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026-1075-10-200
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572852 ~ .9' 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)]. zy 7 2 31 Permit Holder's Name: City Village X Township Parcel Tax No: Butler, Kent & Holly Richmond, Town of 026-1075-10-200 CST BM Elev: Insp. BM Elev: BM Description: / Section/Town/Range/Map No: /00. DO ~pGi,S yld /b i11 G d~ fb 26.30.18.392A20 TANK INFORMATION ELEVA ON DATA AV. ee4 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark * I. 3 /a • 3 100. od w t(. a~K- ~ Zr~ ..JMtS • ~ Z.SZ LsZ p0. cb Dosing Qd0 Alt. BM CIO Aeration o $u Bldg. Sewer Holding St/Ht Inlet (oz.sz .os yb.y7 TANK SETBACK INFORMATION St/Ht Outlet iy TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet N K y, Septic , A/7 q / Dt Bottom .r 1S loz.sz lr. yy 87 d`~ Dosing A , 1 k lY Header/Man. c1 Io2.SL 5•65- f $.~7 Aeration Dist. Pipe 102 .sZ (or Holding Bot. System ~'$•s"D 1uz,SZ Y.02 PUMP/SIPHON INFORMATION Final Grade /oZ.SL ±Z•y 100-l2 Manufacturer Al M oT77O DeP nand St Cover 1DZ. 3 •y3 O ` 91567A wOGrpax)*D . Rf Model Number SF { EF qZ B TI 'SW La+. ur 101341 3.3f-/ IT OD TDH Lift Friction Loss System Head TDH Ft 11.79 3.7Y .3 .83 Forcemain Length r Dia. Dist. to Well S SOIL ABSORPTION SYSTEM BED/TRENCH Width r 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 Type Of System: 114 ~ UNIT Model Number: ~V /'1 ( i DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake 1 A Pipe(s) I N t 3 /j~ U r Length 7 Dia Length ~f Dia Spacing f! 9 2_ 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over r Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 7 Bed/Trench Edges 7 Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 0 / y / /5- Inspection #2: - G.iv flog Location: 1393 140th Ave New Richmond, WI 54017 (NE 1/4 NE 1/4 26 T30N R1 8W) Red Pine Corner Lot 4 Parcel No: 26.30.18.392A20 1.) Alt BM Description "1-104 oK-, SEGMED fun~E ,ocinlaR t/rtEQ21" ~7' 4:,' o:< shy Ate, (,a ~EePf.Wi&1A4-* 1b #191&14& ~~REcPeN Fir96D ISS0 - S77-4411'"P5 46.AVV0, All, 600 2.) Bldg sewer length =/S sKR(.I,oW $ goo7S 5T4I/6P FoR rkb"T PNIrT, 4/ 67- Dt1T'4A&I 4 So/C .~~uGN f}~-~¢tL. - amount of cover = (p' ~UC[L GV/!s Gv~l w' T { F/AIES~ /~Glt/l~~ /~I ~ iFwA~~ T f{qT I-IL~ /jfGSr EA1,%k(Z~ '44S F ED C,on/TPrIVt1 t)A71 13`1 1JAW tlts y/Lau~D P/G. Plan revision Required? 0 Yes No o Use other side for additional information. o LF SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. .~Rr±;, Industry Services Division County / 1400 E Washington Ave .57 r. ell ,01 X B 7 2 Sanitary Permit Number (to be filled in by Co.) {SI }I'i o~ 3 71 2 ~X lk & No's 5 7 z g5 Z- a~ unit Application State Tr/a~nsactionNumber In accordance with 1(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 2 y 7 3 Z3 tJ" is required prior too taming a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different tfian mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(l m , Slats. 1. Application Information - Please Print All Infor .3 93 ii'a r v Property Owner's Name Parcel # O2( , 1675 - /o - zad f /y`ol url ~t Property Owner's Mailing Address Property Location ✓ / Z/`t - 37y O. Ad. r`Z7 " Govt Lot /J City, State Zip Code Phone Number N E y, V e ye, Section YO13 G/R 309- Sao circle one E Ell ~/l ~ l T N; R circle on S H. Type of Building (check all that apply) L/ Lot # ~I or 2 Family Dwelling - Number of Bedrooms 7 L/ Subdivision Name 6K ~ PLA_ ~ - Block # ! QFd AV'r e-0.4 --✓e L El Public/Commercial -Describe Use ❑ State Owned - Describe Use / CSM,Number iltne of X/ G v `TT '6 A 1 5 Town of /G Yelri w 6 III. Type of Permit: (Check only one box online A. Complete line B if applicable) Y A. New System Replacement System El Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) ❑ B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber List Previous Permit Number and Date Issued ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade 19 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/freat ent Area Information: 141 Design Flow (gpd) Design Soil Application te(gp sf) Dispersal Area Requir s Dispersal Area Propos S on c od Goo /.o DI Goo 1t)60 Goo 6 98.5' 9.8,0 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units D ~a W U (J C) y New Tanks Existing Tanks p r i a i Q 14A ~o a U En cn w c7 a septic or Flalden aedc a $O aS 0 4. Es e c ~o~ c~c crE Dosing Chamber 7-5-6 7S0 to ~r Y VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si ture :::MPAa4FRS Number Business Phone Number 745- WSY' Plumber's Address (Street, City, State, Zip Code) DO 4E E,L XuE D .