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HomeMy WebLinkAbout040-1271-10-000 4 0 °'D' ° o ao o �r 4 o o m ov w-� coots tT Y h CM= a N 7 N j CD C c _ N N O °p_W'O O 'O ca C r.i a 3 N ELn y 0 w � mN uO) go 0 E N c ° ° o (D q . a 0 O N` O — C L �o o° E wa o ) 3 E umi'3 og w °o c o o c m 4) Tm mgt 0 3 N c y d °c 3� ° >c c c16 o — y O N O 'O V) cc A f0 f/1 O N Y `03 >aQ ° c@ E [V O'O O NE 14 M N p ayi 7E > 0o0 �Er V Z OV E o m y 7 x N E > l4 = N O m 7 f4 N y N in Y > 0 0 N•- 0 LL `o_ °�co f0 a)cw 8 o m= 3 (1)=0-0 w ° v ° o c o a� E o z o q r�ia c m.� Na 8 o I v a) o - Z iii 0 i+i W O G o O.`p 0 v m c he ° E co w a. m a:3 vi L E N P Z _ E O.c h ° 0 :3 w v E E (D a> �w °c > ; O Z V a ov ° $v �i Z c (_D 0 w �- •- a o c•N E O p N A N Co O.0 o E rn� p-0 c -02 a- coo > N y 2-6 O 0) •�'►� C c r C O O L X 1 0 7 O .-02)-w x N 0 = z z = ro o >^ � ?� c w O o N U) U) U) j x �`V H N V d U. C �i m000 •N Eaaa - r a m 0 N J U o o Z y N Q o v L O N _ Z E U W N O O U) a O m CO'7 A m Q V) ° c ° E cl O I� O o � o m C un' o V P O O M w N ~ O M ~ ° N ° m ti o 0 >, m o U I • �' cs N H 2 O O Z y W (L U) r � I V� m R € a r 0 .2 ` d .� E C A 0 C a 0U) V Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574330 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Hartman Homes, Inc., c/o Michael J. Hartman Troy, Town of 040-1271-10-000 CST BM Elev: / Insp.BM Elev: BM Dgjcription: Section/Town/Range/Map No: C'2 C y z. ;J 2 Rf(� 20.28.19.1498 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 2 9s, 0 Septic Benchmark /2"/ .C) �S�C' Dosing �� Alt. BM Aeration Bldg.Sewer � �� 2 9oM1 ,Z` Holding 11 St/ t Inlet 7• p0 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. ent Air Intake OAD Dt Inlet A� ;/1-1 - i Septic J i l 3 w/3 Dt Bottom o 9S - Dosing 1 p / Head /Man. � 9'1 Aeration Dist. Pipe Holding P Bot. SyWsm r cfL 4'r, Fi al Grade kZ PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM �l / Model Number _ I /s-� TDH Lift Friction s System ea TDH Ft Forcemain Length�a Dia. Z „ Dist. SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No.Of Trenches PIT DIME ONS No.Of Pits Inside / Liquid Depth / DIMENSIONS --7 /7i /),Ul -nd SETBACK SYSTEM TO P/LIE BLDG IWELL LAKE/ EAM LEA ING Manufacturer: Q e S INFORMATION CHA B OR Type Af,$ystem: � f_O, �r � UNIT Model Number: ?�; p�•J� �. DISTRI ON SYSTEM f Header/ anifold Distribution [J I �� x Hole ize x Hole SSpacing Vent Intake L Dia l Length "�' Dia Spacing t SOIL COVER x Pressure Systems Only x Mound r At-Grade Systems Only r Depth Over Depth Over xx Depth o p xx Seeded/Sodded M BedrFrench Center Bed/rrench Edges Topsoil Yes No Yes No c f COMMENTS: (Include code discrepencies,persons present,etc.) ilnsp ction#1: � / ate/ 7 ? Inspection#2: Location: 457 Windy Hill d.Hudson,WWII 5 16(NE 1/4 NW 1/4 20 T28N R1 9W) Troy Woo Lot�2'Z "�` Parcel No: 20.28.19.1498 1.)Alt BM Description r 2.)Bldg sewer length=3� ' �- U-,,-P-- Z- Q17'1 -amount of cover=> I g/�� Q� ,(!p, ti > q2" Plan revision Required. [-I Yes ,_ o Use other side for additional information. SBD-6710(R.3/97) Date Insepctors S'gnatur ,� rt N �tiJp�l J a i Q I I KUILifn on A OE QN-1 l gs,11C Z s �� c WAY o OW - �o1.W_Wssh' nAt+ .P.O.BGrat7162 g by Co.) ,.