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Home My WebLink About020-1478-12-000-dVisGonsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 LaCasse Develo ment, Inc Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: am i s ~ ~~ c, TANK INFORMATION ~-~ TYPE MANUFACTURER ro ~~'~#_ CAPACITY . f Septic i.,._ r X ->., r ~~ Aeration r, Holding TANK SETBACK INFORMATION TANK TO ' - P/~ ,~ ,.ws WELL BLDG. Vent to Air Intake ROAD Septic , ~ ~ ~ '7:~'": f .7 '~ ` ~, _.. , Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head ~TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM County: St. CrOIX Sanitary Permit No: 515055 0 State Plan ID No: Parcel Tax No: 020-1478-12-000 Section/TownlRange/Map No: 13.29.19.3011 ELEVATION DATA STATION BS HI FS ELEV. Benchmark 3 • d3 fj~~,(~ ~Q~ Alt. BM I ~'~ ': 4-NS... G ~ ~~ / ~ v / Bldg. Sewer IZ,~~ ~, SUHt Inlet IZ .to 9Q• ,3 ~ SUHt Outlet IM , `~ ~• fC~, ~ , 3+ a ~~ I ~~ Dt Inlet ~- r Dt Bottom _..,_._~ ,~ Header/Man. 1 c~ Dist. Pipe X3.3 ~-~ Bot. System l~ 1 Final Grade Jam. ~ 9 7 St Cover ,G Z~ e~ / > J BEDITRENCH Width ,,~ Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' ~ ~ ~ ~ SETBACK SYSTEM TO ''~ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:. _.-- ~ ~ INFORMATION CHAMBER OR ; f.-+'(~` ' L ~ Type Of System: ~ ~' may` ~ + y~~ ~ ,f UNIT Model Number: f~ 'Y')~ ~ ~ nISTRIRI`IITI~SN SYSTEM /~~A~~.t _ Header/Manifold s( .. Length ~' Dia ~ Distribution ,. Pipe(s) ~, 'e.. ~' ,., Length Dia ~ Spacing x Hole Size O,, _ ~ x Hole Spacing ~.._,. Vent to Air ntak~ z c~3 Sf711 CnVFR Y ~.e~~~~re c..~rem~ n.,r.. YY Mnnn>1 nr Of_(~radP Systems OnIV _ Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedffrench Center ~ ,~> BedfTrench Edges =._. Topsoil ~., l .~, [~ Yes ~ No Yes [~ No ~,~ ~)~., ~~~tiV~ Cy COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z~/ Inspection #2: / / Location: 868 Hillside Trail Hudson, WI 54016 (NE 1!4 SE 1/4 13 T29N R19W) Alexander Meadows 1st Addition Lot 29 Parcel No: 13.29.19.3011 1.) Alt BM Description = t'~ ; ~'~" ~ ~~J~ ~'"' EZ ~'~~ ?'~'w//~c,• ~1--' cSZ~ .1 ~ S 2.) Bldg sewer length = ~ ~ F,p~-,~~ 'v~'r~ ~~ ~''Oi~' Za `~ -amount of cover = Plan revision Required? Yes No ~ ZZ ~9 W 'Ise other side for additional information. -- 5710 (R.3/97) Date Inse tor's Si ture Cert. No. C. ~ Vvt,~ rw,a~lcl^:•-Q i3 /~twb.Jc.~ ~ ~ D commerce.wl.gov Safety and Buildings Division County ~ 201 W. Washington Ave., P.O. Box 716 (' i sc o n s i n D f C Madison, WI 537 1 ~ ~ ~ Sanitary Permit Num er to riled in by Co.) epartment o ommerce Sanitary Permit Applicatio ~ stateTransacio Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS aze Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be d for secondary u oses in accordance with the Privac Law, s. 15.04 1 m Stats. I. A lication Information -Please Print All Information ,' l sJ ~' Property Owner's Name Parcel # REC Q2C~ - ~ _ - d Property Owner's Mailing Address ' ~ Property Location ~ ~~ ~ l t i ~~ Q ~ 2UU ' Govt. Lot City, State ~ Zip Code Phone NumberST _ y, ~c /., Section .3 ~ ~ ~.-.-~ `- ~~s cucle one T ~ ~N; R~Eo~ II. Type of Building (check all that apply) Lot # ~1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block ~ ,~,^^ ^ Public/Commercial -Describe Use V ^ City of ~` ~~ ~' ~ ^ State Owned -Describe Use CSM Number ^ Village of Z ,~ t,J ZZ + ZZ `~, ~ Town of ,G2~~~; III. Type of Permit: (Check on one box on line A. Corn ate line B if applicable) `~ New S stem y ^ Replacement System ^ Treatment/I-Iolding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner • ~ V . T I e of POWTS S stem/Corn onent/Device: Check all that a 1 ~ ~ , ( -31 Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ~ / Z ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) / V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application R gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed System Elevation ~' ~ ~ ~ ~ (~ ~ V VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units :: ~ ~ o '~„ New Tanks Existin Tanks g ~ / Qp~ ~., ~j~C / '~° o a U ~ 2 v~ h ~ «: rn " ~ R C7 u `" ca L% //t/ V W' V r . , Septic or Holding Tank ~, ~ S , Dosing Chamber VII. Respons' ility Statement- I, the undersigned, assume respo ibiGty for installation of the POWT'S shown on the attached plans. Plumber' a (P 'nt) Plumber' Signa ~ MP/MPRS Number Business Phone Number ~ , Plumber's Address (Street, ity, State, Zip Code) • ~~ 5 ,~ ~, ?