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Home My WebLink About034-1003-95-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574396 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: 518 Properties LLC I Springfield, Town of 034-1003-95-100 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 02.29.15.26C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ,. CAPACITY STATION BS HI FS ELEV. Septic • .L Benchmark /000/000 Z -5 /d .9 ZOO Dosing / Alt.B ` / Z (�D 6 • q j Bldg.Sewer I LA o 1ok,- Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO oP WELL BLD�G� ent t Air Intake ROAD Dt Inlet Septic Dt Bottom S (06 Zb� — �f.2 Dosing 1 &` Z�/ Header/Man. ,46 161.3 Aeration 1O Dist. Pipe /` / �a/•3 Holding Bot.System Z 1siF(� /alb 4 PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover 5 GPM /' f ;� g o- 7 O ` 1� µ�+ �� Model Number fe -1 Z-7• �F r Z c /cc) TDH Lif!?L �Lj Friction System TID�45 G Forcemain Length / Dia.Z j f Dist.to Well SOIL ABSORPTIONS STEM BED/TRENCH Width Length No.Qf Tre es PIT DIMENSIONS No.Of Pits Inside Dia_ Liquid Depth DIMENSIONS 7/ . /vie SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f yste : ,,,.0, ( 75 13Z, UNIT Model Number: DISTRIBUTION SYSTEM 015 Header/Manifold Distribution/� / x Hole Si z / x Hole Spacing V 11Pttj Air Intake Length Dia Length v• 167 Dia Z Spacing-- ] Z I SOIL COVER x Pressure Systems Only xx Mound Or t-Grade Systems Only a. Depth Over / Depth Over xx Depth of Ixx Seeded/Sodded Mulched Bed/Trench Center `z .�� Bed/Trench Edges Topsoil 1 Yes No s No l COMMENTS: (Include code discrepencies,persons present,etc.) Inspection Q Inspection#2: Location: 1115 Rustic Roa 3 Glenwood City,WI 54013(NW 1/4 SW 1/4 2 T29N R15W) NA Lot G ,� ��Paarrc�No: 02.29.15.260 1. Alt BM Description= �4 COO.-, Ci s +" Pla•"J _v' ) � 1 i� 2.)Bldg sewer length= `Q ,S a v� Pow w V -amount of cover= // Plan revision Required? E] Yes X O to / Use other side for additional information. Date Insepctor's i nature Cert.No. SBD-6710(R.3/97) ttts R„sf«,�d3 sw`(�P s�'!�v S2 T24�c(R15w S pnw��i'.�ll TwsP Cw n 71 e I �••O / t M� v roo.o'= +e rt ti� sue( p1�.t 7 a A4 4f z 99 4 r'=fire sl AZTAI wee./type, 5c%40?vc PIPE Bi 2= tpb0.d/• tone g„T,n(S $ar►�•.- f�ws F Cq�ln 4-" County y T° G•` Industry Services Division C �'4La( 1400 E Washington Ave Sanitary Permit Number(to be filled in by Co.) P.Q. Box 7162 q� k� S�•Q GpVNPM��It� nAVII31 JON A1'ti p\X IV \ M�,uN anitary Permit Application State Transaction Number In accordance,;1 SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit 2,45 q /y&J is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law,s.15.04(1)(m),Slats. I. Ap lication Information-Please Print Al ormation Property Owner's Name Parcel# f Property Owner's Mailing Address Property Location / G\ 8'5l-? f p �� Govt.Lot City,State Zip Code Phone Number t/,,SZC/ ya, Section 2... 9 ircle one � -r T N; RE r H.Type of Building(check all that apply) Lot# 1 or Family Dwelling-Number of Bedrooms Subdivision Name Block# z) r Public/Commercial-Describe Use City of State Owned-Describe Use I CSM Number Village of S'pr,� ,e 4J t ^ ,`�ro.