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~ 1 // nartment of Commerce .,ing D~sion PRIVATE SEWAGE SYSTEM INSPECTION REPORT .ORAL INFORMATIONI ~ (ATTACH TO PERMIT) ~sonal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Roshell, Tro Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: ~ eo . ~ ~ . rS' Pic.. ~ C.~~b TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~L n Dosing ' Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ 2 .~ ~ ~ ~ ~ ~ ~ Dosing i t ,~ i t Aeration Holding PUMP/SIPHON INFORMATION 9~ Manufacturer Demand Cr C.I..~..- GPM I - Model Number ~~ ~ ~~~ ~VV Li L Friction Loss System ead TDH Ft \r. 2 'l. 'Z • ~~' ~C -Sa • 3 orcemain Length ~ Dia. t~ Dist. to well ~ I ~ County: St. Croix Sanitary Permit No: 430080 0 State Plan ID No: Sizz2S = T~ . ~d Parcel Tax No: ~~ Section/Town/Range/Map No: 30.29.17.$1 STATION BS HI FS ELEV. Benchmark S• ~ ~S.sf ate, o Alt. BM Bldg. Sey/er ~ ~ t ~ ~ J ~. `+~"JeeR /Z . ~'v ~2.0 1 r SUHt Inlet ' ~. !. 9~ SUHt Outlet Dt Inlet Dt Bottom ~ ~ ~ ~• ,L~ ( Header/Ma ~ ~ ~. ~1 Dist. Pipe , ~ •3~ - ~~ . ~ ~~ Bot. System /~, („ s G . ~ , p BO.OS Final `G•~ra~ ~ ~ 'zu{ r. St Cover f uw~'l A .~ ~ ~_ a~ SOIL ABSORPTION SYSTEM L~rt = ~'y° ~. 2-, BE Width ~ Length ~ MENSIONS 5 0 No. Of~e+ehes PIT DIMENSIONS ~ o. Of Pits Inside Dia. i ui th q Z~ ~a~Gr SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuf rer: INFORMATION CHAMBER OR Type Of System: p ~ ~ ~ ' `~ t ~~ UNIT el Number: ~ . ~ DISTRIBUTION SYSTEM .~~ L~{OC ~ w~t~uw J- Header/Manifolds ? tribution ~~ ~ x Hol ize x Hole Spacing Vent to Air Intake Length Di Length Dia pacing • ~ SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil Yes ~ No -~ ,~ Yes rJ, No to' G-s ~[~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /~fX~'~/yrA3 Inspection #2:~'• ~ /~~~~ Location: 744 154th St Hammond, WI 54015 (NE 1/4 SW 1/4 30 T29N R17W) NA Lot ~~'°~~~ Parcel No: 0.29.17. (~~J(, ~ ~p~ ~ ~ 1.) Alt BM Description = ~, fe,,t V~pl.eL ~ ~Cor/ g~w~y"~~J ~_ ~ ~p~ ~ ~,q /~ ~~ 2.) Bldg sewer length = ^„ IZ ~r~ f/ (~ - amount of cover = ~Q'~~. tA,. tr~u ~at. t-v+~+~'~~ • ~-- ~) Or~~c-c~SyM,~cc, ~;,1~5 ~e.~. a,+r d~;1~ ~ ~~ ~~, ~O; _~ __ --- - --- ------ - -~ r--- -- Plan revision Required? ;`'1 es No i ~ - - -_ _-- ~~~ Use other side for additional information. __ ' ~~ ~A ~ ._._ , _ __ ____ ___ _ __. ._ SBD-6710 (R.3/97) ~ t~ „ ~,1, ~ S Insepctor's Signature Cert. No. Safety and Buildings Division County ` ~~ m 201 W. Washington Ave., P.O. Box 7082 cj`['. L~ ( ~ eons~n Madison, WI 53707 - 708 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 261fi546 `F3~o Of~ Sanitary Permit Application State Phul .D. N~om~ f'_ 8 Z ~~ ~~- [n accord with Comm 83.21, Wis. Adm. Code, personal information you provide r e r /''~ may be used for secondary purposes Privac Law, s15.04(1 xm) Project Address (if different mailing address) I. Application Information -Please Print All Inform ton Property Owner's Name ~"]-'~-o o r~ JIJN (f 4 2003 Property Owner' Mailing Address ST. C f? )! X CO U ~ J~T" S j,3 ~ ~_S' ~ ; oF~icE ? yy !.5'Y ~ -~ Parcel # Lot # Block # 3 Property Location v.,S CVy,, Section 3 ~ City, State J ~ ~ J Zip Co/de~ / Phone Number G40[„S O /V (/«,~ ~ f' ~ ~` ~d / ~ ~ 9 (0 3 - I'Yt~ ~ (circle one T ~ N; R~ZE ol~ II. Type of Bufldiag (check all that apply) or 2 Family Dwelling - Number of B ,t ms ~ Subdivision Name CSM Number 3 ~~ ^ Public/Commercial -Describe Use ~ g • (a0 v 1 ~P, _ t~ t ,,,,,, ~~ ^ State Owned - Descn'be Use ~ d c.RQ~ ~ b tt+ 1 ~ • (~ ~ ~ q ^City ^Village I(~ownship of~ IIL Type of ermit: (Check only one box on line A. Complete line B if applicable) - A. New S rem ^ R lacement S tem Ys ep ys ^ Treatment/FIolding Tank Replacement Only ^ Other Modification to Existing System 13• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration P~umber Owner IV. of POWTS S stem: C eck all that a 1 ^ Non -Pressurized In-Ground Mound > 24 in. of suitable soil ound a'24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: ./po - Dtsign Flow ) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Stcel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank `~ o oD 1 o j ~~~ !~ Aerobic Treatment Unit ~ G~ Dosing Chamber ! f l / ~~ VII. Responsibility Statement- [, the undersigned, assume responsibility for installation of the POWTS shown oa the attached pleas. Plumber's Name~(P 'nt) Plum 's Signature MP/MPRS Number Business Phone Number /~ /,r~^~v/~iE i'~~~Q Q 2 ~ ~$ / 71 S- 7hf 9- 3 ~ `.~Z Plumber's Address (Strcet, City, State, Zip Code) ~ ~ ~ ~S- ~o,~~rfis I:cJ~ SS~o~.3 VIII. Coun /De artment Use Onl ,Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fce) ~ ^ Owner Given Reason for Denial ~ 32.x"-' ~ 3 '~~ IX. Conditions of ApprovaUReasons for Disapproval t7~ ~ ~~,~a~rc:r~t:Q ~ ~~ ' - Atlaeh eompkte pleas (ter the Comely oaly) for the system sa paper not kn rhos 81/2:11 Iwches In sine SBD-6398 (R. 08/02) ," ~:. Lot 39o-FE••~e~.