Loading...
HomeMy WebLinkAbout020-1380-32-000'Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (AT,TACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village X Township Richter, Daniel & Lisa Hudson Townshi ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing ti, __.. Aeration } Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic -. Dosing ~, ~._._ ~~ Aeration Holding PUMP/SIPHON INFORMATION Manufac rer Demand GPM Model Number` TDH ift Friction s System Head TDH Ft Forcem in Length Dia. Dis . SOIL ABSORPTION SYSTEM ~' f-t - `i - t v c. /~ County: St. Croix Sanitary Permit No: 3 0 State Plan ID No: ~ Parcel Tax No: 020-1380-32-000 Sectionlrown/Range/Map No: 11.29.19.2358 ELEVATION DATA ~~ ~3~ STATION BS HI FS ELEV. Benchmark rr ~ -- Alt. BM Bldg. Sewer 5.Z ``'t,~r St/Ht Inlet ~ ~i 1 c7 ~ 2 `-~ SUHt Outlet 7,Z c7.`1ti Dt Inlet .~ Dt Bottom Head~Man,T„_ 7 .7`1 ~ 7• , /© `7 Dist. Pipe 4 ~ `~ Ft ( A~ , ~.~~~ . c? Bot. System ~ ~ ~ ~ ~~ ~ a: i _ 9 (~ , L> > 9G~ I Final Grade .~~ q .'3~ st Cover ,~ ~~ ~ ~ .3.~ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. liquid Depth DIMENSIONS ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR ~ . v c' / ~. v ' Type Of System: l r (' W ~ ~ ~ , _ 2~- '' ~ i ,~ / ~\ UNIT Model Number. ~+`~ D15TRIBUTION SYSTEM - ~- ti ;~ ~ ~_.~ ~ ~- ~~=" <- /~ Header/Manifold n Length~r? Dia ~ t Distribution ,. - y pipe(s) ~,"" __.. ~- Length Dia Spacing / x Hole Size ~ x Hole Spacing ~' Vent to Air Intake SOIL COVER - - x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil (~ Yes 0 No j Yes IJ~ No COMMENTS: (Include code disc~epencies, persons present, etc.) Inspection #1: `~ / f `f / Lam/ Inspection #2: / / Location: 644 Packer Dr Hudson, WI 54016 (NW 1/4 SW 1/4 11 T29N R19W) Homestead Lot 32 Ll w Parcel No: 11.29.19.2358 1.) Alt BM Description = ~hc.; { e!(, ~ ~ r'/''~-` 2.) Bldg sewer length = '~L, -amount of cover = ~ ~ + .~ ~-~ ;" Plan revision Required? I Yes ~ No I~~j~/~ I (,~~ ~`- ~ ~ c cam'-_= J ~i I ~- / ~' ~`.~ Use other side for additional information. `_! ~~ _J i t ~_ I Date ~pctors Signature Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division County ,~ ~ 20f W. Washington Ave., P.O. Box 7162 iseonsin Madison, WI 5707 - 716 Sanitary Permit Number (to be filled in by Co.) De artment of commerce (60g) 266`3151' i~~4t' X53 3 ~-d Sanitary Permit Application i State Plan Ll~umber in accord with Comm 83.21, Wis. Adm. Code, personal information you pmvi~, . i T, may be used for secondary purposes Privacy Law, s15.04(i)(m) Protect Address (if different than mailing address) I. Application Information -Please Print All Information RECEIVED ~ ~'~ ~~t~~ ~~ Property Owner's Na me ' SEP 1 parcel M y J Block rY 0-/3~'D - ~ v~ 0 ~ L~ 2004 2 Property Owner's M ailing A ress 5T. CROIX COUNTY Property Location ~ Z .3 ZONING OFFICE ,,) ~~) l ~ S City, State Zip Code Phone Number w u•Section / t~. .J'~/ ~j (circle o ) ~ II. Type of Building (check all that apply) T ~ N; R~E o I~ // I or 2 Family Dwelling -Number of Bedrooms 7`' Subdivision Name CSM Number ^ Public/Commercial -Describe Use _ _-,_____ __-__ _ _ __-_ _ _ __ Stn" . /fir o ^ State Owned -Describe Use ~ I ST. ~ t~ ~~ ~] ~- ~ f` 1 d I ) [ 1 ~ ' _ _ -- . City _ Viilage I owttship ofJLE~ - III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New Systern ^ Replacement System ^ TreatmenUHolding 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 ~/~~ `~ 7th ~ ~~ 7, ~00 . j' J r f !Y. T of POWTS S stem: (Check all that a 1) Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil IJ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Corotructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter U Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Rtxircula S nthetic Media Filter Leaching Chamber ^ Drip Litz ^ Grav (explain) V. reatment Area Wor atlon: t 6 D (~Fl/Sh`~ 7.D . Design Flowigpd) / ~ Design Soil~lication Rate(gpdsf) Dispersal A~ Required (sf) ispersal Area Pr (sf) System le~tion ~ V u ~ 7 v ~tu~ VI. Tank Info Capacity in G ll Total Number Manufacturer Prefab Site Steel Fiber Plastic a oro Gallons of Units Concrete ConaWcted Glass New ExiatMg Tanks Tanks Septk r Holding Tenk _„ Aerobic Treatmerx Unit ~ '/ Y Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume rPaponsibilily for Installation of the POWTS shown on the attached plans. Plumber's Na me (Print) tuber' i gna MP/MPRS Number 8usittess Phone Number ~ ~~~ 9d 7/.~"~-~8 - Lb2D Pl u mber ' s Ad dre ss (S treat, City, State, Zip ale) / / 1 / / ~ ~ j ' L, ~ 1 / { ~ s~ VII unt /De artment Use Oni pproved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) ~ ~ ~ ^ O Oi R D~ Iss issuing Age t Signature Stumps) ~ Y wner ven eason for Denial d IX ~ondi il~t~s o~A~roval/Reasons for Disapproval - S ~ S ~ ~ eptic tank, effluent filter and ~ ~ `S/ `~ dispersal cell must all be serviced /maintained ~,c., ~ ~~ a~~:,~ i~~4~ ~-2 ~ as_per management plan Dr t b t h id `J '' " I _r y n ~~m nr ov vj] ~ 2. A-I setback requirements must be maintained as per applicable code/ordinances. Allan. r.. ..1~.~ -~-~ . SBD-6398 (R. 01/03) --- r---- .•.. -.~ ~~~~.~ .....n ..n .ne s's~em on paper nor teas man eu~ x r 1 mcaes in aze .. l~ ~ ~'7 1 p/u t~ ~7 ., «~k~ _S ~ ~ ~! ~ u.~i nil e r. ' / s ~.el.:.f ~ /~/ . ~ G ~ --- ~~ ;~:fir ....-~.1._....._.l ill~9%N1 L--" . _ .. :'~~ ~.~ -..... _.._. __ _.__-~_ • - c~u.Il'~~,e3 T~ .. ._.._.._ ----.---______..._..__ . -.-__ ._.,~ ~ ~ 31 oy ._____ .._ ._ ~ ~ ~7~ - ~ T ~. a s' o ,/ C r (,~tihRt(if Gb~~klu~~J a'~YUNCi~ ~ 3~~c~.aS ~ -'1 n., u c,~ 3x l.~t 5~ ' . l U c,-,r~l~w t Iv Qt~`~~5{IZ C lip -~h.er~ r~ ~ Q3 ply ~~p ~ a~ ~ ~p~', ~.. 'rnNk- W AIUo Z.b~ ~ i ~'~th. ~~ / i ~~ ~u ®_ ~Q ~~~ ~~)es 4~w ~~ mank Tp ~~ I ~ ~~~~`''' 0 c~~r~ ~~~ g mp~k ~"~~~.dbk~, ~u f.l~v - IOS.o? ~p~~ ~ . p R~ ~r< s h~ ~~~U ~~ ~~V' ~ 9~.v~ /// ' ~~ ~~~~. y IU ~ & •- ~_ ~ Wisconsin D~artment of Commerce SOIL EVALUATION REPORT Division of Safely and Buildings ,,, ,,.,.,..a,....e ,,,;~,, c....,.,, as ,nr~ e,~.., r.