~ox D LOLf x 6J=' S 7 VIII. un epartment Use Only Approved ❑ sa roved Permit Fee Date Issue Issuing t Signat en Reason for Denial r IX. Condi ~toJ Op MRReasons for Disapproval 'A ! 1. Septic tank, effluent filter and dispersal cell must all be services / mairitained \ as per management plan provided by plumber. T J ,J: 2. All setbacks regWWnents must be tnaintaihed ~ as per apwubl",0 % ordinat>Ces. Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches ie ~ ~ ~~oo ~ Pl a ~ ~o~ rt mss, SBD-6398 (R 08/14) 10 t 5 E { ~ aa s 64 39 364 r ~ 4 E• j i 7-~ ~y r V i 4(vp / +1 14o 4A i t1C AV~'• C 0 l ,u y , Zo4 10 S 5 N 5 - w--- l i t { f \ 400 a ~~rof Z6 loo 4-A AV KENT HOKE Page 2 11/3/2014 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 Fee Received $ 250.00 Balance Due $ 0.00 rard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm PEYAx7t~AN DIVISION OF INDUSTRY SERVICES ti ron 3824 N CREEKSIDE LA ' moo/ HOLMEN WI 54636 2?1 D S a Contact Through Relay P www.dsps.wi.gov/sb/ S www.wisconsin.gov ~ossror~ Scott Walker, Governor Dave Ross, Secretary November 03, 2014 CUST ID No. 224199 ATTN.- POWTS Inspector KENT HOKE H&H PLUMBING LLC ZONING OFFICE 200 BREMER AVE STE D ST CROIX COUNTY SPIA PO BOX 10 1101 CARMICHAEL RD COLFAX WI 54730 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/03/2016 SITE: Identification Numbers Kent & Holly Butler Transaction ID No. 2473231 1393 140TH Ave Site ID No. 807488 Town of Richmond Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NE1/4, NE1/4, S26, T30N, R18W Subdivision: Red Pine Corner; lot 4 FOR: Description: Four Bedroom Mound System / 1% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1510004 Maintenance required; 600 GPD Flow rate; 30 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 CON requirements. A No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, DEPT O PROFESSI stats. The following conditions shall be met during construction or installation and prior to.,o Ccupancy or use: DIVISION OF I Reminders: • 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. SEE COW • 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. • 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. • The area within 15' downslope of the dispersal component shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. KENT HOKE Page 2 11/3/2014 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. VBala equired $ 250.00 Sincerely, eceived $ 250.00 ce Due $ 0. 00 rard M Swim POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm j erry. swim@wisconsin. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i OCT 2 2 2014 "lBY SF~rll VI;'... va On site tment System bi x. and adePage I~DjeCt /KE.vr tAotty ALNrtEa- y-Alf. /'7au.~o Pos,1rS =s e2 3711 eo. Qo. Ei"lE/LAG,O WS syo/3 s G/a .~0 9 -118.20 - )ITIONALLY PROVED IF AND ` Sr. L~o,x bU l SERVICES ~oo/.J£ Lo.c.✓~.c STRy SERVICES Pap ~ir10E~C '9`/~/r'tE .Sid FJ' or A Z f.%) pap Pags 3 C/Loss-S~Gr/OJ 114A.1 vlr4l oF -i'?ou.Jo Papa ~`lPE 4,f r -cod t LAyaar Pap -5 Gloss - S FG re.J Page 6 ~u/•/~ ~~~t F0/1/9►A.JL6 G GlR f1~ ya9p ~osJrS 4rJ.JE~S i'9A•Jii.OL f /°1iPiJAy.~'iYE~r' ®L.i.J w 8 9 f L remit X• ro,,r"VfrA..) lq eof Dedper_ ~CE,~r o,~[ _ ceaseN tb /1~--~2~?y/99 ~a~: /o-I7- Katy ~ _ to€teFQl3a gPD ComponatMwmal and 05PS 81-85_ /~ocda4 ~6~PB~v~.,,r /~~.✓cd.~c tJ~ias~a do SBO-/OG P ~srJ. di/o~~ ~ o T v ~y° ~ y 3 ~ c W Q W N V t ~ e 1wit O '0 C% v v ~ v ~ ~t a a o v c y ~ ~ v I p v o h O'1( W ep c b v W O ~ w w °Q~ n e M .a ~ 3 goo' . ~ O v 1 h j O ~ ~ II Q rv) ~ o ' v a boQ1 ~ o R W V a W` o EL ak, *4 43 4 w •a a o - - - L ~c aQ 1 a 3• IKu_ 12 y Q 43, 14 w All v V ss - k • - ! ~ cR i.3 ~ - j u - - n . It V r4 _H v It Q A- - U N3 43 ` y `y Smart Ey*+ P iT+ V +i _ ~ it 1i l0 ~ V 0% %3 lz C4 s C_ G 7 p ~u 4 O ' v • o h n, L 14 V _ ni ~J_ ~ Mtii ~1Q~ ~ x v b t d Z a e • 1 a Pa 1 ro J. M o i~ a It O. r1 V ~ \ V v V ~ it V ~ ° It a ~ ♦ V x a Vt N 1 w }Z-! L L L 1.1 N in 2 w fa H 0 ~ "i xa war+v~X Page .3- Of 9 -SEPTIC TANK &*PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE WEATHERPROOF /o' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS o0e/.w.jw4ro G azzow W! PADLOCK G~gae' GtAo6 WARNING LABEL ~t.. .1 4" MIN. 18" LIN. may. INLET ` t' ' WATER TIGHT SEALS GAS- ORE,Jto ~ ► TIGHT i '~PP~{OVED