~~c~es ~Ca M da/. ~C., Rj. ys3/~ ~98•a2 , .~ ~ elm - 99. yo' ProFbSed r~o~.~.nd a~ /8.85 X /0~.70' w/ s X 90' d.'S/acrs cc / G2 ~/ 7'wO C.?J d,-stJ'i b~'~ /a~~'~ ~~ Sf~aee.d aL'..Z.5,3: 83 °` c ~,t ,8~ ac„c.h rvto~rK~ op o,f' / "R r. C. p.Pe• w `~ ,4ss,,urac,d a.le/; = lOD.c~." c ~~' w y q~0 , h~ V q~. 0 g~. 61 r v/ ~ ~~~ a y\o occ/ ~o :°~/ ^ P~ z"sv.. ~ep~c. ~ QZ~ ~'orCCMa~Y) ~99.s7' ~Q p postal. d.r'i /G~r ~p ~a9e N o.F- Pic ('O~ "ac ~ 1 Proposed , - ---~ 3 bedra~r- ~3~ 0 ~ ('eSi ~en~-e Proposed r~ooo/bsv ya.P. ev;eser tT./P. c.Q ~t ~ ~/ct_.~_ ~a~~~-t co~z~ ~ c~ ~ 5y~em ec~~' i/1 eor~e~~ ea~ec~-~a+-f..co~cz-~' 98.60. .,/ be 99. is;' Sys'~~-n /oca~'an Co~^/'eC~r i ~G/.Ca..7~tCa~ 0Y1 S•~P/4~., . S ~C. `~, ~-- ~j3 z~3 ~. $ off' 9 ~ ~ ~ ~s~on~~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 27, 2003 CUST ID No.222781 HENRY J NECHVILLE 967 HIGHWAY 65 ROBERTS WI 54023-8510 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/27/2005 SITE: Troy Roshell 154th Street Town of Hammond St Croix County NE1/4, SW1/4, S30, T29N, R17W Subdivision: Emerald Acres -lot 39 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 904436 Identification Numbers Transaction ID No. 872225 Site ID No. 659423 Please refer to both identification numbers, above, in all correspondence with the;agency The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: Conditions of Approval: • This system is to be constructed and located in accordance with the enclosed approved plans. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - 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. Note: In order to maintain a minimum dose of 5 time the void volume of the laterals as calculated on page 2 of 9, the "C" pump tank dimension on page 4 of 9 has been increased to 6.2 inches. o. ~~ ~', ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 HENRY J NECHVILLE Page 2 5/27/03 Owner Responsibilities: • Comm 83.52(1}(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWT5 that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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 describes} in the approved plans. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm jswim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Troy Roshell 3 bedroom residential mound Owner's Name: Troy Roshell Owner's Address: 527 13th St. So., Apt. #119 Hudson, WI 54016 Prop. Address: XXX 154th Street _ Legal Description: NE1/4SW1/4, Sec. 30, T.29N., R.17W. Township: Hammond County: St. Croix Subdivision Name: Emerald Acres (CSM Vol. 16, Pg. 4431) Lot Number: 39 Block Number: na Parcel I.D. Number: 018-1098-10-20, 30.29.17.8176 Plan Transaction No.: Page 1 Index and title Page 2 Data entry ~~~~~~~~ Page 3 Page 4 Mound drawings Lateral and dose tank Page 5 System maintenance specifications MAY 1 5 2003 Page 6 Management and contingency plan Page 7 Pump curve and specifications GGS Dlr. SAFET~I & Bt Page 8 Site Plan ~ Page 9 Soil Evaluation Report Designer: Henry Nechville License Number: Date: 05/09/03 Phone Number: Signature: ~~.~,.,,,,~ ~.~~, °~ ,/ 222781 715-749-3322 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) ...r,~~r or cor,;t,~>:acE~'. Page 1 of 9 Version 3.0 (03/01/01) D~V~SiUN ~F SAFE yq~;0 BiJILGlNOS '~~ C~pKRES O~JL~ENCE iVlound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 3.00 Site Slope (%) ~~5~ ontour Line Elevation (ft) 25.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cel{ Information 90.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) a Center or End Manifold 2.50 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 140.00 Forcemain Length (ft) 87.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 12.02 Vertical Lift (ft) 2.66 Friction Loss (ft) 21.17 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o ions choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1,000 gal. Se tic Tank Capacity (gal) Wieser Concrete Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment fog fecal coliform of <= 36 inches. 5.00 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation ft) of the highest point. 6.25 ft2/orifice Does the forcemain drain back? Y Enter Y or N 22.84 Forcemain Drainback (gal) 81.25 5x Void Volume (gal) 104. Minimum Dose Volume (gate 29.66 System Demand (gpm) Manifold Diameter Selection in. dia. o ions choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) 646.00 Total Tank Capacity (gal) 38.00 Total Working Liquid Depth (in) 17.00 gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Infornation 646.