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HomeMy WebLinkAbout030-2157-15-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix l Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569518 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)j. Permit Holder's Name: City Village X Township Parcel Tax No: Folsom, Joseph & Patricia I St. Joseph, Town of 030-2157-15-000 CST BM Elev: q Insp.BM Elev: BM Description: Section/Town/Range/Map No: /0. 33 P. �3 J 3 Alkvu' 29.30.19.3158 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z Bench_ar 13.2- �3. 3 76 , 33 Dosing 1P0/ /D/G n Alt. BM T 0 t4 Aeration �f Bid .Sew/era 6. 77 /3 Holding �e StA4t Inlet O n VA r� /-0 l0. TANK SETBACK INFORMATION St/Ht Outlet 96. 3 TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / QS Septic \ j > Dt Bottom f�(Vri q Dosing fleader/ an. -` -30 '7f-- Z 3 Aeration Dist. Pipe a 9 3 /if Holding Bot.System o•Z3 93. 3 PUMP/SIPHON INFORMATION Final Lade � Qb B '• 3 -7-2 114J3 Manufacturer Demand St Cove/ �� p 3 qq GPM / /- Model Number M # I it TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. lb-<towell- SOIL ABSORPTION SYSTEM 1441/ BED/TRENCH Width Length No.Of Trenches '/ PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS •/1 [/[ / SETBACK SYSTEM TO jP/LVJ BLDG WE LAKE/STREAM ACHING Manufacturer: INFORMATION AMBER O Type Of System: , J I , + UNIT • �, S Model Number: DI IBUTION SYSTEM Bade stn ution + x Hole Size x Hole Spacing Vent Air Intake /r pipes) t -yf-•o Length Dia Length Dia Spacing O V + SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 6•1A Bed/Trench Edges Topsoil Fe Yes H No Yes � No COMMENTS: (Include c screp c es,persons present,etc.) Inspection#1:�/ /� Inspection#2: Location: 434 Highland View Houlton,WI 54082(NW 1/4 SW 1/4 29 T30N R1 9W) Whip er Valley-Estates Lot 15 Parcel No: 29.30.19.3158 1.)Alt BM Description=T 0 �r��er Cf?VA) 2.)Bldg sewer length= -amount of cover= > Plan revision Required? --�f�� ' ----JII J��� Use other side for additional information. J q � Yes No SBD-6710(R.3/97) Date Insepctor's Signat re Cert.No. mte. sitr �hrs � II c ct y � 1 0 �� rn of Via' l 7s-I PV �.�. U�B3 F—Iev: Iovoo �QQ,cla� 8 a qv,3 t3 3k'?Qp tv a� �'j PVL s U County "V Safety and Buildings Division clz rl t` 201 W.Washington Ave,, P.O. Box 7162 1, rmit Number (to be filled in by Co,) Madison WI 53707-7162 Sanitary Pe Sanitary Perm In accordance with sPS 383,21(2),Wis.Adm.Code,submission on IleL I on of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit, Note:Application forms lbr state-owned POWTS are submitted to 't c s(if fTbrent than mailing address) the Department of Safety,and Professional Servies. Personal information you provide may be used for seconcitt, purposes in accordance with the Privacy Law,s. 15.04 C 1. A lication AP_ information-Please Print All Informago-IN PIT CO Property Owner's Name , -�Zli� Parcel 4 �Sb U") Property Owner's Mailing 0 2-1 a�ItO Prop g Address -------j�l Property Location Govt.Lot Zip Code Phone Number 7 C' t Division Box 7162 v rn 4s �� ell, C( Parcel (3 Property-----j Code e,� Z Phone Section ,W), 'T 546 2_W (circle one 11.Type of Building(check all that apply)ppi or N; R_r___I---,,W y Ok- c_,� Lot n I , 0 1 or 2 Family Dwelling­Number of Bedrooms Subdivision 11 Public/Commercial-Describe Use 0 Block# f El City 11 State Owned-Describe Use TSM Number Village of Town of I Al woo III YPc Of Permit: (Check only one box on line A. Complete line B if applicable) System New s ysten, cement System D Treatment/Holding Tank Replacement Only Other Modification to Existing System(explain) 'tom ❑ T System List Previous Pemiit Number and Date Issued B. 0 Permit Renewal ❑ Permil-RevisilonD Change of Plumb( Pe.-I—it Transfer to New Before Expiration nor T t FOI-1—W11 e of TS -P,,I 9L �em/Com onent/Device: Check all that aoD D T 7 (explain) L 'rmt'Renewal Pem Tie Before Expiration f Ow (NNon-Pressurized In-Ground D Pressurized In-Ground ❑ At-Grade ❑ Mound>24 in-of suitable soil D Mound<24 im of suitable soil ❑ Holding Tank ❑Other Dispersal Component El Pretreatment Device(explain) 'Tank �is er�,, V.Dis ersal/Treatment AreLtKjfoqjjatiOn. Design Flow(gpd), Design Soil Application R - (g s A _(,,_f) Dispersal Area Propose System Elevation (e o 0 �t � - I__j i V1.Tank Info -T-11 - Y,_0 o Capacity in Totai Manufacturer Gallons Gallons Units °o b New Tanks Existing Tanks Septic or Holding Tank I- Dosing Chaavn er VIL Responsibility Statement- 1,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name,(Print) P robe Sig e MP Number Business Phone Number- 10 176_A( Address(Street, ity,State,Zip c7z C) (gpd Design d) New Holding T" S Fiold,—Ank7 7ZE D �MJ C Po —3-5--& WJ o VII �Count artmen Ise on lepa�t ly '4-se Approved:"e 2' _Reason f. Approved Disapprove Pem-lit Fee 1 Date Lqsilcdj Issurn nt Signature.