~o 1834 Page 1 of 3 A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), directio Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance nearest d. . . 020-1380-32-000 ~~~® Please print all ini~rmation, 04 1 5 n~ m o- ~ -. j P~.~~ p~ Re ' ^ ( ) ). cy Law, 1 . (P Personal information you pr ay ta u ~ u t ~.P e r ~ ~ ~ Property Owner ? Property Location Daniel & Lisa Richter ' Govt. Lot NW 1/4 SW 1/4 S 11 T 29 N R 19 W Property Owners Mailing Addr ~`'~'' ? " `°' '` ~ i Lot # Block # Subd. Name or CSM# 644 Packer Drive ~ 32 1st Addition To Plat Of Homestead City ~ State' T,~p_Code i~~horje~lumber _J City ~ Village 1l Town Nearest Road Hudson -"- unfcnown Hudson 644 Packer Drive 1/ New Construction Use: yJ Residential /Number of bedrooms 4 Code derived design flow rate Replacement J Public or commercial -Describe: Parent material Glacial outwash Flood plain elevation, if applicable General comments and recommendations: Install two trenches at 95.00' using 28 leaching chambers. 600 GPD na Boring # .~ Boring 1/ Pit Ground Su ace elev. 98.63 ft . Depth to limiting factor ~89~~ in. Soil Application Rate Horizon Depth Dominant Color R x Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsell Qu. z. Coni. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/3 none sl 2isbk ds as 2f,1 me 0.6 1.0 2 7-15 10yr4/4 none sil 2fsbk dsh aw 2f,1 m 0.6 0.8 3 15-26 7.5yr4/6 none Is Osg dl a 1f 0.7 1.6 4 26-73 10yr5/4 none s & gL, a ~- Osg dl gs 1f 0.7 1.6 5 3-89 10yr6/4 none s Osg dl - - 0.7 1.6 Boring # ~ Boring 1/ Pit Ground Surface elev. 99.27 ft. Depth to limiting factor ~97~~ in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. 5h. *Et'f#1 *Eff#2 1 0-8 10yr3/3 none sl 2fsbk ds as 2f,1mc 0.6 1.0 2 8-21 10yr4/4 none sil 2fsbk dsh cs 2f,1m 0.6 0.8 3 21-33 10yr5/4 none gr sl 2msbk dsh cs 1f 0.6 1.0 4 33-4 10yr5/4 none s & gr Osg dl gs 1f 0 1.6 5 45-97 10yr6/4 none s & gr _ Osg dl - - 0.7 1.6 * Effluent #1 = BOD ~ 30 <_ 22p mg/L nd TSS >30 < 1 m uent #2 = BODS< 30 mg/L and TSS <,~0 mg/L CST Name (Please Print) Signatur : CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osce , WI 54020 8/192004 715-248-7767 Property Owner Daniel & Lisa Richter Parcel ID # 020-1380-32-000 Page 2 of 3 Boring # .J Boring 1~/ Pit Ground Surtace elev. 98.72 ft. Depth to limiting factor >90" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-7 10yr3/3 none sl 2fsbk ds as 2f,1mc 0.6 1.0 2 7-20 10yr4/4 none sil 2fsbk dsh cw 2f,1 m 0.6 0.8 3 20-36 7.5yr4/6 none gr Is 0 sg dl cw 1f 0.7 1.6 4 36-73 10yr5/6 none s & gr Osg dl cs 1f 0.7 1.6 5 73-90 10yr6/4 none s & gr Osg dl - - 0.7 1.6 ^ Boring # -.