HomeMy WebLinkAbout030-1066-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division Sanitary Permit No:
INSPECTION REPORT 574305 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)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Elliot, Todd & Katherine I St. Joseph, Town of 030-1066-40-000
CST BM Elev: Insp.BM Elev: BM Description: �� SectionrFown/Range/Map No:
I L-4-11 J
//V-% 25.30.19.244A
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ti CAPACITY STATION BS HI I FS ELEV.
Septic ZI Zva Benchmark Z ' Q IZ� / ,y
90 C Desa" ` Alt.BMr
Aeration Bldg.Sewer Z .5 114q, 5
Holding St/Ht Inlet 3 �5
St/Ht Outlet
TANK SETBACK INFORMATION ' Z `
TANK TO P/L WELL BLDG. en irr take ROAD Dt Inlet �1 \
1l v
Septic ✓� i /L Z*7 u` / Dt Bottom
Dosing Header/Man. /
Aeration Dist. Pipe (0-
•/
, /a3. 0
Holding Bot. System 7• ®I /a
Final Grade
PUMP/SIPHON INFORMATION
Manufacturer GPM nd St Cover WC.� Ge �
Model Number
TDH Lift
in Loss System H TDH Ft
Forcemain Length Dia. Dist.to Well
SOIL ABSORPTION PYS TEM
BEDITRENCH Width Length / No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Dom`
DIMENSIONS 76 Z
SETBACK SYSTEM TO V P/L JBLDG WELL LAKE/STREAM LEACHING R Manufacture, ,
C OR
INFORMATION Type Of System: ` AJ15 1A— ] UNIT Model Number:
DISTRIBUTION SYSTEM kl\
Header/Manifol� Distribution x Hole Size x Hole Spacing Vent tpAir IP�ke e S
Pipe(s)
Length to Dia 4 Length � Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeds ndded xx Mul ed
Bed/Trench Center ' Bed/Trench Edges �_ Topsoil `1 Yes No Yes ] No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2:
Location: 809 132nd Ave New Richmond,WI 54017(SW 1/4 SW 1/4 25 T30N R19W) NA Lot I / Parcel No: 25.30.19.244A
1.)Alt BM Description= L.. b U 2, a--%-
2.)Bldg sewer length= 3/ J-4
-amount of cover= �p � Q ,
'12 1/
Plan revision Required? FA Yes F No Q
Use other side for additional information. _LD Date ate 4insepctor's Signa Cert.No.
SBD-6710(R.3/97)
PROJECT Todd Elliot PLOT PLAN ADDRESS 20932 Jamestown Ave Lakeville Mn 55044
SW 1/4 SW 1/4S 25 /T 30 N/R 19 W TOWN St. Joseph p COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATE 6/30/14
BEDROOM 4
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890
# of chambers 44
, BENCHMARK V.R.P. Top of 2" pvc pipe
ASSUME ELEVATION 100° Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 106.0/105.0 4' below qrade
132nd Ave
All piping shall be SDR Property Line
30/34,within 10' of tank, 30'
piping shall be Schedule 40.
Pro 4 Bedroom
ST House
108110' 25'
104' 106' 368'
B-2
55'
80th St. 18% Slope B- 355'
14'
B-3 373'
Scale is 1" = 40' 23'
unless otherwise ,300'
noted B-1
Vent Vents
>6„ Quick4 Standard
Of Cover Leaching Chamber
with 20.0 ft2 of Area 341'
4' Long
12" 5.6ft^2/pair of end caps
3 4" Grade at System Elevation
B.M.*
1066' Property Line 300'
oy
Comfy ti
�C Safety and Bindings DrAsion I ((000<C
' b 201 W.Washhgton Ave.,P.O.Box 7162 Sasitary ' Number(to be fitted in by Co.)
SUN 30214
BC 'A 162
671-1365
01X COUN'``T EN —
�oMM�N� terry Permit Application State Transaction ,�.
in accordance with SPS 393st(A Wier.Ades.Code,samissim of this film to the appropr'sgs Fverumcdal resit
is required prior to obtaining a MMY POVEL Nobo.ApplWOM forms for stamp-owmed POWTS are sabmood to Project AddreCs��(rf diet than marling address)
the Depatmaot of Safety and ptofesnooal Servim persaoal information you provide may be and for secondary the 1 /3z j 4 '
accordance with Law.S.15. 1 m Stats.