— El 0�nvenReason for e ial js AJ-75 L-3j5j I."Septic tank,effluent fitter and_on jdSWK0*"EffiWeasons for Disapproval ik—C dispersal cell must all be servtces/maintained as per management plan provided by plumber. 2. All serpat*eeqUir6inents bust bc,,M&A jjq� ' L as Or 81�011atile'C"f Attach to complete plans for the system anrl_Subjnit to the C'mrnty only paper not ,.s th,11,j�1, s n sire nn 1/2 X'),inches SBD-6398(R, 11/Tj) CONVENTIONAL- COMPONENT DESIGN Residenfiai Application INDEX AND TITLE PACE Project Name: �61 Owner's Name: Owner's Address: ----------- Legal D(�scrjptjolj: Township st, so County' Subdivision Nq�Iry)r,, ---- IAN Lot Number: Pait ei ID NuMber: pag'a I Pape 2 Plot Plan-­_-, 'age 3 page 4 Fffter Page 5 imaintename Informp.tioll Pa. i 'g, Page 7 St. Croix CIV SEOtic Tank Form Page 8 pap 9 CSM or plat Atta(t-mains. sotil e'Si. & Uc ?nse NuMber: Date: 4K Phone Number Signature DesigneN laursuant!o the In-Ground Soil Absorptiol, <)"'p"Ont mLln""31 for POWTS Version 2.o sint),I pap Se d- P14i)(-jD fom 4#*c� " Sy' Will BIN X11 IhbK 1C I tip of �� 7s P vG -� Ba X33 3k?� Q� AAk a pvL � 1 Iv i —._..(14 of 17-3 Pvc�JFnt pipe 'Fula! C'rA4ij- iRlifh il��?�4�;��� i✓�v' fi..ear,.Fting �l Chamber Sy4tswrYS EIRvation i nq 1-0,M 4"nfA. Vani Or ObsczyyRtion Pips~ ., Header umm i•, n�.s# a R�su s And Mc dol _ 41L a - 9G fi\fp6lr chamber Soil Appfsc gfio A Rate, yi c U R,apd DE.,,ic�sj FEnjnr _..,gpcf/yep — Applirption Rats? �- �.5�U l - - Chat-nbers ChRmb&Fs each. P qe Nav-11-2010 10:45 AM St. Ernix Cnurilf1y P1znl7nning 715-326.4626 1/2 POWTS OWNER'$ MANUAL & MANA;:GIMINT PLAN pepa—of ,..•• ��r�i tNt1Lr dQ d a 21�)p 0�Sts�Q� ,tapto Tank CapeaNy o� v all N.A Permit 090n, "rank Manufamorwe W Pl�0K C NA Mkitnt Fitt:ar iblsnwfmotur+ar U U t"."f MA Number of Psdron m t 0 NA Vilwatlt filter MOW 0 PEA Nwmiier of f'utbkfa f'80111-N Unit;a Q NA Rump Tank apeolty. .M� �-.�� NA UtirtX fi ffptnr faverag } �� � e d ` Fwmp Tsmk 1�lenwf mwrar NA C1eaign flow (Weak), (Estimated x "1-9) U a1 p 'wtnp�llanwfaatutr r NA Sall,Appffr;atlan kieta It'wmp iVlra ial MA NA ftndsrd Itlflt;t+ertit��f'Fluara�t�,2pssittyr — Mc�ral:hty aur�ra�ta"' Pr�t�aavtt'tatltn�lnft f k�CA, oil! Qr a (K ) mill^ E2 s4ria �rsval Filter Cl Peot Filter 8iapherni0ol 0YvQwrt Demano (Raba) ;aw Mox D NA c3 wpt stalt�al Aareti�tn I Waft llafrl(a }rte I tiYrw 7,0tai wspanda�l M ovo ("('a�) "i 6t j m / __.,. •-�..,.. �y � ,,,,.,._.._....�. _ ..�..�,....,.�--.. . t°,�la ar�sl��IiCe} Cl Ella F'retree,ad)«ffiGtsnt;Qualitu lflprtthiy atreraga W faaht�m9Qe1�? Ygan Do (�',C'1�x1 49'0 mg/l., lcl�farnut t�tprawl y} 0 In»fir ram (prowsttrixed) AT,-Qreds 0 f�vwttd 'total�Msndsd ills IT".) $�Q Melt, l i 1rlA �drip»iniil+� i� A,dlyar I e al tWai'sfartn( p,Z etri rpe lt) `:04 aftaJlQ itttl _ , .. •. NA� laximt�an gnt Particle 8lxe �o in r2a, 0 NA. �, ,�,m.... �----...,. �. - ^ __. - - 0 IAA CIA othon thsr M NA �1Pd14{A1r tNPitaa!tear durnc+att wnatawnter Anti Mtln H nk efflwaM t��taetrarl + I�ftaftYatt yeee� n NA Ax(asM ranAa et�gYo1 t 1., tna}ae*ok aondttten at tank(p) �»w Ia er�ewftlirf}(� wbYB M.N NAe1a carrhtlst et idgr � � r Putrntx gtat�:rantante of UWA) ._ -vim-- } p�fi f�r"IAt c�ract®eueYlfs . �it�rat��9laars'} f�NA 111wpeat d'csp rwat rall(a) ......... _.. vtrs 0 MA _ At least;artrae etirary't r -~ lasn afflutgrtt filter 0 NA lnigpmaj;pwInpz pump oontrala ,aEarrst A least eancaa wary: M . MA MOM 4,51 At least once oV ary, e plush jotarafa and pre urw TOAT MA atlhAri At.faaat eMe syery; 9 ff :�,.,„ MA Ctxt,ar. MAIRtT;NANDE MO'•iRVOT14111 lnspdcvoris Of t;arrl�a end dfspar l ile shall b� marls iay an In�iiuidua9������� �11�111�1ft��J t�� i"arKk N9aater Pl�tmer. Master Ielwambar irra�wia�ed �ern�er) p�W ira�l?