~ Boring Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ::J 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ' Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mglL * 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. c v ~,1 Q~Q~(,~igGr'I~S~ ,~, ~ rc`' /Q ~' ~ n ~ ,LOGE-~d~rc~, ,Std e I Ca( / Q I `d ~t 3,z, / s t hod. Zo F%~ oF,~,4~rnCSt~st.c~, T . oT'r`l~d~~ ~~. i C;c~l- dc- Sam r~Q C~sr' 1Jr'i!/e ~ ~ ~~ ~ v~ - 4 ~h ~G P Iw. ~ Top off' qa ~a~ e ~c~•"-~d as~.~ ar, . ~s4rQq,~ C/Q/G.~uGn QL~Ga~rm of G~Qzn:,~~ / F.-,- 6 ~c: l e~,% Sew=zr~ ~ 9~ 5,2 ". ~ ~ fou.~ab.6rva, - ~ ou.n a ~Gti1. Assume~eltw :~oc~.co.' Boas 1 ~~~~~~ ,~ ~ 6 z ~«,d , ~ 99.sp' ~ ~ 99./9' _99.0; ~ ,~ ~ -P , ~i ~p V ` _ 83 . ~ '`` 9dto' _---__ySz~__ __~. ~~- s '~ ' j_ ~~~- Safety and Buildings Division County ~~ ~ ~ 201 W. Washington Ave., P.O. Box 71C2 ~seons~n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce ~(~8) 2~6-3151 S3 3 ~fl Sanitary Permit Application State Plan I.D. Number In accord with Cornm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) ~ s. '"': roject Address (if differ nt than mailing address) I. Application Information -Please Print All Information ~ yl~/ Lor ~/~' Property Owner's Na me Parcel Lot # Block # Property Owner's M ailing Address a Prope . oration „. ~ i ~' ' 6 S i Ci Sta a Zi C d ~ , , , ect on ~~ ty, p o Phone Number ~~ ~~ ~ ; ~~~ ~~ V 2 .~?;~ CUIa ' ' ~ (circle o ) T ~~ N; R~~E o~ ~ ~~ II. Type of Building (check all that app ~/ p~ 1 or 2 Family Dwelling -Number of Bedrooms -T ~ 1- - S tM~t Subdivision Name CSM Number ------------ ^ Public/Commercial -Describe Use ~3 5 - -i- ~ Sf , - -fo P ----- --- - - - - - -- ------- - -- ^ State Owned -Describe Use 2 3 x 8 ~ l 7City_L_JVillage Township of~~SO/~ III. Type of Permit: (Check only one box on line A. plete line B if a licabl PP o- - 3Z-~ Z3S8 A' New System ^ Replacement System ^ Trea UHolding Tank Repla ent Only ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permi ransfer to New Li P vious Perrr~t r nd Date Issued Before Expiration Plumber ner IV. T of POWTS S stem: (Check all that a 1 ) , CT Non -Pressurized In-Ground ^ Mound > 24 in, of suitable soil I_~ Mo d < 24 of suitable soil ^ At-Grade ^ Single Pass Sant) Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ holding Tank eat Filter erobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Chamber ^ Drip ne ^ Gravel-less Pi ^ Other (explain) V. Dis rsaUTreatm t Area Information: Design Flow (gpd) Design Soil~A pplication Rate(gpdsf) Dispersal ea R equired (sf) l Dispersa Area Proposed (sf) ysterp,Ele a io ~13 ~ ( ,C) U 7 c ~ ~ ~ l g 7U . f t ~ ~ 1 C) • U i VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Q ~-~~ ~ Concrete Constructed Glass New Existing a.1~ ~~~~- ~' ~ylv~ Tanks Tanks Septic or Holding Tank r Aerobic Treatment Unit Dosing Chamlxr VII. Responsibility Statement- I, the undersigned, stone rksponsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) ...-..-. P tuber's S' afore MP/MPRS Number Business Phone Number ~ / ~02 U "7" p q 7~J`~-.