~ , ~ ~ 1 VIII. Coun /De artment Use Onl Approved isapprove Permit Fee Date sued Issuin ant Signatw ^ van Reason for enial IX. Condit' ~p~,~ easons for Disapproval i 1z7vF v~ n ' ti~ ~ ~ ~ ne '"'~ ~~"O ~~ g ~ IJrr~X.l 1 . S~tic-tank, eftlGent fitter and Jt n di ers l t ll b N i , r' ~" r ~'~ ? sp a ce mus a e serv ces /maintained l~k~ ~ ~ b IM.R.~ .,~,~ t" ~ t ~{^ as per management plan provided by plumber. ' 2. AN'a~aclteq!u't[erttents must be maintained ,l 1 + /~ ~ a D~ ~~ ,v dlc t ~r~ 3 ti Attach to complete plans for the system and submit'fo the County only on paper not le~ than 8 1/2 x 11 inches in size 0 SBD-6398 (R. 02!09) Valid thru 02/11 ~C. /~ ~~~~~~ i .~~,5 ~,~ ~ 9`"~ ~ ,~,~ -- ~ i ~ ~~; r a `" `' ~ ~ S ~ i' v ,~ 3 ., ~ fl ,, ~ ti~ ~ i ~.~ x ~ ,~ 1""' __r ~ inc.' r ~ ~ - „ ~~ ._. 1 '~ ~ r _ ~~ . ~ ~ ~ _ ~ ~, ,ti~ ~~ ~~ .~ .~ z / ~ ~'~` '~ '' ~, p ~~ _ ~ ~~~.~ ~ ~_ _ ~._~,cr~r,L T~~ .~~?~-C~ t dv'~~~s ~! ~ ~ %~~~~~l~~G~~~ \ j ~ _- - ___ ~ ~ .- ~~~; ~ ~1C O PY ~ ~I~J'"~~ x""73 ~ ~~~ ~~~0~1 ~.~' ~"~ /(~ ~j~,~ i `~~~~ i ~~s 3~ ~~ ,~ i '~ fJf~~ / ~1 1 ` , . ~~~ f ~ ~ ~, ~~ /_~~~.~ 9~~ -_ __ ~ f,` 1 '~ ~~ '~ ~ ~~ I ~. ~~ ~ ~~~L ~` /~'~te5~0 //'' Hi K ~~ h/~-.~Ys ~\I /~-/~~ J ~~~ ~ ~ ,11~~~~ . ~~~ ~~~~ Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code ~1 #2025 Page 1 of 3 Steel's Soil Service "~ County Attach complete site plan on paper not less than 8'/z x 11 inc e. Plan must incl d b t t li it d t ti l d h i l f t i di i d St. Croix u e, u no m e o: ver ca an or zon re ere po a n ), l on an percent slope scale or dimensions north arrow and locate and di to arest road Parcel LD. ~ ?,1 G - t/ ~ , , , . ~,~. ~ /~ _ ~C~ J g ; Please print all information. ~ Re wed By Da Personal information you provide may be u e or ivacy s. 15.04 (1) (m)). ~L /3 ~~O Property Owner Property Location LaCasse Development , Inc. ovt. Lot na N 1/4, SE1/4, S13, T29N, R19W Property Owner's Mailing Address - Lot # yS Block # Subd. Name or CSM# 573 Cty Rd " A" na Alexander Meadows First Addition City State ip C er CI City [] Village ~ Town Nearest Road Hudson WI - - Hudson Alexander Rd. New Construction Use: ~ Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ^ Public or commercial -Describe: na Parent material Stream terraces and pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 94.85 .Trenches spaced and depth to code 3.75ft below grade or and recommendations: to be adjusted to sand depth at the time of installation. -'-' Boring # ~ Ground surface elev. 98.60 ft. De th to limitin factor 100 in. ^ P 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/3 none sicl 2msbk mfr cs if .4 .6 2 12-25 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 25-36 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0 4 36-100 7.5yr4/6 none ms osg ml na na .7 1.6 n ~y Boring # ~ Ground surface elev. 98.60 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sl 2msbk mfr cs ivf .6 1.0 2 9-20 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 3 20-32 7.5yr4/4 none grcos osg mvfr cs na .7 1.6 4 32-100 7.5yr4/6 none ms osg ml na na .7 1.6 r- * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ~ignatur CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/21/2006 715-760-0347 ~ 9/) SBD-8330 (R.07/00) Propilrty owner LaCasse Development , Inc. Parcel ID # Pending Page 2 of 3 • -~1.