L n Worasatioa-Please Iaforaaatioa Pend#
Proptxty Oaoa's Name j.
le X� 3r) 0
Property Owner's Mamlerg Address Prey Loosdon 4-q L-
3Z Q GovL Lot
State yip Code Phone Numbs t t�Y. L..)Y, Saxton
T30 N; R�
EL Type of Building(check all that apply) Lot#
2 Family Dwdling-Number of Bodroom
D� �-- Subdivision Name
a.& �,,,o�,e� Block# 30
❑PubticiCon modal-Daizbe Use ""— ❑City of
CSM Number ❑Village of
❑State Owned-Describe Use - %d! PL
own of �S¢, �Q,.,� Ir.�-
Z :a� Gel w Z 4-ZZ G�•,Lu5
!Z)III.Type of Poraait: (Chock o one box on bate A. Complete line B II applicable)
A System ❑Roplacuoart System ❑Tposaocutfflold Talc Reply ..A Only ❑Other ModiScMM to awn System(explain)
B. ❑past Renewal ❑Permit Revision ❑Change of Pt+mtba ❑Permit Transfer to New List 0'a P /� and Dui Issued
Bef c o� t-:l l�l wf trt- 4
TV. of POW'I3 S one Cheep all Burt
Noo-prua a la-Groond ❑Pme w and ta.Grormd ❑m-tirade ❑Mound>24 is of suhable sort ❑ <24 in of st»mble aor7 G 5
❑Holding Tank ❑Odw Mpeml Cnapmeffi(explain) Pretrdtmmt Device(explain)
V.Die Area ltafornadoas
DesiBn Fir(G?d) I�ga Soft App Area Required( Area Proposed Sys
VL Tank Info ern Units Ivfanufscoaex v
New Talcs Existing TMIM /i✓ �',_ `�
'cry U3
Septic or Holding Talc
Dig
VII, Statement-I,the aadaaipaed, for hwbMatloa of the POWTS dwm on the attached
's Name(Print) Plumber' t"thuT8 Number Busmen Phone Number
Plumber's Address(Streak testy,State,Zip Cade ,-------------------r
1-,)Q.A—� TC—I --LQ AS�(1)12
NV MIHIL C eat use Only Permit Fa Die ]suing Signature
❑owner for _
DL Co for Disapproval 3� PI�O��t' +5 4J 1 Cam: O k cr ZV
fiK pttdtanIk e* ortfttterand , 1" �,, _- - (,-'11:.�
lispprsal ce"must ad§ft serotces t mainiauted
2: s ptxajr n i a gqet m eent pla/n pidroinvailtt�s:y plumber.
z-
lwrqaineme onet e G. a.•� U
Amaeb m aempYe ptaaa toe Ae aySlea aid.1smak m tk Ca..0 otdr ea papa-ut IM uaa s W-11 ieriec+a me (�
SBD-6398(R.11/11) I U
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 6/30/14
Owner:Todd Elliot
Location: SW 1/4 SW 1/4 S25 T30 N,R19W 30 acres 132nd Ave St. Joseph
In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specificatioret
8-10. Soil test
Signature
License number 26900
PLOT PLAN
PROJECT Todd Elliot ADDRESS 20932 Jamestown Ave Lakeville Mn 55044
SW 1/4 SW 1/4s 25 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATE 6/30/14 BEDROOM 4
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chambers 44
IL BENCHMARK V.R.P. Top of 2" pvc pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 106.0/105.0 4' below grade
132nd Ave
All P�P� g i in shall be SDR Property Line
30/34,within 10' of tank, 30'
piping shall be Schedule 40.