~O G `" IDoZ-D Plumber's Addre ss (Street, City, State, Zip e) ~~ ~D iu s3~Itf ~~~ ~ ~ J`" . D VIII. Count /De nt Use Onl Approved ^ Sanitary Permit Fee (in lodes Groundwater Date Issued Is uin gent Signature o Stamps) ^ caner n for Denial Surcharge Fee) ~ ~ ~ O~ ~ IX. Conditions of Approval/Reasons o spproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all I~@:a;~svl~ed /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. SBD-6398 (R. O1/03) •.v.~.. wmp~eie preps lro me ~ouhq ontyt for the system on paper not tens than 7fllL x ll inches in stze • ~ ~ -h . ._ .... ..... _... _.`..~ .. _. f.`• ...`..~ .~ ... .... r.... _. ~._~..r.~ _.__..__._....._.......__ ....._.~ ....... ~ ~~ ~~~ y . ~ ~ , _ ~. ~~~ Ql S'~~ 1{ ~ ~ TIZQNG~S pip ~ ~ 3 k 87 s(, Q3 ~~ 1~1~Q~C . s~ Iabu ~Y' ~c. ~ ~ A,~o .~ i~e~ ~4 X11 copy C~ ~ ~ e SQL iw ~o~0-ti ~IeQN c~S I-1 • X8.93 ~ ~ ~- 48.y3 r ~ ~ ,` ... _ T^.. ~A;;;q . 1~) ~~/~~ ,.~1 A . j] ~ ~~ h . ~ / ~.-~ . .---.... _..._._._ ..._ _ ./_ .1. .~. _..... _.._. __ _._~~__ .1~~ r.~1_. i° ~e~' .._. _ ._....._.. /.1~i~/~Lj .... _ :'n:~_. ~uu.m~..e3 der..: ... ' ~ _~~... ,_._._._.~._____.__..._.....--- -.._.,...~ c., ~~ ~Iv y +~ T°p `~ 3 _ `~ -- ~Q~- ~1 i ~! fq Fl<v-- (off : _ ~_ _~_~~ Q~~' sfd' ~ ~ ~ - T~~~~s p~~ ~ ~ 3k 87 s(~ a3 f ~~I B~ ~'° _ ± I ~ i~~p'Gp ~ I'~eR ~~,, 8. n1~u~c ys ~`~~~' 3~~'~ (~~p~ . ~ ~~~ ,~_ ~ ~ n O ~, ~ o ~., 56'x` C~ Wet? ~~ ~ ~e SQL s~. .~,-. ~o~o~, ~~~ ~~s I~ ~ 88.93 l.. - 9 $.Y3 1') // A,~~~/~~~II ..~ '~ A ~. ~ .s ~+ ~ ~v~ to ~ ^ r - K ~ h ~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings ,,,,,,,,,,,,,,,~,.,;~,, ~,,,~„„ a~ tnr~ non, ~~ 1298 page 1 of 3 A.C.E. Sal & Site Evaluations ~- --- -- -- ~ County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, a end distance to nearest road. .-~°~°~ . . 020-1012-40 ID# 11.29.19.546 Please print a op~1a'Son. ' Reviewed By Date ~ Personal irdormatbn you provide may be e~for secondary pu~ses (Privacy law, s. 15.04 (1) (m)). Property Owner ~ ~~'~ 11If ~ , . ~,, i i, ' Property Location , _ ) . Miller, Sam G' vt. Lot NW 1/4 SW 1/4 S 11 T 29 N R 19 W Property Owner's Mailing Address --~1 r ~ ~ ~ ~ ~' G~U~ L # Block # Subd. Name or CSM# P.O. Box 151 '`+ _ 32 1st Addition To Plat Of Homestead City St -Zip Code P ~ umber ' ~ ~ j City ~ Village ~ Town Nearest Road Hudson ~ WI \ 6 ~^~7~~$C~L769 ~ Hudson Packer Drive rv' New Construction Use: ~ Resi ~ ~I./ Pju¢~6lerpf bl~r6ans 4 Code derived desgn flow rate 60() v~'u J Replacement ~ Public or crsiet,= De scribe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Boring # -~ Ong ~~ > in Pit Ground Surface elev. 10 3.16 ft. Depth to limiting factor • Sal Application Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 1 0-16 10yr4/2 none sl 2msbk ds as 2f,imc 0.5 0.9 2 1638 10yr5/4 none sil 2fsbk dsh cs 2fm,ic 0.5 0.8 3 38-44 10yr5/4 none Is Osg dl cs lfm 0.7 1.2 4 44-72 10yr5/4 none s Osg dl: gs if 0.7 1.2 5 72-121 10yr6/4 none s Osg dl - - 0.7 1.2 Boring # -~..