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HomeMy WebLinkAbout018-1098-29-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildin~bivision INSPECTION REPORT ~ (ATTACH TO PERMIT) GENERAL INFORMATION par~~~ai infnrmatinn vnu oravide may be used for secondaN purposes [Privacy Law, s.15.04 (1)(m)J. 'ermit Holder's Name: City Village X Township Baumer, Jac ues Hammond Townshi :ST BM Elev: Insp. BM Elev: BM Dq~c~tion: r`~ ~veT~nti net E+-rvn uvrvr~rvir+~ wig TYPE MANUFACTURER CAPACITY Septic // ~~~, a ~ 0 ~ (/f J c l~ v Dosing ~ ~ .- ~( ,1 ~Q U Aeration (~t Holding TeNK SETBACK INFORMATION TANK TO ~~ ~ ~~ L BLDG. Vent to Air Intal;e ROAD Septic ~ ~t lam, ~ / ~ OY` 1 Dosing ~ h'S~V Aeration ~" Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Li Friction Loss Sysyem H TDH Ft ,S ~ emain F rc Le th / Dia. /~ Dist. to Well ~ OIL BSORPTION SYSTEM "~j ~ S Ova ~' BEDITRENCH DIMENSIONS Width / , n Len~~ , (~ No. Of Tr nc~ hes , ~ ~/OK,-p_"/`-` SETBACK INFORMATION SYSTEM TO Typ Of System: ~~U~~ P/L I f"J~/ BLDG ~(/ ~ WELL / nISTRIBf<LTION SYSTEM 7nA , _ 0 ~. county: St. Croix Sanitary Permit No: 420659 0 State Plan ID No: Parcel Tax No: 018-1098-29-000 STATION BS HI FS ELEV. Benchmark °~•Ifl 9.ty o ~ 1~•d Alt. BM /'h _ e, ~(;,~•~~ 1 n yf'~ ~ ~I ~(7 ~ . Bld~t Sewer 1~~ ` yf ' 1 Z. SUHt Inlet / O r SUHt Outlet /, Dt Inlet Dt Bottom B -d oy o n ~ /a Head r/Man. n ptX x-32 ~(7?~~ Dist. Pipe ,~ ! D 7 Final Grade ~ ^ . n ~ J 3~"'- ~~ ~ r t~ ~ • ~ f C,.~ • s(~. 3• a 3• 3. g PIT DIMENSIONS No. Of Pits Inside Dia. uid Depth -mss 6f~-el'1~' lP~ Header/ nif I N ' Distribution t -~ Pipe(s) ~ / x Hole Size ~ ~ i x Hole Spacin ~7 t~ ~~ Vent to Air Intake ~ 7 -/ L th Dia L ~ acing th Dia ~ S Len L / O ` eng p g Snll CnVFR v Drncm~rn C"c4nmc nnly ,rv Mn~~nrl nr et.hradP Systems t]nly .S$c~~'~-~ S Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Ed es g To soil p ~ Yes ~~ No ~ Yes ~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1' ~ / ~\ Inspection #2: ~ / ~ 5 / O ~j Location: 1533 73rd Ave Hammond, WI 54015 (NE/1~/4 SW 1/4 29 T29N R17W) Emer~Acres L 9 J ~ Parcel No: 30.29(,.,1~7~83(6~ "~ 1 J Alt BM Description = w1t~k4Ltf-~d'1DY S~ 1l /~`yt, . ~~6OY Q ~V •~'~ ,~~~-- ~ ~ G' `r~- 2.) Bldg sewer length = (p(p~ ~~ii1 a,u~- ~~ Q"'`~~ 3~_am~c~b+'"'er= 7 2/ ~~K e~ a/Z (m b3 IoS. ~ / -- _ a4- 7 2 D Plan revision Required? [ Yes No ~I~I Use other side for additional information. _ ~ ~ ~~ ~~ _.J ___ _ ~~~ _J - Date Insepcto 's Signature Cert. No. SBD-6710 (R.3/97) OR Safety and Buildings Division County r ` ~ 201 W. Washington Ave., P.O. Box 7082 S ~• ~j(-p~-~-~ ~ scons~n Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261-6546 ~D • Sanitary Permit Application State Plan I.D. Number ~~ ~~~p [n accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~ ~© may be used for secondary purposes Privacy Law, s 15.04(1 xm) Project Address (if different than mailing address) I. Application Information -Please Print All Information k ~ i~ ~ ~/~ ~ s.3 ?~ 3 Property Owner's Name Parcel # Lot # a Bloc °~, ~ 70~~ - -- Property er's ailing Address ~ Property Location d(B - /~ p0 ~ ~ ~ - _ ou~~rr~r i~f 1=1 ' 3v, ~-4 IZt 83(d NE 'b S~y ,3 ~ ti S City State Zip Code one um a , . ., ec on S'- ~ '1 OC - 6 _ .~70~ ^- Ot ~ , `(circle e) T N R ( E ~J I. Type of Building (check all that apply) ; o / `~ ~tJ Subdivision Name ~ SM Number _ or 2 Family Dwelling -Number of Bedrooms ~ ^ Public/Commercial -Describe Use ~~ ^ State Owned -Describe Use ^City []Vi11ag~Township of ~C III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ~ r , ~ ^~ ~4 A' Q New S stem y ^ R tacement S stem ep y ^ TreatmentJliolding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POW'TS S stem: M ei - ^ Non -Pressurized In-Ground Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recircnlating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe , ^ Other (explain) V. Dis ersaVt'reatment Area Information: S 5 Q W 4.5 6Lh Desi Flow (gpd) Design Soil ppiication Rate(gpdsf) Dispersal Requir d (sf) Dispersal Area Proposed (sf) System Elevation ~ D .