Fra 8~a-,y6 Fit rrt, A SEAL i JOINTS WITH APPROVED ALM APPROVED PIPE PIPE ' ON C t i PUMP OFF ELEV. QZrFT. - - V"HWOFF RISER EXIT D PERMITTED ONLY. IF TANK MANUFACTURER - 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC-! DOSE TANK MANUFACTURER: L✓jESES 6zptkrE NUMBER DOSES PER DAY: S.3 08.81.) TANK SIZES: SEPTIC 47510 GAL. DOSE VOLUME INCLUDING /42.7 3 DOSE 7so GAL.. FLOWBACK: 1,?9.o GAL. ALARM MANUFACTURER: S. T. !1 o"dus CAPACITIES: A = 30.3- INCHES GAL. MODEL NUMBER: trtr I SWITCH TYPE: /''6cNilwicwt B = ` 2 INCHES = ~J?2.s? GAL. PUMP MANUFACTURER : Lisr~ E GiAN r C = -8,40 INCHES = 7 o GAL. MODEL NUMBER : sy- „y SWITCH TYPE: "~EG~AJ/GAG D z 7 S INCHES = Sao. 9 GAL. REQUIRED DISCHARGE RATE 3,13.2 GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL 'DIFFERENCE BETWEEN PUMP OFF AND DISTAIBUTI ON PIPE .FEET MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . .3.3 FEET t _ /ooFEET FORCEMAIN `X FT1100 FT. FRICTION FACTOR . a, S FEET TOTAL DYNAMIC HEAD - J FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH SS it ; WIDTH 8o d ; DIAMETER - LIQUID DEPTH yg " ~4.Gef9 +--4Er 9EN-CIA RF 9EN-C1M { Performance GPM 0 Head Dimenslons Solids Size Running Amps/ 5. 10' C15. 2tY 25' Shut Off Cord weight H X L X w (in) Item Model Listing (S) HP volts (dia. In.) watts (ft) PSI Lerift ft 509209 9131-CIA-RF CCSAus 410 115 314' 9awo 80 70 OD 45 25 32 14 MY 27.5 9.15 9.6 6.8 509210 9EH-CIA-RF cCSAus 410 115 314• 9,w920 80 70 60 45 25 32 14 30' 2115 9.15 9.6 6.8 509207 9EN-CIM cCSAus 4110 115 314' 9.0/920 80 70 60 45 25 32 14 20' 26.5 9.15 9.6 6.8 509208 9EN-CIM cCSAus 4/10 i15 314' 9.0/920 80 70 60 45 25 32 14 W 27.5 9.15 9.6 6.8 Cover Epoxy-coatad cast iron Flow - Liters/Mintrte Motor Housing qwy-coated cast iron 0 50 100 150 200 250 300 Impeller Material Themmpi M Elan ww 35 11.0 impeller Type Non-dDg 10.0 30 Volute Epoxy-coated cast iron 9.0 Power Cord SJTW 25 &0 Mechanical Shaft Sal Wle with caron b and ceramic faces m 7.0 m Fasteners Stainless Steel a 6.0 Shaft Steel 15 &0 0 = 4.0 m SeSrrngS t/ppef =Wed sleave and lower ball bearing 10 3.0 = 5 20 1.0 0 0.0 0 20 40 60 80 Flow - Gailons/Minrrte Franklin Electric P.O. Box 12010 Oklahoma Orty, OK 73157-2010 Phone: 1.800.701.7894 Fax: 1 .800.678.7867 LWe Gante is a regrstered trail Ito Franklin klin t3eeft c Co., o., inc. www.LittleGiantPump.com Forth 996193 - 07/11 disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your PO1VTS . . and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. INSPECTIONS & MAINTENANCE: Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry the tanks. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT: When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 383.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTING„FNCYYPP ,AN: If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area render it unusable. Replacement systems must comply with the rules in effect at the time of replacement. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name A ev r IVO&e /0- '72YI19 Name Ea f' or „►I, Phone 7/S 9G 2 - V/SS' Phone /S 6.? - /S.s' SEPTAGE SERVICING OPERATOR (Pumper) - Kn►o j d LOCAL REGULATORY AUTHORITY Name Agency .6r Cit o qr Zo rv of D ia6' Phone Phone /S 386 - f4 to Page 8 of 9 POWTS OWNER'S MANUAL. AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner j r f o c u r4 ESL. Septic Tank Capacity /?S"o gal Q NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer a .~c o [3 NA Number of Bedrooms 100 d/bedroom t/ Effluent Filter Model FIOB.7a- B O NA Number of Commercial Units Pump Tank Capacity 76b 1 ❑ NA Estimated flow (average) y„ gal/day Pump Tank Manufacturer Lo v_ p NA Design flow (DWF), estimated x 1.5 Zoo gal/day Pump Manufacturer rrc A,►r C3 NA Soil Application Rate Pump Model 9EN- Girt p NA , 'f pl/day Unit ( 3rNA) Influent/Effluent Quality NA) Monthly Average p Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODS) ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) s ?20 mg/L 5 150 mg/L Manufacturer. Model: Pretreated Effluent Quality NA) Monthly Average Soil Absorption Component (p NA) Biochemical Oxygen Demand (BODS) - 30 m ❑ In-ground (gravity) p In-ground (pressurized) Total Suspended Solids (TSS) FgtL ❑ At grade 15 Mound Fecal Colifotm (geometric mean) 5 30 mg1L p Drip-line ❑ Other. CIO cfu/IOOml 0 Dispersal Units Manufacturer Maximum Effluent Particle Size 1/8 inch diameter ❑ Aggregate Cell(s) Model Calculations: Soil Dispersal (EISA) or DWF _ Application rate = Area. Required = (Trench Width) Units or Total Lenp-th of Trench(s) boo - ~ o = 600 - G ' _ /oo ~ DESIGN CRITERIA ❑ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publication 9.6 (SSWMP Manual) ❑ "ICC Flowtech Mound Component Manual" Version 1.2 ❑ "EzFlow Mound Component Manual" Version 8/20/2007 ❑ SBD -10854--P (8.1112) "At-Grade Component Manual Using Pressure Distribution" Version 2.0 © SBD -10705-P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 X SBD -10691P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD -10657 P (86/99) "Drip-line Effluent Disposal Component Manual" )9 SBD -10706-P (N.01101) "Pressure Distribution Component Manual" Version 2.0 Q Other - MAINTENANCE MONITORING SCHEDULE - MAINTENANCE AND MANAGEMENT Service Event Service Frequency Pump/inspect tank s), inspect dispersal cells , clean filter At least once eve : 13 months 3 ears ❑ Other - Inspect um & um controls, alarn4 pretreatment unit At least once eve : ❑ months 3 ears ❑ NA Flush and pressure test laterals At least once every: ❑ months 3 ears ❑ NA START UP AND OPERATION: For new construction, prior to use of the POWTS check treatment tank(s) for presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell s) high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of teaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biode5radable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, Page 7 of 9 into the not be flushed Y damage your POWTS disinfectants, pesticides, antibiotics, solvents, etc., should system as they can serious! and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. INSPECTIONS & MAINTENANCE: Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry the tanks. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet fitter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a I day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT: When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 383.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area render it unusable. Replacement systems must comply with the rules in effect at the time of replacement. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort t0 replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name KEN r /COKE /yP- .72Y/99 Name Eat o.c C V /a idc Phone 7/S 9d a - y/SS Phone 715' ,6 R - OS' SEPTAGE SERVICING OPERATOR (Pumper) - .014.06,0 d LOCAL REGULATORY AUTHORITY Name Agency S r Gt o.x 26..u.~& D iu- Phone Phone /S 386 - f/6 80 Page 8 of '9 Effluent filters improve the performance of new or existing gravity septic systems an and extend dralnfield life by reducing the amount of solids discharged to the drairifield. F(=Series Biotube effluent filters are used in new or existing tanks. Titers include a 4-in. Biotube filter cartridge. PVC housing, and extendable PVC E handle. O BiOtube filters have a higher flow area than other effluent filters^~' on the market, so they don't have to be cleaned as often. Sturdy tubular design mists crushing and warping, making installation and removal easy. t ® Both 1 /5-in. and ' ll &1 in_ fiitration are available to conform to ' local regulations. is U G ti i ® Optional float bracket allows attachment of float stem for tank E level alarm floats. ( Optional flow modulation plate restricts flow from 'Lank to prevent solids from washing out to the drainfield when a large volume of t i water enters the tank. a Models to fit Type 3034 or Schedule 40 outlet pipe are available. i, 391 L j See -Selecting a Biotube Effluent Titer" on page 12 to choose the right filter for the system's flow rate. iV1- ~1=00 W Orenco also manufactures commercial-size Biotube filters with FSO444-36 4-in. diameter, Schedule 40 ~f 8-, 12-, and 15-in. diameters for design flows up to 8,000 gpd. FFw0444-36 4-in. diameter, ASTiVI 3034 Contact Orenco for details. Oft: The base inlet filler is a short 8-in, diameter effluent filter for use in residential applications where extended time between cleanings is needed. Oa~o€~s e MF1 A-Y-5FTL float elbow allows a float to be attached to the base inlet filter to activate a high-level alarm. Can be used instead of the float bracket on new filters, or can be retrofitted in the field to existing filters. 9 t t; SMAN'DARID WRODEU c Fi 0822-148 Un. diameter, bottom inlet , - . FT0822148-FSO 8-in. diameter, bottom inlet, includes overflow plate . ,x r i L t F. ~4 dti .ff~ .fis-s i -t s.z .ri a r t JVL EE9 2 2 201 8!