� Town of III.Type of Permit: (Check only one box on line A. Complete line B if applicable) New System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Existing System(explain) Permit Renewal Permit Revision Change of Plumber Permit Transfer to New List Previous Permit Number and Date Issued B. Before Expiration Owner IV.Type of POWTS S stem/Com onent/Device: (Check all that apply) Non-Pressurized In-Ground Pressurized In-Ground t-Grade Mound>24 in.of suitable soil Mound<24 in.of suitable soil Holding Tank Other Dispersal Component(explain) Pretreatment Device(explain) V.Dispersal/Treaidnent Area Information: Design Flow(gpd) Design Soil Application Rate pdsfl Dispersal Area Required(sf) Dispersal Area Proposed( System Elevation /SU t (p 2-50 250 So ' VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units D U w h New Tanks Existing Tanks / `�1 1D k„ 5Z U Septic or Holding Tank d Dosing Chamber s'�,, I 1_�101 P� VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. PI u ber's Na a(Prin) Plu is Signal MP/MPRS Number Business Phone Number ��'l -G 2-G7 7f-S 71s-Z6S y/1s Plumber's Address(Street,City,State,Zip Code) 7 2g .3 /�}r•�, .��.c. ��¢ne.�-wed G!� v� O/ VIII.Count /De artment Use Only Approve 'sapprove Per/mit Fee Date 71ue7d Issuin ent Signatuweer eason for 1 $ (� / IX.Condl#q teasops for Disapprova l •,E 7�a„t,p s to 3 Goy. t 1 ' �eptid'tank,etflttltrtth�lterariif (�� ,.� dispr ml cell must all be seft"/maiiit ineti j q t'tc'C wC> aS per rtlanagemerd plan provided try plubel /J/� 2. A se4? Ck r l erneett fattst be r irtta(hest tX-� ` vKJ S�— �/t.a.�C_ �.�� j 1 25� ��I as per aPP cane/ordirmitces. Attach to complete plans for the system and submit to the County on on paper not less than 81/2 x 11 inches in size SBD-6398(R0313) �r��- o�ennTa �� DIVISION OF INDUSTRY SERVICES 141 NW BARSTOW ST FL 4TH ' WAUKESHA WI 53188-3789 .�e Contact Through Relay y http://dsps.wi.gov/programs/industry-services www.wisconsin.gov �O�ssrorrt*y�� Scott Walker,Governor Dave Ross,Secretary September 23,2014 CUST ID No. 267985 ATTN.-PO WTS Inspector MICHAEL J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA 2943 130TH AVE 1101 CARMICHAEL RD GLENWOOD CITY WI 54013 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES:09/23/2016 Identification Numbers Transaction ID No.2454765 SITE: Site ID No. 805798 518 Properties Please refer to both.,identification nuxrt$ers 1115 Rustic Rd 3 above,in all., with the Town of Springfield Agency. rISt Croix County 'SWI/4, SWl/4, S2,T29N,R15W FOR: Description:At-Grade Object Type:POWTS Component Manual Regulated Object ID No.: 1501669 Maintenance required; 150 GPD Flow rate; 37 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P(N,03/07,R. 1/12),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. 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: This system is to be constructed and located in accordance with the enclosed approved plans and with the At-grade Component Manual, Version,2.0, SBD-10854(N.03/07,R. 1/12), and the Pressure Distribution Co nt Manual- Version 2.0, SBD-10706-P(N.01/01,R. 10/12) O,L ARO In the event this soil absorption system or any of its component parts malfunctions so Od, the property owner must follow the contingency plan as described in the approved plans. In � �� ro p oer must comply with the operation,maintenance and monitoring duties as desc *bed ins VI o rade component manual. A copy of this information must be given to the owner ul o pletio f the pro�ct. Maintenance information must be given to the owner of the tank explaining that pe rig of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approva tions. 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. MICHAEL J MYERS Page 2 9/23/2014 Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stats. Owner Responsibilities: • SPS 383.52 Responsibilities. 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). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as PP g required under s. SPS 383.54(4)shall be considered a human health hazard. • SPS 383.55 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. 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 Fee Received$ 250.00 Balance Due $ 0.00 Julia Lewis-Osborne POWTS Reviewer 2,Integrated Services WiSIvIAR'F� fi3 (262)397-6005, Fax: (608)283-7481 julia.lewis@wisconsin.gov 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. A ps 1 of 6 At Grade Cover Page RECEIVED AUG 2 8 2014 /NDUSTRy SERVICES Project Name: 518 Properties-At Grade Owner's Name 518 Properties Owners Address 18567 Fontana St W omin ,MN 55092-9772 Legal Description sw� '/e �sw %. Sec�� T 29 N, R 15 Township Springfield County Saint Croix Subdivision N/A Lot# N/A Parcel ID# Table of Contents Pg- 1 Cover page 2 At-Grade Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank Calculationse 5 Management and Contingency Plan 6 Plot Map -7 PV4,12 C ver i I total#of pages: 6 Designer Name: Michael J Myers _ License#: 267985 Date: 8/26/2014 }� Ph.#: 715-265-4115 f�Tyq Signature: V S At-Grade Design Methods Used per"At Gra de Component nt Manual For Private Onsite Wastewater Treatment Systems"(Version 1.0)SBD-10570-P(R.6199) �s P� per"Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems"(Version 1.0)(06199) cF f ' Page 2 of 6 . At-Grade Sizing Calculations Project Name: 518 Properties-At Grade Site Conditions Design of Entire Component Private Dwelling or Commercial: p (P or C) Upslope Width added to A(E): 2.0 ft 8 0 ft. Slope: 2 % Total Width of Distribution Cell(C): #of Bedrooms 1 Perimeter Beyond Aggregate(D): 5.0 ft Depth to limiting factor: 37 in. Overall Width of Component(W): 18.0 ft. Absorbtion rate of in-situ soil: 0.6 gal/ft2/day Overall Length of Component(L): 51.7 ft. Effluent quality Eff#i . Elevation of Lateral in Cell: 100.50 in. Max BOD effluent value: 220 mg/I Height of Component Over Lateral: 16 in. Height Over Rest of Cell: 14.0 in. Hei Max TSS effluent value: 150 mg/I 9 Final Grade of Component: 101.83 ft Design of the Distribution Cell System Design Flow: 150.0 gal/day Distribution cell credit width (A): 6.00 ft Observation Pipes Distribution cell length (B): 41.7 ft Location from end of cell: 6.9444 ft Area of Distribution Cell: 250.0 Contour Elevation: 100.00 ft At-Grade Plan View D-� �1/N Observation �11 D Pipes / C • B � D L J At-Grade Cross Section i-Final Grade Lateral Invert Synthetic Fabric Cover Material Distribution Cell System Contour , a Observation Pipe 6 1 . V $ e 6 4 u n s D L b Tilled Area t n ~'-''� -,e68 'd6-°�. E °7 D� Slope Notes: Distribution cell aggregate to comply with SPS 384.30(6)(1) Synthetic Fabric covering on cell per SPS 384.30(6)(g) Distribution Cell to have minimum 6"aggregate below lateral and 2"above. Page 3 of 6 At-Grade Pressure Distribution Calculations Project Name: 518 Properties-At Grade Lateral Layout Lateral/Manifold Design 2 n. Lateral elevation: 100.5 ft Lateral diameter: `__ I Rows of Laterals: 1 Lateral to upper cell edge: 2 ft Manifold type: end Lateral discharge rate: 27.96 gpm Orifice diameter: 0.250 ! In. System discharge rate: 27.96 gpm #of Laterals: 1 Distal Pressure: 2.5 ft Lateral Length: 40.67 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 21.22 Inches Forcemain length: 120 ft Orifices per lateral: 24 Forcemain diameter: 2 _1_71 In. Avg. ftz/Orifice: 10.42 fe Friction loss in forcemain: 2.043 ft Avg. Lin ft/Orifice: 1.736 Lateral Side View Lateral Lateral Length Lateral