and pits shalt boved and the veld space filled with e excavated and removed or their covers rem • After pump g, soil, gravel or another inert solid material. If the PO WTS fails and cannot be repaired the following measures ide a code compliant CONTINGENCY PLAN have been, or must be taken, to prov replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil d uco,t�on o 'replacement area should be protected from disturbance and compaction and should not be ie replacement upon f ' system. The p required setbacks from existing and proposed structure,stablin a n. ale rep aaceumenj� areaecReplacement systems must q g �fj � result in the need for a new soil and site evaluation to establish with the rules in effect at that time. /%�/l vances i POWTS t to replace the failed POWTS. ❑ A suitable replacement area is not available due to setback and/or sail limitations. Barring - technology a holding tank may be installed as a last resort area. If no replacement area is available a holding tank ❑ The site has not been evaluated to identify a suite bleQcreplacement area. Upon failure of the POWTS S a soil and site �o55�bt e' evaluation must be performed to locate a suitable rep) may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstri cted in rules in effect at that time.the biomat at the infiltrative surface. Reconstructions of such systems must comply with SEPTIC,<WARNING>> R INSUFFICIENT C PUMP AND OTHER TREATMENT TANKS MAY CONTAIN�Y C RCUMSTANCESD/DEATH MAY RESULT. RESCUE00 OF' ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. • ADDITIONAL COMMENTS POWTS MAINTAINER POWTS INSTALLER y Name t Name Gwt't'�- $ �' _ ; Phone ; Phone ? OCAL REGUL.nTORY AUTHORITY SEPTAGE SERVICING OPERATOR (PUMPER) Name NameI CA.- Phone Phone ; 75c — —?S �' This document was drafted in compliance with chapter Comm 83.22(21(b)(1)(dl&lf) and 83.54111, (22) & (31,Wisconsin Administrative Code. Feb-06-2014 03:45 PM St. Croix County Plan/Zoning 715-386-4686 2/11 ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OVINERSHM CERTIF'ICAnON FORM Owner/Buyer S'�-�v a 1 D N Mailing Address °/ 3� v G Pet, -� Property Address (Verification required from Planning&Zoning Department for new construction) City/State C'ca / Parcel Identification Number =2.6 /b u&r.AL nRSCR2nON ("^� Property Location 2JA,Nu' r/4, Sec. �.T S O N R6./,5 'W,Town of � i►'�t a J Subdivision Plat: W h ,�"� 4,2 i t ���� d o of s ,Lot# <� Certified Survey Map# .Volume ,Page# Warranty Deed# (before 2007)Volume ,Page# Spec house 0 yes$/no Lot lines identillabld.10yes 0 no SYSTEM atNr'�N ACE 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 tack as a treatment stage In the waste disposal system. Owner maintenance respomibilides are specified in§Comm.83.32(I)and in Chapter 12•St.Croix County Sanitary Ordinance. The property owner agrees to subriiit 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 vwifying that(1)the on-site wastewatar disposal system Is In proper operating condition and/or(2)after inspection and in (if necessary),the tic tank is lase than 1/3 Hill of sludge, �P pumping( arY). �P Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the .standards set forth,herein,as act by the Department of Commaroe and the Department ofNatural 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 mpirntion date. Uwe cartiff that all statements on this fbA are true to the best of my/our knowledge. Uwe am/me the owner(s)of the property described above,by virtue of a w7deed recorded in Register of Deeds Office. Number of bedrooms r IUD SIGNATURE OF APPLICANT(5) DATE /L ***Any Information that is misrepresented may result in the sanitary permit being revoked by the Plamtiitg&Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Offiea and a copy of the certified survey map if reference is made in the warranty deed. (REV.09/07) .. °- O W N U asa ffi ; R4g� Q m J M Z ooh S,g'-��$o' N 4e AK ZN �Wz o z N y_ _ I age I o f N Z U I a Z s E 'LLB a I 1 vrran o�vnn � vron m ------------v�--�-- -- 1 I 1 i 1 m i ® ® 1 i v do a 00 § R x -— — - --- El - .e-m 40 Ss8 o a ry ac q q - R e x ---- ----------- � I 1 1 � 1 vmoxe I I I 3g m I I rl xp j � * 9 0 8 3 5 0 1 State Bar of Wisconsin Form 3-2003 908350 QUIT CLAIM DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI RECEIVED FOR RECORD 12/14/2009 08-GOAM THIS DEED,made between Dalstock,LLC,a Wisconsin limited liability company QUIT CLAIM DEED EXEMPT tI ("Grantor,"whether one or more), REC FEE: 11.00 and Steven M.Dalton TRANS FEE: 141.60 PAGES: 1 ("Grantee,"whether one or more). Grantor quit claims to Grantee the following described real estate,together with the rents, profits, fixtures and other appurtenant interests, in St.Croix Recording Area County, State of Wisconsin ("Property") (if more space is needed, pleas attach e addendum): Name and Return Address Lo 15 itetail Meadows,Town of Richmond,St.Croix County, Brent R.Johnson Lommen Abdo Law Firm Wisconsin. Grandview Professional Building 400 South Second Street,Suite 210 Hudson,WI 54016 026-1160-15-000 Parcel Identification Number(PM) This is not homestead property. (is not) Dated December 7,2009 DALSTO L (SEAL) (SEAL) By: Bill Stock,a/k/a William B.St k,Member (SEAL) 4 (SEAL) " By: Steven M.Dalton,Member AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on )5s. ST.CROIX COUNTY ) + Personally came before me on December 7,2009 , TITLE:MEMBER STATE BAR OF WISCONSIN the above-named Dalstock,LLC,by Bill Stock,a/k/a William B. (If not, Stock,Member,and Steven M.Dalton,Member authorized by Wis.Stat.§706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. (ANNE F.HALLSTROM THIS INSTRUMENT DRAFTED BY: np No"PlIhIsc- Brent R.Johnson-Lornmen Abdo Law Firm BMW of n Hudson,Wisconsin Notary Public,State of Wisconsin My Commission(i&jmnrartent)(expires: (Signatures may he authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED ©2003 STATE BAR OF WISCONSIN FORM NO.3-2003 'T c name below signatures. �Y�VFWI� r � O%ft low a� c W to r h � Z � ¢ . . . . 11Y 099M li' '1'S Ol 33a'/ 32110 ON- "lo, moo .os Ao'SLL— Now — t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division 0 Safety and Buildings in accordance with Comm 85,Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include,but not limited to:vertical aryd horizontal reference point(Brut),<direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. e eviewed Date Please print all information. _ �7 Personal information you provide may bo used for secondary puropm(Privacy,Law,s.15.04(1)(m)). Property Owner Property Location ;� %Co✓ Govt.Lot 1 /4 S3T N R E( a)W Property Owner's Mailing Address/ Lot# Block# Subd. Name or CSM# yyf City State Zip Code Phone Number ❑City ❑ Illage own Nearest Road l . -c New Construction Use Residential/Number of bedrooms Code derived design flow rate ��d GPD ❑Replacement ❑, P�uAbl1i or commercial-Describe: ---_—__. __-- --------- --- Parent material / ��'„' Flood Plaielevation if applicable General comments and recommendations: `�i�C�„�/ r� ❑ Boring it Ground surface elev.Ayi Zft. Depth to limiting factor in- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color ar.Sz.Sh. f 'Eff#1 `Eff#2 2 5 ® Boring# Bonng Pit Ground surface elev.L Z16 kZ Depth to limiting factor in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 �r 1041-3J L -fir � f 3 7 1 Effluent#1 =BOD,>30:S 220 mg/-ar4 TSS>30<150 'Effluent#2=BOD <30 mg/L and TSS<30 mg/L CST Name(Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird �, 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ' .,0J 715-246-4516 t Property Owner rcel ID# Page of Boring# ❑ Boring it Ground surface elev. ft. Depth to limiting factor ��• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Muns II Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 3 'U l N, Y-I F✓ 0/, , f a Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 F—I Boring# E] Boring 11 pit Ground surface elev. ft. Depth to limiting factor in. NINplication 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 =BOD6>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 nVL 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(8.6/00) i Soil Test Plot Plan Project Name William Stock/Steve Dalton Shaun Address 1748 112th St. New Richmond Wi 54017 CS# #226900 Lot 15 Subdivision Whitetail Meadows Date 8/15/03 S 1/2 N W 1/4S 23 T 30 N/19118 W Township Richmond M Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" Pipe System Elevation 97.3/96.9' *HRpSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Scale is 1" = 40' Please note: Installer must unless otherwise verify all lot lines and setbacks before installation. noted Please Note: Tested area may not be suitable for desired building area. Check system location before excavating. 