+3728 VOL 22 PAGE 5351 ST CR01X COUNTY CROIX COUNTY KAMM= H. ALSH ST REGISTER OF DEEDS SURVEYOR'S RECORD SURVEYOR'S RECORD ST. CROIX CO. , MI RECEIVED FOR RECORD CERTIFIED SURVEY MAP 02/01.2007 02:15PM Located in part of the Northeast Quarter of the Northeast Quarter of Section CERTIFIED SURVEY MAP 26, Township 30 North, Range 18 West, Town of Richmond, St. Croix:' County, REC FEE: 13. 00 Wisconsin; including Lot 1 of Certified Survey Map Number 688845 recorded in COPY FEE: 3.00 Volume 16 Page 4361 in the St Croix County Register of Deeds Office. PAGES: 2 BEARINGS ARE REFERENCED TO THE EAST LINE OF THE NE 1/4 OF SECTION 26, TOWNSHIP 30 N., RANGE 18 150' o 151Y W. RECORDED BEARING SOO-19'18"W. GRAPHIC SCALE SCALE IN FEET: 1 inch'= 150 feet NORTHEAST CORNER NORTH QUARTER CORNER N. UNE OF THE NE-1/4 SEC 26, T30N. R18W SEC. 26, r30N, R18W (FND ALUMINUM MON.) (I-WD RAILROAD SPIKE) UNPLATTED_LANDS - S89.43'23"E 2621.00' S89'43'23"E LANDS n S89'43'23"E 655.25' 140th AVENUE ~i~ ~ ~~-32.25' 416.01 I ~>30.83 239.24 \ ~ 416.01' 11.69' _ i 1965.75' -S8955'117E 62770'- W lpr- F I LOT3 L07'4 229,069 sq. ft. 3 0 105,535 sq. ft. e NO ~ TH a 2.42 acres I - 1 5.26 acres N v , V) l C) W/O NOW o W/o ROW o p M! to 215,950 sq. ft. g 86, 759 sq. ft. I Q 4.95 acres 1.99 acres -00 LOT 24 JI w v3~ 3 to m N rn N Q I p - -239.21'- 0 3 W 1 z 208.00' 210.83' to Z I 418.83' 28.38' cr) ~ I - -N89 43 ZD"W 44724- - o ~ ~ t 1 3 LOTS f~ 0 ( z N °0 97, 946 sq. ft. V o I W t a a; 2.25 acres U p N W/o ROW a N 1 W j 91,67J sq. ft. 1. Z 1 1 _ Z. 70 acres -447.24 - _ I 1 20799' 418.37' 28.87' I3 1 N89"43'20"W 555.23' ~EOT_25 LOT 2 f 1 ` CSM ~I3J 33 DOC _ NO._ 688845 a VOLUME 16 PAGE 4361 1 l 1 ntf EAST QUARTER CORNER SEC. 26. TJON, R18W (,-ND ALUMINUM MON.) CZAR'.- . LEGEND: 203, Prepared for and at the request of: Section Corner Monument Eileen Holland Y of Record 227 Meridian Drive Ste #1 • Set 1" O.D. x 18" Iron Pipe weighing G~ New Richmond, WI 54017 1.13 pounds per linear foot U Rv O Found 1" Iron Pipe i11[Dv~`n Drafted by. Nicole Gulick JOB # WI057SU236 . • . • .Building Setback Line (100' from Right of Way) Prepared by. i0 0 Consulting Group, Inc NOTE: The parcels shown on this map are subject to State. County and Phone No. (715) 246-4319 Township laws, rules and regulations (Le. wetlands, minimum lot size, access to 0 No. 246-3830 parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix Fax (715) County Zoning Office onJ the appropriate Town Board for advice. , P* 0. Box 325 New Richmond, WI 54017 40M Sheet 2 of 2 Vo1.22 Page 5351 00 ! ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ 1 ~P_1- k-p I I v' LEI I 1 12 i Mailing Address ~2 q O U r&v~l C~~i^rt2 aG C~ I 5Lf0 I Property Addresst 3~ _I G-f-~ (Verification required from Planning & Zo i Department for new construction.) City/State hl~'1~i1 Parcel Identification Number LEGAL DESCRIPTION Property Location '/4 , Sec. T 1U N R~_W, Town ofI Subdivision Plat:__ 'L 6)rr, - Lot# Certified Survey Map # Volume , Page # Warranty # (before 2007)Volurne _ Page # Spec house 11yes&o Lot lines identifiable ❑yesOno 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. I 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 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. Uwe certify that all statements on this form are true to the best of my/our knowledge. 7/we am/arc the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms- SIGNATURE OF APPLIC T( rf l l 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) AP a~ I I ~IiIIII 111 ff ~II~III~I~I II I~III ~TE CONSIN FORM 16-1982 8 2 4 0 3 1 7 DOCUMENT NO. TEE'S DEED 997991 BETH PABST Eileen M Holland, as True IMOTHY M AND EILEEN M HOLLAND REGISTER OF DEEDS LIVING TRUST, dated ecember 11, 2009, and any amendments thereto, for a ST. CROIX CO., WI valuable consideration coveys to Kent Butler and Holly Butler, Grantee, the - 07/01/2014 11.10 AM following described real estate in ST CROIX County, State of Wisconsin: EXEMPT#: NA Lot 4 of Certified Survey Map, filed4n Vol. 16 of C.S.M., pg. 4361, being REC FEE: 30.00 located in the NEV4 of the NE% of Section 26, Township 30 North, Range 18 TRANS FEE: 96.00 West, St. Croix County, Wisconsin. PAGES: 1 **Vol. 22 of CSM, pg. 5351 being formerly part of Lot 1 of CSM filed RETURN TO Tax Parcel No: 026-1075-10-200 Dated this 19th day of July, 2013. Timothy M. and Eileen M. Holland Living Trust, dated December. 