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 17.00 Dose Tank Volume (gal/in) A100 Filter Model Number Wieser Concrete Manufacturer Project: Troy Roshell 3 bedroom residential mound Page 2 of 9 Mound Plan View 1_ 1/10 B ~' ~' Observation Pipe. ~ ~ ~ '0' :~'~' •~• o _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ •_' . ^. v. . ~-~• I I L Mound Component Dimensions A 5.00 ft E 12.80 in B 90.00 ft F 9.50 in D 11.00 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate H 1.00 ft K 8.35 ft z 7.77 ft L 106.70 ft J 6.08 ft W 18.85 ft 1149.73 (ftz) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.31 (ft) ~I H Dispe ateral Z F . ; : : ~ •••~~rsai•Cetl 100.02 (ft) L 99.52 (ft)--- - ~:~ Invert Dispersal Cell . 3~ : ~ ~ ~ ' ~ ~ t .. .. Elevation E ~ ~ D ~ ; ~; .. ... - .. .•. . . •. . ... . . . .. . . .... . :r," . .~w ..... .... ..... .... .~ f :y. ~~ ~ ~ tie's--4 ~~ •<''ky'4~ +c ~ ~,., ~,. •. •. {. ~ • -889 (ft) Contour Elevation 3.0 °k Site Slope ~~5~ /~ Geotextile Fabric Cover Shading Key 10 _ Topsoil Cap © {~~~f Subsoil Cap ' • ~ : ASTM C33 Sand Tilled Layer ^5 :::~:~ Aggregate a C 1.5 ft ~ a, ~ O 0.5 ft Dispersal Cell ,~~ ti ti • •y T ~ . : j I ti: :ti;:ti;1:: F ,: •rt;• 'ti' Typical Latest • . ._. _.!:t. _._._ _ ~--- A See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). -1 _f -1 Project: Troy Roshell 3 bedroom residential mound Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over the A & B dimension ~ =Turn-up wf ball valve or cleanoutplug E P .I A8laterals are identical IE X--~I Holes drilled vn the bottom of the lateral equally spaced r Force main connection uia tee or cross to maniFotd at any point. Laterals & Farce main of PVC Sch 40 [per CONIM Table 84.30-5] Number of Laterals 2 Lateral Diameter 1.50 in Lateral Length (P) 88.55 ft Lateral Spacing (S) 2.50 ft Lateral Flow Rate 14.83 gpm System Flow Rate 29.66 gpm Total Dynamic Head 21.17 ft Orifice Diameter Orifice Spacing (~ Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -~ ~_ Comm 16.28 WAC ~„_ ~ Dksconnect Tank component is properly vented Wieser Concrete Ca acit 646.00 Votume 17.00 Manufacturer _~ Gallons gal(inch A Dimension Inches Gallons A 17. 313.4,3 B 2.00 34.00 . (0.2 94.5.7 D 12.00 204.00 Total 38.00 646.00 3" tank. Alarm Manuafacturer LevelArm Alarm Modet Number DLV Pump Manufacturer Zoeller - _ _~ Pump Model Number 137 Pump Must Deliver 29.66 gpm at 21.17 ft TDH B 3o2.6C 105. D 0.125 in 2.53 ft 6.25 ft` 2.50 ft 1.50 in 3.03 fU Locking cover with warning label and locking device and sealed watertight 4 in. min. ~ Aftemate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ ump off elevation (ft) 88.00 D~tank elevation (ft) 87.00 Project: Troy Roshell 3 bedroom residential mound Page 4 of 9 Mound ~vstem Maintenance and Oaeration_S~ecifications Service Provider's Name ~ H. Nechville,MPRS #222781 Phone 715-749-3322 POWTS Regulator's Name St. Croix Count Zonin Phone 715-386-4680 Svstem Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum GODS 220 mg/L Septic Tank Capacity 1,000 al. gat Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested every 1.5 ears Inspect for pondin and see a e once eve 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .,~~~~........ ............... Grade \ , 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Troy Roshell 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.8 (01/81)] 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at I~st once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall tie serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be pertormed to maintain less than maximum scum and sludge accumulation in the tank. The addttion of biological or chemical additives to enhance septic tank Performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pumn 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 fitter is installed wtthin the tank tt shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem 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 anti 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 mglL BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mglL FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permlt for this installation. The pressure distribution system is provides! with a flushing point at the end of each lateral, and lt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertormed lt should be compared to the inttial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring addttional, more frequent monltoring. Continaencv 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, tt 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Troy Roshell 3 bedroom residential mound Page 6 of 9 HEAD/CAPACITY CURVE N ~. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING SERIES aJ~sa b7d9 97 N fJ7-1 J9 181 1!J t66 166 IN 1M ie0 FT. M. S 1.62 Gil Ltr1 u 163 Gv Llyd SB 212 Gr Ln 72 273 Gd. l.trY 701 JD{. Clal Lln )06 101 G.I. L71 SI ?7) 13aL Lln. 61 '2J) Gal lta. Cad Lta. 64 '2y0 CiaL -'19a. IK X647 UaL lls. 166 647 10 .306 >r 129 a6 17! el 231 79 300 100 379 6/ 2J1 61 Z31 6B .220 149 640 1St 672 16 4.67 19 72 >b /JJ 45 170 6r 742 91 J44 60 27J 00 ?27 68. yzo 142 -:6J7 145 549 20 6,10 16 b7 7b ti6 06 1J6 82 J10 69 223 60 ?27 6B ?20 1J6 816 110 6J0 26 7.6? a 30 71 260 S7 210.: 69 22J 6B Yd0 12B .:44f 133 60.1 JO 914 66 246 66 206 ba ?20 Zb J!0 ba :?TO 121 '.466 127 W1 40 .)219 46 171 !B 1M 66 206 76 293 be gyp 106 JfT7 114 4J1 60 16.24 2t 90 3J 126 6t 191 6f 219 68 220 90 J41 100 J79 60 19.79 )6 b7 IJ 10) J6 )J6 66 ?2p 7i PflQ 96 Jy 70 2t,3/ JO 154 10 ~ 62 IP/ 61 Iq 70 266 W 24.JB 14 6J Ib 170 ?0 106 64 a'11t 90 ?7,4J J2 121 2 9 J7 )40 100 JO.4B f9 'N 2t 7a 110. Jy,00 7 70 1 JO LockVW1: 19.26' 2J76' ZY Zd' 66' 66' 9T 7J' 115' 91' n?' EFFLUENT &DEWATERING Warning: Model 185 should not be subjected to less than 30 feet TDH. Note: For Head Capacity on Model 112, industrial column-explosion proof pump, see FM 219. SEWAGE &DEWATERING WARNING: Model 293 should not be subjected to less than 15 feet TDH. l , TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE SEWAGE ANO DEWATERING SERIES 262 266 267 ?8B 262 264 292 297 294 295 FT. M Gel. Llr6. Gal. Llra. Gal. Lin. Gal. Lua.~ Gal. LIr6. Gal. Lin. Gal. Lln. Gal. Luz. Gal. Urb. Gal. Llrs 5 L52 90 341 126 484 128 484 128 464 130 492 180 661 140 530 196 742 . 225 852 10 3.05 60 227 89 337 89 337 B9 337 95 360 15B 59B 124 469 IBI 865 205 776 15 1.57 22.5 85 50 189 50 789 SO )89 63 238 735 511 106 40i 130 492 165 625 185 700 20 6.10 10 3B 10 3B 10 38 33 125 106 401 B8 733 118 450 t50 568 168 636 25 7.62 78 28B 68 257 106 101 776 515 153 SEo 30 9.71 43 763 47 17B 90 340 12t !58 140 530 40 12.19 5 19 50 169 94 356 n 5 435 50 15.24 58 220 89 337 60 18.29 13 49 59 223 70 2).31 25 95 Lock Valre r` 18' 21.5' 21.5' 21.5' 26' 35' 42' S0' 62' 77' p9. ~0~9 I ~-- ~-- .__ •~~ ,~~ ~w ~w uv f6v nw 2W Z1U 220 230 r--- -~ I 1 I ~ I I -- f- - LITERS 0 80 180 240 320 40p 480 560 840 720 800 BBO a _. Lot 39o-FE.r~e~.~.Qe~es ~98.oz , Pro fb seal rnou. n d a~ i8. BS X io6.7o ' w/ S" .X 9d ' d,'spcrs al cep/ T'~ ~~ (Xa''z fem. SS'w/ f'8 "o~~ R'c.¢.s / spact.d a~ ~Z.s3: ~, 83 ~' ~ a c/ a ~` 151 `~~~ occ/ b 3~ ~c .~~/ a~°~~ ~ Q ~ z"sue. uo~~c. ~p2 ~orCCMa~'Yi ~94.sr' c ,,~gl~. B. io o~',~;ove.~o,p~. ~,( ~~ Ucn ~ p of/"R~c. p.Pe. e/ar: - 99. yo' ~ r ~ ,4ss ~c~1 a.le~; = ~ao.c~.' w /^~ ~ ,o~ a~ ~y 0 q~. - ~cv49e ProPo~d 3 be.dre~o•r, p ('eSi ~l ertc.e (_}o postal. d.ri /~+y M o,E-- P~o~~ ~~~~ /do's 9syy' s!",S~.i.~rORd. e.bu,%d;.~3twe% proposed ~1voo/bsv ya?. uresw' ~ '~ ~[. P ~ u~/~ so .rt R, eo.r, 6,Tafi cvi s.~/Ac. ~~ s~-b c l •f- acv e~~K,-s ~. S o~ 9 FROM ~c:"•-u;r~~l•:er ~;~ iri~inq FAX 1~. 7153863121 May. 07 2003 05:54AM P1 4,,~;,, fl~rh„,~,~ ~~41,,, SQI I~ EVALUATION REPORT ~ _ ~ ~ _ 1)rvisiari of Safety and Bulldlnps ecm-dance with ,^„omrr• 95, tMs. Adm. Code ~uMy AttBCh o0mp1~-te aNa ple+~+ on Paper net less there 911x x 1 f incahes in sea. t'tan must ~tek-d6, bu# net rymttad t0: VgtUeat ertd fiortzorNal ratsesnte point (Blt), dkec4an and Paroet tD. poraentsiOPg, sc81e or dtmea~usiates, north arnnw, atld beeti0n and dfetsnaole noare5t rgad. Pl~ex p-iitt' a!/ infoalt$tloR. tired #+Y Date Penr6nM bfarmANen you prunes mey bs Wwid fir seooedary pwp~ {Privtlry Lew'. s. t G04 j-ry Im1}, propettiY~lw~Qr ProPprhtlo®6on { `~-(Zj~ Cy ~ f L~-'~, ~ C,nvt. ioi S-o 1~ S 'C !~1 R F (,nr;;Ai 1 rtivpitty "tri!!rt"514«`~sgAstc'rass LaR ~ t'3bdc B 9ibd. f+larree tX ~' "" St+ete ~p Codas Numdr3r p ~ ^ ~vJlMtxie C~ Town Nearest tioad "~..,._ w,t' ~ I w! 1 S ~ ~Ll~ t let Z > ~~ ? ~ . ~~`~~ _...._ f~+ar rY~ r'rl v /l ~ I , 1~itVewConalruatio++ t1se:E~ RaaitloeetlaEllV-+rnt~otbedeooms 3 "' `~ Codededvaddeeign ~ ?7 G~ GPD [,,,~ Rgpla~rngrit © PIIbIiC tlt COI1tnIQ~t • De6ashg: -- -..~--. t~r,t m~rial .,,_ ~~_ t=load Pmt Blgvatbr: It apna~te __-.,..1Ur ft. (t3vnaadarnrsnat~s $~/s~~~''t ~ +'v. Fultz f~lCf+lilr~~inQ51tt6r`.S: ,t. r Oirt ~ 41r ~+ ~'~• i ~ -- t~~ ~) ~~ # ®~ pp Ground su~laeE star. ,~s(/_ & lam sa 1Yniting /aGDr ~ .._^ In. !3011 Re Fiormon lSePel+ t)oenefaett RRaddmr [tastxipttan Texlawe Slheo4ue CoTMSietawe Beurdary RoO1s GRt]AN< in. Mut>seft Qn- Gz, front. Caaor far- 3z. 5h. t '6f'aFZ -Z~ Aoy~ g/ --- L/ ,~rr~ m~t C~ -- r Bertng ~ ~ tieeurg t]opur ~ r s ae ekv ~ a ~ D fay ~ - n,. . . r~ _ P~ sea Horizan t .t~ominpsr-catar RedoseDasar~rdese Te>~e 9-nFdu:ea C-ana~n~ 9oulldMy . ita0ba GPU!