~~ 3 ^ 3,~5 ^ Boring # ~ Ground surface elev. 95.50 ft. Depth to limiting factor 100 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 0-14 10yr3/2 none sil 2msbk mfr cs if .6 .8 2 14-50 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 50-100 7.5yr4/4 none grcos osg ml na na .7 1.6 ,~~ D ,, ~ /~ $. b ' ^ Boring # ^ 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 ^ Boring # ~ ~ [] 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. *EtT#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 <150 mglL * Effluent #2 = BODS < 30 mg/Land 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. SBD-8330 (R.07/00) Steel'S Soil Service STEEL'S SOIL SERVICE David J. Steel LaCasse Development, Inc. 994 200' St. CST-POWTSM NE1/4,SEl/4,S13,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Alexander Meadows First Addition, Lot 3 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for yow use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. ~ // nr;,N~ ~C~ Legend 1" = 40' • =Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • =Alt Benchmark Ele. 99.10 ft Top of 3/4" pvc pipe ~ =Borings Boring Elevations Bl = 98.60 ft B2 = 98.60 ft B3 = 95.50 ft B4 = 0.00 ft N _. 3of3 ~ i r i i I j;fi;fr ~=1 ~~£~t j -'t` ~T- r-----~-3 ~ 1 ~ _ ~ ~~ ~ t : ; t I ~~~ I,~;~ff~;• ~;;£i•'rtl r T-w~r'''~ u~ j ~ i~ '~ ~ 1 •' i~ 11 i .t ~I, `` }} ~ ... t i t S i t `\ r. ~ , t f ~ I . { € ; i ; ~ 1 i ,, _ .._5~~~7 "1N 133.''' f I t I ~ , - ~ .. , .. r s~ ~' ... ! :il F- '1# ;#• ~ ~y~ \ "' X78' r- ~ \ `~ ~ \ t f; ~t, i i b :} . • r r 'f .• t: 1 , i ~, t ~~~ ~ ..~ .~ .. a : ~ ~.' , l 1 ,~ £ BQ=92W.~: i ~ ~~ ~ .,`^.,.,:,: ~ i"' ~'` o. ~ } 1 ~ ~ t I t r ( f £ } i 1 `~ ~ ~, ~= ; z ...... ` _ ~ •~" ~• ~ LOS` 3 ~ 13 ~~ tf I ~ # ~ ' LO~J ~ ~ ?. \~. ~ ..~ ~ ~ : ~ ..may r/ ! i 3.36v At). I #' ;i ~r ~ '~ ~~ ,~13~(AC.\~~`, ,r \.... f ;. N ~• \ ~,. /, ) ~• (1.35j AC.~ ~ ~ £ i ~ £ ~ ~~1:t47~1C.) \ t 1 \~ ~~ ~~ w ~ ~ ~~ / It ~ s ~~ ~ ~ ~ i 'r I O~ ~~, ~ \ ~\961.3 , ,~ i , ' `. / ~ s i ~ i ~ ( # I E• : } } M "~~ 'til `~ ~ X j w ~ 'ti' ~ X938.9 # ; f~ ~ \ `` ~'' ' , ~ ... ~.. :~,~. `` . f ~ 1 } •'•}.• ••~•• ` A I \ r' i r t ... { ~ ~ WA1~~ / r tt `r9 , ~,.~ . I •` ~. '`, ~ J!"'~ ~\ '~. i~ 1 •'•t„ ,, ~ _. ~.~_`. -1,-- `~--~ v /' ~f •~'~ :~ LOT ~$ ~ ~ ` • < i 1 .~- ~ . 1 .~ _.......~.. _. ~\ I . ~; ~~ -> 2.553 AC. 11- , ~ . M~ .- ' i' i ~ 1 q ,• ~-. ~i _'~ -- ~ ~ ~'~~ / of `; '`` ! ~ i ~ ~, .~~ `~ ~ ~ • .., ~ ~ 1 • t,BO= R ~ ~ t ~ "` ~ i 1 ~. s .., _ 4 .i `` ~ + `t `\ `'~ • , / w. 1 1 M. Vy .r+ w.. r ~ ~ .+/ ~• ~ ` ~. `' -,.-...... ... -... ' • ... / 949.0 ~'° ~ ` ,~~ `~ ' • ~` i \ ` \ \ ~ 1~ ` ~ ••. ~ ~\. i '' ~. ~ ~ ^ ~~ _9~s3.o ~ y ~'~~ ~ ~ ' ~ DRIVE11~1Y ~ ••JOINT ~ - s r ~ ~ ~ `~ . .. ° ~~'~;.~ ; X9s~.o \ £ x94~.o NEl~fl'/[Y"' ~ r ~ % / 0, ~`~~~ \ ~ ` - 950. ... ~ ~~ .~L ~~~J/~J~9 i ~~~~ Soil Absoration System Cross Section ~~kY~d1t~~,L' ~kfi~<IS ~ ~ ac~~ ~11~L_ ~ Final Grade 4° Schedule 40 PVC Vent Pipe ~ J ft _ Vlfith Vent Cap ~ Leaching ~~ Chamber Q. ,3 ft . ~ •- System Elevation .~ ft ,~ft Soil Absoration System Pian View ft ~ft { 1 ft Leaching Trench 1 Vent Or Observation Pipe ~ Chambers 4° Dia. Trench 2 Header l.eachinn Chamber Specifications Manufacturer And Model GJ. ,s~¢. E/a ~ -- EISA Rating sq ft per chamber Soil Application Rate 7 gpd/sq ft r~,:/ gpd Design Flow z ~~ Soil Application Rate ~ EISA = _~ Chambers 2 rows of 6-~~ chambers each. ~. ~~..5/~~~ Page -~ of -~ 13 -- ,~: oo~ ~®- °'"~~~~ O r~ ~ ~ I t~n~~2 s I ~ ~- ;~ wns~s~ AEI I.O~ 1" ~~ '` .~~~ Nti~w om. t v °~ i ~ '~ ® I ~' ~ a ~~ ~ I vm ~ i ~ t CCC ~. ~~ ~ ti • o -v °•\ ~ ~ ~ ~~ `~ ,~~\ ~I ~ ~~~ Q~ otl $ vi canb~ D p ~'~ _' \ ` ~+' ~~ ~ y z m z1 o Z S~ Ct ~' ~ ~ csi Li m ... \ ,~ ~~ \:• ~\ o \\ ~D - m ~ v ®~ ~`' ~o` a~. \ bj '• o~ o r°-, o~c j "\ ~' tzn ~ ~ ~ n.,. ~ o \ ~ i ~\ ~ •' e _- .~" ' .~\ •9T .ice ~. ~Q . "~ °t i _ W . ~S ~ • '•• ~ \ tom. ~ ^^-- ~ \ ~' o ~ ~i z O C O O ~ 1 ~9 • ••\ ~ ~ .~ ~ ~ ~ mr~ •, ~ "~ . , ,~' ~ ~/, • , ~'o i • , .r ~- ,/ ~ .t o .