- ,WI 53W-7162 3 30 sm�eTraasac�m TT S't• mry Permit D 1 7 I V In ,Wis.11u�ea 'u at assubwmiftd 10 PfopdA*kM Une wrtltffie - S.13 M S� , z S H— r ran H 040- 1271 . k3 DDO Ff%MtY 05-A ftwerty gyt3WradsA �� l Z�J`ilb ��I�MO 'f RAIL N ��V aw V, = zip Coft ciw�Soft II.Type of 1.Mog(ChgekSU VW apply) i acf �Mob xx_of ❑stat OUwd -7' x �bez oe iiue A. Go�PIe#e�B if } �Type of Perneit+ (tom�9 Taeic Rspla Oah' []OgM �D (om) Airs II3 ❑T IistPied�us p�Nmm6a end� B. ❑Pec�it []ChwVGfPhUjw ❑?e 13 ftus&RwM3M Traasf��°New Owner Be&xe Expicafm G'itied�aII Owt O l�<�in.of�� �... N T afpow" >24bLOf N..prate U*°aad r1 P ❑ e t . D Tee aO&Wct � V. Sir TOW #of VI.Taub Iu#o m Galte� alb —� — Sep&� T� SbC� gDt� f� oftiePOWTS a �eatelam p6weNanber s Doe a (,Z5^ �' -6 � � new ❑ ttsasoa axumt UL Can 'b1 ++ '� n rP=raj 3 J,l '� n� , " � `r+. 1.� ptid' tank,ettluhnY ✓ `° f fli jorsal c must ah be services/maintained nane r 1 ag l,erl� gement plan provided by plumber. eMentsmAt be'maintained A, «Ji.[► n pef 7 ordinaw+o � j> � T9 'a:p er` to Aift& AJ / SBD.6398{R.S I/il} JEFFERY V FOX Page 2 5/30/2014 • Limit activities in the area 15'beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. ' Sincerely, Fee Required$ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L orf Please Include a Copy With Your POWTS Plan Reviewer, tegra ed Services -Payment Submittal. (715)634-7810, Fax:(7 5) 44-5150,M-F 8:00 a.m.-4:45 p.m. WiSMART;code:7633 r pat.shandorf @wiconsin. ov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. AR T DIVISION OF INDUSTRY SERVICES O �'T 10541 N RANCH ROAD HAYWARD WI 54843 Y Contact Through Relay www.dsps.wi.gov/sb/ www.wisconsin.gov SfONP1 Scott Walker,Governor Dave Ross,Secretary May 30,2014 CUST ID No. 223242 A777V.•POWTS Inspector JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING&SEPTIC INC ST CROIX COUNTY SPIA PO BOX 565 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 05/30/2016 Transaction ID No.2401710 Site ID No. 802125 SITE: Please refer to both identification numbers, Josh&Kim Kluge above,in all correspondence with the agency, E Cove Rd/Windy Hill Rd Town of Troy COND{ St Croix County APP NE1/4,NW1/4, S20,T28N,R19W FOR: DEPT 4F Description:Mound,4 bedroom residence P1:ZOFE$S1t) Object Type:POWTS Component Manual Regulated Object ID No.: 1484790 �c� Of iN Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original gradeQ$'�9t 9 Mound Component Manual-Ver.2.0,SBD-10691-P(N.01 101,R. 10/12),Pressure Distribution Component Manua - Ver.2.0, SBD-10706-P(N.01/01,R. 10/12), SSWMP Pub.9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Co SEE CO and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be co cted and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. No person,may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans.In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound component manual are complied with.A copy of this information must be given to the owner upon completion of the project. • The bottom of the distribution cell shall be level per the Mound Component Manual. The"D"dimension shall be a minimum of 10". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual • The proposed pump is near its limit with the proposed total dynamic head. If upon installation,the total dynamic head increases,the proposed pump must be reevaluated and may be inadequate. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. JEFFERY V FOX Page 2 5/30/2014 • Limit activities in the area 15'beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs.SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L orf Please Include a Copy With Your POWTS Plan Reviewer, tegra ed Services -Payment Submittal. (715)634-7810, Fax:( 5) i(4-5150,M-F 8:00 a.m.-4:45 p.m. WISMART code 7633' - patahandorf @wiconsin. ov A cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484 -Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1,2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. 4 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Josh&Kim Kluge Owner's Name: Owner's Address: 20416 Evirton Trail N. Forest Lake MN Legal Description: NE1/4 NW1/4 S20 T28 N/R19 W Township: Troy County: ST. Croix Subdivision Name: Troy Wood Subdvvsion ONALLY :OVE o Lot Number 22 Block Number: 11 TY AN0 AAL SERVICES Parcel I.D. Number: 040 1271 10 000 )u FFVICES Plan Transaction No.: Page 1 Index and title Page 2 Data entry itE5P0 E Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications t, i . / C ol Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 plot plan Page 9 soil test Designer. Jeff Fox License Number: MPRS 223242 Date: 05/22/14 Phone Number: 715 755 2461 Signature: / . r Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P(N.01/01,R. 11/12),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01,R.10/12) Version 7.0(R. 11/12) Page 1 of 9 I Mound and Pressure Distribution Component Design Site Information R Residential or commercial Design Note: Sand fill(D)calculations assume a 400.00 Estimated Wastewater Flow(gpd) Table 38344-3 in-situ soil treatment for fecal col"dorm of-36 inches. 1.50 Peaking Factor(e.g. 1.5= 150%) 600.00 Design Flow(gpd) 1.00 Site Slope(%) 91.10 Contour Line Elevation (ft) 26.00 Depth to Limiting Factor(in) 0.50 In-situ Soil Application Rate(gpd/ft2) Distribution Cell Information 85.00 Dispersal Cell Length Along Contour(ft) = 7.06 Cell Width(ft) 1.00 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? e Center or End Manifold 2.35 Lateral Spacing(ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter(in) 3.00 Orifice Spacing (ft)= 7.14 2/orifice 2.00 Forcemain Diameter(in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 85.00 Pump Tank Elevation (ft) P 1.66 System Head (ft)x 1.3 6.52 Forcemain Drainback(gal) Vertical Lift(ft) 114.82 5x Void Volume(gal) Friction Loss(ft) 121.35 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 452 System Demand (gpm) 12.731 Total Dynamic Head(ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options I choice in. dia. options I choice 0.75 1.25 1.00 1.50 x x 1.25 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator Treatment Tank Information Total Tank Capacity(gal) 1250.00 Septic Tank Capacity(gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity(gal) Bear On site Filter Manufacturer 22.24 Dose Tank Volume(gal/in) Bear Onsite Filter Model Number Wieser Manufacturer Project: Josh & Kim Kluge Page 2 of 9 Mound Plan and Cross Section Views . . . . . . . . . . . . J . . . 1/10 B Observation Pipe - F4- K A W . . . . . . B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L Mound Component Dimensions A 7.06 ft E 10.85 in H 1.00 ft K 7.98 ft B 85.00 ft F 9.50 in z 7.06 ft L 100.96 ft D 10.00 in G 0.50 ft J 6.19 ft W E20.0.31 1 ft F 600.10(ft2) Dispersal Cell Area 1200.00 (ft2) Basal Area Available (gpd/ft) Linear Loading Rate 8.