(f ire Nlunsdl Qx1. si Cast. Cpk-r (~. Sz. Sh. ,^ ~ ~ I ,J, 1 I t ! t • 6Bueln tMt = BQD r 30 = 221J mglt_ ae+e TSS ?3o t ta0 myft. ' ElRuant ~l2.-BOO _~. TSS ~ ~ ngR e ~ - __ CST Number CST tWm9 f~fhR) p~~ ° ,.~ G ~ .- -- E>Btec/EvaYta6at Cfitad' 1'eta~Onel~Mm~er hI. •Y MM iM..~IN\ i Parcel ID # ~`~ ~~'P ~,. ~~~~- sropariy- Owner ~~~ a~.. _.~. - . -_ (~ ~u eww+.rd aufaGe asrr.~ t _._._- m taebr _ ~ "'' ,'~.'.,~~ tror~ron ~ 17nn~aca aeaWCox~xrpilan ~ Ted struaure Con9se~rrce Bow~.~ ~' ~, NraraeN qu.3a_ Coln. Cobr C,r. Sz fir- "~"' ~:'~ ~ ~. !f ~ ^~ e. ~ ~' Ebrs~ fl P# -^-~..~~~tt~ekw,._, r.~..r- !o taaior ,,.__ ~~~Snii.~ ~ ,__:~ M.~ a {, Harizarr ilor+dtrant. ftedcr De9e+ipliorr Teodwe 6frrrohxa Nr. MtstsrrN . Cu SP ContCotar-~~G~ ~~. ~ ~'^~.-Y-~-r ~~ ~ ~~ ^ Wt Ctoruv~ surface ele+r. _ - R. -~P~ +o tad~or - ~- $pil aiioa fiaAe ~HOr~df E?epre i». bomi~ 1Ars~a t Co Reeen Dee=+4aort 11 Qu, Sx. Cdc+Y. CAlor -i~:re ~'=:'~'•"` •,~'"~+'n~x i 8a. Rt N~ F-~+''~SL. ~~,~,,,,~,~ ,~ -2~It 'E1~2 EI'~ax~rd #1 ~ BODE # 30 c 220 mglL and T5S ~3fl 51§4 n-gfL _, • ESltss>t~ ~ 90D,s 30 mgtl arnl'CSS ~ 30 mgl~ ''I're Bell>in~relK af! :ommCrGe iS an ogUai ~~ serv(x pivvldcr xad ensploy,sr. 1fi you need aasistsrrce m access 4a:'viCCS or • . -- --~~M •~~ ~,.ewn,~.,t at ht1A-2b6-3151 br T!'Y 6108-~64~8777. {1ECd rllaRerlB~ 1fl Ya1 ilt¢irWWE: t~Cxnei, rnwa~.....+..-- --- -r- - mD-eaw~.aarool NAML: o ~.. ~ l _LUT~ 3~LEGrLL- DE4CRIPTIGN:_ SCALE: !"= ~l,Q y ,~;"•°': ~ F'Y 'I='v'•?,7'1~-'r =~~• L sir:: _ r,,i BM 1 DESCRIPTION: ~ '~''~' -~---F.~~- F' ~ IIM 2 ELFVA'~pN; ~ a BM 2 DESCRiP ; ,' ~ ;% SYSTEM ELE VfiTION: ,ga , ;y ~` ~,,o n.~ „r .30 SYSTEM TYPE. •~~` °a /I. !.~ ~~~ ~~l e 4 r ~, ~?a ~~`j ,. ~~ r 'f/ +~ av Q~¢~ ~~~ ~ ~~ f~AC1E~4F~ . ~- ~• ; ~ , ,~ { ~~ , 5~ __ _ / w"rr`~`~' ~ _' ` SOIL EVALUATION REPORT ~ ~ 0,<_3 wscatsm pepattrnent of Comrrteroe Division of Safety and autldings in ~, comet as, wte. Adm. cone / /~ Courtly f ` ` /~~ ~C Attach corr~lete ~ pbn on p~ tat less lhan 8112 x 11 ind-es in sig. Plan must include, but ~ ~mibed to. vterGkal andlarizorttal r+el~tce po&tt (aM), direchOn and Patt>N I.D. percer-tsbpe, scale or dimensions, north arrow, arrd bcation and dance to nearest road. ~ ~ _ ~ ,~ Date Pxaonel irtronrwtiort you Provide may be ueetl se ~~e~i-aw. s. 5.04 {t) (mN• .. V ~hQ.. propertyC)wwner t.oc~tion `~' (~ ~ ~ ,S~ l' ~ ~ N ~ dot 1/4 1I4 S T N R E (or) W property awrters Mang Address # Block # Subd. Name ar CSMtI ~~ l~~l srcrolxcou~v. ~~era.(~ ~ .~ AA State Dom gg~' 22FFI CE ^ Cfty ^ VNIe9e ®Tow/Jn Nean3st Road \//Y 1~.1~ t S~~Zlnl 1~~~)!~J _ //Y'm/Vl0/~Q v ~ yS7?//~~G GPD (~ New Construction Use: ~ Rtasidar-tial I Nurr~er of badraoms ~~ Code ~~ ~~ Clow rate ~ Repl~ement ^ Pubftc or r~mmercial - Desaibe: ft. Parent material ~~ ~ ~ flood Plain tBievatior+ ~ appliCebie ~/'`f- Ger>eted oarrrnertts SYS~~w. >~/tv, /d(T• 3 U~ and nrcwrtrrrrerrdations: ~ori. ~ ter' e%e t/. ~Q, 3 d U ~s b• I B0'"'g # ®Pit Graard surface elev. !~ ft. Depth m s ~c6or Hori2on Depth Daminarrt Cobr Redox Description Texdxe Structure Consistence Boundary Roots in. MunseU Qu. Sz. _Cant. Cobr Gr. Sz. Sh. I o -~ l~Yr3iz - S-` rns hz~i- GS ~~ -38 y~ ~ ~ s- y~~ ~~ sl m ; ~ - - soy Rate GPDIfEr •EtNt1 'Eft#2 r , ~ u ~~ B tm ~ 3 o g ~.L_ m• ~ Pit. Ground surface elev. _~QY ! v -tt. Depth to ~rr~ng facsor S~ Rye Horizon- Depth Dominant. RBdoxDesaiptlon Texttxe Sttttdute Consis0ertce Boundary .Roots GPD/ff `Eff#1 'Eff~k2 in. Munseq t2u. Sz. Cont Cobr Gr. Sz. Sh. ~~-z ~~ iy - . ` sd~ ~ ~~ - . ~ 30- ~ G C2' ~ , ~ 6 /' -- ,S '9 • Etiivent ~ _Bpp > 30 .a22p mgfl and Tss >3u ~ 1 50 mgfL • Etftuent 82.=Boo < 9o mglL and Tss <_ so nrg-l. CST Name (Please Prim _ -- _ CST Number G ~~ Date Evaluation Condu cted Telephone Number n,. ~ ~~ ~ ~-~ C_ _. ; /~/ _, c-- yon ~-- /-mil 0 3 7. s = 7G o - Oz~ f ~ 1 D # / o t' y l / Page ~ aF~ P~dY Ovmer d,S~ _ I Paroe ~9 # ®~~ Ground audaos elev. it Depth b Mn~n9 factor ~- Soil Rate Horimrt Depth Texture Strut~a's Consieter~ce Boundary Dtxn~rerd Color Redox Dssafptbn Sz Sh tar Roots GPDpf 'Et81k1 'Et11f2 tn. tNarse . . M Ctu. Sz Cont Cobr S, ,~ ~s b ~- C~ ~ / ~ - ^ ~g ^ ~9 ~ ^ Ph iGrasrtJ.sraiaceelsv. 8. Depth to ~9 factor in. Sol Ra Horiaon Dsp>h Dominant Color Redox Deeraiptron Texture Strucprre Gonabtence Baratdary Roots GPDIif~ in. AllunseB t]u. Sz Cont. Color Gr. Sz Sh. "elfifl 'EtdR2 ^ # D Ground s stay. tt Depth to fecior in. ^ Pit soi Ra Horinon Depth Dominant Color Redox Deacrtption Texture Strucf,ne Consistence Boundary Roots GPDAt? in. Mutu.el7 Qu. Sz Coat Color Gr. Sz. Sh. 