��ltrtrl or looks, inspeatidn:4 rnuret)nrlutda vlauai 9"pdp lan he ft i�i$jr r�Y alrl fn Up nw a k utp broken iyif4t a lw �G an the bra r►et1 wt rP a+, mmaawra the sr0,11.1njra of aomolned w andtne The dtepersel ar4llle) a'h�+Il he v qt 11 The fr9g of efflw r t affluent levels eurfsre ma ndiaate apfaiitng 'nd:ltion and requires the pf affivanr,on the grOWI1d swrf �' irrM061ATM n4tifigatiOn 01 the lraael rpoUlinary euthpa hv. 1A1f1�sn the r�pr YxRnad ar�atamulstiart V, slu l a as ae em�I I o ie n nkaratrari and d ) } or dent a With dtt C r N( entire 113, oontants of the tank Shull Pao remo y r� � Mhgnanaln A4i-n1nlatrarive Grade^ M g of All other �artzlr«ea,InoNding�u� limit 14 hs,e h(a►� e f 1 ref a i d Vt!C n SntsY wr 1pen >x t Pretreatment unim, and Brie aarvining et e A Ac�rulne raparr s11;AII ixe farms lloed to the I�rr�f rsgwia�ary�uttl�rtty anritllin 'I G1 tlt3ya of ctstvtxVk�4rsf"c tt�� �e'et:�nt'" gtUtnl t�ioati Nov-11-2010 '10:45 AM St Croix County Plan/Zoning 715-386-4686 2/2 START UP AND OPMRATjON Pegs—of , For new construction,prior to Use of the POWTS check treatment tank fa)far the prasance of einttn t aft W other chemicals hat may impede the treatment process and/or damage the dispersal califs). If high cancantratisans are dotal have the contents Of the tank(s)removed by a s11110810 s>srvirting operator prior to use. `3ysterrl Start up shall not occur when$011 conOTIanS ere frozen at the lnfptri tive surface. During power outages Pump tanks may fill above normal highwptsr levels. When power da restored that exAsoo w Mjt4w.%"r will he dlacharged to the dispersal cells) In one large dose, overloading the calif$) and may resuif it,The ba>~ltuip or ewirfSCa discharge of effluent. To avoid this sltuatlan Dave the Contents of the pump tank removed by a Septagra Servicing dpeMor prior to restoring power to the effluent pump Or contact a Plumber or POWTS MaIrtatnar to assist in manually operating the lyump tfCrritrclS tc resters normal levels within'the pump tank. Oc not drive or park vehicles over tanks and dispersal calls, ilia not drive cr perk over, or otherwise I.rb or compact, the area within 13 feet down slope of,any mound or"rods soil aibsorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong.the Ilfe of the POWTS; antibiotics; baby wipes; ctgareita butts, condoms; cotton swabs; degreasers; dental flans;diapers; dielrlfat3tepltsp fst; foundation drain (comp pump) water; fruit and veget8tila peelings, gasoline,. ,grease; herbicides; most serape; rnedicatlons; oil; painting praduets;pesticides;sanitary napkins;tampons; and water softener brine. ABANDONMENT" When the POWTS fells and/or Is compliantly taken out of eervdce the following stspa Shall die VdkI to Ir lrS that the system to Property and safety abandoned to compliance with chapter Gomm 83.33,Wisconsin Administrative Code! • All piping to tanks and pits shall be disoonna eat and the abandoned pipe openings sealed, • The ccnterift of all tanks and pits shell be removed and properly disposed of by a Septaga Satvlrtlnty Operator, • After pumping, all tanks and pits shall be excavated and removed ar their covers removed and the void sacs fi soil,gravel far another inert solid material, lled wltn CONT"INS 3NCY PLAN If the POWTS fella and cannot be repaired the following measures have been, or must be taken, to provide a dodo compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a rapla+aertlant Sd#t BlYSorirrlen system. The replacement area should be prntaeTed from disturbance end*oMpgctlbp and ekould not be i�lf'ringa�upon by required setbacks from efi#stlrtg and proposed structure, lot lines and welts, callus to p�rm�ein the refalecemI area will result in the need for a new soil and site evaluation to establish a suitable replacement area, Replacement syetr�ltta trust comply with ft rules in effect at that time, 0 A suitable replacement area is not available due to eartbaak and/or soiit limitations. Marring advances in POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTB. Ci The $ite has not been evaluated to Identify a suitable replacement area. Upon failure of the Site e pOWTS a smell an avaluatlon must be Performed to loosta a suitable replacement area. If no replacement area is "llsbis may be installed as a last resort to replace the failed POWTS. $holding tank 0 Mound and at-grade soft absorption systems nlay be reconstructed In plane fallowing removal of the blomat at the infiltrative gurfeae, Reoonstruatirrnsr of such