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 93.73(ft) H Q2 G .F Dispersal ....cell 92.43(ft) Lateral 91.93(ft) . . . . . . Invert A Dispersal Cell p Elevation E . . . D . . . . . . . . . . . F 41 .0 91.10(ft)Contour Elevation 1.0% Site Slope Geotextile Fabric Cover Shading Key 4 in. + Dispersal Cell See lateral details on Topsoil Cap dia. 1.5 ft age 4 for number,size, Subsoil Cap slotte and spacing of laterals. d 0 Laterals are equally ASTIVI C33 Sand obse F spaced from the Tilled Layer rvarti 0.5 ft Typical Lateral distribution cell's Aggregate on 0 centerline in the pipe A distribution cell(AxB). Project: Josh&Kim Kluge Page 3 of 9 End Connection Lateral Layout Diagram 1h.A :.F?dim-n=i_n •=Turn-up•.i ball.ra l..a.-.r claan out plug P All lateral= id�rai,-al 1-X-•) Hs,[ drilled cr,the bottom,of the lacer al equaflq ML;-=it�rial:=—'--�forcemain �Irh 40 per ',-Pc-Table:--84 %0-� Number of Laterals 3 Orifice Diameter 0.16 in Lateral Diameter 1.55 in Orifice Spacing (X) 3.05 ft Lateral Length (P) 83.43 ft Orifices per Lateral 28 Lateral Spacing (S) 2.35 ft Orifice Density 7.14 ft2/orifice Lateral Flow Rate 15.08 gpm Manifold Length 4.71 Ift System Flow Rate 45.23 pm Manifold Diameter 1.50 in Total Dynamic Head 12.73 ft Forcemain Velocity 4.62 sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC W n Tank component is properly-WeRnfiRr— 'AdMate outlet location B Forcemain diameter Wieser Manufacturer 2 in. Capaci!4 800.00 Gallons Volume 22.24 gal/inch Weep hole or anti- Dimension Inches Gallons siphon device A 17.61 391.75 B 2.00 44.48 Pump off eL-vation 00 C 5.46 121.35 r 85.-9-11 D 10.90 242.42, Total 35.97F-800.001 Dose tank elevation(ft) 3" Bedding under tank. r- 85.001 Alarm Manuafacturer Septronics Alarm Model Number MJJ1 Pump Manufacturer Zoeller Pump Model Number BN152 Pump Must Deliver F---45-2--31gpm at F--—12-73-1ft TDH Project: Josh &Kim Kluge Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Jeff Fox Phone 715 755 2461 POWTS Regulator's Name St. Croix Cty Phone 715 86 4680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.1 z Maximum FOG 30 mg/L Type of Wastewate Domestic Maximum Fecal Coliform >10E4 fu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure Systeml Laterals should be flushed and pressure tested every 1.5 years Moundl Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30(6)(i), Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ....�........•. Grade ............... \ ,� 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box . . . Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Josh &Kim Kluge Page 5 of 9 ■ ! ! ! i p,M UNUTE 3s p,_n.'',; •.1E +f ' 7[ R t -1 " may: moms _ MODEL �:�. 64 Wa Q 231 el 231 201 53 f 4r� Wo 52 197 30 25 26 i ® 2i � 23 _ 22 85 7rcrrT3f Hawk i a"IL 4g 60 too ., y pm WROM !�' S &7,M f i - 3 7A lid Acb TIS r .� -- r �•do <r v us is _ - 0 smoopmWamd r - .-"c+SAA i 1-i IN KLl'l,C L r Cl_ ` TL v tit t�ne� i)y NW (A) sZc)°T'2R L*4 lLL �N IIJp� i [ it 61�1?