Pro 4 Bedroom
ST House
108110' 25'
104' 106' 368'
B-2
55'
80th St. 18% Slope B- 355'
14'
B-3 373'
Scale is 1" = 40'
unless otherwise
B-1 300'
noted
Vents
Vent
>6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area 341'
4' Long
12" 5.6ft^2/pair of end caps
34" Grade at System Elevation
B.M.*
1066' Property Line 300'
er
Cross Section of Infiltrator Quick 4 Leaching C h a m b
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
5.6ft 2 pair of end plates
Finish grade elevation
Typical Installation 110.0
Vent Grade Vent
3' 4" A31 X30/34 Septic Tank
99 5' Long 5' og 1
3691 Grade at System Elevation Grade at System Elevation
Spacing 5'
2-3' X 90 ' Cells
Same on other end Observation tubeNent
At end of cell
A
B
22 chambers per cell
System elevations:
A-1 06.0'
B 105.0'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page_d_
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner ! Tank Manufacturer: ❑ NA
Permit# t%$eptic ❑Dose ❑Holding VoIu me:/�,j'_r— (gal)
DESIGN PARAMETERS Tank Manufacturer:
Number of Bedrooms: ❑NA ❑Septic O Dose ❑Holding Volume*. (gal)
Number of PutAc Facility Units: 2I.M. Vertical Distance Tank Bottom(s)to Service Pad: (ft)
Estimated(average)Flow: yaCl (gauday) Horizontal Distance Tank(s)to Service Pad: /V)e� (ft)
Specific servicing mgchanics must be provided if vertical is>15 feet or
Design(peak)Flow=(estimated x 1.5): g (9811day) If horizontal Is>150 feeL SpecifMc insttuaMans to be provided an back.
In Situ Soli Application Rate. (gallday/fe) Effluent Filter Manufacturer: p NA
Standard(Domestic)Influent/Effluent Monthly average.. Effluent Filter Model:
Fads,Oil&Grease (FOG) 530•mglL Pump Manufacturer:
Bioohemkal Oxygen Demand (BODs) %40 mglL ❑NA Pump Model: . A
Total Sdids SS s150 mQfL
High Strength Influent/Effluent Monthly average Pretreatment Unit
(FOG) >30 miyL - Manufacturer: �p
(BODs) >220 mgA. `>�NA ❑Mechanical Aeration ❑Peat Filter
SS >150 m ❑Disinfection ❑Wetland
Pretreated Effluent Monthly average ❑Sand/Gravel Fitter ❑Other:
(BODs)(TSS) s30 -4 -Z6 Soil Absorption System
Facial Codform mean s10` nd(grewh) ❑in-Ground(pressure) ❑ NA
❑At-Grade ❑Mound
Maximum Effluent Particle Size 36 in dia.. ❑NA [3 Drip-Une ❑other.
Other: NA Otimer: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) combined sludge and scum equals one-third(Ys)of tank volume
❑When the high water alarm is activated
manth(s) (Maximum 3 years) ❑NA
Inspect condition of tank(s) -At least once every: s3
Inspect dispersal call(s) At least once every: month(s) (Maximum 3 years) ❑NA
Clean effluent filter At least once every: 1 month(s) ❑NA
Inspect pump,pump controls&alarm At least once,every: ❑ )s) NA
Flush laterals and pressure test At least once every:. month(a) IA NA
❑yWo)
Other: At least once every: a month(s) ❑NA
Other: ❑
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper).
Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware,kW*fy any cracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil
absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent
on the ground surface. The ponding of affluent on.the ground surface may indicate a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any treatment tank equals one-third(Ys)or more of the tank volume,the entire
contents of the tank shad be removed by a Septage Servicing Operator(pumper)and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.,
All other services,including but not limited to the servicing of effluent filters,mechanical or pressurized components,pretreatment units,
and any servicing at intervals of 5512 months,shall be performed by a certified POWTS Maintalner.
A service report shah be provided to the local regulatory authority within 30 days of completion of any service event.
GMW-005(02105)
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of palming products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concxntratlons are
detected have the contents of the tank(s)removedY a Septage Servicng Operator(pumper)priar to use
Pump tanks may foil above normal highwater levels prior to startup or due to.pump failures. Start up or restoration of power under time
conditions is not recommended,as the excess wastewater will bedisc arged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent.and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. Do not.drive or park over, or otherwise disturb or compact,the
are@ within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment
tanks and soil absorption system: adds, antibiotics, baby wipes,'cigarette"butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain(sump pump)discharge,fruit q nd vegetable peelings, gasoline, greases, herbicides, meat
scraps,medications,oils,painting products,pesticides,san M,,ry napkins,solvents,tampons,*and water softener brine discharge.
ABANDONMENT
When the POWTS fags and/or is permanently taken out of service the following steps shall be taken to insure that the system is Properly
and safely abandoned in compliance with s.Comm 83.33,Wisconsin Adrtiihistralive Code`.
• All piping to tanks,pits and other soil absorption systems shag be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator(pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
t soil oat system.