syetepa must aornply with the rul+ea In effect at that time, ��'WARIVlIV1�>� SEPTIC, PUMP AND OTH9R TREL&TMENIT TANKS MAY DONTAIN LETHAL, GAS&M AI91t IR fNSV.FFp1I141T #1�W�1�IV, �o �1O7 RIiITEFt A SEPTIC,PZJMA 1111 'f'HSFk 7"FiMAT"Ni1t 1T TANK UNDER ANY O1ROI,iMla"dAhF le. 6AT14 MAV'Rai,0X gN,D;OF A PERSON FdtO1Vt THE 1111TERilJR OF A TANK MAY Bi~DIMOULT OR 1NdP'C ISLE, ADDIT101VAL nnillimail 1°1i1(1l7'S Nt6TA1.I.MR w POWTS MAiN TAi Napa � M bk rT Name Phone '7 Phone SEpTkt3fi S FtV1iNw G1p ,ATtFi f�CA4 RSC�:TJL,+4ol lr TIM �igl I Name T p Name S C k Phone ��V-1 W Ph U�► w one Thta document was drafted in compliance with oi'sapts COMM a3.22(2)(b)t91(d)&(f)and Sa,54i11,(S)&(a1,uvreaona(n 4dministrativa rode, Nov-11-2010 10:45 AM St. Croix County Plan/Zoning 715-386-4686 z/z START UP AND DPBR.•ATiglll Page—of_ For new construction,prior To wee of the pptWTS check treatment tank1s)for the pra saarzrm of:pe?ntlrsg prgr3krt�s.ter�1#her�ktttt�r►fsalQ that may iraapade the.�treatmant prcasse art for damage the dispersal cell( high ctanoan athans are dastaactad bean the cam,foals Of the tankis)rarnoved by a septege eervigIng operator prlar to use. System start up shall not occur when soil GsGsrlaMOns are frokan sr the?nfRrei ve surface. Duri"S power outages pump tanks may fill sbave.normal highwettor levels. When Power iaa rastored the Aftese"st4Wster vigil be effluent. to the this rsal ate Iia,) in one large da5ar overloading the 0311141 sand araaay result Ira The baalor4p or Surfers discharge of a3fPluasn#. To avoid tirla silos#lnr� Dave the 012ntarataa of the purntx tank removed by a Sal gp$4r.Vlslrrg dowaor prier to rag ring power to the effluent pump or aoritact a Plumber or POWTS Maintainer to assist in manually:oparatirtg the Pump ci�itrols to restore normal levels wlth(n The pump tank. Ciro not drive or park vehicles over taroks and diapersal calls, Do net drive or park saver, or ctherwfsa disturb or campaar,the area within 15 feet dawn slope of any mound or at grads sail absorption area Reduction or alirnirtaft of the following from the Waagtawaatar stream may improve the perfcrftasn�a►ad,pr�larng.tFttr Fife of the foun afl adrain tta u baby wipes; clgarexCa butte, condoms, Cotten swabs; dagreaserg, dontai floss;diapers; dialf t njim fat; f4urtdat?an drain {sump pwxnp) water; fruit and vagatsbls peaiings; gasollrts, grease, hwhidideg, meat gaaraapo., rfriadfoaflons; all; petnting products;pesticides;sanitery napkins;tarnpans;and water softener brine, ABANpONMSNT When the POWTS fails and/pr is parmanantly taken out of service the following steps:asha11 is TiNkS.A.to.Insure..that the system to Property and safely Abandbried In compliance with chapter Corm 83.33,Wisconsin A t inistrative Coos- a Ail piping to tanks and pits"hall be disoonnectetf and the abandoned pipe apaninge aealet1, A The cantarate of all tanks and pits shall be removed anti properly dispoesd of by a sagaage sarvitalha Ciperator. a After pumpjn% all tanks and pits shall be excavated and removed ar their covers removed and the void spite*filiad With soil,gravel or another inert solid material. 0ONT111,11 NOY PLAN If the POWTS fsllaa and cannot be repaired the follawing measures, have been, or must be taken, to 011069 a bode compifant replacement system. A sultable replacemant arse has been evaluated and may be utilized for the )mutton of.a repl�ettteiFt.Cbfit _ ar�len sygtom, The raRlaaamen#area aahaw3d Iaea prrrxacTed from disturbance one la+ssrrapactalt r1 and otio;wld n be hif'r nset w.pa�0 by regwtrad setbacks from.044114 and proposed structure, lot Plies and wells. Faiiu*re to prom pia raplwawrnent area w011 result in the need for a new soil and site evaluation to establish a auitefale replaoemant area, Repl osmufft mt=1 must comply with the rules in affect at that time. Q A suitable roolarement aces is not avwllabla dare to sertbeak and/or soil Itrriitations. 381ring advariceas in POWTS technology a 40fding tank rosy be installed as a last resort to replace the felled POWTS. 13 The site has not been evaa4us ed to identify a aawitabie replaosment area. U.0 failure of the FOOTS a soil tend-site evaluation rrruret lab paarfsrrmgtl to traaate a suitable raptaaasrr nt arse. If no replacement area is a llabis a )itsfdinj tank may be installed as a last resort to replace the i�ilad POWTS. L Mound and at-grade gaff absorption syaaten.8 may be raconatru►clad in plains follow-Ing removal of the blaMst tat the Infiltrative surface. Raarrranrstrua#lane of such systems must Comply with the rules In a"act-&t that tuna, <<WARD NO> SEPTIC, PUMP AND OTI.