~ ~ '•\ ~ •• "' w LOCATION SKETCH TO AN OF HUDSON v \` ~' . ~\• c u w $ ~ `' oe Lana ' '3 .1" z Unlit Rdtroad 4• COUNTY PLAT OF: t >OOIIIXA91 W'Z * ~ ).wLER szws ~ O SECTION 731 T2BNY R19W` ~I~o M6T 1/I SECTION 1J 1011.20 I Ii I~ I~ --4~C ~C d ~ ~ -- ~ i~l I I I`I ~ I~ I I ~ ~~ -----~ - -HILLSIDE TRAIL- -;L it i ~ / I i i. i i® ~ `I i i~ / I / I ~®_V 2i ALEXANDER MEADOWS FIRST ADDITION LOCATED IN PART OF THE NW 1/4 OF THE SE 7/4 OF SECTION 73Y T28N, R18W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. PREPARED FOR: LACASSE DEYEI.OPMENT, INC. CURVE DATA TABLE (ALL IAxoms ARC W PEES 57J CTY. ROAD 'A" aNY. Yaaw cNtra aa.d n,aad An ratpml YeaMw HUDSON. M 6{018 NWMa/ lol Lw,NN Auy. a.wWq Lrpa Impu ralyrl W Tanwnl wt C 000.00 apTp'6Y 8777 016'E 0Z].N N6.M 90p9T1{Y SITOCIJ•E LOT AREA TABLE a IaaO e1TYm MTJ1'Aaa'E xiN zam 9oeb'{Y[ aesa'aa•E ca N].ro asTYY2{• NNb'60'E Iona In.O N6)'aYJW'C NPnY«'E I' III~II III~II) 111'111 l~I IIII1III 1 1 I La / Sa R. ACIES C{ T]J.00 t11LWJ0. 90PS0'at'E N)A] 0pa07 N0p'JY«'E SOY90't6'E N1 LOT]] 1101J1 2IN 2sD ~ Z 9 3 A Z M 2yx~ x,67. 066T0'I1.0•E 1 1]am 50~C IAT R4 11p116 2N1 6•E S•1PJ]'N•E lOT 26 IAON{ SN6 2) 23100 Jp47N• SOC1Y6aS2 13p.2{ 10261 S00R70YE SIOR6b{'E 85621 LOT ZO p2p10 2111 ?e 237.00 Olb'N' SNITIOT T.M ).a6 310]SYN'E SO01C10Y LOT ]) Ni7p 20p] CS 3.E1W JOOY2S 500'JW20.6'W 121.08 1]200 40T1w10'E 8]tb'OTW ,a111l FEN H. VaIS'N NEGISiER O: pEE0.S LAT 78 010]1 L010 p 16).00 21•N']Y S1BWYt0A'E 02N 01J] 5060YNT. SN'N'06'E Sl LTMIM CD., fll LOT 19 106088 2SOD C) 233.00 21YJ']p' M0pIh0.6•W YIA] 0aY N0p•N'N"N N000Y20•W L01 JO nlJm z6ss a 2]3.00 roaTN• SH21'31'M 2ae6 ]aro S]6M•N•W 5«b'3p•W PECEIVEU :m OE[UNU of/ss/YOU; IU.2oA LOT al IOON2 2711 ro 60.00 M~Y]C 8]>SY1J'W aaOJ aan SNb'3]•w SIOTIS6{•W LOT J2 1701» 11){ CO )aOD ]06l{h0' N3TOb'W 10100 J]A06 310W6'60•W SBA7p'6p•E CWt1TV PLni ~iOL: 11 PALE: i7 LOT JJ tOpS1S 251{ A )0.00 000YIp' SUTN'aJ.S'W NA] N.01 EIOT6'N'W S6O1J1TW AI'A ~' Z DRAINAGE LOT a{ lalms lD2s LoT as 10.NI9 zit{ . R l W al m.aO a0•«'N• N)ob'sl•w A{.la e{.ep xewn•n'w NJY30'71'W ~•i) _!/ / / '/ "~>~g !Ya EASEMENT TABLE'Y' ~ ~~ et {~N'N 65~e 61N 0) M 6 1 N N~ CO[ NEGISIEB OE O[[os r aBCC'wxY asr. 1 arxcncw asr UI JYNw Ai M' Ula 501 SYTOw cll ~ N '726T Palo p 0 p x1 9' 6 T S Y eaao esrc]r Nasn]'aet e{ep euz ssa•,»•6p•E xaoos'aYE U1 5B9'JYTIw 9B UIJ JISSBJIw 9 C3 10).00 70]{'38' NIO'KIJT Ita« 112N N]0o6'{YC NOBRphO'W UJ 5%b>'T9T T6a 65' UII NISTT'A2'W ! I sIJSO SI'w JSBY UI5 NSJ50YJw BJ1T' CJ CI• 10).OD []1b']O' NOpb'31•W ?%.W J50.61 N00Zph0'W 50I~]'[{'YI 23).00 760)'2{• 508'J6'68^W 16210 166.07 500.71'1{'W SYTawM'W US JIJSBSI'W I>{I6' UIB 9B6S0'!l'W %Bl' L1S 3100 0TwO0' SYIYSYW 32N A.pO SYISY00•W SOSTI'pYE u6 ssrioJlT IJaor ul> sB6%Yrw IIITY --sep•JYxsw aue.Ja-- ce am.ao Jr{YJr sw«•z{.s'E a{2m u)w: sl{~o'aet s{~Im'Irt w senalzuw rasa' ure N%sllrw n.on' sJarw rIJ 9T• ua NB9D>•TIT Ta21a• l9N(~I.A5TI~D LdsNCS ~ NISSBJIT 9J ge' UTO N@936YI'W 1910' Ulo Not l>wF I>{al uar Nns Xr rrw ~r. it - - -------- I-CAST-YER 1/I IINE Jo mao Ao76•x• s/ozs'm'w AaaT N ap s6mah3•w N(Y lh • X CApT I/{ L'abYli ~'@ LEDEND \ FWNO AWYIRIM COWNY \ SECINW CCRNR YOMUYENT SET 1-1 Y OINIEIFA YY 18' -----~--~------~~~~. o Larlo w YAR WaaIIN {.1» Lui PEY uraAA i00r NL oTNER LDT twRrtNS 9ANPI~ Y~1"cD ~~ YONUYEWIED w1H 1' W15pE OINIEIPIt BY IB' LDNO __________ wwl PIPE MFla1Pl0 1.15 lB4 PFA LYFAR PDDT v/w vARUNE WotN _______ oRANAfE EASEMENT eallxD,wr \ \\ ~. SWIM LWE 0i 111E ~NWI/1 p' THE SE1/{ vN~o~v u ~® LAND3 _ O.ANID 6NLL ~ ~~'Y ~~ MONROR WELL ACCESS NNE . pOAp NN11 WAIEIt ELEVATw NOR 81RUCTwF3 MAY BE APTFCIFD W MULTIPLE NPUWa RooWBCr~ FoY PPaeee le UW'~W 1P tla MameH Oepallmrl 01 ~ U of ~ lBO . pBap LOWEST BIlRN110 OPENING -THE LOMESi WWDDW DY Wal ELEVAlia4 l.B.a (LOWEST BUIDpq DPENINO) RE51RIClla15 DPEI~IO ~~ THE PIAfYSfSIT 6i THE SIINIDTIYE a`L GDH LOt YNIDER 91NL 8E YL?L'NSME Rp b IPr PodePblm lrPV.l rly fa IHe PWPP wnlYWed cOOWw an o a .aM Tmlla W.0 BY ao D,PL of Nelwal NwpWSN a Ib nawntalM. 