11, 2009 (SEAL) (SEAL) * * Eileen M. Holland Trustee Trustee AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN authenticated this day of , 20_ COUNTY OF ST CROIX1 ss. * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me this 19th day of July, 2013, the above (If not, named Eileen MHolland, trustee of Timothy M. and Eileen M. authorized by § 706.06, Wis. Stats.) Holland Living Trust dated December 11, 2009 to me known to o executed the foregoing instrument and be the e s) wh ackno the same. THIS INSTRUMENT WAS DRAFTED BY ~JaD-T~-x D"' . - - * Am L. Monson •ti e Notary Public _St. Croix County, Wis. g~'•} rS~, t 31 (Signatures maybe authenticated or acknowledged. Both are My Commission is permanent. (If not, state:e,~fih~ date? p, ) 3-9-2014 Z 0- not necessary.) o a+ .li.' 'Names of persons signing in any capacity should be typed or printed below their signatures. T IN oIxSGAoun~ 997991 Page 1 of 1 FORM N0.16-1982 i 4 vSn a cabs IWONOMOW M3N 3nV H101, K fill, 5 $ ggyf~~. 3 d a ag i~Wp iN g iEF ;2,X 3# x g °MM4~ igg- +3,nneA110H IN3 Yost nayy g w Ell. °s f= ~s, tli3 rf~ f ra ,t k ~ a gg g~q ~ t }~11~p~a'g I $ 8y N I I I sZF ~ 6 Cµ *r"' t U U ~ 1 ~ ~ rv ' N !r j ( ~ s 11 r I r 1 s I ~ 1 tp - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - l vsn-am IM'41VOWH~R!M3N 3AVH.LOP& EM xga ~F ~W~ ~ ~~~y rc c ~ t 83 MIN y 1 f . a a Q .mad .r i a A.dc FsC .04 ~ QID U0,3 ~ g d Rr P r9 I .Pl .i.P{ .aA ~ ' h C'Li C~ gSCOt p zr gO I i~ n4 ♦ ~ a } l t ".x.arot 9kA A K . i l IN r ~a^' 3€rdli'/7anU>3- o s Iij a ~'i f ~ - ~ N♦ S A I 'N1~aY7NNW"-• / M1 I 1 ( 5t QQ t § R .m 1 6. ~aa.. 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' ~~L 11 O k ~T-AL-&1 h5 .isP wit t, qg8qq t:3~ 4 I i ilia bb 46 JL rat tuu a s§ aL+eau .P-..~ .4'a .o-st yjj-.__.' .a-a - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - x 0 CD ~ ~ m ySy C~ L O N~~ m V moa O WEc v E r o O W` c L' m i. m o N o R m U o v N x Z H t _rn v NC$m m m O O m m c .~S U m m m L ° m v m _ c E E m FNF __rn x y. N K m U E FmF III d ° m o ~ 2 2 Z 2 3 U' U r x m m ° ~ E m ~ ~ O t~ 3 •Q ° E m O (n p Z m m m m o m m ? = , m o m o N O m cg 3 $ L, LL io o o w LL U a a a a a r- N in O R :D V J ❑f 1❑F1 ■ I I I II N g~~ E 25 'Z O o 1-110 ~ Q o II I I I, r 0 N Wisconsin Department of Safety and Prof s Services [division of industy Services - ® SOIL/ INEPORT pop~of Z n Q~ in accordance with sPs County Attach r not less then 81/2 x it Inner in size. Phan must C r a indude, but n to: rat reference point (BM), direction and Parcel I.D. percent slope, sic pj~ nth arrow, and location and distance to nearest road. 214xs > ~Please print aH kdb nnalian. P;,e Personas r rtr~a6on ~ pratirde,m~r be for sowndery wrmim; (Prt~ar Lew. IL 15.04 (1) W)- 17 Property Owner Property Location e1v 'j'` fl ` gtak e t- Govt Lot t,~ e. 114 114 S 3a N R E (or) `w.i Property Owner's MMrV Address Lot# Block # Srbd. Name MW Vol- -'Q CRY State ZP Code Phone Nurrber OCIty own Nearest Road 9VMW ff LI C), New Construction Usew Residential I Ncanber of bedrooms_ Code derived design flow rate ,S o a GPD ® Replacernent Pubic or oornrneroaal - Describe: Parent material Flood Plain n d applicable 6Rj fl ft General conirnerits CJ 6~A a r atitms Ir Qt.o "V% rW,0rt7- 0 5 *,r&7q ~t~ rma u y l o r l~'9~ c r' 9 8 Borings ©1 a ph Ground surface elev. ft Depth to GrnbV favor 3 a in Sad Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPQ ff in. Munseil Qu. Sz. Cont Color Gr. Sz Sh. *Efifl7 *Efr#2 6 / *T1 040A., ,o -Z Iz-I ;7-5-Yo? L/s •s - ~w~-~,- 4 4-1~ o L 1012 1-d 3qfj 75V Vq -L -Cvy YK -15 tdflf~ 01-9 kd # © Boring ® a Pit Ground surface elev. Depth tofanning factor 5-~; in. Sod Application Rate Horizon Depth Dominant Colo Relax Description Texture Structure Consistence Boundary Roots GPDW in. Munssii Qu. Sz Cont Color Gr. Sz. Sh. *M *Eff#2 3 nNC s ZO-L 1-0 1 Ft o _ y f ,Y z4c 1 -6) 26-6,9 3 ecT3 5Y y S V t,s 2.C o-7 3 y 9 I Amq~, Elm #1= BOA > 30 < 220 mpt and TSS >30:5 150 mg/L * Effhod #2 = BOD < 30 mg& ark TSS 5 30 mg& CST Name (Please Pr*Hl Heldt Solt Testing CST Number .z- Address Date Corrdtx~ed Telephone Number Monitors, M 54755 / _ 5_ 9 w Z ~t,~- PmeeifDO Pap of ~ Boft# ~ p~ ~doedsrr_ Oepolb)lerirr 3z a` Fioriaon Depth DoanEtbior RedozDr Teadre Sfe ftmdW tools ~ _ lQ Nkmd Q L ,8L CURL Color GG Sh. nn4r_ ~5`eQ3~ 5 2►-n..IY1 944. a6 Z ~ f 4.6 ~-a Y/67 o-CF- # , frrrrdsurtela cI ,v $ Dap~tor~far~or 3_ Z i,, Fft ffa tmrt Deplb DOWN" Color R1, 1 cf]iplian Teskm Roots GPCM z kL taMurrsei Qu. Sa CURL Lbior ar sLSh 0- - Z t ;2~~c 64 Vb z 7-ffl7Y yy S 5 IVAA 1 p-y O.7 17- V-?z: -2-s 94 k6 3 7- 11 ?,5k Al -V F-I BMW Q Pic c~roasNr>~e.e>~+►. a. ~ft SM ROft Frorfmr, oepa, Reda~Des~pBan Tama MUCI M - Favors = a ! CAL Sa. gnat. COIK Gt sz Sir. ~EOueat#t=BOD s>9Q<_2~agRaad'Iffi~D <<issDar9ti- =BCaD <~s~~'(Bg s- atx~ a[ne~dln~ m ~f~at®ttil; t~at~ts~ep~t~60g-x.3251 arlTYfi~tltda9• l It*~cC#3o eo 0 TZ, ~ M v Q d ~r o d Q ~ ~ r ~ Q a ~ ~ r3 60 j ~ a a -dE-_ U J< ~ • 4 . f1W!IIi~1Y.