3 a N `q B-3 101' 4°Io Slope 100' 35 B-2 Alt. B.M. 10 IL 469' Property Line B.M. 5' 40' 45' 100' Bird Plumbing Inc. 1008 192nd Ave New Richmond WI 54017 715-246-4516 Subject: Whitetail Meadows Soil Tests To Whom it may concern: I Shaun Bird did the soil tests on this subdivision known as Whitetail Meadows in Richmond township. Aftbr a couple of installations,some of the soils were found to have a more weak structure than what was found in some of the .borin 9 s In order to protect home owners and contractors, it is my recommendation after discussing the issue with Pam Quinn from St. Croix County Zoning office that the systems be oversized using a.3 loading rate Instead of the original.4 rate. On the lots that were originally sized for a.5, 1 recommend using .4 not then w.6 that the state h suggested. The soils are what the tests indicate e e to a as su e 9 � 99 but the large areas tested did not reveal some of the weaker structures that were found upon installations. If a installer can prove otherwise,that the weaker structures do not exist, then the installer should proceed with the soils that he/she believes are present. Shaun Bird CST #226900 I Z .d d61► = TT 40 sa Jdd ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT N N N would ST.CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 Phone: (715) 386-4680 Fax(715) 386-4686 Memo to File From: Pam Quinn Date: 4/27/2004 Re. Sandy loam structure misinterpretation on subdivision soil reports Recent soil on-site determinations have brought a problem to our attention. During these on- sites,bofings were excavated to confirm soil conditions where two conflicting soil reports had been submitted for zoniflA department review. The soil profiles, evaluated by myself,Dave Fogerty, and Dave Steel(all certified soil testers)differed from the original soil reports in that massive(structureless)sandy loams were encountered in horizons that were described as having either moderate, medium subangular blocky(2msbk) structure by Adam Schumaker or weak, medium granular structure(I mgr)by Shaun Bird. There apparently has been a misunderstanding between"structure"caused by handling samples of the soil during texturing versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand texture, with pressure parted into"crumbs"that appeared at first to be subangular or granular in shape. However, these were not true peds that broke apart along planes of weakness, but fragments created by handling. The soil when observed in the horizon did not have distinct units of structure and should have been reported as "massive". Added notation: on 4/23/04 Mark Iverson(Cedar Corp. certified professional soil scientist), Shaun Bird, and myself did an evaluation of soils on Lots 6 &9, Richmond Meadows where the original soil report described the third horizon as sandy loam, "l mgr". On Lot 6 we checked soil profiles within a POWTS distribution cell and then excavated a test pit on Lot 9. The sandy loams in question were a weak, coarse to very coarse subangular blocky structure, where planes of weakness were just discernible when peds were parted from the profile. The peds separated with very light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9 soils,which supported the determination that some structure existed to allow water to move through the upper portion of the sandy loam horizon. However,below the weak-structured soil we found massive(structureless) sandy loams and the boundary between these horizons was irregular,which would mean a distribution cell could encounter alternating weak and massive sandy loam. Shaun said he would amend his soil reports with a memo recommending that any sandy loams he identified as"1 mgr"or"2 mgr"be assigned a lower loading rate of 0.3 gpd/ft2 (see attached memo for Whitetail Meadows)to provide a larger dispersal area. Page Two—Soil Memo 4/27/04 Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft2 with the code changes in Comm 83.44-2, effective as of 2/1/04. The application rates listed on the soil reports were higher due to the structure having been described as either weak or moderate,which affects the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to make sure loading rates for the soils are not in error and allow undersized POWTS to be installed. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy loam at the system elevation. The sandy loam horizon had been described on the soil report as "l mgr"with firm consistence. Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this situation and advised the zoning department to require on-site verifications for any lots with this potential misinterpretation on the soil reports. All soil reports with sandy loam"1 or 2 mgr" as its structure will be required to use a design based on the current code's soil application rate for massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise. Z Page Two—Soil Memo 4/27/04 Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft2 with the code changes in Comm 83.44-2, effective as of 2/1/04. The application rates listed on the soil reports were higher due to the structure having been described as either weak or moderate, which affects the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to make sure loading rates for the soils are not in error and allow undersized POWTS to be installed. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy loam at the system elevation. The sandy loam horizon had been described on the soil report as "lmgr"with firm consistence. Leroy Jansky,Dept. of Commerce Regional Wastewater Specialist, has been consulted on this situation and advised the zoning department to require on-site verifications for any lots with this potential misinterpretation on the soil reports. All soil reports with sandy loam"1 or 2 mgr" as its structure will be required to use a design based on the current code's soil application rate for massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise. ST. C► _ ;JIX COUNTY WISCONSIN ZONING OFFICE ��IIM/M1111■^— upon* ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680• Fax (715) 386-4686 June 16, 2004 File Ref: 10-04 Dal Stock, Inc. 1748112 th Street New Richmond, WI 54017 Re: Board of Adjustment Decision Dear Applicant: The St. Croix County Board of Adjustment has reviewed your request for a special exception permit for five two-family dwellings in the Ag/Residential District and has approved this application with conditions. The enclosed document is the formal decision regarding your application. Should you have any questions or concerns,please do not hesitate in contacting me. Sincerely, Ait Rod Eslinger Interim Zoning Director dz Enclosure cc: Donna Ray,Clerk,Town of Richmond,w/enclosure Ty Dodge,JEO Consulting,w/enclosure Pete Kling, LWCD,w/enclosure FINDINGS,CONCLUSIONS,AND DECISION OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY,WISCONSIN Case: 10-04 Applicant: Dal Stock, Inc. Complete Application Received: March 15,2004 Hearing Notice Publication: Weeks of April 5 and 12,2004 Hearing Date: April 22,2004 FINDINGS OF FACT AND CONCLUSIONS OF LAW Having heard all the testimony, considered the entire record herein, and conducted an on-site inspection,the Board finds the following facts: 1. The owner of the property is Dal Stock,Inc., 1748 112th St.,New Richmond,WI 54022. 2. The property is located in the Whitetail Meadows Subdivision, 146th Avenue,New Richmond, WI,in the SW '/4 of the NW 1/4, Section 23, T30N-R18W, Town of Richmond, St.Croix County, Wisconsin. 3. An application was made for a special exception permit to construct one twinhome on each lot(lots 12-16)of Whitetail Meadows, for a total of five twinhomes.The Board of Adjustment finds that the requirements have been met to grant the special exception pursuant to Section 17.15(6)(a)of the St. Croix County Zoning Ordinance. 4. The Town of Richmond has recommended approval of the request. 5. There was no opposition to the request. 6. The plans for the project have been designed by a professional company and will be professionally installed. 7. The Land and Water Conservation Department has approved of the request with recommendations stated in the conditions. 8. The Board finds that the location chosen in the subdivision is an appropriate place for proposed twinhomes to be constructed. 9. The Board finds that the twinhomes will provide affordable housing to the residents of St. Croix County. 10. The Board finds that the request is not contrary to the public interest. 11. The Board finds that the spirit and intent of the ordinance would be met by granting this request. DECISION On the basis of the above Findings of Fact, Conclusions of Law, and the record herein,the Board approved the request for a special exception permit for a two family dwelling in the Ag/Residential District with the following conditions: 1. This permit allows the applicant to construct one twinhome(two family dwelling)on lots 12-16 of the Whitetail Meadows Subdivision. For any other use,the dwelling would have to fully comply with the provisions of the St. Croix County Land Use Regulations. 2. The applicant shall demonstrate to the Zoning Office that each lot has an area sufficient to accommodate for the Private Onsite Wastewater Treatment Systems(POWTS) serving i the structures before this permit is valid. 