Plan View Lateral Length — n Orifices on bottom of Turn-up wlball valve or cleanout plug—�' lateral equally spaced PVC laterals and forcemain to comply with specifications per SP.3'384-3012)(e) Clean Out Detail Observation Pipes Clean-out plug Final Grade or ball valve Water tight cap or plug Lawn Sprinkler Box Slot Plote.Cioset Co9ar be used in " may 6 tviinimu place of 318"bar Long Sweep 90 3/0"Bar or two 45's Lateral .At-Grade page 4 a s Septic, Pump and Dose Tank Project: 518 Properties-At Grade Tank Information Dosage Volume Pump tank manufacturer: M88.71 crete Does forcemain drain Pump tank s ize/model: 500 back to tank? 7.1 al Pump tank gat/inch: 13 Lateral void volume: g Tank bottom elevation (inside): ft Dosage to absorbtion Cell: 30.0 gal Septic tank manufacturer: WieserConcrete i Forcemain volume: 20.9 gal Septic tank size/model: 1000 Total dosage: 50.9 gal Pump and Filter Total Dynamic Head Pump Manufacturer: Goulds Are laterals highest point? Pump Model: PE41 P1 if not, enter highest elevation: 0 ft Pol lock 525 System head (distal x 1.3) 3.25 ft Effluent Filter: y Vertical Lift("D"to lateral) 11.29 ft Note:Access opening of sufficient size to be provided to allow Friction loss in forcemain: 2.04 ft removal of titter Opening to terminate at or above grade. Head loss from filter: =�ft Pump Tank Diagram Total dynamic head (TDH): 16.58 ft Watertight Locking Cover 4 In With Warning Label Finished Dose Tank Levels Minimum Grade In. Gal A Reserve 26.5 345.1 Alternate Outlet B Pump off to Alarm 2.0 26.0 Location Elect.per Comm C Total Dosage 3.9 50.9 1 ar 28 and main NEC NEG 300 Effluent depth for pump 6.0 78.0 Total Capacity: 38.5 500.0 Weep Hole A or Anti- B Siphon Device Pump Curve: PE41 P1 C FLOW- LITERSlI113UR 0 1000 2000 3000 SIN D 0 30 N 7.53 Pump must be capable of: 28.0 GPM 2u and head pressure of: 16.6 6 ft a W La 10 2.5 0 0 20 40 60 so Little Giant FLOW- GALL014S/MINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ At Grade Management Plan pursuant to SPS 383.54 W.A.C. pages of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components,checking for surface discharge,treated effluent levels,etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s)are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemica cereatrment "is no Comme rce, required or recommended. If such additives are used,make sure they are app roved b Department Pa rtn Safety and Buildings Div.. Effluent filters are to be removed&cleaned as necessary,with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge,tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank,then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank,it must be removed&cleaned as necessary,with provisions to keep solids from passing to the mound component during removal. The pump,float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. At-grade and Lateral System The at-grade system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes,the owner must be notified of possible problemstfailure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted,or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance(i.e.excessive walking,pets,vehicles,etc...) could compress the component and reduce its absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at the end of the distribution laterals to remove scum that may dog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem,complaint,or failure. Contingency Plan: If the septic tank,pump tank or any of their components therein(including