1M IwN a Poor wwM N of a. OYvNlon al a. bl xnr. _ _ _ _ -' 17 uTwtt EA9DIEMT APPROPRUIE mADB~+D ~ ~A~ ~ CONSTRUCTION EASEMENT6 .••••..•..••....••... ROAD SEIBA(X (AS sHDwl1 NOR iW3 PROPPattt IS LOGTEO MTIW A PEO Lob m PN Z0 m saeyel b ! mebvatlan eePemrl. MPCy ~r .m w -•-- EMSIINO BARB MRE PFHOE s Aa YAIL DaxsmuDnax AREA. Au wEIL ca+snnlc7px WNL PEa1181E vARIANLE APPROVU am xd q qB To.n a Nwr P N i n an. Tnw w..n.la a. ee C. B.PIaY.a. P[ u• 0bwsan or aP ro.n a Hu4aU H ae ....1 qPl - - FwSTIq MOKII PENCE illgl 1HE Y60a19N Olw. MESLS W1MW 1NE IDFHTFIFD 1200 i00T ZONE IMY BE lIB.ECI ro Y Y dPernN OrYabla q areWot SPall LN AWm HYNde TPP to Ilw rt Oau,OVy PI qM yylel lgan wmgWen of rq aw.watlon Bit D.EVA110H5 APE RQFAENm ADMTCMAL RE010PESIOIR W V NN N rleml le6 YI a• 1 aN 9eau1 TPY 4 n% 4 YacPled. qr wIW1lNOlbl eoeemonq PCN N taaaled « n ro E NailH AMFPoCAH VWiW;AL DATUM Oi IBBa NOR FACN PNIC6 SHOWN 011 IN9 YAP IS SUB.ECT ro 5fAR WUIITY AND TOYWIMXP l UWS RINE§ AND REwUlN1NS (LE. WEILANOR LINlIMW LOT YzE, Arms ro CONSTRUCTION OF SCOUT TRAIL DRAINAGE EASEMENTS PARid, 6iO1 BEFOAE puRa4tSWO BY llu Tam N MrMm nw 6garunM not IN awlluNlm a Lnprewmeot NO OY61E7t 01t DE90FNT SMALL DO ANYMWO wpa wwln W70WERE W7H oR aAraz 1HE DEVFLCPTNO /Ji1' PABOEI CONTACT THE St. GAU cDlRltt zbr6xB olYlcE ANO THE roWN N SPeul TnP Y mt W IN pM Furl N IM Wit Pt qM ILI,a It Y uW nerlNn of a. town a HNd aNl Plawar q. HPNo-or.er and OPFAATpI K THE APPROVED W14RUMNYVE WA1ER DRNNAOE NiD 50. FROSMIV PLAN fUR OF NWSCN FOP AONCE owPlNn oooemrq w eNeWll w aN pMl w wtlwe emeWnlNn w Yngownenl M no WPY 76711 a0 lwnW Wlwrl W vow rgNl-ol-. vita q u u s q Pr IRIS PUT. 1H6 MYSUDFS BUT IS NOT UYIIFD ro ~~ ~• OBSIRUCltl10. N.1COY10. RYya . ow oan.wa a YnPIrW NY 9aeN1 r a aNwle ao [wit b Vy% W euNr rNrvNlan r MWrawnPn4 In YW 11Na1 tlW l n dNWmYN qal ScaPt T bd a t M t N U iWLWO OR F%GVATN6, 011 PIANTNO W AHY w anW NP ro o ilMNaw4 IM aa01o a auaN cm WuPlbn a YnpOwm.n1. Wwll N Can POND OR aIAWACE GBk]IDl15, WATER 0Y 1Ne was a dMap~ I ao NagNN Oua1a N a. 9rINaN DRANiAfP a17a1Ei WAIFR RUNWAYS WA1LW aLwlTi IWNYS DR suss slmwcs glar/a o/ 8rYm la, 12BN. RIBW. 1NP qWn WW PNO aPelYl W Lllar[ ~LaaNYNaHn .o..m.lq to .aN was a a.rNPr a uw THE lowN a Nupsw. m 1» REPRESENTATYE, R OYANiLD ADDESS ro ALt a 1NE DRNNADE FASEIENI3 SHOYM HEREON FOR INE PURPOSE Of MSPECTNIN• YAWIFYIANCE tlt PFDAIRS OP 1HE STgWWA1Eq CONT[OL FACIUllf3 CWTAWID MTRN 5Aq FASEYENII INS wSTRLWIwr pRAFRD Br. WiW W MANE JOB ND, sou-« DAR 00/16/200) REW5Eq ro/]p/200) SHEET 1 OF Y SEC^71011 1] -1]3D.~~ DRMNADE E4SEMEMT TABLC'V" WAv n sann'TIw ]7618• w s1>)3zYE Iw.1)' a s1rTS:rE laaw• w Nsawvrz I rs axY1+IbJT T ve sl9sraw suer SCALE IN FEET 1 DRAINAGE EASEMENT TABLE "YY• AwFCwCW J ses+J•s9w rs3r) w1 soon osw )a1Y' »~ seBSlTrw !J NY NeAv1%w Ia..u• W9 NYTZJ'II'W 1S b' DMINADE EASEMENT TABLE'%' ' / aBEC2Aw asr. ~ aNtclxw asz / a?FCnaN asE M>+J 50•W JOaJO' X 'IJw TTS%' X71 J1YJ0'Ilw at)1' XT 'Ilw JA a NI>EWYJw 91 )Y X.II J)3SOYJw 91JJ' vrw 65 a' wT r xis NTSDBY9•w 99 'OTT IJATI' xT0 N6lLb:16T 80.00' XJJ NJYTJ'T9T XJ Nb 10%T !%J!' x11 NJ6J9%T 51.19' XJl NJT1J'19T 168.91' YJ'S1T BAJB' XTT N%uSBT 1).01' XJB N6T307TT lJ1B0' Xl NA1wJ 11T »AAI' xTJ NBiJY1l'C !),JI' X19 /m1~STT J6T1' NlMSI'OJ'w 151.8?' XT1 NBI JYII'C J2JS' b NBISO'T1T J091' 9 NT>b5'SJT T5. N' XTS 519 J1'01T SII' X1i N6150'1TT IW 11' >b5'vT >l.os' X17 JI9O1'oTT Ja u' N6TJOITT J XII N66b6'S6T IY119' XI) sN:l1%T 9W 61' XN NBISOSIZ I91A5' XIT 51)sBS9T %A6Y XIB NJBYO'%T IIJ01' X« NIB%Slw /aJJ' xIJ N1>bB'IJw 1].N' X19 M00'USTT JAl9' XI9 NIBZOSIw J9101' X I N09Y501T 1J>.10' X% NGw'U'SlT TSJI' XIB SIOaYb>T IOAIJ' x15 N>SSO'TI'W J$TT• S10J'W ]0169 r1> 51aTeb>T TSATJ ~~ XIB JJ6'1331w I>ATJ' XJT N36SI%'W MN' ~~~ UTILRY EASEMENTS N $'~~ ND PaIE OR YDRm cAMET AM ro z PIACFD 3 auul 7NAr 1NE INSUUAINW wpulD DSTIRB ANr b1R1YEY STAKE DR OB8IRUCT VBON ALCMO ANY LOT LINE Dn SIREET DNE. TIE aSOA09ANOE p A 7 A: C W SWVE/ STAKE W ANYONE B A VAIATNW Oi SECTW 2J1J1 Q WSCONSW STANRS ViDtt ~ FASE11F11R A$ IIEIIM EET PORM ARE i131 TIE UY df PUBIIC 1N2M8 AND PRIVA/E PUwIC ~ IrnulES HAWxD ME waNr ro ffRM TIE ARiw 78 ,~ L ~~~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of ,~ FfLE fNFORMATION S" Owner _ c C Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ^ NA Estimated flow (average) gal/da Design flow (peak), (Estimated x 1.5) .