�GE 11 R CD ' M t� Z)1 S8 l rq w nA D F I\1�, &2 CL = 100 c- a SO(L ►z�►J(,� Ho property owner Humbird Land Corporation Parcel ID# pending Page 2 of 3 2 ] Boring# Boring ft. Depth to limiting factor 45 in. Pit Ground Surface elev. —91-0 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots -GPDr *Ef1#1 *Eff#2 1 0-11 1 Oyr3/2 none sil 2rnsbk mvfr as 2f,1m 0.5 0.8 2 11-15 1 Oyr4/4 none sil 2rnsbk mfr cw 1f 0.5 0.8 3 15-25 7.5yr4/6 none sil 2rnsbk mvfr cw 0.5 0.8 4 25-35 7.5yr4/6 none gr.sl 2rnsbk mvfr cw 0.5 0.9 5 35-45 7.5yr4/6 none sl 2msbk mfr cw 0.5 0.9 6 45-52 7.5yr4/6 cap 10yr7/2 sl 2rnsbk mfr 0.5 0.9 7.5yr5/8 ❑ ng# Jng �j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ---.-GPDlft2 *Ef1#1 *Eff#2 Boring # ng Bori F-1 -i Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Hodzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots — GPD1ft2 *Eff#1 *Eff#2 III-------—----------- Effluent#1=BOD?30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD5--i.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. • 1340 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code Gustum Septic Service Attach complete site plan on paper not less than 8'/:x 11 inches in size. Plan must County St.Crobc include,but not limited to:vertical and horizontal reference point(BM),direction and parcel I.D. /,,� percent slope,scale or dimensions,north arrow,apd lecatiorreAd�istance to nearest road. DyD �—��"(SU 0 Please print 0'4 0" .>yo».. \ R By Date Personal information you provide may be up"Se�ndary purW(Privacy Law;s�k5.04(1)(m)). Property Owner Location Humbird Land Corporation Go .Lot NE 1/4 NW 1/4 S 20 T 28 NR 19 W Property Owner's Mailing Address I w 7 �I Cat"# Block# Subd.Name or CSM# 332 Minnesota Street, East 140 22 n/a Troy Wood Subdivision City State"�ipbode Ph(Mtflumber ��j City J Village #�j Town Nearest Road Saint Paul I MN 5101 z ��2�1�- 55,, Troy E Cove Rd/Windy Hill Road e New Construction Use: M Resicl"4j,/4tintb4r of'He�r ms 3 Code derived design flow rate 450 GPD J Replacement J Public or comin eta:bescribe: Parent material loess over shale bedrock Flood lain elevation,if p applicable n/a General comments and recommendations: Part of 1.64 acres. BM#1= 100.0'. BM#2=92.6'. Recommend mound system along 91.1'contour. P53 from preliminary boring work done 5-5-00. [F53 Boring# l Boring t1 Pit Ground Surface elev. 91.2 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= *Eff#1 *Eff#2 1 0-6 10yr2/2 none sil 2msbk mvfr as 2f,1m 0.5 0.8 2 6-14 10yr3/4 none sil 2msbk mfr cw 1f 0.5 0.8 3 14-18 10yr4/4 none sil 2msbk mvfr cw - 0.5 0.8 4 18-36 10yr4/6 none sl 2msbk mvfr cw - 0.5 0.9 5---- 36-50 10yr4/6 c3T5yr3/g 2 sil 2msbk mfr - - 0.5 0.8 Boring# J Boring e Pit Ground surface elev. 91.0 ft. Depth to limiting factor 26 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft2 *Eff#1 *Eff#2 1 0-10 10yr3/2 none sil 2msbk mvfr as 2f,1m 0.5 0.8 2 10-14 10yr4/4 none sil 2msbk mvfr cw 1f 0.5 0.8 3 14-26 7.5yr4/6 none sil 2msbk mfr cw - 0.5 0.8 4 26-35 10yr8/3 none UWB m mefi - - 0.0 0.0 *Effluent#1 =BOD?30<220 mg/L and TSS>30<-1 50 mg/L *Effluent#2=BOD5<_30 mg/L and TSS<30 mg/L CST Name(Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St.,New Auburn,WI 54757 11/17/00 715-658-1344 Property Owner Humbird Land Corporation Parcel ID# pending Page 2 of '3 F2] Boring# 2j Boring Pit Ground Surface elev, 91.0 ft. Depth.to limiting factor 45 in.. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 I I I �- *Eff#1 *Eff#2 1 0-11 1 Oyr3/2 none sil 2msbk mvfr as 2flm 0.5 0.8 2 11-15 1 Oyr4/4 none sil 2m'sbk mfr GW 1f 0.5 0.8 3 15-25 7.5yr4/6 none sil 2msbk mvfr CW - 0.5 0.8 4 25-35 7.5yr4/6 none gr.sl 2msbk mvfr CW - 0.5 0.9 5 3545 7.5yr4/6 none sl 2msbk mfr CW - 0.5 0.9 6 45-52 7.5yr4/6 c3p 10yr7/2 sl 2msbk 'Mfi - 0.5 0.9 7.5yjr /8 -.1#Boring Boring Soil Application Rate ❑ Pit Ground Surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color I Redox Description Texture Structure Consistence I Boundary Roots GP /ft, *Eff#1 *Eff#2 �j Boring# Boring F-1 j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color I Redox Description Texture Structure Consistence Boundary Roots GPM' *Eff#1 *Eff#2 ---------- --------- Effluent#1=BOD?30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD 5-S 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. I _ c 'v O v c m c O C N ^^ Om V N O Mo ") 00 �N v i z m mzsoJ3 E g F Z rn U x o c o 0 Eg_cm Z. o J 2W Mfrg�F 3z p cz U_ a J� a� Up O o J Q a J� -0� mop -° o O Vi N -w_______________.__ m _ --- ----------- --------- - ------------ J Ir Cl-d 0� m 7 n C N N O d S O m Q oui- Alj@dojd w CD x U Q m _ d = I I O r, O N O N H O Q' II w w_ w Q � U II II ■ N J O] m O� ST. CROIX COUNTY RECEIVEFD SEPTIC TANK MAINTENANCE AGREEMENT AUG 0 4 AND ST CROix Cod OWNERSHIP CERTIFICATION�F/ORM ,OMMUN/7-y dEVELON MENT Owner/Buyer �Q�4t1 -6Y tea VTi�'Vl G Mailing Address 7q y &okt-, �qe 1412 A Property Address .-4– /-/5 7 W%V%A!i yt, �/ (Verification required from Plannin Zoning Department for new construction.) City/State Litf(� -0, / Parcel Identification Number O(/(,) ��-71 ` /0 060 LEGAL DESCRIPTION Property Location Nc 1/4 , %4 Sec. T 29 N R--O—W, Town of 77!�� Subdivision Plat: (�y Vl�tr�11 ��B, , Lot# Certified Survey Map # / , Volume ,Page# Warranty Deed# 7(' 9 j (ol (before 2007)Volume �3 ,Page# Z Spec house[1yes0ao Lot lines identifiable❑yes❑no SYSTEM MAINTENANCE AND OWNER 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 every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§SPS.383.52(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. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning&Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are rue to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a warranty dee recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICA DATE ***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 Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) t , I �. 11 ,+,.s bo xt 67iI9 A\. � �` � � " `lL�i�W`TFiE NWt/4 OF THE VW�,�4.THE NE 1/h OF THE'SWt�4 THE SWil/4, THE$W1/4,AND THE$E7/4 11— I i $ � R"3 TI X14 F r#10f_ 1T ANp THE hl41 , OF THE"WTA l©F- E T1QN , , AL.1.IN 28N.R'4gw Tf1WN';OF I'll elf r irRl�?X 1�f�1T"' ", ,I QMIIN BEE$HFE1 �';� A 13 F III_ \v F f s � `✓ ,�, v v �� �i, t>rtRKt /� \ u►ro-ue' ,, \, ,�,�s'roaMZtssl':►a ;;,f 11 \I * y.c, 20'CMAINAQt f; I I O,t ', iR \ v_ vv r�J �_ \\ �!]SA/t,tR o , �." �\ \� \�`\ < ', ,a0 AQRttI .��� r. !I� 11 MN'1NIO;t1AtIMQ '"�, Y V C v AV; q A PYD t10 FT > 1 O >N�1dIL ��f pp +�y, ,r A .1 J A V� a ,�I \:\\ N'___I'll �1e , , '1l 4 1 \ �±!�\ �\ 1\ �yF _ 1 I N , ;e 1' neon t7"111ftf� \:\ \,11_ tAnvf�pwul.la.16l1t11 M I F."'