floats,alarms,pumps,etc) become defective,the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the at-grade component cannot accept wastewater or ponds wastewater to the surface,the component must be repaired or replaced in irs current location by either:extending basal toe to provide added absorbtion area;or by removing the dogged bacterial mat,aggregate cell,and distribution piping within the cell and replacing said components in order to return system to proper working order as required. sw�t� sue'/� S2 TZ-9�c(R15w >5� � t I � �M1 /Trn- "TM 01785 • ScH40'tvc pl 2, t6 lo- Tkftll -opSe.d $drw- Ids F W�el, �biA MOULDS PUMPS Submersible Effluent Pump PE "Rujiff PUM, SPECIFICATIONS MOTOR FEATURES Pump—General: General: ■Corrosion resistant • Single phase construction. • Temperature::1 04 F{40 0 C) ' • Discharge: 1 NPo 60 Hertz ■Cast iron body. 1 maximum,continuous when • 115 and 230 volts ■Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover. • Solids handling:'/2" tection With automatic reset. ■Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■Motor is permanently • Manual models available. shaft. lubricated for extended Specially designed for the service life. following uses: • Pumping range:see PE31 Motor: ■powered for continuous • Mound Systems performance chart or curve. • .33 HP, 3000 RPM operation. g y PE31 Pump: • 115 volts • Effluent/Dosing Systems p' • Shaded pole desi n ■All ratings are within the • Low Pressure Pipe Systems • Maximum capacity:53 GPM g working limits of the motor. • Basement Draining • Maximum head:25:TDH PE41 Motor: ■Quick disconnect power 3400 RPM HP, • Heavy Duty Sump/ PE41 Pump: • .40 cord,20 standard length, Dewatering • Maximum capacity:61 GPM • 115 and 230 volts heavy duty 16/3 SJTW with • Maximum head:29'TDH • PSC design 115 or 230 volt grounding PE51 Pump: PE51 Motor: plug. • Maximum capacity:70 GPM • .50 HP, 3400 RPM ■Complete unit is heavy duty, • Maximum head:37'TDH • 115 and 230 volts portable and compact. • PSC design ■Mechanical seal is carbon, METERS FEET ceramic, BUNA and stainless 40 !MODELS:PE31,PE41,PE51I steel, PEST NP 33..40, so ■Stainless steel fasteners. t 35 t — - 1 0 � : _ ,_. . —�► 2 GPM� ,, " AGENCY LISTINGS 30 1"f' 1 FT i+ 25 — -- C�p US I Tested to UL 778 and a zo } i CSA 22,2108 Standards Z I By Canadian Standards Association Fie#lR3$549 15 - i Goulds Pumps is ISO 9001 Registered. 0 00 10 20 30 40 50 60 70 GPM 80 ` _ 15 m3/h Goulds Pumps 0 5 10 CAPACITY ®2004 ITr Water Technology,Inc. ITT Industries Effective June,2004 BPE31141 Property Owner 518 Properties Parcel ID# Page 2 of 3 F3] E] Boring Boring# Pit Ground surface elev. 99.43 ft. Depth to limiting factor 37 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 0-12 10YR3/2 A 3sbk mvfr Cs 2m .6 .8 2 12-25 10YR5/6 A 3sbk mvfr Cs 2f .6 .8 3 25-37 10YR6/8 sc 2abk mfr cs if .2 .3 4 37-48 10YR6/8 7.5YR5/8fif spots sc 2abk mfr gs if .2 .3 5 48-54 10YR6/8 7.5YR5/8flf spots fs Osg mfr gs .5 1.0 ❑ 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/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. `Eff#1 I 'Efr#2 ❑ Boring F-1 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/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Etf#1 *Eff#2 Effluent#1 =BODS>30<220 mg/L and TSS>30 al 50 mg/L Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SM-8330Test(ft.11/11) Northland PWmbxlg,Inc. SOIL EVALUATION REPORT #89 2 1 S p Department of s and Pr rr Page 1 of 3 AA S Division of Safe1(y ar& GtE4C� 1 Northland Plumbing,Inc. g`C 0 In accordance