+~ Boring Pit Ground Surface elev. 98.77 ft. Depth to limiting factor > 126" in. Soil Application Rate H i D th min r D t Ca Redox Descri tion Texture Structure Consistence Boundary ' Roots GP DIft2 or zon ep o an o p 1 0-14 10yr4/2 none sl 2msbk ds as 2f,lmc 0.5 0.9 2 14-29 10yr5/4 none sil 2fsbk dsh cs 2f,lmc 0.5 ~.8 3 29-35 10yr5/4 none Is Osg dl cs ifm 0.7 1.2 4 35-81 10yr5/4 none s Osg dl gs if 0.7 1.2 5 81-126 10yr6/4 none s Osg dl - - 0.7 ~,~ "Effluent #1 = BOD ~ 30 < 220 mg/L and TS >30 < 150 L ~ Effluent #2 = BODS< 30 rng/L and TSS <~0 mg/L CST Name (Please Print) Si ure: CST Number James K. Thompson `7~'-- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number Osceola, vVI 54020 9/18/00 715-248-7767 .~ ~P .~ .~ .} ~~ . (e ~- .~ t~ p,pWnef Miller, Sam Pare ID # 020-1012-40 ID# 11.29.19.546 Page 2 of 3 Boring # J Boring rI Pit Ground Surface elev. 100.46 ft. Depth to limiting factor > 122" in. Soif Application Rate D i ti R d re T t Structure Consistence Boundary Roots : Horizon Depth Dominant Color escr p on e ox ex u *Eff#1 *Eff#2 1 0-12 10yr4/2 none sl 2msbk ds as 2f,lmc 0.5 0.9 2 12-21 10yr5/4 none sil 2fsbk dsh cs 2f,1m 0.5 0.8 3 21-26 10yr5/4 none Is Osg dl cs 1f 0.7 1.2 4 26-60 10yr5/4 none s Osg dl gs if 0.7 1.2 5 60-122 10yr6/4 none s Osg dl - - 0.7 1.2 Boring # Boring - Pit Ground Surface elev. 98.24 ft• Depth to limiting factor > 117" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-32 10yr2/1 none sil 2fsbk ds as 2f,1mc 0.5 0.8 2 32-60 10yr5/4 none ? 2fsbk dsh cs 2f,im 0.5 0.8 3 60-77 10yr4/4 none gr.ls Osg dl cs if 0.7 1.2 4 77-105 10yr5/4 none s Osg dl gs if 0.7 1.2 5 105-117 10yr6/4 none s Osg dl - - 0.7 1.2 .~ •b .~ .~ .} ,b .~ .~ ~- Boring # ~ Boring h to limiti factor > 113" in. ;~ Pit Ground Surface elev. 102.71 ft. ~ n9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 *Eff#2 1 0-11 10yr4/2 none sl 2msbk ds as 2f,imc 0.5 0.9 2 11-19 10yr5/4 none sil 2fsbk dsh cs 2f,lm 0.5 0.8 3 19-30 10yr5/4 none Is Osg dl cs if 0.7 1.2 4 30-68 10yr5/4 none s Osg dl gs 1f 0.7 1.2 5 68-113 -- 10yr6/4 -- none -- s Osg dl - - 0.7 1.2 ~- 9~ 5 «~ 9~ Y~' IFS ~ S(• 3~i Sl 3 S~. 3e * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L . t' .~ .~ .~ . "~ 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. - ~, 3 aF3 ~ Soi ~ D65erda~ pn ~; t Sca/e: / ~= ~o /off 32 o{P~e~oased ~ i~Add.~ /~kdso,-,, ~E .c~oTx Cow/. l . 8 • rr1. ~ T p off' 3/8 Pc.ba/: 8~ ~ ~ 8L io 8 3 s~ a. ^ ^ ~ ~ 8~ y77. (~/' ~!, : ~p of ~'rcb.T c~ Private Onsite Wastewater Treatment System Management Pian Septic Tank And Gravity in-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Fiow -Peak (gpd) ~ p Estimated Fiow -Average (gpd) v't) Septic Tank Capacity ( al) / Soil Absorption Component Size (ftz) g Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Com onent Desi n Flow -Peak ( pd) ~O ° 0 . ~ a r Maximum Influent Particle Size (in) ~ 1/8 Maximum BODE (m /L) ~ ~ 220 Maximum TSS (mg/L) ~~ 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once eve 3 ears Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the sept' k and outlet filter shall be assessed at least once every 3 years by inspection. T outl filte shall be cleaned as necessary to ensure proper o er inn. The filter cartridg a removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the f~^~"^' Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge 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 an 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. ~ ' 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 upgn the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standarols for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance,: and system use within or below the limits of reliable operation. Good water conservation practices by ail occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspectfon for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. in general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. ?_ Management Plan fora Septic Tank and Soil Absorption Component Plantings ofdeep-rooted trees and shrubs directly over or within ten feet of the . component should be avoided since root intrusion into the component may obstruct wastewater flow. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-4.680 Boumeester & Sons Excavating 386-9020 03,f 13f 2901 16:21 71-53868473 _... Ca~"V CAT PAGE 01 ~avttetarBoly+er ST ~AtV~X ~~Ul~'I'9at ~~3~' i'RC 'X'ANRG~ 11~f~1,t~'BNJI~IGR3 ~AGti~Bi~RRIeIT A,I~tD S2WNERS~#1R~ ~~R~'R'IFI~ATION R't?R~M c e ~' .~ (Yaritreallee obgah~cd lkom Fieruain; l'~epecueNp~rt far naiv Qve,elruatio~ ~~°' .,.". _„~,,.,,,_ Paaxael RdetatiCwrttion Nunnbcr _ 020 - j ~~ ' 3 Z - awn ~• Z 3 S'g> PnoFaxaty dam ~~.~'!+, .,'0., Sec. ~,, Tt~1-R.'W- ~owp of .~L:~_• $ttbd~iyeuira~t ~ ~ J ~ ~r° _, Lot # ,~~ . Cad l~+eirtrcy N~typ ~ VoRtttrte . _.... _ ~ Ftrgo ~ ~. ~~ p ~ C~ yes ~ Ro Lot litrat~ idcettel~able~yea ©ato ~rpeapsr aeo #ed eR' ee~pria syeuan cfluld r~aartt in to 4uCe 4itrrte to b~~e,~taa• ~ rater epi,ot 1M 11~as~ M 1~ ~' ~ , ~ aid 1by a tiaa~od Whet y~-n ppt lets tlMr tam teo track as a t .leµo is the ermete ~l y~soeen. ~ u e~ tW ~ to lit. C~OIx ~oeies Ues~tpttt~et a cattliioatios ib>•rorr, «IRaod ~ the t-tan~ ~11_y- e ~. twe~diedplutamiDer er * ilaeeeedptaoae~orT sroa:ityiugt tfret (I) the wr-site w-est~eraterr~rptaa4 s~gMta~ M W,rcopw' ~ r~voP C~j . !!!R'~~ tied giC ~eeaiety)f fba taaptk tttatlc is laq t~et-.1a~-,~adu adeire~. ~ 4 ie ~t~ tlirra ~ + ~# e~'qp to 1~intpiq ~s ptlvato ~ewy~e diaapataul ~~rw~~.gdt ~- ~trnd the ~ of lVetrerel R,eeaurrrce, :hate ~e!' i~lonAllRi1. ~ Rttpr ba cveted ~-d amid h- tha fit, ~roi~ Cam' Zoeaiwm~ a trtWM 30 ~~r of-Ilre tlmgtr ~rearr ~ daate. , `f pia°,' ~ ~ ' , 4~Fl-mod' ~-. ~A,~ ~~A11n.' . F . ~'~ ' ~ ~ . R ~~} dtaat ell ,..,,,, . a.: ~ ebe~ ~MAteenopt~ e~~ +u. aatr h+ a4e kit cf aety (tiwj lteowlaq~s, I (wej tort (eunaj 11ie ,(~~ ,~' ~ ~Y vitiae of ti r~ daeel recaerkd #rr lledlet~t~ o!' Desde {Dllicc. e.*oa4 pey lefarentatten a~ li telt#- ~ ~ ", . , . K~o~q-: repa>~ in toe ~"I" Ir,~g11 bei~i xavaload by ilt~ ~, ~•*~~ ~~ ~ttittde a1Nr tlde a1-~INeeti~,; a eM ' "~'~~ ~ x. ~d=!~+~nti'q- deal 0~prtit the 1~a~ietee o1" I)sede erltiaa • ~l-Y ~ MMt t~tlrkrl arrroey ttetgt if taoibrarr~t;s enede Irr tha errrtrrtmy dtaatd L~ \~ U 2 S 3'i -P 5 0 6 75'7695 4 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY~DEED . This Deed, made Grantor, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin pace is needed, please attach addendum): Lot 32, omestead 1~ Addition in the Town of Hudson, St. Croix County, Recording Area RATHLEEH H. MALSH REGIS?ER OF DEEDS sT. cROIx co. , MI RECEIVED FOR RECORD 83J2612084 18:08AM MARRAIITY DEED EXEMPT # REC FEE: 11.80 TRANS FEE: 286.50 COPY FEE: CC FEE: PAGES: 1 Name and Return Address ~' 020-1380-32-000 Parcel Idernification Number (PIN) This homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-oi-way of record, if any. Dated this day of March , 2004 * * 'chard A. Peterson * * Patrice A. Peterson AUTHENTICATION Signature(s) i racy ~. i urner - - -~-------Notary Public authenticated this _ _ q,~ _ __ * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _________ __ authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland_ Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT STATE OF ) ) ss. ~_ County ) Personally came before me this _s-~~~~ay of March____ , 2004 the above named Richard A. Peterson and Patrice A. Peterson, husband and wife [o me known to be the person(s) who executed the foregoing instru t and acknow d m . ..~ * Nota Public a of ~_ My Commission is permanent. (If not, state expiration date: * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, Wl STATE BAR OF WISCONSIN 800-655-21721 WARRANTY DEED FORM No. 2 -1999 m// /~~ ~~ , ~_~ J N14Y ~ R ORI~ w ~ ~ ~~ ~ / ~- if ~ ASS. I.OI ~ ~ .9LC io ~~~ ~ ~~ a e ~ '~` t a ~ ~~ / ~ ~ t i ~. ~• o J ~n ~? ~ _ .~ ~ ~ N r ~ \ ~ ~ ~ O+~ ` Its ~ ~ ~ ~ ~ _ ~ ~w \ ~ ~ ~ ~ ~ ~ ~ ~o~. ??' ~ ~ ~~ I ~ ~ o N o.,~; I ~ O .~ m w r / IZ ~ `° I ml ~ ~® I ~° p ~ w .p. ~I N / , tern ~ A j ~ ~~ / ~ W ' ~~ I O m O •~- f 3 I ~ // ~~ 1 rn '~ ? 502'44'43"W 261.77' I ' ~, I ~ ~?4~35'F i ~ ~' ,,~ N N \ ~ / / ~ 9'' N ~ti~'~ o ~ ° _ ~ ~ / ~'" of y N ~ I 1 \~~ _,~~ bq ! /9.46.• Z`rsy ~ ~ ~ N ~`~' L i~ `L v. U ' `~Pr :.. F W w r O 5~9. + ti~ pp 2 N N "t 1'; ~~°' y ~v r0 a; y D ~ J D n q c0 ~ -1 > v ~a V~ ~ n W ~ ~ N ~ ~N r O .\ c~ rn ~ ~ '"" W u ~n N ~~Z= -w ~ ~~ ~ A to ~O II 7C W O po~ N C W I v -DI ~ V ~• N 38.24' ~ ~ w ~+ 402.48' 271.90' N EAST LIN OF NW 1 /4 - SW 1 /4 SECTION 11 S00'29'S5"W 712.62• ~ I co ~ 0 o~ I 301.27' ~' w V 610.50 UNP~.ATT~D LANDS