- 3~ ~~TC~ ~ t; ~flt (d0 roa I b ~ ,~ VI. Tank Info Capacity in Total Number a.,utacturer Pref Site Steel Fiber Plastic Gallons Gallons of Units (q/~~~~ ~ /~Q~ O/L Concrete Conshvcted Glass New Existing /~ l ~~ `~ ' Tanks Tanks ( /- Septic or Holding Tank ~ v0 ,....- ~ r Aerobic Treatment Unit ~~ ~- ~~ 1 Dosing Chamber ,~,~ t7 VII. Responsibility Statement- I, the undersigned, assume responsibility for allation of the POWTS shown oo the attached pleas. Plumber's Name (Print) Plumber' igna PRS Number Business Phone Number ur ~ o~ ~..~- a~ ~6~ Plumb/er's Address (Street, City, State, Zip C de , > su l O 6 l .2~~1~ ~ t~ •~ ~ ~ ~ `' C VIII. oun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater ~~ 0'7S Surcharge Fee) ~ Date Issued ~ suing gent Si atu Stamps) ^ Owner Given Reason for Denial ~ ~~ ~ IX. Conditions of ApprovaUReasons for Disapproval / ~ b/b 3 l~+t.~ I~Ium~J mtitSf prov~~e, OUrn~,~rJ w~~oF~~s~e "~ ~ ~~~ ~ t ~ mot.. ~~.~- -~~~t- sys~., `~ ~~~ s~ ,~ ~ y~. ~- ~ d f ~ ~/~ra~-rt - ~a-e > S' ~~`C^~7 Attach rem ere s (~oun only) for e~Fystemr6n pa r n~es~/~ x I~ipches siu s /)~~ ~` ~0,,,_ _~ SBD-6398 (R. 08/02) • PLOT PLAN •page 3 of , Scale 1 "= Sp ' Lb T 3 ~ oS s s' ~~ ~~.~_ uy , 0 ~~ Q~ ~~ _, 'tb 150 `i~4 `T. r L or Ztiy ~ ~ Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov James Doyle, Governor Corry L. Nettles, Secretary January 16, 2003 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/16/2005 SITE: Jaques Baumer 73rd Avenue Town of Hammond St Croix County NE1/4, SW1/4, 530, T29N, R17W ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 FOR: Description: Proposed Four Bedroom Mound Svstem Object Type: POWT System Regulated Object ID No.: 888522 Identification Numbers Transaction ID No. 828105 Site ID No. 655007 Please refer to both identification numbers, above, in all corres ondence with the a enc . 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: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening use to service t e i ter s all terminate at or above finished grade with a watertight cover. • 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. Owner Responsibilities: • Comm 83.52(1)(x) -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 POWTS 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. sue-- o~zc ~~ ~ _ S -' ~~, ARTHUR L WEGERER Page 2 1!16/03 Owner Responsibilities Continued: • 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 may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter 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 isconsin Department of Commerce January 16, 2003 CUST (D No?67341 LCPvii~'~" QFFICc Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. usisb www.wisconsin.gov James Doyle, Governor Corry L. Nettles, Secretary ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/16/2005 Identification Numbers Transaction ID No. 828105 SITE: Site ID No. 655007 Jaques Baumer Please refer to both identification numbers, 73rd Avenue above, in all comes ondence with the a enc . Town of Hammond St Croix County NEI/4, SW1/4, S30,T29N, R17W ,~~-' FOR: S,p,~, Ld .~:cc~xfv Description: Propose hree Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 888522 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: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • 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. 