*R TI'<B>a,T'IU.ENr TANKS MAY CONTAIN LETHAL QA( A�D lW5Ff *Xy. N �-NOT)INTER A SEPTIC,P1V° R VK 73A1 UMi T TANK UNp9R>ANV ClA0jjf%&TAN"$. 0 TH!lllAY)�laSktl»T. �Sl;$CG1£Cfl:A PORSON FROM THE INTERIOR Of A TaANX MAY BE Dmr aULT OR IMPCiIII�SBLE. ADDITIONAL nitlyfmmuTS P t1llNa3 H4tl6TAlWLFF! POWTS,Morrie M bk dame __ Phone '7)S — Phone SlnPPTT, 3E S F1ll)rl119 OP ATOR W, PLgi OnAL RFC et Name a'reafty p Mama Phone oa S - Phone , k i b lri)W This document was drafted in compliance with ohaptsr'Comm 83.22(�)tE7)tRl(dl&(f}and 0,54(l),(s)&(a1,IlYlteconsitt andralnlatrat[Va3 Cade, I E'�altviok fns, P°#it�FP�*1t1 filvs1,t a•Plingfaj*d,,CT 0644 O Pt TO Fro+l �5�3,?t •• RS >rrsw,aYr f Mi }-0 :�r�'r4sGll,ira f�etkiih^•., ,,,.,,,,.,., ,,,,,,,,,, ?'!" 'llil I •i ro r f i EFFLUENT FILTER ................. RJR„ � � '#��r���yy qq,y ";�.,•,, .. ,, �.. , t'alYlol<,Inc Is l?f zvwl ro a0d its Tien r rommarr ial filter to its 4ri tiny liner rif qoa ity i 'RX'And t.,OVI l''ers.9"hrti f'i_al is steel,°ar'�v�r'I Q a'(7L1(�F��(1n911c�n�p r Jay) n klrl�j ft ant?iii fi^�r %"'^"�^,M�,W�,�...�.ww ,,.. largest CUrnfrY�JfCiKdl frltttars in its rlra s,!t('IbtS Lr�?9 linear f�tet of 7A ifltratirrn glitn. I_Itcca th,? , 8.184 M&Riser Qovem n r Polylok PL-122,thn nesre PI01 rloic fi. his ya,,,1r�ttsPt�tic shear off ball ins91tdlled troifh every ;tG,., fjliar,thMer~tha Titer is rr•,mov'kid for CM111.rinq, thy;beill will 61bwi:trp ancl teinplornrllV slud nfP i�i>st'llblatio ti Sawa Am 11i 6;1 i. theyfem 44)the Affluent urnr7't ir� ur tits tr�ttk, hinniher flPter on the m�,rkt.t r.an nuke that I�Git� 9+F I:ir i»� ! rl�irYt! ' f I Ad' „'U, ^•F'tdd!i'1ya isRP�sg �"''Y,ItY'��it "!;', „r �?r+d risy In rSrnr,r�rY,lr.�,t,....,m,._,_.i.• R e qrI est e re and Stop sys ems 1ie1 t t CI �rnNlJc a 10 1 I l a/ al5rrt+�Pa� 11•ff1a ,SANtary Taen i. Rated f'ot"i 0,000 wrAD(rrallona(per 17aY} ( i at�Rds��k"R ti7�finer;� ;of?/1t7"ryl`ration - -------.".�,�� Enlarge for rat tails �rc�rf t �'r' tnri Ca"SCHD,40 pip, �n r3triit i11 C.rl;�;�ilq'fleotctr wio177atio ahe.tirooff hell wl rr�n iitr r ill rnlnovcacl Handles and Roca w n Q Alarm accesslhiiity 0 Alexapts FV(r CrXtensirstt han�i�t w it�ftG� .wnpmn,wxm,wemw,w,mwn.m.,,wre......in.o.M, i«�nta1 }g lriNa;� s l.PI_,•575 t fllupns r'iltnr ahoi.r)rr oe erat+ti r ffir.,Innll f, r snv I' I "" ""w°"" •""" """ ""'� conclitian i�efnre requiring,cieaningf it is rrinmm�'tenrle Y tltq tN a t9�a aej�all evgrwf ril"lli " Ply 1di Clamps, Cimru Ci'tP tarot is pun'tlar�r{or at least ewen�throe year9.1f tltq fl��•teli�ci filtr�r otarCt�'1118�f1 „ „�"..•�,".w._,......",rw.. nFatftsnrrl afar n,the".MMIer wiR lie n,11'IFad hlr rrn alanrt whr n thF fTli r,itetatia gs rv'raing I SOO$0814011% 8 5/lclnc should he done by a oertlfiari 9aptic"'Ilk pr.rnt(Zar or InstFlHr�r. R11� '+r t Ri"d t't e sp PrreSeWre Filters 7. 1,acace the Outlet of the septic tank. 10.44ir c'ra ntrPal Product: 2, '(remove tank never and frump twnk if 3. Ito not use phamlail A wltrwn'fltr•:r i t rranioN ed, � ��r��rro��'r�and CMLI P1I_57.5 31.11 of U1 ho+asing, s+r1a l t'itsP �. 11gse of 1111tes'over,the,aptia tank, I��i<a ar.rre all anlicis fait Insert rite ilt r t�7rtritlgES Mark intc3 thn houstn,q mrakinq;sure tha filter 18 properly �0;1�intp at'pkic tank 'e4 N # 1 ri�P r Gt ii�flrar n rosr7l4t��iy inaPr4c,,l. „,..,, W 7. R puce St.)piir tank=166.PI-525 InS1,911kltinn. I �3ssN fliwe Laitlnd83oape wuta Plows op to 10,nnq cl-,111 sns Per Day(r�r�rncl��l ftal°rasiclerltial�1ncl ccmmPrcfai �— --- �-�" Tpohrti4Ri Spec .R.q%jal ..,� 7. t.tsca4rrr¢h,q nl,rtfrt nP the y��,ttu bank. ..,w_...�zP�11pr� Rstt�y, 7. RiUncva tapir orn for')nrl r f F'l,lt1'i FlltW rind Slit? t. Gifurz the filter hnl'Ning to Via 4'"lnr if itc�ee45rary, "x�1 "Riser the"a,aress openinr�crap a PQkyrrrrr lnx pit t�POO, If fho filter iM riot on.w tred s�n+lrr. i FilterA1larm hinel an �. Inaert the into its ljousinq, ar piaar'e Of 1711 O fits Coiter'fll$'er. � SmFjrr.Flltr�rTM 4:>,Mtrc'f I , ... mm I� I � I n M , r •' gx l�kilr„lr���' .rlikr I/J�1/�r,r/rrir fl > �1 ! /��ir7/✓ �� r,/ r� �' ,�j>l. ���,�/ � s.l 1��1 /bl�il'/l�ll��l,(Ulfirr%rll��ldr; •r r� i,1, �. U r l l! rir� �ll!!!I��,f�rll�,����il�j%`�l,�rrl�l i!l jl%l��',l;�',,,"; , ! ���Q :•, �J �r ¢! /r r irr! !"f. !r r I•r 7 f r ,r * �,n ��, � � I�i�IV��I�h�,� �;,;,;���,, �I'.I '''I ggI1!l�l'i�6111�1i11i��fl�a�ll'rllllll) "{���►I� '�'hl,�, ,I , ; I , , I � � �, �,�II�i,, f�,��I�GI,��,l�,� �I I�,�;i�l('I�(i►�I�� I ,I lil i �i i ii I ;,. 