w Coo ode �``��N County Attach complete site,Rl J'4Pp1 aper not less than 8%x 11 inches in size. an St.Croix include,but not limit to:vertical and horizontal reference point(BM),direction and paI.D. � / percent slope,scale or dimensions,north arrow,and location and distance to nearest road. S _l Please print all information. By Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). /0 Property Owner Property Location 518 Properties Govt.Lot /SW 1/4, 1/ S2,T29N,R15W Property Owner's Mailing Address Lot# Block# Subd.Name CSM# 1115 Rustic Road 3 City State Zip Code Phone Number City E,Villagef Town Nearest Road Glenwood City I WI 54013 1 Glenwood Rustic Road 3 IF' New Construction Use: Residential/Number of bedrooms 1 Code derived design flow rate 150 GPD r I Replacement L � Public or commercial-Describe: Parent material Glacial Till Flood plain elevation,if applicable fl• General comments and recommendations: Boring# L Boring 7 Pit Ground surface elev. 100.00 ft. Depth to limiting factor 38 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 sil 3sbk mvfr Cs 3f .6 .8 2 9-32 10YR5/6 sil 3sbk mvfr Cs 2m .6 .8 3 32-38 10YR6/8 SC 2abk mfr Cs if .2 .3 4 38-42 10YR6/8 7.5YR5/8flf spots SC 2abk mfr gs •2 •3 5 42-48 10YR6/8 fs Osg mfr gs .5 1.0 L-6 48-54 10YR6/8 7.5YR5/8f1f spots SC iabk mfr gs 0.0 0.0 2]Boring# ❑ Boring Pit Ground surface elev. 100.0 ft. Depth to limiting factor 37 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 'Etf#2 1 0-8 10YR3/2 sil 3sbk mvfr Cs 2m .6 .8 2 8-28 10YR5/6 A 3sbk mvfr Cs 2f .6 .8 3 28-37 10YR6/8 SC 2abk mfr Cs 2m .2 .3 4 37-46 10YR6/8 7.5YR5/8f1f spots SC 2abk mfr gs if .2 .3 5 46-58 10YR6/8 7.5YR5/8fif spots fs Osg mfr gs .5 1.0 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5 S30 mg/L and TSS<_30 mg/L CST Name(Please Print) ignatur CST Number Michael J.Myers 267985 Address Northland Plumbing,Inc. 47 Date Evaluation Conducted Telephone Number 2943 130th Ave Glenwood City,WI 54013 7130/2014 715-265-4115 SB13-8330(R.I I/I l) Property Owner 518 Properties Parcel ID# Page 2 of 3 F ❑ Boring `I ] Boring# Pit Ground surface elev. 99.43 ft. Depth to limiting factor 37 `t 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 0-12 10YR3/2 sil 3sbk mvfr cs 2m .6 .8 2 12-25 10YR5/6 sil 3sbk mvfr cs 2f .6 .8 3 25-37 10YR6/8 sc 2abk mfr cs If .Z .3 4 37-48 10YR6/8 7.5YR5/8flf spots sc 2abk mfr gs if .2 .3 5 48-54 10YR6/8 7.5YR5/8flf spots fs Osg mfr gs .5 1.0 F-1 F-1 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/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 F-1 ❑ 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/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *EM2 Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SM-833oTest(FL IM1) Northiand Plumbing,Inc. 518 f ropu-{lts , Uz �{c1 = d. 5 �� -rwsp �t 5�.Crot sc Coy�r� /vo•5`f I � a i q (are-,- M n Nth I= I oo.o'- t0 54eel Fire- 9 fK# t1� p Slce,( pl p,e 82a (oo.o' �1-ot�d i ea�'in � � ST' CR0IX COUNTY S[PTl[ TAINI& NIA|NT[��/\NC[ &6REE1\4ENT AND OWNERSHlP [ERI1[lCAT{AN' F[)RN/1 ation re —4i IC f(ldred from riannitig&Zoning Department for new construction.) [liiY/Stu{r Parcel Identification Number L/ 7 LEGAL DESCRIPTION � Property Location ' ��u u Sec. / ��1N m_25_= Town of Subdivision Plat:Subdivision Survey Map # , Volume Punc# . WarrankyDeed # � (hcfomc2A87)V0}ume , Pogc # Spec house yc, �� Lot lines identifiable /E� 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 o{pumping out the septic tank every three years or sooner,if needed,byo 