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 POWTS 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. F.Cs.~h~.T.~. CUatr~t7t`a~j~~~i' '` ARTHUR L WEGERER Page 2 1116103 Owner Responsibilities Continued: • 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 may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, /f~ /~t/G , • 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 TITLE SHEET Page ~ of ~7 FOUND SYSTEM FOR A BEDROOri RESIDENCE This plan has been prepared in accordance Faith the Mound Component Manual SBD-105 7 P and the Pressure Distribution l!Ianual SBD-10573-P CCZ_ blgq CtZ. ~L4~~ LOCATED IP1 THE N~ 1 /4 OF THE ~~V 1 /4 OF SECTION 3~, T Z~ N, R ~7 W, TOidi1 OF ~yv~~~y~~ ~'r ~t~`K COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET 9'~` c/ ~4" PAGE 2 Of 7 SYSTEM I~IAiQAGEi~ENT PLAiv '9 ~~ ,~ PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIE`7-CROSS SECTION ~~ PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT lO 00 PAGE 6 of 7 PU'r~iPIl`dG CHAZiBER CROSS SECTION ~A PAGE 7 of 7 PUyiP PERFORI.IANCE CURVE VO'_ ~~ PREPARED FOR ~~4V ~ t3PrUMLI~_ _ -_ l O S N~ Y"1. L A~ U t~1 Lt~1 ~ PREPARED BY WEGERER SL7 I L .TESTING AMID . - DES I Gi~1 S~RV I CE P.0. Box 74 421 Id.iiain St. River Falls, tdI 54022 Phone 715-425-0165 Fax 715-425-6864 pIVISiQN GF SAFETY RNG BCIiLGIt~GS SEE CORRESP DENCE a as .]~y` 4`rc~:«~t r7 C:-3'• i ._ ELLS"rdORT~ f ~P . it a3 .,, ' ~ ~3 ~~~ JOB NO .. c~Z_ZS9 - Mound System Management Plan Page Z of -] Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank ~ ~~~ ~~ Tlie septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once eve 3 ears by inspection. The outlet toter'- s b !€arrt~'~s-rtes, aryTo e filter cartridge should no a remov 'sions are mace to re am~so ids m the tank that slough off the filter when remov ,~ from its pnr+nci pro If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Interm(ttent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank; If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Tie addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Puma 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. tf an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution S stem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)] arid 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 five locking device to prevent accidents! or unauthorized entry into a tank or component. Contin enc PI ank 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 shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. ~~~~~~~__~ a~~u~ ~rre operation or maintenance of this system should be directed to: The County Zoning Office at 1 L S -..~b~b - l1,(~$-C7 ~jr +~,~~ LX The system installer at ~~ ~ S - z.~j~- (~ plus l~'T'G,p~ZD The tank manufacturer at _ ~C)~~ 3ZS - g ~ S (~ Wl ~`t_ Z The effluent filter manufacturer at _ ~fJO - Z~Z~ ~ S 7 Z ~i~~Z The --- . _ pump manufacturer-- at --- - 30_ X70_ ~$~ -- _-C~0u~aS • PLOT PLAN • •Page 3 of ~ Scale 1"=5p' ~--b Ip ~'N 5 Pcge ~'} Qf' ~ Approved Synthetic Covering ASTiK C33 Medium. Sand Topsoil S % Slope • Distribution Cell of ' 2" to 22" Aggregate ~, 3 istribution Fipe F 0 G Elev. \ O~o._O b Force Main From Pump CROSS SECTION OF A MOUND SYSTEa Flowed Layer 0 o-S Ft E ~ - Ft . • F o.~ Ft. G o • 5 Ft. Linear Loading Rate= 6-yGPDfLUFT B 10~ Ft. Design Loading Rate=a.3gGpD~SQ FT <fi,a I ~C~ Ft. ~~ Si•~f Sods . S win /Z ~c.~ ~~~ ~57y ~ Sasu,(f1~r~ea_ J Ft . ~ Position L 11 Ft. OT Force Main ~ W Z 1 Ft. .. ._ L • - .t 6 a ~-~/------------------ y __ b ~ -~ W ~_ ~__ - ---_--- .------------ ~ ~---- Distribution `- Cell of %" t %" z o 2z ~ PiPe aggregate Observation' Pipe (.'