~ gal/day Solt Application Rate , 7 gal/da /ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oit & Grease (FOG) S30 mg/L ~ Biochemical Oxygen Demand (BODS) 5220 mg/L ^ NA I Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODS) S30 mg/L Total Suspended Solids (TSS) S30 mg/L ~. NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size %$ in dia. ^ NA Other: ^ NA "Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity a gal ^ NA Septic Tank Manufacturer - ~ ^ NA Effluent Fitter Manufacturer ~r ^ NA Effluent Filter Model y ^ NA Pump Tank Capacity al .~ NA Pump Tank Manufacturer ~ NA Pump Manufacturer ~ NA Pump Model .1~'NA Pretreatment Unit ANA ^ SandlGravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dispersal Cell(sl ^ NA ,f~ In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA i MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once eve ry' ^ month{s) ~ ear(s) (Maximum 3 years) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third {% ) of tank volume ^ NA 3 `aspect dispersal cell(s) At least once every: ^ month(s) (Maximum 3 years) year(s) ^ NA Clean effluent filter At least once every: ^ month(s) l~ year(s) ^ NA `aspect pump, pump controls & alarm At feast once every: ^ month{s) ^ year(s) ANA i=lust let=rats and pressure test At least once every: ^ month(s) NA k~ ^ yearls) . ~'~'~~ At least once every: ^ month(s- ^ year(s) ^ N'°` ®~,~..' ^ NA VfA{NTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shaft be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined .accumulation of sludge and scum in .any tank equals one-third (y3) 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 NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of Sit months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If 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. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain {sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, 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 another 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 will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ 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 CONTAIN 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 Name ~ l Phone 7/ ~--_ ~ _ e- POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ,,~ ~ ~ , Phone ,~ - , ~ This document was dra~;e~ '- ~:-~ lance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & {3), Wisconsin Administrative Code. START Up qNp OPERATION Page ,~ of For new construction, prior to use ofi the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shalt not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction. or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; .grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • 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 another inert solid material. CONTINGENCY PLAN If the POWTS faits 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 will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ 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 fast 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 CONTAIN 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 Name ~ Phone ~-- ~ 7/, - s POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ,, ~ ~ ~ Phone ~ ~ ~ ' This document was dra~;e~ - ~_-- ante with chapter Comm 83.22(2)(bl(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM Owner/Buyer ~AC:A~~~e. ~~ ° ~. C~ ~.~ Y ~~ Mailing Address ~7,~ ~ ~y ~~ ~ ~-~~ ,~~~ ~ ~i Property Address 8~g ~ C L s ,d ~ ~„~ ~~.y.