1 i�l I,}ii ICI I I i .I Irl,l.► I� II I II 1 1� � 1 �;�11 �� � I�I'i�ll�i �'. l�ll�I�i ��II I I � •il 'd ��i'ill� �� III � �I� .� !� F1 bil �I�I I 1 i�h�lll� l��I ,d � Iru �I„�II(�llfll�i�(1911�i��lE�llil�I�lll�'��;Vlrlt II71111iuiafluilUUgilr�Ya�iilu�+molt ��!Il'('III�i��ll6�,i��lil�6lI�IIP�i�I11G��il��l�l�l�lf�6�11i�1�«i111�I�IIIIIIJ'I►111�iINI��fVlllillh�la'�II�W,19I111III��II(I��111�I�6��I�iII�N�l4llll��l��;, III fli11111f X1111,"Ii1��111fB�i'f6 1��1111111i�T�11 IhI1�lI� milli]Ill A F11'4I114.1Zf II 111�III �JII!I((I I11Nl1111�6111li11'U Illll�llfl�II91 [IIII��,llll rll•"IJ�'IPfilI�'f�ltl�lll�'fi�llel�l� o�T�i���ll� lf11�1141i41►1'1111' ', it ;k I ��I l ti la�11f111�IIIi1 d 'hlldli�1d ll yIlJ X1111 If11fE1 '�I�I,��illl� llili d�I li ill 41q 11 I�1111 i I I ill III l• i Ifi���1111611�1� �� -,. 1�llill Illllh�alA��h���ilHd(�I II�E�I'14�1ID1111�,1�1�11PI1��IIlI�Il�llllllNfIIRIII�I,�4�IJlll�l�il�llll��Illllll�llll��Il''N —lli�il�'I ;'i',III�F Iq�l;':11��Ill�l,l'��,�li�iil�gll Ill�l�l`�ln7orr��ll!@ ellHft�flJlai>�I�I�INA�III��i'���1,��=, U: 1 2AM No. '3066 :r P!! rri o �D Co 1"0 -T3 m rn 1W �;M_w;� _ =.�_ — - ,tea If L Gfi no go ST. CROLX COUNTY SEPTIC TANK MAT.NTENANCE.A.GREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 09 Cib 0 0 1\4ailing Address Property Address '. 4�54 w W"'i V,=e- 'p. tment f -u, (Verification required m Planning&Zoning Depa,TtMent for new co ction.) o kqi YI City/State Parcel Identification Number 2-157- /5 - Ej4w"s F�- LEGAL DESCRIETION Property Location Sec.a 9 T 3 N R 1 9 W, Town of Subdivision .Plat. f Lot 4 Certified Survey Map Volume-, Page Warranty Deed # (before 2007)Volujiie Pa.ge Spec house.0yes D no Lot lines identifiable❑yes❑no SYSTEM UENANCE AND CIWNER CERTIFICATION Improper use and maintenance,of your septic system could result in its premature failure to handle wastes, Proper maintenance consists of pumping Out the septic tank ever);three years or sooner,if needed.,by a licensed pumper. What 31071 put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zon g Department a certification form,signed by the owner and by a master plumber,journeyman plumber,restri n in 'eted plumber or a licensed pumper verifying that(I)the on-site operating condition and/or(2)after inspection and Pumping(if necessary),the septic tank is wastewater disposal system is in proper Opel t less than 1/3 full of sludge. Uwe,the undersigned have read the above requirements and agree to inaintain 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 maintaj.ned must be completed and returned to the St.Croix County plann Zoning Department Within 30 days Of the three Year expiration date. ing& I/we.certify that all statements on t A*s form are true,to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a w rra.nty deed recorded in Register of Deeds Office. Number of bedrooms --S G�A TURE OF.APPLICANT(S) 3 —/1 1 /1 / � DATE ***Any information that is njisrepresented May result in theSanita:rY permit being revoked by the Planning&Zoning Department. Include with this application a recorded warranty deed-froll,the Register of Deeds Office and a copy of the c reference is made in the warranty deed. ertified survey neap if (REN7. ()9/0) STATE BAR OF WISCONSIN FORM 2- 1999 8 2 0 3 1 9 9 Document Number WARRANTY DEED Tx:4168301 990819 This Deed, made between Keith M. Loeaering Grantor, and BETH PABST Joseph M.Folsom and Patricia J Folsom husband and wife Grantee. REGISTER OF DEEDS Grantor,for a valuable consideration,conveys and warrants to Grantee ST. CROIX CO., WI the following described real estate in St.Croix County,State of Wisconsin 12/30/2013 12:10 PM (if more space is needed,please attach addendum): EXEMPT#: NA Lot 15,Whisper Valley Estates in the Town of St.Joseph,St.Croix REC FEE: 30.00 County,Wisconsin. TRANS FEE: 210.00 PAGES: 1 Recording Area i Name and Return Address Attorney Kristin Ogland Estreen&Ogland 304 Locust Street Hudson,WI 54016 030-2157-15-000 Pared identification Number(PIN) This is not homestead property (is)(is not) Exceptions to warTanties:Easements,restrictions and rights-of-way of record,if any. NNAt , aa)i c N n ! pO Dated this day of !/e C-e-'"J� 2013 cv= a LU �U ° • n � x * Keith M.Loegering E o c o AUTHENTICATION ACKNOWLEDGMENT a ES Signature(s) — - _ STATE OFCA��-lZ_�;ZIJt/� )ss. " • __.. .— .. . .._ _ __ County ) LdNN authenticated this day of _ Personally came before me this day of C42TO gt�:e— ,?A13 the above named Keith M_Loege.ring — — — — TITLE:MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s)who executed the foregoing authorized by§706.06,Wis.Scats.) instrument and acknowledged same. THIS INSTRUMENT WAS DRAFTED BY — Attorney Kr(stina Ogland Hudson,WI 54016 Notary Public,State of My Commis 'on is perpauertt.(If not,state expiration date: (Signatures may be authenticated or acknowledged.Both arc not necessary.) Iwo _ _ _ _ __ _ _ ) NIWf-R OQEV •Names of persons signing in any capacity must be typal or printed below their signature. Commisb*nr 11ti4 @?8Mional Co..Fond du Lac.WI STATE BAR OF WISCON^- Q Notary Public-California Z 800.655-2021 WARRANTY DEED FORM No.2-1999 San Mateo County St.Croix County 990819 Page 1 of 1 Comm.Expires Feb 1,2015 / j ,* :> N8S°4 i'0f J t�J245.1-3_.`._._ 'E 1120111'-- -1 _ e 549 _- s X/ 979,_ ;" x� =j _ ^� e 983.6 F _ / q 9.3 t X / X 975 4r/ et J= 984.9 X - 981.5 `9 \ ES 983.3 rD I' 977£6 X / 883.2 3. DES+'�� �' - y 1 X z (SEE IN NC 97$.6 982 l8��5\�;�f 3 X � N f LSO fl t .i . x83. 2.9 rn X X r, fit i`' / 979-� �Jr�f�� d 8'j✓ 9 X���� /v/ �-�• _9B( t 9'f8 6 �! �• ^ter x ``. 't ss� r_ 9546 s # x .957.6 ~`} ;. ��.�i"�-� v ; - � 1•f, / r. � '' ` cam- 1`S•S ! 1 �/r �'r.r -- if � f~.ate' � y r fY '....'�{� !�: ' - �. �`Y ,arg.•.y�_ /� � ._ � \.i fst�yxrlrttx/Efr �r�f _ QE .{: `ttJ {. ' /r f` ...:• /r,��/i} .�-it/�r�f.tf t` i s° r w- °'• \ r ..r. 1 4:.. .E /. � ' i µ/ /i�; /hf `I> 959'3- w_ \` ''Q56.5 95. 8.-a-. 9;l.v ,y ✓f✓�vsi7>,- t t ti 1.2 �_•X ". ttrrff.°;tlt✓ .i I ,�` '`� JJ X � / � ,� ,� �.�t� '�.._... .•_ -- - - >? ,�if �.,ffr. y-..."y/1,�v f 'F�.t�� t t!t ,1 5�` \` �` 'r- s? �•1:` :1 971 8 970.7 972.9 r 589°23'29-W 733.89 -\ —— X %.aj.%i'j 'r•«+ ...-.. t' s s j) ! C� R i ~` +... _ ./ �' 973.2. i'.w✓.'ice/.`ri/�� l S 967.1 ~' x .-.r /� (M°((�� ``' — --° 969.1 \ r ,�! J 975.1 -970- _. - � _. X.••-..�' .q� !4 `- M ,\ e - -�..�� C_�,7 X- 1 . X 974.5 _v -_ `\ y r. 971.8 '. `` y �` y�r J 970.4 —- t A LOC10i�J —— sss 9 S. INFILTRATION NOTE: 1 ?' A'\ �1 1 MA is it E " q it ;"'� •• t pp 1 •J ``� 11/�• 741 � , L p a d i E!"� �4 bs� �•\a ••, � �Qa� � , fir" ' '� � 4=vs 1• �� 1116 !Q` w g an.:,usaaMp C f 66 MUM slow, ff Cc FU fir WRM III Sm za1 ti (any JSa61 HIS ( .fill It 011 ZI � if III _ ----------------------------- ------------------------------ ------ - ----------- -------- -------- -------- isVSn-NPSNOOOM'NOSMH HII C" -iewvs womp womw u3 R C'A LA l A tj W hp yy R Is ig Ji -t—41 ----------- I TTi ZW -9-2 Mir W Z 0 aa rn --------------- - -- -------- --- --- - ---------- -------------- - -- - --------- IJ31ONvu woisnp-wosio=l M IC'3 CJ I -—---------- ------------- Lu I— sox 0 z uj mi Rik; H lit' ----------- -- ------------ ------- --------------- - --- --- vm 14M r+Ooslm Nosom co jai wos H3isw"woisnp "io:i sm3mirle XKM IS II 0 ' 9 LL 0 8 h- m ELI� TE 5 � I OU __- ® I ELE - - ��� III 4 LEI]II Ell � L-3 FE 37 M- ------------- a a �r .vi NOS OIL EVALUATION REPORT � : :_ #1676 Department Commerce accordance with Comm 85,Wis.Adm. Page 1 of 4 Division of Sa ty and Bu(I ' g¢,,r 3 Schmitt Soil Testing,Inc. County Attach complete sitf,plan oh paper r(Rt+l 3 ` 1 inches in size. Plan must St.Croix include,but not limit to:vec,%* erence point(BM),direction and percent slope,scale r dirn ow,and location and distance to nearest road. Parcel I.D. Lot 15 W.V.E. se print all information. I twie _ Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). l 1/ Property Owner Property Location Loegering, Keith&Kirsten Govt.Lot NW1/4,SWIM,S29,T30N,R19W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# P.O. Box 2143 15 Whisper Valley Estates City State Zip Code Phone Number City ❑Village ❑ Town Nearest Road El Granada I CAI 94018 1 650-678-4823 St.Joseph I Highland View Road ❑New Construction Use: Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD ❑Replacement ❑ Public or commercial-Describe: Parent material Outwash(Hubbard loamy Flood plain elevation,if applicable na ft. General comments and recommendations: Area is suitable for a conventional system with .4 gpd/sqft rate Possible system elevation for Area 1 is 95.0'(high trench) 93.5'(low trench). Slope of are FTI Boring# ❑ Boring ® Pit Ground surface elev. 97.83 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none SI 2fsbk mfr gw 2f lvf .6 1.0 2 6-14 10yr5/3 none sl 2fsbk mfr gw 2m,2f .6 1.0 3 14-24 10yr4/4 none sl 2msbk mfr gw 2f,lvf .6 1.0 4 24-45 10yr4/6 none Ifs lcsbk mfr gw lvf .5 1.0 5 45-96 10yr6/4 none i ft Osg ml -- ------ 1.0 � ►I Boring# ❑ Boring ® Pit Ground surface elev. 97.83 ft. Depth to limiting factor 97+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-5 10yr3/3 none sl 2fsbk mvfr gw 2m,2f .6 1.0 2 5-10 10yr5/3 none sl 2fsbk mfr gw 2f,1vf .6 1.0 3 10-19 7.5yr4/4 none grsl 2msbk mfr gw 1vf .6 1.0 4 19-43 7.5yr5/6 none fsl 2msbk mfr gw ----- .4 .8 5 43-57 10yr5/6 none Ifs lcsbk mfr gw ------ .5 1.0 6 57-97 10yr6/4 none fs Osg ml ---- ------ .5 1.0 . t �- *Effluent#1 =BOD5>30<220 mg/L and TSS>30<151 mg/L *Effluent#2=BOD5 S30 mg/L and TSS<_30 mg/L CST Name(Please Print) Signature: CST Number Thomas J.Schmitt 227429 Address Schmitt Soil Testing,Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond,WI 54017 11/29/2011 715-247-2941 SBD-8330(R.07/00) e � Property Owner Loegering, Keith&Kirsten Parcel ID# Lot 15 W.V.E. Page 2 of 4 t Boring# ❑ Boring ❑ pit Ground surface elev. 90.33 ft. Depth to limiting factor 100+ in. Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-5 10yr3/3 none sl icsbk mvfr a 2m,2f .6 1.0 2 5-14 10yr4/4 none sl lmsbk mvfr gw 2vf .6 1.0 3 14-52 10yr6/4 none fs Osg ml cs ivf .5 1.0 4 52-100 10yr6/4 none fs Osg ml ---- ----- 4 6 52"-100"has 1"bands of 7.5yr4/6 Ivfs Icsbk,reduces rate of horizon. F-- �i F—I Boring# El Boring F1 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/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Ef#1 *Eff#2 F—I 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/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Ef#2 *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(P-07/00) Schmitt Sod Testing,Inc. Page 3 of 4 Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Keith&Kirsten Loegering Thomas J. Schmitt, CST 227429 Address: P.O.Box 2143 1595 72nd St. City, State, Zip: El Granada,CA 94018 New Richmond,WI 54017 Phone: 715-760-197 Subdivision: Whisper Valley Estates signature Lot No. : 15 Date -�'/2 !/ Legal Description: NW1/4 SW1/4 S29 T30N R19W ® Backhoe Pit Township, County: St.Joseph,St.Croix County ® Bench Mark 1 El. 100.00'Top of 1"pvc pipe Bench Mario 2 El. 100.03'Top of 2"pvc pipe Slope= 20% 1,.=40' i 1 4017 a5t4i� �0 8 vial' / f 1 � )o9' c 1 1 <ael This Soil&Site Evaluation Report was completed to fulfill a St.Croix County Zoning r4irement. The location the eva u iti,n was completed may or may not be suitable for your use and a new area may have to be evaluated. �- " � i !, . �.t ( ,, �\ i�'" �`'� � ��, i F ._ i.� ', 1 �.��. ,� ,\.� . ,w _� �� =;� - � } _ �� :`ti- 1 -� `� -_ ,. - � JNE OF SEQTIO,N 29- ✓ .,r . 9°4�'0 5245.18'- `\ - _.., , �>t NS 7 E v 97'9,. , ;` / , ✓ / XI J 983.6 99.3 x 975,4 984.9 '�/ /;f X 981.5 '980 : X �� '�� 983.3 x 979.6 \ /, - s , JF x �OIC D a of - l 1977,'6 X ti, a2 ,, 983.2 { 3.(SEE IN N N 97 .6 98 s 9 5.�5: x x W �0�! �} 2 lAf � �..« ,� - -- - 982.9 r' t x ,r W /979. .,^:.'.',•� •``".."` ,.✓ ' ' y i * ? „\\/��/✓. "y../ ,,, 68.8 �BQ . h 1 / 9 966.4 75.w. «.. _. 8s✓", ` 2 \ v X,976.3 f H E'= �!r/ 9G2 O''� L.B.O.=964.0 I 1� ' -'- �18( J 9% }• rt 954.6ji / 978.9 957.6 X 982 ! / f� `` a� 1t y C • 'iii✓�'� .`err: ��! :l t �� t \\ _ a� ti'�c,� Sr. s � �-: rr . RES- 959.3 � ' .. 966. \ , \ �� �,� �.. X r ✓i/� J %e �4$2 € ,.l, ! - 968-i ':� -9 ._ 971.2 \� y ' X • � `y> o Y ✓ . ` 4 971,3 X X 971.8 r� $ o « M 972.9 r .�!< !/✓� �. ,{ i 970.7 \\ ) e co X ,S89°2329%V 733 r - - '�� �3► 973.2 r r ice, i fir ;f f t�.3 89' 967.1 S \ ✓� x ,�. 975.1 3 969.1 \ lOICD LaC�a�G°3C w x x E \ o-- ---- IN ; 7, ..- --- �i x �� 9 4' 5� �11 4--�� -'` '-`+` � ; 2 T� X `�� � 971.8`-. . � . 970.4 _ _ 969.9 f ; " LOCATI ON Sc INFILTRATION NOTE: LOTS 3,4,5,24,11415 MAY BE REQUIRED TO � _ INSTALL AN INFILTRATION TTIENCH OR RAIN _ -t BEN DEPEND94G UPON THE MAL � \� LOCATION OF CMMWCr SEE P 1S FOR 4 i0ooll „