+acscr securely) , I I I I~. -Observation Pipe 1 ~ K I ~ R e ct-ss FLAN VIE~rl OF A MOUND SYSTE24 r ~ Distribution Pipe Layout pace S of ,7 Place the holes at the bottom of the distribution pipes . at~equal spaci~lo. Remove all burrs from the pipe and 'Holes. Extend the ead of each Iate2l up with the use of long ttun or 4~ ° hr.:nQ to a point crithia sx inches of the fina.i Q*ade. Te.-minaie the ends of the late.-aIs with a valva,~tbreade3 can or • threaded pIu~. Proti-ide aces from fnaI made for the valve; thresded caa or thre: ded pIu~. T~ F ~ cr, L LIDS S .s--; '~~ 1~7 FV C F`J~ PVC Later! Maneofd Later) X f ~ x ~ z ~xQ ~xQ ~. _x ~ x ~ x ~ x ~ LprN V \ cvJ - P -~ c- ~ "~ hr".11F-~~ C , G- -_ I ;rC~~yS Sfl~ -~ --~ 1'oQ=~ T1t`,LV P ~_ Ft. ~ ~ Hole Diameter ~~~ Inch~~ -~~~ S 3 Ft, ~ ~ Lateral ~~InchEes) X ?~ InchPS Manifold ~ Inches -- ~ Force Main " ~ Inches _ - :~: , ~ of holes/pipe 'Z:S - . Invert Elevation of.LateraTsl~6.~ Ft. 2S~.k ~. ~.l = ~ 0 . ZS x, . ~' ~ f• ~ Gl~~j - .. • _ - ~ - Combination •6ept~c~•Tank and -, PLI~MP CHAMBER CRO55 SECTIOtJ ANO SPECiFICATI0IJS ' PAGE (~ OF 7 • .._. '. -VEE.1T CAP ~- WEATHER PROOF .ltJ1JCTI0fl 80X .. 'i~C.I. VEIJT PIPC ~ ,IPPROVED LOCKIAIG ~ 10 ~ FROM DOOR, MAIJHOLE COVER K71~'{ :iiN00W OR FRESH ~ wARt.~IUG l.P.gEC.. 1+~3P~pU P tP` ~ K -uT~IKE t ~ co~.~twlr • w lH-tCL~ s ttT Grp ~- .. _ _ ~! I ' F! N LSftE~ 6 .~ W . i G ~C<J E f I ~-- ~' 18'MW. 1S~KIf.1. ~ ---------- ~~~ .. f1JLET ~" PROVIDE I - --..- . ~, ~~ ;,'~ ~ RIRTlGHT SEAL I I i ( ., I I 8 ra~LC I APProved Z~zB~- u~~ _.e i III APProved point w/ ~_~$~~ ! I joint w/ I II ALARM PVC pipe PVC pipe o -I 11 I I of~ c ~i I CLEY.~~-~3 FT ~ - I PUKP ~ -'~ ~ OFF D • C o1JCRf:TE .LIZ. ~ g- C)Q ! .. BLOCK 5 - RISER EXIT PERMITTED 01,ILy IF TA1JK MA1rUFACTUR!`R HAS SUCH APPROVAL 3~~ADPRotiF~ • ~B~pD! rv4 SEPTfC F SPECIFICAT101.1S . DOSE ' TI,-,IKS MAt,1UFACTURCR: ~`~~~ CU>,IG~J~ AJUMBER OF DOSES: L"J_' C~ PER Del. TAtJK 5-ZC : - 1 Z-oO ~ 8y O CALLOUS DOSE VOLUME z , / ALAR1~- MAUUFACTURCR; S S ~ St-{ ST~'jrtij `3 INCLUOIAIC, 6AtKfL0~,1: _ 1~3 -'i GALLOh15, I"10DEL -JUMBER: ~D ~ l`~ ~ CAPACITIES: A_ ~ ~ pJCHES DR y 0t7 -~' ~~ ,Z~, ~ CALLOUS SWITCH TyPC: - ~~ ~ 8 = Z 11JCHE5'OR LJ . S O V LAS - G~ILLOIls PUMP MA3JUFAGTUREA: C= E' tUCHES OR ~33- ~yGALLous MODEL 1JUMHER: CPDS lO !)= IAICHES OR Z~~T GALLOIJS SWITCH TYPE: ~~ZCU~Z-Cf' IJOTE: PU11P A~1D ALARM ARf TO 6L MI-JIMUM DISCHARGE RATE ~ ~- ~ GPM INSTALLED OA1 SEPARATE CIRCUITS VERTICAL DIFFEREAILE DETWCEfJ PUMP OFF Au D..DISTR18UT10-J PIPE.. ~'b1 FEE7 -~- t M -.-ETWORK SUPpLy PRESSURE , .SQ FE:CT ~S.p~I, 3) H' ~ S FEET OF FORCE MAIfJ X 3 • ~~ ~ F~o Fr.FRICTIO-•1 FACroR.. ~ 'SZ FEET TOTAL OyUAMIC NE:AO = `~-~~ FEET As per manufacturer ZZ -Z~ gal/in. Liquid depth 3 6 `' Goulds ~-sC ~+ °~ ~ Submersible Effluent Pump ~ i r~, u ~~ ~ EP04 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/4" maximum. -~ • Capacities: up to 55 GPM. • Total heads: up to 24 feet. ~'~ • Discharge size: l'/z' NPT. • Mechanical seal: carbon- . rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/a" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:lYz' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Nz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l 0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METEiiS FEET io 9 a o ~ a w x U 6 z 5 0 1 .~ 4 H 0 3 1 2 1 0 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle 'and float switch attachment points. ^ Power Gable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) i 30; I ~ ~ ..