3. Applicant shall secure a sanitary permit for each structure from the Zoning Office and a building permit prior to commencing construction. 4. The best management practices (silt fence)must be installed before commencing grading activity(site preparation) for the project per recommendation from the Land and Water Conservation Department. 5. In an e-mail dated April 5, 2004 from Pete Kling, the LWCD has reviewed and approved the request with three comments. The applicant shall comply with the following recommendations made by the Land and Water Conservation Department: 1) Constructing the driveways all the way to the building pad would be ideal and provide an even better construction entrance for the twinhome construction; 2)Require twinhome construction to adhere to the Uniform Dwelling Code erosion control procedures identified in Comm.. 21.125; 3)Additional erosion control maintenance. In addition to the silt fence around the existing wetland, require twinhome builder to accept the responsibility of maintaining and repairing existing erosion control practices(erosion mat and temporary ditch checks) in the west road ditch from station 2+00 to 11+00. 6. Applicant to maintain at least 1. %2 off street parking spaces for each family for which accommodations are provided in the building plus one more space per building per section 17.57 (2). 7. The property shall be kept in a neat and orderly manner. All outside storage of garbage containers shall be screened and protected from rodents. No junk,junk cars or garbage shall be allowed to accumulate on the property that may attract rodents or pose a threat to the health, safety and welfare of those citizens of St. Croix County. 8. All driving and parking areas must be provided with a dust free surface (asphalt/concrete/road millings, etc...). The applicant must submit a paving plan to the Zoning Office prior to commencing this project. 9. Any proposed lighting is to be directed away from neighboring properties. 10. The Zoning office is to be notified at the start and the finish of the project. 11. The applicant must allow free and unlimited access to the project site at any reasonable time to any Zoning Office employee to inspect the property for compliance with these conditions. 12. Any change(or addition)in use, or expansion of the project, including building, signage, shall require review and approval by the zoning administrator and in some circumstances through the Special Exception approval process, where applicable, as stated in the ordinance. 13. The applicant shall have one(1) year from the issuance of the special exception permit to commence the construction. Failure to do so shall result in revocation of the special exception permit. If the special exception permit expires before business commences,the applicant will be required to secure a new special exception permit before starting or completing the project. 14. These conditions may be amended or additional conditions may be added if unanticipated conditions arise that would affect the health and/or safety of citizens or degrade the natural resources of St. Croix County. Conditions will not be amended or added without 2 i I notice to the applicant and an opportunity for a hearing. 15. Accepting this decision means that the applicant has read, understands, and agrees to all conditions of this decision. The following vote was taken to approve: Peterson, yes; Marzolf, yes; Krueger, yes; Golz, yes; Chairperson Speer,yes. Motion carried. APPEAL RIGHTS Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30 days after the filing date shown below,pursuant to sec. 59.694(10),Wisconsin Statutes. St. Croix County assumes no responsibility for action taken in reliance on this decision prior to the expiration of the appeal period. St. Croix County does not certify that the identity of all persons legally entitled to notice of the Board of Adjustment proceedings,which resulted in this decision, was provided to the County. If an appeal is taken of this decision,it is the responsibility of the appellant to submit at his/her expense a transcript of the Board of Adjustment proceedings to the circuit court,which is available from Northwestern Court Reporters,Hudson,Wisconsin. It is the responsibility of the Board of Adjustment to submit its record(file)of this matter to the circuit court. ZO G BOARD OF JUSTMENT Signed: Chairperson Attest: A i , • Date Filed: 06/16/04 Interim Zoning Director i I� 3