A suitable replacement area has been evaluated and may be utilized far the location of a replacemen absorpti Yat
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. 'Replacement systems must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area Is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and baring advances in POWTS technology,a holding tank may be installed as a last resort.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sod and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed.as a
last resort to replace the failed POWTS.
❑ Mound and at-Wade soil absorption systems may be reconstructed in place following removal of the.biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING TREATMENT TANKS., .PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT 13E POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER.
Name a u r✓ "�' . / Name
Phone �J�, y!�— j L �j Phone f q
SEPTAGE SERVICING OPERAT PUMPER LOCAL REGULATORY AUTHORITY
s
Name '� Named �r .
Phone Phone -1711 9 —
This document was drafted by the staffs of the Groan Lake, Marquette and Woushara County POWTS regulstory agendas in compliance with seC:tioM
Comm 83.22(2xbMlxd)d,(f)and 83.54(1),(2)a(3),Wisconsin Administrative Code.
.•.L :..._ • '�
FILTER .
:sets CARTRIDGE INSTRUCTIONS
MP 2 Dry TiT t11e Mw Lase ante the end of the outlet pipe to ensure R is
centered under the acom open*-. If aok then solar+nett mute pipe into the
tank tiaronyh the outlet or solvent weld(illue)addRkmal p*ato the outlet
pipe-
STEP 2 While dW case is$ir dry fitted an the outlet pipe,measure the Imlo
of u!i-inch pipe needed to brava the fiker to the tank end well if utitlaing the
optional to�We t,If side sapt�oit method.is not uHllmd,
4 79P 3 For k*telfdiDNe utfibing the optional suppiwyawtal side support:
solvent weW the X11-kscb pipe onto the fikn case. if 4"support method is not
Utilized,proceed to step four.
S's{vant weW the gker case onto the outlet e.
the into the case, down rive. insert the otter ^� r
rresshtg uMM the filter locks into the bottom of ry k
If a VRS switch is utitimd:insert into the Mber and lock by buying
clockwise g0e.
Maintenance
1. The effluent filter shook!be cleaned cave time th
serviced. ry aseptic tank is
2. Open the outlet access opening to inspect the tank and Bret
3- +'ump the septic table em"ristefY,making sure to renove the sludge "
iayer on the bottom of the tank and net jtut the scum and affluent.
4. Once the effluent level has been lowered below the irww t of the `
wm'*dgePfnunrtlne ease an the MtW handle to dislodge the
cob S. Slide the cortridge up and out of the case for cleaning.
Q V a VRS switch connedad to an alarm is prow*,the switch. 't `
hl be
ermn�by turning W and cleaned
with
7. While holding the cartridge an its skfa(large gat surface facing ,
down)avar the aaoaas opening,tiros aR the cartridge with water
Offt m*WM sure M saptage materiel Is rinsed but into the tank.
8. If VRS switcb is utiiteed,replace '
turni ng clockwise 90•. into finer and �/ , �,.
9. Insert the filter esrtvidge bads irde the ease,pressing down until � yr. �_ 'e''~•
the tike'lodes into the bottom of the ease. `
10.Repieca and sKWv the access opening on the tank-
C7 w.swat"e••�ft-"C:aH'It:7f(.� -1�"E-'2 r..:tiKt':.p:.vaJW.+v•.
wwwAW-ass UWkLCOM 877-MAMRS(6S3-4S83)
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing.Address_� `�� ����bu/n,/ �--- ��/S',� t/t%� mil✓ 5�0��
Property Address U �, Z
(Verification required from Planning&Zoning Department for new construction.)
City/State Parcel Identification Number � �'"// �j
LEGAL DESCRIPTION
Property LocatiOD�_ r/4,.-5C0 1/4 , Sec. N R W, Town of 57� aoS
Subdivision ��f� ,tui _. . Lot#
Certified Survey Map# ,Volume ,Page# ---"'
Warranty Deed# d ._ , Volume ,Page#
Spec house yes no Lot liner: identifiable
yes o
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its prc..mature 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 wash 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&Zoning Department a certification form,signed by the
owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site
wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is
less than 1/3 full of sludge.
Vwe,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 Departintut of Natural Rcaourcm,State of Wisconsin.
Certification stating that your septic system bas been maintained must be completed and returned to the St.Croix County Planning&
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we arn/are the owner(s)of the
property described above,by virtue a ware my deed recorded in Register of Deeds Office.