....",.a., � I z(OP :����I , `'� 34 �� , 1 °' _I _ :; a ., �;16 . , ;111,� 1 �, ;�� x. �y�� 9 1 �� J'J 11 J ✓i !, 1Py 66. �� t " l� (� �. � _ �1. \\ irrr ',.�0 X11?744.a'qR �� 1 ,a � >:li /�r7`s P w",e °ovnrwa"w �� � �„ a�e.7W abtirt7 .t 1 s + i 1 i m I ��f/r ° �''+4c ' _� xvr 't , s *� i i i r Q e,V4 °oR �Q 1 �� r �'q l� t t Y1CNCI 1 i 1 i ,�+ �,�A , �\ `' ! ry t� 0.'74pr rr r 1 \ice\\ \� r I a 1 11 # $ f d 1 `� .: ,11 \� 1 ._ / 'I il"\� J Pte ; �� 1 1 \� > ; e Y t\ , 1 .J 1 >•I `. ft.t{s AORtt I 11 - _J 11, T e� t y , , � 'a 1 i 8 1 1:W AORB� i ` t�a xalt$P nk' " t 2 ti '� 1 j 11034 ,Ke" i x Y ' i .t � ,tn �, a _ zv orwwwc ' �'TO.I'��Xf��" - � , I I\\ �FJ19[MgVt" p ,��,��,',�,,� ,,',,�,-"::,-.,'�,l �,�­ �­ ,"I't IW�e _ t \,� ?..WI/-= 1 1`_ �= 1. r J_ /�� )!v K 7bQ�O 1°T � > a 1• .�� 41A0 1 n A V'„^� a�; /. 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YAft t 't7:,1ti7 6p:f7, .�ZB^ .: ' '1.11'4" ..NmRanw(.4wtriaMU.a0rlMe.weoawesa^ww.►.- --1 -- � - 'IS ] 'La.� +�rn;;,ro. a. >Rwa.wo...«sm.r.r�a.ow.+s.�we.w.r+I'll aunorM .w"�.w..�y....ne".aee.Mn,ow+rr mma..,om.I,L TIJI$WSTgUMEt7f bFWF75q @Y W�ILVIA MANE Awn ei .aww...rAww'�b Mew pr,..ar-.ur. 71v Viµ' i Yar I w..alnea...wraS.w�.ra.ao.dMt e.1n m.+.,rrrt:+.. :� :t�o..1.y pew au.n w +W aaq a�naEn 11 pr pc 1 nagp.,!m nm a.yo •a wee .w..ew...rswx,.M.w..rw.. " toa Wagb l.a^ ,eMMI.MNN..kUmw�.Mewe�a,. W: w1MO.,.MS.wpgew.oeMeaeo'larin.. R' r7 I�a � ' r n�' �. . &xa k :. � .� re,x a, 'r Yf!F .4�hkY,"rr.nr-+fe ,�°�.�t'waxy.+ �K., w x�."' .11 ._ .. _-'- ten. .... ��.e9 Es,t... __ ,.,i"2'_aE 7S!firZ E'>r=. i U 2 6 1 3 P 2 9 S KA'T'HLEEN It, 44LSH REGISTER OF DsEDS STATE BAR OF WISCONSIN FORM 1 -1999 ST. C 11311 CO, , WI Document Number WARRANTY DEED RECEIVED FOR 3ECORD This Deed,made between Mary J.Haun 07/05/20023 0.1:00Pt1 WARRANTY DEED t4E?!ji l Grantor, and Hartman Homes,Inc.,a Wisconsin Cor oration REC FEE:: 11.00 P TRANS FEE: 282.00 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor,for a valuable consideration,conveys to Grantee the following described real estate in St.Croix County, State of Wisconsin(if more space is needed,please attach addendum): Lot 22,Plat of Troy Wood in the Town of Troy,St.Croix County, Recording Area Wisconsin; Name and Return Address Laux Cutler,S.C. ii P.O.Box 456 1 G� � Osceola,WI 54020 040-1271-10-000 Parcel Identification Number(PIN) Together with all appurtenant rights,title and interests. This is 140+ _ homestead property. Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except easements,restrictions and ordinances of record and will warrant and defend the same Dated this day of July 2004 I i I I * * M16 J.Wa.. I s * ! AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St.Croix County ) authenticated this day of Personally came before me this day of July 2004 _ the above named Mary J.Haun * TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who e:xi;i6dlit�`ed the;olt�rpitt (If not, i ru ent and ackno ledge the same•." authorized by $ 706.06, W is. Stats.) THIS INSTRUMENT WAS DRAFTED BY • 4 • �, Priscilla R.Dorn Cutler,Attorney at Law Notary Public, State of Wisconsin:^ I , •� Osceola,Wisconsin 54020 € My Commission is permanent.(If t$te e�plra (Signatures may be authenticated or acknowledged.Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature. 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