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Home My WebLink About008-1061-20-075 Foaoe main t mb"ion via tfe or oross to manWOM at aft paint• Lawals so idwwft at p i.Tum-up wtbsllwlwor KX--+I+Wi ,)s1 LeterMsMorCeoeMSeh40PVC alanoiApluQ per SRS T"384—W Hobs drifd on 0*bottom of 0*lawat I Wisconsin Department of fQessional Services P A 1 1) Division of Industry SOIL EVALUA I ION REPORT Page 1 of 3 � n accordance with SPS 383,Wis. Adm. Code *_"d 1�tAh County ST.CROIX Attach complete site pla i than 8 1/2 x 11 inches in size.Plan must include,but not li horizontal reference point(BM),direction and Parcel I.D. 008-1061 -20-075 percent slope,scat r a sions,north arrow,and location and distance to nearest road. Please print all information. R by Date Personal inforrnation you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). Property Owner VQ Property Location TODD DOORNICK Ao '"I Govt.Lot ----NW 1/4 SW 1/4 S 21 T 28 N R 16 E(or) Property Owner's Mailing Address /. Lot# Block# Subd.Name or CSM# i P.O.Box 423 't / City State Zip Code Phone Number Doily Vllage • Town Nearest Road Baldwin, I WI 1 54002 ( 715) 684-2461 230th Street B New Construction UseE] Residential/Number of bedrooms 2 Cod j derived desi flow rate 300 GPD Public or commercial-Describe: 0 Replacement T�k Parent material sandy loam till Flood Plain elevation N applicable N A ft. General comments Mound System-- 1.0 ft,sand fill --0.40c loading rate and recommendations: Plow depth minimum 12 inches. 1❑ Boring# d Boring El Pit Ground surface elev. 99.12 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -Eff#1 "Eff#2 1 0-11 10YR3/3 - sil 2fabk mfr cs 3vf-co 0.6 0.8 2 11-17 10YR4/4 sil 2fabk mfr cs lvf-m 0.6 0.8 3 17-26 7.5YR4/6 — sl Ifabk mvfr as lvf-m 0.4 0.7 4 26-36 7.5YR3/4 c2d 7.5YR5/8 scl Om mfi -- -- 0.0 0.0 some gr/cobs ❑2 Boring# ❑ Boring 98.62 24 Q 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/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -Eff#1 -Eff#2 1 0-9 10YR3/3 sil 2f-ma&sbk mfr ai 3vf-co 0.6 0.8 2 9-16 10YR4/4 sil Ifabk mfr cs 2vf-co 0.4c 0.6 3 16-24 7.5YR4/6 sl 1f--mabk mvfr cw lvf--m 0.4 0.7 4 24-30 7.5YR3/4 c2d 7.5YR5/8 scl Om ME -- -- 0.0 0.0 horizon 2 has some broken Impl. "Effluent#1=BOD >30:5 220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD <30 mg/L and TSS 5 30 mg/L CST Name(Please Print) Signat CST Number MARY JO HUPPERT/Hollistees Soil Testing& )esign 224832 Address ate Evaluation OWducted Telephone Number W9875 690th Avenue,River Falls,WI 54022 07-29- 14 715-426-1775 SBD•8330(807/13) � C dC dC s 1� bnp s -Ak arc OAd S K Said CpAd der- DOORNICK,Todd 008- 1061 -20-075 Property Owner Parcel ID# Page of 3 Boring ❑ Boring# a pit Ground surface elev. 99.42 ft Depth to limiting factor 24 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Efr#2 1 0-8 10YR3/3 -- sil 2fa&sbk mfr cs 2vf-co 0.6 0.8 2 8-13 10YR4/4 -- sil 2fabk mfr as 2vf-m 0.6 0.8 3 13-24 7.5YR4/6 -- sl if--msbk mvfr cam' lvf-f 0.4 0.7 4 24-31 7.5YR3/4 c2d 7.5YR5/8 scl Om mfi -- — 0.0 0.0 Horizon 2 has broken Impl;few cobs. F] Boring# Boring Pit Ground surface elev. ft. Depth to limiting factor 1n• Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Efr#1 *Efr#2 ❑ Boring# �Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Efr#1 *Eff#2 *Effluent#1=BOD,>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L SBD-8330(1107/13) Pkt PIM for Site Md� E i"Pt e 3 of 3 paV fi ner >�r LerWDaCr0&m e M_ / AWA a- Tom `+ ST. emvifX CotmiM W tsw,rssw .