~_ (Verification required~from Planning & Zoning Department for new construction. City/State ~i._~i ~ r ~ Parcel Identification Number LEGAL DESCRIPTION Property Location ~~'/4 , ~ 1/4 ,Sec. ~~, T o"1. a/ N R~c~W, Town of ~~~~-~----~ Subdivision Certified Survey Map # Warranty Deed # Spec house yes Lot # ~_~ Volume ,Page # Volume ,Page # Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper raintenance 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 §Comm. 83.52(1} and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zonuig Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and,pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein,. as set by the Department of Commerce and the DepartmenE 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 & Zonng Department within 30 days of the three year expiration date. Uwe certify that ail statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Nu of bedrooms SI URE OF APPLICANT(S) ~i~~ /~ DATE =~~"*Any information that is misrepresented may result in the sanitary pennit 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. 08/OS) c I STATE BAR OF WISCONSIN FORM 7 - 1999 Document Number TRUSTEE'S DEED Paul A. Spott as Trustee of Renee Spott Trust dated January 15, 2001, for a valuable consideration conveys without warranty to LaCasse Development, Inc., a Wisconsin Corporation, Grantee, the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): The Northwest Quarter of the Southeast Quarter (NW 1/4 of SEl/4) of Section Thirteen (13), Township Twenty-Nine (29) North, Range Nineteen (19) West, Town of Hudson, EXCEPT that part located within the Plat of Alexander Meadows. Recording Arca 8457 1 '9 HA7HLEEH H. MALSH REGISTER OF DEEDS ST. CROIx CA.. MI RECEIVED FOR RECORD 03/02/2007 12:00PM TRUSTEES DEED EXEl~T # REC FEE: 11.00 TRANS FEE: 2220.00 COPY FEE: CC FEE: PAGES: L Na!me~and Re~tum~Address °~~„/~'; ~ •:- ~:.i ~. t-~AC~ & TITLE 1200 HOSFORD STREET, SUfTE 201 HUDSON, wi 54016 ozo-lols-ztwso Parcel Identification Number (PIN) Dated this ~ 5't day of March 2007 Trustee AUTHENTICATION authenticated this day ofTf3C)/ L. TUrn@C 0.i?ry U IC' -~~i~sc ~,Ts+n Signature(s) * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) * v A r i- A evn~r~r Trustee ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ST. CROIX County ) Personally came before me this I~ day of March , 2007 the above named Paul A. Spott as trustee of the Reuee Spott Trust dated January 15,2001, to me known to bet erson(s) who executed the foregoing ins~r tmgnt,an~ac,)trecy~,Rt( the same. * Notary Pu~lj6, State of Wisconsin My Cgm~ission is~ermanent. I not, state expiration ate: (Signatwes may be authenticated or acknowledged Both are not necessary.) J` L (), '`j-gyp` ) * Natnes of persons signing in any capacity must be typed or printed below their signature. ~rdortneUon F~olessiona~s company, Fora du tai, vin STATE BAR OF WISCONSIN B°°r~5-2°zt TRUSTEE'S DEED FORM No. 7 - 1999 THIS IIdSIRIJ1V1E7YI' WAS DRAF'IID BY Judith A. Remington, Remington Law Offices, LLC P.O. Box 177, New Richmond, WI 54017 i ~/ ~~ ~~ j ~y ~~ ~~ Property Owner LaCasse Development , Inc. Parcel ID # Pending Page 2 of 3 . r 3 ^ 3,~5 Boring # Ground surface elev. 95.50 ft. Depth to limiting factor 100 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 0-14 10yr3/2 none sil 2msbk mfr cs if .6 .8 2 14-50 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 50-100 7.5yr4/4 none grcos osg ml na na .7 1.6 ,7~ D ,, ~ ~~ $, Boring # ^^ Ground surface elev. ( y ft. Depth to limiting factor /~~ in. Soil Application Rate orizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Q~i.-Sz-Cont. Color Gr. Sz. Sh. *Eff#1 ~Efr#2 C 6-~ ~~ ,P rz s~ -- ~ s ~ , Z ~ Z f D ~ ~ ~ ~` ~S , ~ ~f A 7.~-y,~ ~ -„ o ~~ ., ~ R / O r l ~ lZ-2 ~,.