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§Comm. 83.52(l)and in Chapter l2-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning& Zoning Dcpa,tnoco/a ocni6codon Knrm.signed by the owner and by a master plurnber,journeyinan PlUrnber. restricted P11.1111ber or a licensed pumper verifying that(\)tile on-site nxstevxur disposal nyozm ininpo*pxropcmtingcondi,ionxnd/nr(2)uhrriospcc�oomndpumpin�(Jnccessxdbc /cp,icmnk i, less than \ '3 full of sludge. |/we,/he 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 Department of Natural Resources,State w[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 tbre year expiration date. Itwe certify that all statements on t s farru are true to the best uf my/our knowledge. lkpo am/are the uwocr(x)o[the property described above,by virtue of anproperty y deed recorded in Register of Deeds Office, %&IGNATURE OF APPLICANT(S) 6AIE ***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. i . iIIINII(IIIIIIIIIIIIIIIIIIBI 8053882 State Bar of Wisconsin Form 1-2003 TX:4040097 WARRANTY DEED 954143 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 04/10/2012 2:23 PM THIS DEED,made between Michael J.Gardner and Gloria J.Gardner,husband REC FEE:EXEMPT#: BA BA and wife as survivorshin marital property ("Grantor,"whether one or more), TRANS FEE: 1080.00 and 518 Pronerties,LLC PAGES: 1 ("Grantee,"whether one or more). Grantor,for a valuable consideration,conveys to Grantee the following described real Recording Area estate,together with the rents,profits, fixtures and other appurtenant interests,in St. Croix County,State of Wisconsin("Property')(if more space is needed,please attach Name an " UMEM TO: addendum): DCATITLE S1/2 of SWIM of SWl/4 EXCEPT commencing 276 feet North of the Southwest 1280 NORTH FRONTAGE ROAD corner thereof,thence East 232 feet;thence North 139 feet;thence West 52 feet; HASTINGS,MN 55033 thence North 62.8 feet; thence West 180 feet; thence South to the point of FILE# beginning; AND the SWIM of SEI 14 of SWl/4,ALL in Sec.2-T29N-R15W,St. Croix County,Wisconsin. 034-1003-30-100;0341003-50-000:034-1003-20- AND 100;034-1003-10-000;034-1002-95-100:034-1002- 90-0.00;034-1003-60-100 NW 114 of SEI/4;N1/2 of SWIM of SEI/4;NEIA of SW 1/4;N1/2 of SEI/4 of SW 1/4; Parcel Identification Number(PIN) Sl/2 of NWl/4 of SWl/4;N1/2 of SWIM of SWl/4; ALSO a parcel of land located This is not homestead property. In the S112 of SEI/4 of SW 1/4 described as follows:the North 100 feet of the East 50 feet of the S1/2 of SEI/4 of SWl/4; ALSO a parcel of land located in the S1/2 of SWIM of SEI/4 described as follows:the North 100 feet ofthe West 198 feet of the SI/2 of SWl/4 of SEI/4 and the North 112 feet of the East 322 feet of the S1/2 of SWl/4 of SEI/4;ALL in Sec.2-T29N-R15W,St.Croix County,Wisconsin. Granter warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except:easements, restrictions and reservations, if any,of record. Dated (SEAL) SEAL) * * is el J.Gardner (SEAL) (SE „ * *Gloria J.Gardner <R AUTHENTICATION ACKNOWLEDGMENT W 3 Signature(s) authenticated on STATE OF J(/[/✓ ,E'.�� ) )ss. „ COUNTY ) *TITLE:MEMBER STATE BAR OF WISCONSIN Personally came before me on g!/i'v0,'N 141 20 11 ~ (If not the above-named Michael J.Gardner.Gloria J.Gardner authorized by Wis.Stat.§706.06) to me known to be the pers o executed the foregoing instrume nd a:kn ged the e. THIS INSTRUMENT DRAFTED BY: Kristina Oeland,Estreen&Oeland 304 Locust Street.Hudson.W154016 of P c,State t�0 1 of 1 M Co ssio s permanent)(expires:� 3/ 1S ) 5/O P � S' Jiw1I� 32� � roeA - p G n 3a N � 0 0 0 �r � $ O N�❑ V — �do m� oo z Z b Z po ^^ o u eI p 4.J tl 0 m$ tl �1E�E W u rod "°. y J }-{ Q — i �n ly If n S m po d o _ O X I'D .