~alkac: M#'~iM•i!: lam' ~ t Property Owner 1~w,~' 10-hA Parcal ID # _I Page . of © Boring # ❑ Boring J Pit Ground surface elev. U,7 n. Depth to limiting factor YL? In. Sou 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 a-~Y Yp. 1.5 L 11 k I r- t, - Cw t F-1 Boring # ❑ Boring ❑ pit Ground surface elev. h. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPON in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Effg1 •Effg2 ❑ Boring ff ❑ Boring ❑ Pit Ground surface elev. h. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/M In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'E"2 'Effluent #1 : DOD/ > 30.5 220 mg/L and TSS >30 5 150 mq& ' Effluent #2 = BODI < 30 mg/L and T$S < 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. ~'L LoTS D~CSv1'1 ' .4 Wisconsin Departme. It VI SOIL EVALUATION REPORT Page of y_ Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code C Q D 1 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County Include, but not limited lo: vertical and horizontal reference point (BM), direction and Parcel I.D. /9 1 ( ~ 6 _ 2X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V o~10 Please print a// Information, Revio d by Dale Personal information you provide maybe used for secondary purposes (Privacy low, s. 15.01 (1) (m)). L`O/P Property Owner Col we-Property Location E ~ ct~ak~'` ,I t y. Govt. Lot n E 1/41J E 1/4 V.3~ T30 N R E (o !a Property Owners Mailing Address Lot N Block ft Subd. Name CSMN 'Ib Kt. o -5 Auc L/ City Stale Zip Code Phone Number ❑ City ❑ Village (5?Town Naar sl Rogd W R,GI<+wea 1 Syi3t `7 W71503-5010 'k Mp h O V New Construction Use:fC,7 ResldenUal / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commerci T Parent material ~ J. v Plain :evation if applicable General comments = Jr C' s 4, b nr` \ +t e;" 3 ~1 ° and recommendations: V55 ?_006 OJ 44 - a~ J Boring # ❑ Boring pit Ground surface elev. _ ~►.tt7 ft. Depth to limiting factor, In. Soil Application Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf In. Munsell Qu. Sz. Cont. Color Or Sz. Sh. T"i 'EI* 7R3 a. s ads G2 w r~ e 1a -'!8 -7619- Y)~ 1, b 3-f P'L 'IV F' I, S Yk 'e)8 5 L 0-M rMf 3r - a ® Boring# ❑ Boring a Pit Ground surface elev. 97,~r It. Depth to limiting factor _ s In. Soil Application Horizon Depth Dominant Color Rodox. CescripJon Texture Strucfvro Consistence Boundary Roots GPOrtf In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EftN1 EXsa 7-51AY/Y1 I _-S 10 - ---6 A L Cw , toe" 'Effluent #1 = SOD > 30:5 220 mWL and TSS >30 < 150 mg/L Efiluont #2 = 1301 30 mg/L and TSS < 30 mgrL Name (Please Print Signature CS lumber gss i tot t Evaluation Conducted Telephone Numbet is-aY~ 3ss~ syva (-8-a(o Property Owner LA- /L.h Parcel ID # _II Page 52. of © Boring # ❑ Boring i d Pit Ground surface elev. ft. Depth to limiting factor Y._ In. - EA Sou lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 7 a~~d 1 0 10 1 - - I I- ' - I- ~1-0 IS Y ~Hl I I P Y 107 1 Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Soil licalion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/tF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#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/tF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Elf#2 ' EMuent #1 s BOD, > 30.5 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD{ < 30 mg& 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. 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NO. 8, ST. CROIX FALLS, MS 54624 715 483-9 4 p. SEC. 25-30-18 SCALE: 1®= 100' : t DATE July 20, 2011 CLIENT Tim and Deen Holland a' 50' taa• : 200. ~L01), a ~I ,984 MAJ P1 IV89'45.20"W 4.47.24 LOT l o b f _9_11 973.5 ! 4--►gtoPS -i i X 878,3" 0 9~5- 3 $ ~ o Ms3• -+r~cr~~~' \ s7~ - ~y 985. • re0 t' r - $o• a 977.$ X 976.8 X` 83.4 978.8 I~ GND 7P 98 0 79. '.a _ • o-v X 8012 , l~ •fi.