~. ~-5 Boring # ^ Ground surface elev. ! f ` d ft. Depth to limiting factor ~ in, ^ ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. M un s e ll Qu. Sz. Cont. Color r . Sz . Sh. G 'Eff#1 `Eff#2 /'~ ~ / 'J] / R /~ / ~~ . / //' ~~~ 7~`r -- ~~05 ~~ ~ <,~ 7-~-a~ * Effluent #1 = BODS> 30 < 220 m /L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) S6eel'S Soil Service ~~ . t~ ~~ Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code .~ #2025 Page 1 of 3 Steel's Soil Service Attach complete site plan on paper not less than 8%= x 11 inc ~ e. Plan must County St Croix include, but not limited to: vertical and horizontal refere poin ) d' tion and . , percent slope, scale or dimensions, north arrow, and Iota i and di to arest road. Parcel I.D. C`f. `~ - f_,2 -OCI~ Please rint all i f ti g p n orma on. Personal information you provide may be u e or ivacy s. 15.04 (1) (m)). Re wed By Da ~L /3 ~~O Property Owner Property Location LaCasse Development , Inc. ovt. Lot na N 1/4, SE1/4, S13, T29N, R19W Property Owner's Mailing Address .Lot # Block # Subd. Name or CSM# 573 Cty Rd " A" na Alexander Meadows First Addition City State ip C er ^ City ^ Village ^ Town Nearest Road Hudson WI - Hudson Alexander Rd. ^ New Construction Use: ®Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ® Replacement ^ Public or commercial -Describe: na Parent material Stream terraces and pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 94.85ft. Trenches spaced and depth to code 3.75ft below grade or and recommendations: to be adjusted to sand depth at the time of installation. --- ^ Boring # ~ ® Ground surface elev. 98.60 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/3 none sicl 2msbk mfr cs if .4 .6 2 12-25 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 25-36 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0 4 36-100 7.5yr4/6 none ms osg ml na na .7 1.6 ~~ ~5 Boring # ^ Ground surface elev. 98.60 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sl 2msbk mfr cs ivf .6 1.0 2 9-20 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 3 20-32 7.5yr4/4 none grcos osg mvfr cs na .7 1.6 4 32-100 7.5yr4/6 none ms osg ml na na .7 1.6 n * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 =GODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) atur CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/21/2006 715-760-0347 ~ ~ri SBD-8330 (R.07/00) STEEL'S SOIL SERVICE David J. Steel LaCasse Development, Inc. 994 200th St. CST-POWTSM NEl/4,SE1/4,S13,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Alexander Meadows First Addition, Lot 3 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. / ` / Legend 1"=40' • =Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • =Alt Benchmark Ele. 99.10 ft Top of 3/4" pvc pipe ~ =Borings Boring Elevations B 1 = 98.60 ft B2 = 98.60 ft B3 = 95.50 ft B4 = 0.00 ft N ---~ ~ _ l//Y~ /~'3 ~~ ~~ ~ 3of3 E ~ ~ ~ ~~ ~`:~ f if ~ ~j! r -; ~ ~ ~ ~ ' f f ~ f ~ T•WES~i LJNE / ~ ~ '4 .fit ~ ~ I i ~ , .`` ; _. ~ ~; ~~ ; r , ~ ~ ~ t ~ > 1; ~ it .; 1 ` ~~ \ .. __ ~••~8~° 7' 4"W 133$.52' f# i ; ~ ~ ` • ' ~ ? -- ° ~~ ~ . ,,. .:. e 1 X9~: ; ~ ~ / ~ z .... ,- ~ ~' ~ .. _.~- ~.. ~` '~ ~ ~ LO'S` 3;~ ' ~ ' ~t '' ~ ~ '~ ' , LO~' 't ~ if ~~ ~ \ ~ ~ ,f j i I 3.36~i ACS. ~ # ~ / ~13~(AC.~~ ` l;' m ~ ~ ~, W .~ ~~ ~~ ! f X94.6 r , ~ { i St ' O` \\ l\ ~ •\961.3 ~` ( X9'38.9 ~ ~ ! A \ ~` ~l' II ~ ~ _.. ~ ~......y.. , ..~... ~~}...• ~ (,..~ j~-: ~~,'~ `, ` ~ ! i ~ f ~' \ `a ~ ~ ~ ate' ~ O f s ~ ' --...`` f y J W,~7'L.ANI~ ~ ~ ,~ ~ ~ 930. ~ Z j Z ~ `, ,~ ~ !r-'_.~ .- , ,l\ , € ~ ' '~ 1 ? ~ t / ~ i a sir ' l ;Ia ~ • ~, /~ ~ ~ ~~r • ~ _) t. ~ ~,. ~• j..• y.~ , t~,. ~ .2.553 AC. ~ ~ ~ ~ .~ ,. ~, ~ ~~ ~ `. ~ ~ .\ --gip • : ~.. _., t ~~ . \ 1~ /, (1 M ~• ~y 6 ~ ~~` ~~ '` ..... • "`p"~Q~._ ,~ "'~-~ `~~` -~ ~ ~ ,...~ ... ,': _ ~' ~, ,/ X9431•• , ~,`. ~ `,~~. ~ _ ~_„ .... _ - ~.. -....~ • ..., ~ \ ~ 949.0 ' ~-... \ ,:,y~ ~ ~ ~',.: l •; g f'" ~ ~ ..~ ^, `.,,.9s3.o N ; ~~,•~!~', l XaSt~ o •~~Y } X947.0 QRIVE~{fAY`~' "'. r, •; ; , ~ ~ ; :. _ ~. _...~ ., LOT ~0 ~' • ~ ~ I ~ ~-