Number oo �//
GNATURE OF APPLICANTS) DA
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Uffice and a copy of the certified survey map if
reference is made in the watranty decd.
(REV.08/05)
State Bar of Wiscatsin Form 1-2003 8 0 3 5 3 1 5
WARRANTY DEED Tx:4025596
DocumMAl,osber per,Ieane
940562
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
THIS DRM,made bedweat David H.Raibrbad�.n , RaiLback.tre nd 08/24/2011 2:59 PM
andwife EXEMPT#: NA
(`Gnow,"wbedher one ormorej REC FEE: 30.00
and?odd i BBMtt and Kafterime T EBiott bnsbaad and wife � TRANS FEE: 450.00
lr " Oma•me)• *aka Todd Elliott and Katherine PAGES: 1
Elliott
Caaotor,far a vAmble conAkratian,conveys to Grantee the following described real Reoon t Ass
0810106 together with the roots,profm,fardm sad other approrte -%� bteregk ink
Cmk W-moimsfa MKb �m__x David J. Estreen
'nwSo &WWQuRrWof the SoutllwestQmkr(SW 1/4of the SW 1/4) 304 Locust Street
lying Eastmiy of W%b% y, Section 25, Township 30 North, Range 19 Hudson, WI 54016
West,St Crony County,Wisconsin ,
M-1AKMMa
Parod Ni m*w tt"
Mds k so hmesbW psopaty.
Graotar we.aolst oft We to the Property M good,inde&mble in fee simple sad free
and cim of mcururbraocss�easements,ements,notrknoas and ne swre ons, if say,of reeve&
Dated Ake o'—
(SEAL)
• •David H.RWMmwtr,II
(SEAL)
=Aria J.Raidoback `�•� �hZj•'�:
•'�OTAq ' ;
AUTHEPMCATWN ACKNOWLEDGMENT ••
Sigoatere(s) N • .o
ardeendmed an STATE OF r w ) :J' &wlj ••2-'
_,yu lj r N COUNTY ) ''�OF WISG3?`'1�
s
/� ,
TITLE:IrrI hMMt STATE BAR OF WISCONSIN Permo dly same before moon Aru 6 'j o tj
(if nK due above-named David EL 0. and Aria J.
authorized by Wis.Stet§706.06) Ram,bubmM sad wife
to me known to be the person(s)wbo eaoecu ted the foregoing
THIS INSTRUMMT DRAF nEO BY: mom and admowledged the same.
Kea OdML Estmm&OdMW
344 lmenst Street.Hndssa.W15/016 •
Notary Public,State of u.3 I e k vr.
My Commission(is pexmamas)(ems:
NOTL T11181S A STM HARD FORM. ANY MODWWATIG M TO T®S FORM SImULD w•CLEARLY EDWIN=.
WARRAKIY D® 02M STATE BAR OF W1SC01MSDM FORM M&1.2013
4 Typ erne rdm dpwweL N;O-PRO"Legal Fe a004e6-20xt sswrJntop,atomraoom
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PROJECT 4154 123rd STREET N.P.C.A. CERTIFIED PLANT
q 1,250 GAL, LOW PROFILE HUFFCUTT CHIPPEWA FALLS, WI 54729
PUMP, SEPTIC, HOLDING, (715) 723-7446 1 (800) 924-1516 MEMBER OF:
❑R GREASE INTERCEPTOR C 0 A C R E T E. I n C FAX (715) 723-7111 x www.huffcutt.con r 4 NATIONAL k MSCONSIN PRECAST CONCRETE ASSOCIATIONS
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NVisconsin 'ECFj'VF-0 SOIL EVALUATION R #1685
Department of Commerce 4 in accordance with Comm 85,Wis.Aim. t Page 1 of 4
Division of Safety and Buil9 2 ��I Schmitt Soil Testing,Inc.
Coun
Attach complete site plan on p.Ver4t jA6grCffYiW a 1 inches in size. Plan must St. Croix
include,but not limited to:gentitilrlld zontal reference point(BM),direction and
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.
_ 030-1066-40-000
Please print all information. Rw;ewed Dafe /
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). :� ! i j' �Ill v /�,7 /
Property Owner Property Location
Elliot,Todd Govt.Lot SWIM,SW1/4, S25,T30N, R19W
Property Owner's Mailing Address Lot# Block# Subd.Name or CSM#
20932 Jamestown Ave. na 30 Acre Parcel
City State Zip Code Phone Number City ]Village Z Town Nearest Road
Lakeville MN 1 55044 1 612-281-4433 St.Joseph I 132Nd Ave.
New Construction Use: ❑ Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD
❑Replacement ❑ Public or commercial-Describe:
Parent material Outwash Sand (Burkhardt- Flood plain ele tion,if applicable na fl.
General comments C�^eck_ �o f �✓(�o('�G 20�•��^ } a { `}7� �
and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft ratessible system elevation for Area 1
is(high trench) 107.50', (low trench) 105.50'.Slope of area is�18%. •'
10j.�=
F1-1 Boring# ❑ Pit g Ground surface elev. 110.00 ft. Depth to limiting factor 112+ 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 0-8 10yr3/4 none grsl 2fsbk mfr as 3vf .6 1.0
2 8-20 10yr6/4 none grcos Osg ml CS ----- .7 1.6
3 20-38 10yr5/4 none grvcos Osg ml cs ------ .7 1.6
4 38-112 10yr6/4 none /grcos Osg ml ---- ------ .7 1.6
'1 �:,' _ .�; ` r� 1 . 1. y ,• °1
"�.�'r r'YI •'E"`I'SG �n°�h•.r .Y"fit' "l./'�-. /'t V /, .
U
Boring# ❑ Boring
Pit Ground surface elev. 110.00 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD&
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-8 10yr3/3 none sl 2fsbk mfr as 2vf .6 1.0
2 7-19 10yr4/4 none sit 2msbk mvfr gw 1vf .6 .8
3 19-56 10yr6/4 none s Osg ml cs ------ .7 1.6
4 56-110 10yr5/4 none grcos Osg ml ---- ------ .7 1.6
I
V
*Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS s30 mg/L and TSS S_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 4/12/2012 715-247-2941
SBD-5330(R.07/00)
Property Owner Elliot,Todd Parcel ID# 030-1066-40-000 Page 2 of 4
F73 ] Boring# ❑ Boring
Z. pit Ground surface elev. 103.32 ft. Depth to limiting factor 111+ 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 0-10 10yr3/4 none sl 2fsbk mfr as 2vf .6 1.0
2 10-27 10yr4/4 none sl Osg ml gw 1vf .6 1.0
3 27-49 10yr4/4 none sil Osg ml gw 1vf .6 .8
4 49-94 10yr6/4 none s Osg ml Cs ----- .7 1.6
5 94-111 10yr5/4 none grvcos Osg ml ---- ---- .7 1.6
Fil Boring# pit Boring
Ground surface elev. 106.42 ft. Depth to limiting factor 108+ 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 0-9 10yr3/4 none grsl 2fsbk mvfr as 2vf .6 1.0
2 9-26 10yr6/4 none s Osg ml cs 1vf .7 1.6
3 26-62 10yr5/4 none grvcos Osg ml cs ------ .7 1.6
4 62-108 10yr5/6 none grcos Osg ml ---- ------ .7 1.6
/D r
F-1 Boring# 1 Boring
Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate lEl
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
*Effluent#1 =BODS>30 a 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.
SBD-8330(8.07/00) - Schmitt Soil Testing,Inc.
Page 3 of 4
Conducted by: Conducted For:
Schmitt Soil Testing, Inc. Name: Todd Elliot
Thomas J. Schmitt, CST 227429 Address: 20932 Jamestown Ave.
1595 72nd St. City, State, Zip: Lakeville,MN 55044
New Richmond, WI 54017
Phone: 715-760-1978 PI D: 030-1066-40-000
sigure
� / Lot No. : 5
Date _ /'/e? j/.2 Legal Description: SWIM SWi/4 S25 T30N R19W
■ Backhoe Pit Township, County: St.Joseph,St.Croix County
A Bench Mark 1 El. 100.00'Top of 2"pvc pipe, (South property line)
0 Bench Mark 2 El. 112.07' Top of iron lot comer iron pipe, (SE lot comer)
®Bench Mark 3 El. 97.64' Top of iron line point pipe, (15'west of BM 1)
Slope= 18%
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BOUNDARY & TOPOGRAPHY MAP lath•ConsalUw/usadda Sm load SuveyiDg