�1 •nl •nt x ]'� 319V9 f.HX09.42 e Z LU J � � e jN W_ 2 V z z - � c 7o Z_ � w � W LL �V m �N•�qi �+ ® yry ,g L TPV9 .VZ III 0 N N o 0 R t8h R z 3 n s d R R c C S � Z 0 X X ! N z El W N§ W u z p Z o W uj � Q U 3 4 o❑a❑ - ❑0❑❑ 0000 0000 OF 0000 000❑ Do am� 0000Q R x po 715.386.4680 Note new email address: kevin.grabauC&co.saint-croix.wi.us "When everything seems to be going against you, remember that the airplane takes off against the wind,not with it" -Henry Ford ST: R FNTY ........... From: Tom Nielsen [mailto:Tom Nielsen0)mo-tech.com] Sent: Tuesday, September 09, 2014 9:49 AM To: Kevin Grabau Subject: RE: New Building Hi Kevin Just following up on this.....did you get in touch with Mike? Please let me know status.... Thanks From: Tom Nielsen [mailto:Tom Nielsen(abmo-techxom] Sent: Monday, September 08, 2014 10:31 AM To: Kevin Grabau (kevin.cirabauC@co.saint-croix.wi.us) Subject: New Building Hi Kevin Thanks for your help! Here is the building specs......not sure if you connected with Mike Meyers yet.... Would like to get this started Sept 22 if possible... 518 Properties 1115 Rustic Rd #3 Thomas Nielsen President Mo-tech Corp. 2920 Granada Ave. N. Oakdale, Mn 55128 651-770-1515 ext. 206 612-963-8037 cell tom nielsen0mo-tech.com 2 i Kevin Grabau < - From: Tom Nielsen Tom Nielsen @mo tech.co m> Sent: Thursday, September 11, 2014 9:25 AM To: Kevin Grabau Subject: RE: New Building Follow U P 9 9 Flag: Fla for follow up Flag Status: Flagged Hi Kevin We are going to finish half of the building so it will be over the 720 min.... Is there anything I need to do to secure a building permit? E realize we need the septic permit first....'ust want to make Y g gp P p 1 sure I not losing any time..... Let me know thanks From: Kevin Grabau [mailto:Kevin.Grabau(&co.saint-croix.wi.us] Sent: Tuesday, September 09, 2014 5:01 PM To: Tom Nielsen' Subject: RE: New Building Hello Tom, I did get a hold of your plumber Mike Meyers. He said that he sent the plans in to the state office in Waukesha, as he has had the fastest turnaround times there, and the least problems with the State Reviewers questioning design criteria and holding up approval. The review is scheduled for September 23,as they are backed up that far. He did also say that he checked with another office and they were just as backed up. But, if the reviewers in one of the state offices gets ahead of schedule, he said that the different offices will at times send some paperwork to the ones that have the least workload or that are ahead of schedule. It just seems to be that time of year where people are scrambling to get plans approved and systems installed before the weather takes a turn for the worse. At this point there is not a lot that any of us can do, except maybe pray and cross your fingers that one of the other offices gets ahead in its scheduling. Also, I did receive your building plans in a previous email. The building looks large enough, but please remember that n the living area must be at least 720 square feet in size to meet ordinance requirements. I know that we discussed this before, but I could not tell from the plans on any designated living area to be used. I did see that one of the entrance doors appeared to be more like a house entrance door than the other service-type door. 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