'E~#1 'Etflt2 ' EWuent #1 = BODS> 30 < 220 nglL and TSS >30 < 150 mgtL ' F.tl4rent dl2 = GODS < 30 mgll-and TSS <_ 30 mglL The peparhnent of Commerce is an equal opportunity service Provider and mat 608-2166-3151 or 7'fY 608-264-gcc~s ices or need material in an alternate fomnat, Please contact the departrnart SRi)-8330tR.07/041 l +~, r ST CROIX COUNTY SEPTIC TANK MAINTENANCB AGRBEMENT . AND OWNERSIiIP CERTIFICATION FORM ~uyer Mailing Address ~~~ ~ ~~ ~ ~' ,~{{ -- -P'C~ ~ 1 ~ 1-~'y S U~. W ~ ~0 l to Property Address (Verification required from Planning Department for new City/State ~~~ I',t>~ Parcel Identification Number O/~ - ro~'g 1 ~.?(7 .3°-~ 9< <7' LEGAL DESCRIPTION Property Location ~ 'l,, ~ tJ/ `/., Sec. 3 D , T~~N-R~~W, Town of Subdivision ~~"'n,--°-'` ~~ ~ .Lot # Certified Survey Map # ~ ~ ~~ ~ ~ ,Volume Page # ~-3 Warranty Deed <# ~ ~ ~'f' ~ 1® , Volume ~ Z 0 .Page # ~ `~ Spec house ^ yes no Lot lines identifiable L~lyes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result is 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or alicensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce 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 Zoning Office within 30 days of the three year expiration date. S ,~~ ~ ®3 SIGNA OF APPLICANT DATE OWNER CERTIFICATION 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 descn'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. / /B S GNA F APPLICANT DATE ent. ****** ««*«** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Departm ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed t . f , ~~ a" Wisconsin Department of Commerce Division of Safety and Buildings RECEIVE SOIL EVALUATION REPO `Page _ of _~ .,.... in aaxJrr7ance wren c;omm tsa, vvrs. Aam. was y Cou ty 2 t P lan mus Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. include, but not limited to: vertical and horizontal reference point (BM), direction and pa I I.DS~~• CROlX COUN 1'Y percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ZONING Please print all information. 75 L P i 04 f iT (m)) R ~ Date ~ 3~( C7 Q 3 aw, s. . vacy r • Personal information you provide maybe used for secondary purposes ( ~ Property Owner Property Loption Govt. Lot ,,(f 1/450114 S Q T ZQ N R ~~ E (orb Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# l3 ~ 3 e r 3q -->a.ld t S City State Zip Code Phone Number ^ City ^ ~Ilage ~ Town Nearest Road SzJ~ S~ d I ~,n l v/ (7rs) S -G~3/ . - n New Construction Use: ~ Residential /Number of bedrooms _~_ _ Code derived design flow rate - </ ~ Q Q _____ GPD ^ Replacement ^ Public or commercial -Describe: _ -_.----- -- -- _-----.-- Food Plain elevation if applicable _-.,~L! ~ - ft• ~ i (~ Parentmaterial _ _-- -_--____ General comments s ~ S7` ~ G r{v ~ !06 ~$ ~/Tl-~ ~Z ~ ~'~' ~j r ~ ~ '~-~ ~ l v and recommendations: I Lv ~.~ Boring # ~ Bonng pit Ground surface elev. _~.~ft. Depth to limiting factor Redox Description Texture ^' u c' ••- ~ - Horizon Depth in. Dominant Cokx Mansell O O~Z !b ~3! ~ - Y y~y ~o iy~t ~ ~~ ~v ~ q~.>-~ V ~" ~, G, o \A~~ ~ - in. Sol pcation Rate ence Boundary Roots GP D/i(~ •Eff#1 'Eff#2 - C} _. .( ., _ . ~ . ~ ^ Boring Z Boring # l~ pit Ground surf Horizon Depth Dominant Color F in. Mansell Qt I ~t c ~ j~ ~j t' Y `~ "- `~ • ~ ~ .~~ s.~x ~ tn' Boundary c s - Sol lication Rate Roots GPD/IP 'Eff#1 'Eff#2 Ilr~ ~ ~ • 8 - • ~ • 6 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' trrwenr ~t = ewu ~ ou mgrs arnr ~ ~~ ~ ~v ~~yr~ CST Name (Please Print) S' tare CST Number a .~- s ~ 9 Address Date Evaluation Conducted Teleptxxie Number ~)l3 1< ~ ~o rSe l Q //-/~/`'0Z 7i5-z~- y~,~ ,~,.. .• .r Property Owner ~~ Parcel 1D # Page ~?' of _ Boring # U Boring qq Pit Ground surface elev. _L~ ~ ft. Depth to limiting factor __,~.~_ in. Soft lication Rate i H D th minant Color D Redox Descrfptiort Texture Structure Consistence Boundary Roots GP Dlflz or zon ep in. o Mansell Qu. Sz. Cont Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 Z ~ / / Sr, L n~tsb 1'n~r C -- . ~ 3y- /v- / ~ ~ ~ .5 ~ nt ~ m ~ - ~ ~ • ~ a Boring # ^ Boring ^ Pit Ground surface elev. ___ ft. Depth to limiting factor _ in. Sod A ication Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPDlFIz in. Mansell Qu. Sz. Cont Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. _~.~__ ft. Depth to limiting factor ___~~ in. ^ Pit Sod lion Rate Horizon Oe th Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/fg p in. Mansell Qu. Sz. Cont Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 =GODS > 30 <220 mglL and TSS >30 < 150 mglL * Effluent ff'L = BODS < 30 mg(L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. 500.8330 (R.07/00) PAGE~OF~ NAME S-}~~,t •~ LOT# E~ 9 LEGAL DESCRIPTION N1= 14 ~ X14 ,S~Z,is T ZQ ,LI Rte/ ~- E(or)~ SIGNATURE ..~%~- ~ DATE / I - L~° ~~ SCALE: 1"= ~ f BM 1 ELEVATION /QG . D BM 1 DESCRIPTION .