-~-SCPM T --~---I - --- ---- - --- - - ,. ~ ~ ~ ". -~ I 25 ~ i --- I , 20 ~ '; I .. ~ -- - ~ ~ ' I-- ~ ~ -- 5 i I l~• 6Q I i , ~ EP05 o ~ i - --- _-~ -- - ~ + `~ EP04 _ 5 i -- I .. i - i ~ i ~ ~ I ~ I 00 10 90 ~n an sn ~ moo.. 0 2 4 6 CAPACITY 8 ~ 10 12 m~/h ©1995 Goulds Pumps, Inc. Effective Mav. 1945 Jan 08 i73 lO:t7la David St:e~i { ~ 8or~g 7M __ Borng u / Pit Ground Surtace elev.. 105.80_ L. Dzpth to limiting rador 34 . - _. In. ~ Sntpppliptpn Ratz ibrizan I Dtplh Danir~trgt;otor RedoxDesuPton Texf;re ~ S7uciore i Consistence i 2 wn~ry Roots Gf~iR! ~. Murdf Ca..5~. Cert. cover ~ or 5:. sn. I _ i --"EffJit' `Eff#z 1 0~T8 I t0yr3/3 ~~ none sl ~ 2msbk , rrrfr gw 1` .5 j .8 ._ ._. _ . ! r--.__.__. ~._ 2 16 ~ . L _.__? Syr4(6 _!_ none sicl ~msbk ; mfr ~w raa i k f _ ~ m 4 i 6 3 ~ 34-54 1Gyr8/3 f1d 7.5yrVl6 andslon~ residuum ~ na ~ na na 0 i^4- .0 _..._---t ---.._.- ...~. _ 1 ._...._ __._. _ J 4 54-72 I 8/1 .-Ee c2d T.5 516 andslon -_-_ _ ___ _.__ ! _ _ ~9 9 Y yr iE residuum ~ na na , r!a ' .0 .0 +I -- - _.. _, - i.._ .. ,. ...- --- -- -_ r JI5-246-`su75 ta.1. 1240 wscans~n CepartmertotCommerce SOiL EVALLIATlON REiaORT Page I___ of a _ :ivision cf Safety and evilcirgs rn accordance with Gomm 85, Vuis. Adm. Code Sleet Soil Serwre ,0.ttach template ste qan on paper not !ers than 8„ x 1 t ixtes m sue. Pfau must CawYy include. b.invt limned to' verYCai and horizontal reference point (BMA, hiredion ana _ __ _........_:_5f. Croix _____...__.__..-._._-... percent stage, sale G diremsians. north arrow. and lor~tion ar~+ detente b nearest roan. ~arcei i G~ Pleasepnntafliafwmation. ___..__........ ._ _.. -----__-_._ _..--- Prnonal krmnaior yGU PrOYidB may DCV'9!Q brrecOnOary pupoBax (Pnvuy Law s. !S.M (1f ;~,p. Reviewed BY Date P`oP~ Ovuner Pr;perty location • -.-'._ 9aumer'. Jaques _ Caul. uct Nl 7!4 SW 1kt g 30 T 29 -~ R ] 7 W Property Ov+me!"s Maiulg Address Lot # .. _ _ .. ,-- .._..._-- -----_- -_ __ _.... Btnck ;r ~ Suhd. Naa a or CSM!! 105 N. Mc~dow Lane _ ?9 ~; na j Emerald Acres - ... C`tY State Zip Code Phase Number __ City Yllagz y town Fleetest Raad Raberts Wi 54023 715497-5395 Hatnmand ~ 150Th St. --__. New Construction Use: / Residential. Nurnper or bedrooms 4 Code derived d6sig : Oow rate r1!)0 GPD _. Replacement ._ . _ - -------------- .- Pub~icorcammerciat-Desenbe: Parent malaria! Arland,5andstone uplands Fbod pram elev: lion, i(a 6cable na ------ ---- PP - - - - - - n8ra! comments and recommendattonsr Mound Design, system elevation 106.30ft based on corrtour line elevatiw 105.30ft i - r..... __~... .. ..._-.. ~ .... r- _ __ .. --~-.-__ ..~ ~ I , ~ I -____ .- __.~.. __r_._._ ' 1 'Boring # - 3or:nr~ 1__._~ / rid Ground 5urtaoe elev. _ .105.80 R n.,..x, r,, w..,u.,., r~..~,,, t0 Hcrizorr Depth n. ( Gati~ant Cgior i lrunsa3 Reicx ^,escription Gu. u. Cart. Caa Texture Sinrcl;re ~ Gr. Sz. Sn. Cons:srence ' is r 4 undarY ' tipcis ' r --.. ~ _GP,Dm' 'Efit1 'Eit&2 f 2 3 ' 0-17 17-30 ~ 30-60 10Yr3/3 Z5yr4l4 ~ 10yr8f3 ~ none - ---- none ' c2c 7.5yr5;6 ~ nil ~ 2rnsbk i mfr ~ 11 t----- - --- --~-------r--- sicl E 2mSbk mfr ~ gw ;~ na andston¢ rESlduum ( na I na ~ na I .5 .6 .4 ~ .g 4 r .0 -- f . _ ~------- - -- --- - ~.....---~- --- ~-- i ~ _.~ i f -- -- -l- i -----------_~ --------- e ~~~wo~~r rr ~ - rivus~ au 5 etu mg/L antl TSS -30 ~-150 mglL ~ Effluent #2 _ BOGS _f 7 rng/t ar~d T33 ;36 mglL CST Name (P'ieara Prktp ~- yigratvre~/~ "'-'~hu~ David J. _Steel !'~ l;,.r_~~ ~~~};- 246956 Adorers Steel Soil Service ~ - '"-- Date Evaluation Conde coed Telephone Number 1564 CR OG New Ridnnond, WI 50017 1/6!2003 715-246.5085 svv ,d ~~vv~rv av!avr~v 210~SHbZSTc J^ IlHrlt~~iC3 "110'!:'7 ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT /~' AND ~/ OWNERSHIP C;~RTIFICATION FORM OwnerBuyer ~ ~ ~~~-~ ~~ d- J c~ L _r,,~ C ~ ~~,~~' (' Mailing Address C ~' ~ r..~., ran 2« ~ ~~ ~., ~,~ ~<,o ~ ~, ri-S- 1.,.,i ~' ~~ ~1 u- ~S C '~ ~ Property Address ~o+ ~v ~ ~• (Verification required from Planning Department for new City/State ~~r'~t,N!