* 17.079 N o- 01 t$ / Pie • i,pq�r moo , Cleo D Ape I-ITJ Site Loca (ono 'f'L A,C a Parcel #: 008-1061-20-075 08/28/2014 04:51 PM PAGE 1 OF 1 Alt. Parcel#: 21.28.16.314A-15 008-TOWN OF EAU GALLE Current ❑X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-JON DE REAL ESTATE LLC JON DE REAL ESTATE LLC 2021 30TH AVE BALDWIN WI 54002 Property Address(es): "=Primary Districts: SC=School SP=Special Type Dist# Description SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Notes: Legal Description: Acres: 17.078 SEC 21 T28N R16W PT NW SW EXC PT TO CSM 7/2037&EXC PT TO CSM 14/4020&EXC AS Parcel History: DESC IN WD 1724/122 Date Doc# Vol/Page Type 01/31/2014 992112 QC 11/07/2013 988772 EZ-U 11/04/2013 988556 WD 09/24/2001 657316 1724/122 WD more... Plat: "=Primary Tract: (s-T-R 40%160'x.GQ Block/Condo Bldg: "N/A-NOT AVAILABLE 21-28N-16W NE SW 2014 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/07/2008 Description Class Acres Land Improve Total State - Reason UNDEVELOPED G5 3.078 1,100 0 1,100 NO PRODUCTIVE FORST LANDS G6 14.000 42,000 0 42,000 NO Totals for 2014: General Property 17.078 43,100 0 43,100 Woodland 0.000 0 0 Totals for 2013: General Property 17.078 43,100 0 43,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 MARY JO HUPPERT Page 2 8/21/2014 . Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.SPS 383.54(1). • 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. The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of 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. #erd M wim v When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code:7633 cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm q; ��9gpART.titp�ron DIVISION OF INDUSTRY SERVICES 3824 N CREEKSIDE LA 3 � K1 ��` S �, HOLMEN WI 54636 Contact Through Relay �y www.dsps.wi.gov/sb/ oA �° www.wisconsin.gov , Scott Walker,Governor Dave Ross,Secretary August 21,2014 CUST ID No. 224832 ATTN:POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING&DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/21/2016 SITE: r Identification Numbers Todd Doornick Transaction ID No.2445442 277 230TH St Site ID No. 805065 Town of Eau Galle Please refer to both identification numbers, St Croix County above,in all correspondence with the agency. NW1/4, SW1/4, S21, T28N,R16W FOR: Description: Three Bedroom Mound System/ 1%slope Object Type:POWTS Component Manual Regulated Object ID No.: 1498187 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed 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. CON No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, AP stats. DEPT OF The following conditions shall be met during construction or installation and prior to occupancy or use: PROFESSI Reminders: a'VIS10N OF IN • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis.Stats. • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with SEE C RR the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. • A state approved effluent filter is required.Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required.Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384,Wis.Adm. Code compliant. • The area within 15' downslope of the dispersal component shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A cony 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. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: TODD DOORNICK Owner's Name: (same) Owner's Address: P.O. Box 423 Baldwin, WI 54002 Legal Description: NW 1/4 of the SW 1/4, Sec. 21, T28N, R16W Township: Eau Galle County: St. Croix ITIONALLY Subdivision Name: NA 'ROVED Lot Number: NA Block Number: NA SAFETY AND PJAI SERVICES Parcel I.D. Number: 008-1061-20-075 )USTRY SERVICES Plan Transaction No.: ��gt111Y111Nlp�i %4 o p N,&��ir�� Page 1 Index and title DENCE ••..•••••.., �I 'y�y Page 2 Data entry :'•MARY JO••o Page 3 Mound drawings * d : * _ Page 4 Lateral and dose tank = HUPPERT Page 5 System maintenance specifications D 1859 = Page 6 Management and contingency plan ;RIVER FALl.S,,� Page 7 Pump curve and specifications �y ••'•...WI ..••' �� Page 8 Plot plan IG 111►►►N11,1,,,,, Designer: Mary Jo Huppert License Number: 1859-007 Date: 08/01/14 Phone Number: 715-426- 1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P(N.01/01),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) Version 7.0(R. 03/2012) Page 1 of 8