~~ c -~- t " p vim. DT { BM 2 ELEVATION 9 $ • ~!~ BM 2 DESCRIPTION {T a -~ ~ ~ ~ ~~L ~~ D t SYSTEM ELEVATION /Oo • 50 SYSTEM TYPE ~ au n O~ CONTOUR ELEVATION q9•~ N EC" ~ Q t ~ + .~ I CERTIFIED SURVEY MAP LOCATED IN THE SE 1/4 OF THE NW 1/4 AND THE NE1/4 OF THE SW 1/4 OF SECTION 30, T29N, R17W, TOWN OF HAMMOND, ST. CROIX COUNTY, WISCONSIN, BEING LOTS 10 AND 11, PLAT OF EMERALD ACRES. PREPARED FOR: RICHARD 0. STOUT JANET P. STOUT 1353 AWATUKEE TRAiL SURVEYOR: NORTH 1/4 DOUGLAS J. ZAHLER S 8 N LAND SURVEYING, INC. COR. SEC. 30 2920 ENLOE STREET HUDSON, W154016 HUSON, WI. 54016 I wZ o~~ U w~~ U~ ~Z~ W J w 1 m ~~o ~~~ z= ~~~ ._.~._._ L',0U ~c~J __~ TOWN ~N89°45'02NE~321.16'~_ VI' C~ ~y 1 d04 9 ~ C°~' d' i o~ ~' ~~ ~~ ~~ 15_WIDE NON_-MOTORIZED VEHICLE, _EQUESTRIAN1 N co ~~ d' O Z ...-.~- .. ~ ..~-. hoc; e /~ ~/ ~ b LOT 36; ~ ~ ;. '- 2.500 ACRES : ~ M (108.900 S0. FT.r ~ C "' q~J, I " b~°~~ :~1°°'~ • ~ N89°44'39"E 32y .16' ' ~~~~ ~,6, ~~ ~ :- LOT 37 r 2.500 ACRES ; M (108,900 S0. FT.); ~Q, ~° i~ ;~-i00'- L~O~ ~~ ~ ROAD~$- ~ ------ ~. ~ r S89°45'02'W 739.78' - Y - 33' 33' I I~ I - I ~ ~ ~ d04 ~~ I ( Q ; a l (a~ ZI ~ I I I 0 ~t ~ ~ ~ ~t o I ~ { ~ ~~ m o ~ O ~ ©i I O m ~I (gi C~04 ~~ ~ w r W ~ ° I ~I ~ I wl ~ N Ln o ~ ~ ~~ wl MI ^I ' ~ Wisironsin Department of Commerce i Division of Safety and Buildings SOIL EVALUATION REPORT P~ -~'~~ Page ~ of n, oa.w~ua„w nm, wnun v.~, ~~,a. run,. vvuc ^^un~ C W -~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must r0/ - include, but not limited to: vertlgl and horizontal reference point (BM), direction and Parcel I.D. ~ /_ L vt ~1 " ~/ 30 3 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. . l~ P/eaS@ plY17t all illfOrltI+atiOll. Reviewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (~'v~ ~ 3// ~ 0.3 Property Owner Property Location Q~C~~~ 'i' Govt. Lot ~ ~ 1/45cJ 1/4 S T Z ~ N R / yam- E (or)~3 Property Owner's Mailing Address # Block # Subd. Na a or CSM# 1 S3 -ee T. ~ Ciry State Zip Code Phone Number ( -1~1 ~ ~ lt ~ ity ^ ~Ilage ®Town Nearest Ro~ a i ~ - D ( U.~I O 15) ~- -- ~.~ cP /s S New Construction Use: ® Residential / Number of bedrooms 3 "y Code derived design flow rate ~ .S~ fly Q CJ ^ Replacement T- ^ Public or commeraal -Describe: w Parent material / ~ ~ ~ Flood Plain elevation if applicable General comments s y 5 ~ fyt ~~ t J, ~~ ~p ~ ~- ~~(,_/ T-- and recommendations: ~ ~~a~ o -~ GPD ft. •_.; ,~ ,, D r, ~~~rl~lF .J ` _.~~ - J 1 Boring ~ :: `'""ry' Boring # Q ~~ zoPt-NGO~~tCE r, `,,~ ® pit Ground surface elev. q9 S ft. Depth to limiting factor in \ ~` Soil Application ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary ~2oo(s GPDfftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ' "Eff#1 *Eff#2 I 0-10 ICS. r 312 .5i1 2 r ~5 1 v~ .5 • S -~~2 l U y %l r ~ - 3 4~- U g 3 P 5 r 2 i cl m-Fr -- - . Y - C~ ^ 2 Boring # ^ Boring ^ pit Ground surface elev. ~j9 9'0 ft. Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~ d-II ICS ~ ~31Z rn K c 5 ~ . 5 . g Z I I - 3d r ~ Si ~ Zrr~-J~ i'~ ~ 5 - • FJ 3 30 - - D 1 2 P -15 r `tI ~'S b5 -- - . ~ * Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 _< 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL CST Name (Please Print nature CST Number c14 ~, mot_ke~ ~~ ~-~~ 2 s3.~9 Address Date Evaluation Conducted Telephone Number Zi/3 ~ATh_ 5-~-. SbmerSef ~~ 54 p2s I Z- c ~ - o / ~-~ I'5~2~}-~-~{ao8 ,- Property Owner s~a~-~ Parcel ID # Page Z of Boring # ^ Boring a Pit Ground surface elev. ~~~ ft. Depth to limiting factor ~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlftz in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 ~ -10 ~2 ~i ~ (v~ . 5 • ~ Z 10- ID ~y 5i1 m r ~s - 5 ~ 8 3 2U - ~D r g 3 m ~.5 r/ c~ k rr~'I-- ~- ^ Boring # ^ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ^ 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 GPDlftz in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 'Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB0.8330 (R.07/00) r .. ,~ • - , . PAGE 3 OF TAT A b~F S +O V ~ TOT# I ~ t EGAL DESCRIPTION ~If ~ ~~ ~ ,S~ T 2Q .N.R. / ~ Elorl~ SCALE: I"= ~Q r BM 1 ELEVATION /O~ • ~ BM 1 DESCRIPTION {~~-~ ~ ~ ~1 d c _ BM 2 ELEVATION `19', (o O BM 2 DESCRIPTION -~o~ ~ •-~ ~..~QvC SYSTEM ELEVATION ~~ ~/~ SYSTEM TYPE %{'Ivv nc:Q ~T~ wi CONTOUR ELEVATION ' g, SO ~,l07~ ~isr~-~ fiZor-~ L.oTt,< u qq;, q yo ~~ 1 .~ .-~ ~~~ 1 a r c° ~~ QM.Z ~M N ~P~, 30 ~ rt SIGNATURE ~~ ._.~~--~~ DATE S~ /~^ ~ ~~. 7~ . 4'-O•x 2'-0' --~ A ~O ~~ 'c - ~ x a '..~ ~,~,pe ~ 3~x~ ~= ~ \\\ b,~ ~ i b '~ ~ x J ~(,tj• X 1i I ~ ~ ~ ~ 1 ~6 1 ~~ I ' x ~~x ~ rn ~ a 12;5' - ~ d~ b ~ $ W N ~~ ,~~ ~ ~ 's ~ a x b v 1 ~' x 4' 0' x 4'-0° 1 ~- i3 ~~ ~ i io s ; ~~~~~ x ~ ~~` ~ ~f o; 1 ~ a . ~ `~., ~~ ~/,,~ .q N 1 1 4~ ~ ~ ~~ ~~ ,o i a•x s•-8 s=0'x T-1 ~~~~~~^ b 3 ~2---~- 2 =B'-~- B'-8'~- ~-Q'x s~ - a _~ a :. 