• a`~ X 97&2 i z j ` Hvtched ores GND1. ii to be removed X 987.6 i . I 2MO Y tirtD boon 247.24 45.06248'N 589'43 20°E ( _ J /9~/ 925t8181N 447.24 I I t 4&06277N 92 5t79fi'W 4870-S46.8-3,318"W. ~ 92"31 `05 7 2425"W ' 84 GND LMAL M RIFIMNaFARFATO$HREMOVED .1 Al! tbit pail of Lot5,-of Cerdfied Survey =mdcd in Vok= 22, Page 5351, bdvg located in the l z "i f jj Nophost Qumta of tha NoNxazt Quarto of Sc; ioa26, Township 30North, Range 18 West, Tout of • i Richr and & Cmiz Cmudy daddb as follows COinmeaaog if tfie Na9ioaCanet of said 5ccuon 2S; ilxace $ {1W`1S' 18"W ,along the east line o f ~Pn said spctiat 44L15'fcet to t~ Norzhps! Comer ofsaid Lot f tltenoe M89°43'20"W 447 24 feet to the Naribwest Corocrofsaid LotiS;'*== s oo*i r25"W» along 9w west Tine of said i at 5170.00 feet t. thcpo6tofbconning;thencesAo°197m,i490ofeet dmsouthwestComerofsaidLot5'tlxocc & VP43W"P--, abagtbc soutb ii= of said LotS, 200.00 fcM ihcnco N35°04'WV, 46183 1hatthence N.63°Ali'12"W»1d400fectto1hepointofbgOnm4 ConIDwting18,Q0Sq.FL SURVEYORS CERTIFICATE: i 1, .Wayne Swenson, Registered- Land Surveyor; heri~y--- certify thbt; this map -is a- true l' l representation of the lands surveyed and is correct to the best of my knowledge -and belief. Wayne Swe'n o , `RLS NO. 9496 i February 20, - 2012 ` Sl TE: SURVEY ~ OF LOT 5, C.S.I. NO: 22=55. 1 l: '.LOCATED IN 'NORTHEAST QUARTER OF THE NORTHEAST QUARTER ct-n ~c --r zn>,i M4 ctar I L9£tt abed 9 L ' Ion Z AO i 133HS AOAU*d 'M jnW dq PaUMG luouml)" STU, M1 T (1uamnaoW mm" mqwq Po„oA) A„SZ,61o009&Mna9 M 8 t ll'N 0£.L'9Z uoln"s , papa03-v'9Z uopaas fo to HN aw fo ,awo~,a►nna;sr~; ' cull ISng all of Paouaaafat vv SSuunag OOZ 0 001 OF lOl I If lb`f I _ ,OOZ „l laad ut alms II aN111 0311d`IdNn (M., ia£ 068 N 0 PaW0001d) ---i` ,ZZ-S0 141 „Ll,M68At L hZ9 h/ t 3NI-6/[ 3NI earl 4~S ; l grim j (M/Y •7X31 j 1-4 b.9 OK,?FkY0S3VY0'6.6 zooz zAmr j z 107 A -Q:I,,dQ a ~ ~oo0 0p0 ~M SZ 10'1 0 PausD Il,gg q otJe ° ~Opp~pp e° p~ v ° tt-- ~l o 'IM L n ~gMa - G ~Y° ° S-1-IH ° o R • 1 MaAl K Qa a!&sy danw iZ N M m 4-.*%u 30Namn~! 1 a Im, N n' °IZ 00 ° WA. 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SURVEYOR'S RECORD RECEIVEDxFORDf?ECORD CERTIFIED SURVEY MAP 02/01/2007 02:15PH Located in part of the Northeast Quarter of the Northeast Quarter of Section CERTIFIED SURVEY MAP 26, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, REC FEE: 13.00 Wisconsin; including Lot 1 of Certified Survey Map Number 688845 recorded in COPY FEE: 3.00 Volume 16 Page 4361 in the St Croix County Register of Deeds Office. PAGES: 2 BEARINGS ARE REFERENCED TO THE EAST LINE OF THE NE 1/4 OF SECTION 26, TOWNSHIP 30 N., RANGE 18 150' 0 150' W. RECORDED BEARING SOO'19'18"W. GRAPHIC SCALE SCALE IN FEET: 1 inch'= 150 feet NORTHEAST CORNER NORTH 0UAR7ER CORNER N. LINE Or 7HE NE-1/4 sea 26, rJoN. R18W SEC. 26, =KO R18W ^0 ALUMINUM MON.) (~WO RAILROAD SV/KE) _U_N_P_L_A_T_T_E_D__LANDS _ UNPLATTED LANDS - 589'43'23"E: 2621.00' T- S89'43'23"E 655.25' 140 AVENUE 416.01 i~30.B3' 239. 416.01' 211.69' 1965.75' S89 55'11 E 627.70'- l M I LOV 1T 3 LOT 4 Z 229,069 sq. ft. 3 105,535 sq. ft. i N O T H 26 acres 2.42 acres 5. u, 1 V) i W/o ROW r ~ W/o HOW ~ o Z co 215, 950 sq. ft. g 86.759 sq. ft. ~n 1.99 acres J I w 4.95 acres I LOT 24 o e 3 IQ C~ I tV O I Q : 4N Ot N 1 a i Z -239.2l'- 208. d 1 00' 210.83' I N I 0 Z I-r 418.83' 28.38'1-l I -N89'43 20'W 447.241- 3 5 T 0 y I I O o 97, 94 sq. ft. t~Jt` J W o; 2.2, s 0• a /o HO V N N I 91, 673 sq. ft. Z 2. 10 acres - 447.24- 207.99 418, 3 28.87' 1 N89'43'20"W 655.23' i LOT_25 LOT _2 l I l CSM I 1 ~ I a JJ JJ _ NO.- VOLUME 16 PAGE 4361 I EAST OUAR7ER CORNER 1 / ^rf SEC. 26, rJON, R78W I pewee (FNO ALUMINUM MON.) ip • CLAR .!%.t' LEGEND. 211)3'.:; << Prepared for and at the request of: Section Corner Monument HUf?SON,Ly; Eileen Holland Y of Record 227 Meridian Drive Ste X11 • Set 1' O.D. x 18" Iron Pipe wei hin ••`e New Richmond, WI 54017 1.13 pounds per linear foot g 9 O Found 1" Iron Pipe Drafted by. Nicole Gulick JOB # WI057SU236 • • . • • - • -Building Setback Line (100' from Right of Way) Prepared by. io iC„ncrrlfpOrnup Inc NOTE: The parcels shown on this map are subject to State, County and Phone No. (715) 2 up, Ina 9 Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to Fox No. (715) 246-3830 parcel, etc.).. Bye pur. g or veloping any parcel, contact the St. Croix P.O. Box 325 County Z g Office anJ th appropr to Town Board for advice. New Richmond, WI 54017 • Sheet 2 of 2 ~r Vol.22 Page 535 00