~~ n ~~ ~ (N r~ I ~ -Io~7 . t}J -i~0 Parcel Identification Number (~ LEGAL DESCRIPTION ~, ~~ ~• Property Location ~ ~ %4, ~ ~'~' '/a, Sec. ~ , T ' N-R ~ ~ W, Town of ~~ ~'~ Y~/1 uN=~ Subdivision Lot # J~ j Certified Survey Map # ~ ~ ~ ~~ ~ Volume ~ ,Page # -~ Warranty Deed # 7(~ ~ ~ ~ Volume ~ ~ ~ Page # O~ Spec house ^ yes ~') no Lot lines identifiable ~ yes ^ no 7 3 ~`~ SYSTEM MANTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatmettt 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 a licensedpumperverifying 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. Uwc, 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 ee year expiration date. SIGNATURE LI D ATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. the pro described above b virtu y e of a warran deed recorded ty rn Register of Deeds Office. SIGNA OF P I ANT I (we) am (are) the owner(s) of Z~ vl~ vZ DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** 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 'J 2068F' 622 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED Dacurrrent Number This Deed, made between __._ . __ _...__....__-_ RICHARD. O. STOUT and JANET P, STOUT husband and wife_1 _ _T._ ___.___ ___ _ ._______ -. Grantor. and JACOUES M. 13AUMER __. .._ -.. - ._..__ ~_,_._ _ . _._._. _~. Grantee. Grantor. For a valuable consideration. conveys and warrants to Grantee the following described real estate in __ 5t . CIQ1X . County. State of Whcansirr at 24, lat of Emerald Acres, Town of Hammond St. Croix County, Wisconsin. ~ictro .Legal Sers~ices EDIRET 377073 A Z?3379 Wll 1~8)7b Exceptions to warranties: easements, restrictions, rights-of-way and covenants of record. Dated this 25th day,~.o,F~, , '~(~November 2002 ' SV~~ (SEAL) ~~~_"~ Q"(-.'l. ~~L~vl' ._-_ _ __ ESEALt Richard O. Stout Janet P. Stout (SEAL) AUTHENTICATION Signature(s) authenticated [his day e! TITLE-~4EMBER STATE BAR OF WISCONSIN (!f nat, autnori2ed by §~Dti.06. WVis. Stats.j Ian a STAfIMENL WAO ugRAFTEO BY 1353 AWatukee Tr. , ,Stgnaaeros nwv be auttsonticatoti or acknowledged. Both are not necessary.,' 018-1067-40-000 PerCgl Identification Number (P1N) -_ This 7.S rlOt hamestcad nropeny (is) (is not} ACKNOWLEDGMENT (SEAL) State of Wisconsin, 1 JI, SS. St. Croix _Counry. Personally carrre before me this 25th day of NC1Vember . ,~QQ~, the above named Richard O. Stout and Janet P. Gt.Ont ._ .._ _. ._..._..--- ~_._ rt~L~ _~. ._ w me Known to ~~et~v~xe tired the foregoing Instrument and ac now c ge he same No y Publt State u( ~ti »i ~ bt zommissitot/t is ~r~(ttarttn: (1f •tot. state rxpir lot to 7 21 127 9 5 3 KATHLEEN H. NALSN REGISTER OF DEEDS ST. CROIX GO., MI RECEIVED FOR RECORD 12/05/2002 08:20AM EXEMPT M REC FEE: 11.00 TRANS FEE: 134.70 COPY FEE: CERT COPY FEE: PAGES: 1 .....,.r ~ .. Name and Return ass '~ 3~ /yr~Qe~ St ~c-~'~5 ~~~~1 L ~,~Z''ro73 ___ _. __ // ' Ndrn,u r7) r)+_rsirN s,Rn,n~ ir_ any t'epai',ly rYrnsl !fu tpped w Nnnrltl 6 irlw l1Yll 6lxnplurn STATE BAR OF WISCONSIN :visra~-"=~ ra:~a- 3~:,, ~. ~c ~~ WAHHAN"fY DEED FORM Nu. 2 - 199a nn.n.uo+ee w~,. r 7 Wiscorisin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach com lete site anon County p pl paper not less than 8'/= x 11 inches in sae. Plan must include, but not limited to: veRical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please prinfall'i ~~~ ~~ E ~ Review By Personal information you provide may be used for secondary purposes (Privacy law, s 5.04 (1) (m)). Property Owner j - ,, roperty Location 0 9 1003 1240 Page 1 of 3 Steel Soil Service St. Croix o~ cf~_~Dc~ Date/ /~~iin.,,..~ (/ o~ 5f/d Baumer, Jaques `~' .l - ovt. Lot NE 1/4 SW 1/4 g 30 T 29 N R 17 W Property Owner's Mailing Address 5l :;IZ01X COUNTY of # Block # Subd. Name or CSM# 105 N. Meadow Lane 7._OPJING OFFICE 29 na Emerald Acres City State rp o e Phone Number J City _f Village ~/ Town Nearest Road Roberts ~ WI 54023 715-497-5395 Hammond 150Th St. New Construction Use: ~/ Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement J Public or commercial -Describe: Parent material Ariand,Sandstone uplands Flood plain elevation, if applicable na General comments ~~ and recommendations: Mound Design, system elevation 106.30ft based on contour line elevation 105.30ft 3p ,Spt'( .f- ` K~ _--~ Boring # ~ Boring /J Pit Ground Surface elev. 105.80 ft. Depth to limiting factor 34 in• Soil Application Rate Horzon Depth Dominant Color Redox Description Texture Stnrcture Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-16 10yr3/3 none sil 2msbk mfr gw 1f .5 .8 2 16-34 7.5yr4/6 none sicl 2msbk mfr gw na .4 .6 3 3 54 10yr8/3 f1d 7.5yr5/6 andston residuum na na na .0 .0 4 5472 8l10bg gley c2d 7.5yr5/6 andston residuum na na na .0 .0 Boring # ~ Boring ,/ 1/ Pit Ground Surface elev. 105.80 fl. Depth to limiting factor 30 in• Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-17 10yr3/3 none sil 2msbk mfr gw 1f .5 .8 2 17-30 7.5yr4l4 none sicl 2msbk mfr gw na .4 .6 3 3 10yr8/3 c2d 7.5yr5/6 andston residuum na na na .0 .0 `Effluent #1 = BODS> 30 <_ 220 mg/Land TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 3D mgn_ CST Name (Please Print) Signa ure: CST Number David J. Steel ~~` 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 1/6/2003 715-246-5085 j Property Owner, Bdumer, Jaques Parcel tD # Page 2 of 3 Boring # J Boring / Pit Ground Surface elev. 103.20 ff. Depth to limiting factor 30 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/3 none sil 2msbk mfr gw 1f .5 .8 2 13-30 7.5yr4/4 none sicl 2msbk mfr gw na .4 .6 3 30-60 7.5yr5/6 c2d 7.5yr5/6 :andston residuum na na na .0 .0 ^ Boring # ..~ Boring J Pit Ground Surface elev. ff. Depth to limiting factor in. ~~ gpplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # J Boring Pit Ground Surface elev. ff. Depth to limiting factor in. Soil Application Rate Horzon Depth Dominant Color Redox Description Texture Stnucture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM -~~~u~~ .(3«un~~~ New Richmond,WI 54017 Lic. #248956 NE1/4,SW1/4,S30,T29N,R17W Bus.(715) 246-6200 Town of Hammond, St.Croix Co. Res.(715) 246-5085 Emerald Acres Lot 29 Legend 1" = 40' • =Benchmark Ele. 100.00Ft Top of 1" steel pipe • =Alt Benchmark Ele. l O1.lOFt Top of 1 1/4" steel pipe =Borings Boring Elevations B 1 = 105.80Ft B2 = 105.80Ft B3 = 103.20Ft ~ qc,, 03~ B4 = OO.OOFt ~ag .~3~ s~ w ~~ /~~ ~~~ c ~~ S/~~- ~"~~5~b e ~ ~"~~ yo ~S~l~o ~P~~ ~~f7~ ~/' 1 D5,3a-~'+- ~'~. /p3.2.~~ > /I~" ~. io?.~d-Ff-- ~_~ 03 ~~~ S~L vT '~ ~ ~ S3, `~ 3'~ 5`a w~~ ~`~ ~!'~ r ~' : 1 ' ~ ~ ~ ire _ ~ I i 1 ~', ~ ~ 12 11 !~! I ~ ,~ 1 _ I Z % ~ I ~ ~ ~ j i 1 ; ! / 23 c~ s-~s>« 1 I j = 3 ~~ m I 1 ' / j.L~-' L ~ asrsrtaw tseo.ssr = w . ~ " ~F -------t-- -~ --t-----7wr~eess.Ta ---- ~ ~ I ~ ~ I i .~~~ . tt s ; ~ ;~~`4 i I ~' .taw ~ ~ • ~~~ ~ ~~ •. ~o ~ ,~ , ~ ,~-, ~ _/ ~• NaYV6~'e eraar 9 ~ _,~~.- , i •i ,sow ~ ~ ~ ~ ! i - ! i I ~i 25 ssrsa~aw4oasr MIN FFE ~ 108!.00 ~_~ r. 2.B0 /4R:l1lS ~~~~ ~ ` 100,00080 FT 4 ; _~~~ ~ ,~CB .- ~ ~~St~,~ ~ ~s _ • t~~ / ~~-•- - -.._..2st.oe i -- --~~--TOWN 4 ~ "~`' a. wut.ts ... 22~.tr tosoa eaj ca `. / ~ zaswaas so Fy. a 1 ~ `~~~~` //~ via ~~. O ~ s q 30 29 2g ~ ,'~ ~ .L = toaoo ;~• ~I. r~l ~ _ ~oisoo w~ ssowox~s ''°°°>~ Fr '~ ioe,9o8o toswssQ Fr~ Z : MN ws= tamsoo ~• Ik ~ 1 sr ~ ~°' : ~ ; esaoa~ e S'08'W 2882.88' LINE OF THE NE1/4 OF THE 8W114 a NJBflP6~ u~ ---------------- S1/4 C S~TLON ~ to s 0 c r 2 el DaXi1.A8 J. Z%WLlR BW I.AWD SURV6YN0 ~ 2020 ENLOE BTR~T BORE 101 MJD80N. WI 8016 m~ Wisconsrr Bepartment of Commerce Division of safety and Buildings a SOIL EVALUATION REPORT ~~ ~~ Page ~ of r _ ......,...,........,,........,., ..............~. ,,,......,....~ County ~ C Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must • roy 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. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ~~~'.r L~li U' "~' Govt. Lot ~ 1/45W 1/4 S ~p T ZQ N R / ~ E (orJ~W~ Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# t- 3 ~ee T. q ~merf~ld es City State Zip Code Phone Nu~m(b~e~r / ~] ^ City ^ Village [~ Town Nearest Road _ [~ New Construction Use: [}~ Residential /Number of bedrooms 3 _y Code derived design flow rate ySZ7 ~(~ O O GPD ^ Replacement ^ Public or commercial -Describe: - '`~ Parent material ~,' ~ ~ Flood Plain elevation if applicable ~~~ ~ 1 ~=~ ft. General comments $ ~r S ~t /ti1 ~ ~ -Z V ~ 9`~ Ste` ~ ~- "~ •'., and recommendations: C~ ~~~ -e(cv , p.~O~ Z?~~~1~/[~ "~•' L ,,~. " ,- ~..-. i "" ^ Boring # ^ Boring -'`', Cf)t)N?Y ! ;,~ Ground surface elev. ~ /` ~~INCG~r=tCE , •` ' y' ® pit ~~ f v Depth to limiting factor ~ in. a S il' tication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence B ary; ; Roots, '~ GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -~ *Eff#1 *Eff#2 I 6-~8 ~ 3~2 '/ Z m~r c s -~' . 5 2 ~~- ~ ~t/~ -~ s;~i 2 bk ~5 - 3 3y-.5N l d 4/ -- 1 c 5 - . -7 /. 2 ~ s~ ~o ( ~ G 41 Of7, e ~ - - 3 5 ^ Boring # ^ Boring , / ®pi( Ground surface elev. ~'~?.~~ -, Depth to limiting factor "'~` Q in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~ o-ro / Z `~ '1 Zw,~bk mfr c lv-~ . 5 • ~' 3 2 -40 /0 - S ZmSb m-~'r ~~ -- - 9 `~ c~a so !o F2P ~ s~ Zm36k f'r - . s , 9 - trnuenc ~i = taws > 3Q < ZZt) mg/L and TS5 >30 _< 150 mg/L * Effluent #2 =GODS < 30 mgiL and TSS < 30 mg/L CST Name (Please Print Sig ature CST Number edam ~~c.~um~ker _ ~ ~ Zs33a9 Address ' Date Evaluation Conducted Telephone Number 2113 gds' ~- '~me~--Se-~-, (,rJ! ~ ~OZ 5 / Z-/~-o / C'~is~Zy~-`lao~ w Property Owner S~-o v-~- Parcel ID # Page 2- of a Boring # ^ Boring ©. pit Ground surface elev. ~(p, ~~ ft. Depth to limiting factor ~_ in. Soil Applicetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ~ -iz --~ s~l 2 ~ ~ ~~' -s 2 ~ 2 - --~ icl k ~s -- • N • ~ 3 • yL ----- ~ ~- 2 c 5 -" - `~ u2•~ .S ~ ~ m ~ - 9 ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ^ 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/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/Land TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-833U (RA7/UO) Property Owner S~-o~~- Parcel ID # Page Z of 3 Boring # ^7 Boring [lJ• pit Ground surface elev. ~p. $~ ft. Depth to limiting factor _~_ in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Descxiptlon Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell tau. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 f ~`~ ~ ~-1 f ~ r l ~ C (` 1~-1- ' S - 2 ~ 2 - -^~ icl k cs ~ • ~ ~ ~O 3 -yL -- ~~ ~ 5 _ _ - ~ u2-~ .S `>~- ~ m r - ^ Boring # ^ Boring ^ pit Ground surface elev. R Depth to limiting factor in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Shucture Consistence Boundary Roots GPD/ft2 In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 'Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mglL ' Effluent #2 =GODS < 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 fozznat, please contact the department at 608-266-3151 or TTY 608-264-8777. 560.8710 (R.07/00) r .' PAGE~OF .3 NA MF J ~ ~ -~- LOT# Z~ L AL D RIPTION 1V E ~SW t4 , 7 9 ,N,R, t ~ E(o SCALE:1"= y(j BM I ELEVATION f OG . O BM 1 DESCRIPTION ~v~ o ~ ~u c BM 2 ELEVATION `~ ~. 5?7 ~i BM 2 DESCRIPTION ~,p p..~ ~ k ~0~lG ~ - ~ ~ c ` `3 ~ SYSTEM ELEVATION ~~, ~y SYSTEM TYPE /~ -~a cQ~ ..~.~ `~ CONTOUR ELEVATION ~ ~, O~ 1 B ~,~ B~ SIGNATURE__7~~~`.._,._._._.- ~/ ~~ -- DATE -~~ J ~,5-` ~~ .~