3'- i ~I _ ___ 2'-0"x 3'-0' A 4 c ,y_/ Bbl I/- x `' v. -14=0' -----~- 4'-0'-- 7 2 4 1 1 t2~ U, 2 2 6 0 P 3 9 ?a STATE BAR OF WISCONSIN FORM 2- 1998 ~ WARRANTY DEED Document Number it This Deed, made between RICHARD O. STOUT and JANET P. STOUT, husband and wife, Grantor, and TROY J. ROSHELL Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described re tate in St. CrOlX County, Slate of Wisconsin: Lot 39 of Certified Survey Map filed December 23, 2002, in Volume 16 of Certified Survey Maps, Page 4431_, as o ument No. 703425 located•in the SE 1/4 of the NW 1.4 an the NE 1/4 of the SW 1/4 of Section 30, T 29N, R 17W, Town of Hammond, ST. Croix County, Wisconsin. Said Certified Survey Map previously being Lots 10 and 11, Plat of Emerald Acres. KATHLEEN H. kA[.SH REGISTER OF DEEDS ST. CROIX CO. , WI RECEIVED FOR RECORD 06/02/2003 10:15A![ MARRANTY DEED EXQIpT # REC FETE : 11.00 TRANS FEE: 143.70 '~ COPY FEE: CC FEE: PAGES: 1 i Fiocordiny Area _. ! Name and Return Address Ed1na Realty Title 400 S. 2nd St, #115 ~~ Hudson, WI 54016 ~i~d~ _.___ 18-1067-90-000 Parcel Identification Number (PIN) This 1S riot homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights-of-way and covenants of record. Dated this ~~ day of Apr 11 , 2 0 0 3 (SEAL) (SEAL) * Richard O. Stout Janet P. Stout (SEAL) AUTHENTICATION Signature(s) authenticated this day of , ACKNOWLEDGMENT (SEAL) State of Wisconsin, ss. St. Croix County. Personally came before me this ~ day of Apri 1 2 m 03 ,the above named _ Richard O. Stout and Janet P. S.f- mil] t' r 703425 VOL ~6 PAGE 4437 KATHLEEN N. N~- REGISTER OF DEEDS ST_ CRflTY CA. LT RECEIVED FOR $ECORD CERTIFIED SURVEY MAP 12'23'002 03:15Pl1 REC FEE: 13.00 COPY FEE: 3.00 LOCATED IN THE SE 1/4 OF THE NW 1/4 AND THE NE1/4 OF THE SW 1/4 PAGES: 2 OF SECTION 30, T29N, R17W, TOWN OF HAMMOND, ST. CROIX COUNTY, WISCONSIN, BEING LOTS 10 AND 11, PLAT OF EMERALD ACRES. PREPARED FOR: SURVEYOR: NORTH 1/a RICHARD O. STOUT DOUGLAS J. ZAHLER S & N LAND SURVEYING, INC. COR. SEC. 30 JANET P. STOUT 2920 ENLOE STREET 1353AWATUKEETRAIL HUDSON, WI 54016 HUSON, WI. 54016 I d04 9 J I I dOD 4 ~9 wZ OFD rUpp O ~ o U ~ ~Z~ UJ J W W O rD ~~o ~~o Z 2 ~Q ~~~ ---J---.-_=--J I ~------ ~ TOWN ~-- - - - ~ ~' ROAD- ~~ - N89°45'02"E,321_.16'~ ~ ------ ~; ~I @~I ~I QI X04 9 ~~Q,1 a LOT 36: ~ 2..500 ACRES ~ (108,900 SO. FT.r I ~ M C ~~~. , I o ' ~1oa- d0. i N ~o '~f N89°44'39"E 32J .16/x,,_ , : ~oS~%~i dl Q 333' I S89 45'02"W 739.78 6.6.6.6.6.1 1 1 1 1 1 66666_ I I ~ I Di (~~ L04 ~1? ~ ~i i Qi ~I I I ~I I NI I I +I ~ ° O M QQI o C~II °o °pi r LOT 37 ~ ~ ~ I QI ° I ~~ d04 ~~3 l i~l Z ~ 2.500 ACRES : ~ ~ r I ~I ------- C~% ~ (108.900 SO. Fi.): ~ ~1 W I j 1 Qo, : i ~ ~ ~ ( 15' WIDE NON-M_O_TORIZED ° ..-100' ( QI ~~ VE_HICLE_EOUESTRIAN1 ((~~~i? i i ^ I RECREATIONAL TRAIL EASEMENT ~~'~ ~ ' Q I"" - - N89°44'16"E ~ N89°44'16"E 321,.16 ~ ---- 175.26' 496 42' ~~' NI ( ~l . ~ : ~,'T Oi ~ M p ~ LOT 38 app r, ~ I ~I ~ ~ 2.500 ACRES a ,': ~_ l~°~' I N N (108,882 SO. FT.) Z I p I 3j I OI ~~4 ~~ ~ - ---- dU4 ~ W ~ ~~' " ' ' / ° Di I 48 38 02 N89 E 4 8 ( Cp ~; n ~~, --1oa~ I a l~ : ~ ~ ~ ~ I o LOT 39 ~ Q %' ~ ' ~ I a ~ Z a0 ~~ i 2.500 ACRES ~ N Q i (108.918 SO. FT.) ~ N I I ~I C ~ • - 33' 33' ~ ~~Q ~~ ------- S89°44' 16"W 499. ~ ~ ~ LEGE sT. cROlx co ND d~4 ~_ PlanninaZonl^^°^4°-~ M M TO `'~". l', C v mi O J m N W ~I N Ln O wl SOUTH 1/a COR. SEC. 30 FOUNDALU INU COUNTYSEC I N DEC 2 3 2002 SCALE IN FEET 1" = 150' CORNER MONUMENT • FOUND 1' IRON PIPE • FOUND 23/8" OUTSIDE DIAMETER IRON PIPE If not recoroeu w~uia~ u~ °°~'" 150 0 150 approval date approval shah be 0 SET 1.OUTSIDE DIAMETER BY 18" LONG IRON rtuli °^'' "^" PIPE. WEIGHING 1.13 LBS. PER LINEAR FOOT THIS INSTRUMENT DRAFTED BY: WES ANDERSON • • • • • • • • • • • ROADWAY SETBACK LJNE (AS SHOWN) JOB N0.6052-16 DATE: 11/11/2002 - - -UTILITY EASEMENT REVISED: 12/12/02 SHEET 1 OF 2 SHEETS Marion Standaert Subject: Troy Roshell, Permit # 430080, Hammond, Mound plowing, Nechville Location: Hammond Start: Wed 8/6/2003 10:00 AM End: Wed 8/6/2003 11:00 AM Recurrence: (none) 30.2~.i ~. ~~ ~~ ~~ ~ ~~~ ~~ LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HAMMOND COMPUTER NUMBER 018-1098-10-200 Parcel Number 30.29.17.8176 OWNER NAME: First TROY J Last ROSHELL PROPERTY ESS: Hse # 1/2 PD --Street Name-- Type SD Apartment T~j 154TH ST SECTION 30 O N 29N RANGE 17W '/4160 SW '/440 NE Line Description Line Description TOTAL ACREAGE 2.500 PLAT CSM 16/4431 LOT39 BLK 01 SEC 30 T29N R17W PT NE SW 15 02 ~ t~MERLY LOT 10 EMERALD ACS 16 03 NKA LOT 3 4 04 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit