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HomeMy WebLinkAbout020-1376-39-000 I ~ ° I ~ o o ~` ° ' ~ fO I ~ h C i y O ti ~ p ~ ~ ~ i O L y N w E °; ,y N - fd I ry y C 0 u °~ '~ a C I y yv y 3 ~ ~ ~ c ~ p ~ i ;~ v-•~ c m~ ~ ~ N p_ 7 y O •j ayi~L~ .. .. C I .. 'p ~ O ._ rp . > O z •- v I c ' ~~y. Z u . o ~ ro 3 w. > y ~~~,~~. ro I ca ~ v ~ ~ ~ N I I ?J ~ ~ Z y E ~ p N E o z ~ v o ~ Q a y m ~ ~ ~ c ~ ~ic m=~ E I c a (~v p~ o I o Z ~- c y y N Sa'c o ai w I ~ ~ ~ ~ r a~ >° a iz~ t/1 F- ~- ~ ~ oo o ~ Z c E ~~w v I o- ~ ~ ~c`o~ ~ I ~ ~ v'' ~~ ~ a ~ y ~ N C O C ~ Vl N O y f0 0 p ~ C ~~w tll U 0 Z y E N I y y ~ y ' N y -~•~ y s y N C y C a ~p d ~ a o C N p O 3 rn o = ~ `~ ~ ~"' r r r ~ aid o }~ ~ 3 3 3 ~aaa I Z V~ ~ ~, I •~ f J 0 0 I V n = Z O y N N C ~ O per' ~ N ~ co ~~ .. ~ E I ~ m a ~ ~ Q rn w I `ov-°1 ¢zin m C LL ~ ''4 ~ G O L y ~ N C ~ Q C~ O p rn M ~ I~ N N 3 ~ L d p l i.r M N p ~ ~ f.. I i Q. ~ o N C -O N ~ y ~ w M ~ ~ i N N U~ N=~ ~° ~ ~ y a~~ I d rn ~~~ a~ ~ •c a ~ c a i ~~ ~, o ~ 2 ! C7 c+> o ~ Z_ Y ~ (~ O ~ '= E I r ~ ~l ~ dti ~ i ~ , ~ ' r~ r + + c E 4 a~ ° I C .~. ~ ~oa ~ A c ~ ic , /* Wisconsin L'`zpartment of Commerce PRIVATE SEWAGE SYSTEM Sa€ety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you prowce may oe useo ror sewnaary purposes ~rnvacy yaw, ~ia.uv t~)(m)). ~reene,l~e~eame: ~ City ^ ~t1~S'Cn°~"8~fnship ~ST BM Elev.: Insp. BM Elev.: BM Description: ~~~~'}' CjU . o - ~/C TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~-- Dosing Aeration Holdin TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~ p' ?j ~ ~ NA Dosing NA Aeration ~.~ '' NA Holding PUMP /SIPHON INFORMATION Manufacturer ~ Demand Model Number GPM TDH Lift Lriction System TDH Ft Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM~~ .-\ n ELEVATION DATA Count~t. CroiX Sanitar~3~tZNo.: State Plan ID No.: Pa rce-d~tc).376-39-000 STATION I~'~S FS ELEV. Benchmark (3 `~Z ") 1(0 , cFb (~ . o ~--r= -~' ~ - ~ ~ l I b. g3 r Bldg. Sewer ~ ~ O IIs; ~-3' ~Ht Inlet `t{ 5 ((~,, 0 3 ` / Ht Outlet ~. ~ 12 . ~-g ~ Dt Inlet Dt Bottom Header / Ma IS ~o (oZ .13 Dist. Pipe 02 . 0 Bot. System ~ DI Final Grad 7 ~_ ~ e 4t.~ /(~"~~ cover o ,~. ~ " 11 b . 7p ~a BED /TRENCH r Width length ~ No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN 1 N 3 DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE / STREA LEACHING Ma a urer: SETBACK / INFORMATION Type O + t r CHAMBER ~ r' ~ ` ~ System: C_m~ ~ SD S (~ ~ T ~ c~h nICTRIRI ITION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ~ / ~~ f Depth Over xx Depth Of xx Seeded /Sodded ^ No Y xx Mulched ^ Yes ^ No Bed /Trench Center Bed /Trench Edges Topsoil es ^ ~f 1„L ,~ ?~ P COMMENTS: (Include code discrepancies, persons present, etc.~nspeetion #1: °~/ ° ~° 1 Inspection #2: / / Location: 948 Florence Lane, Hudson, WI 54016 (SW 1/4 NW 1/414 T29N R19W) -1429192300 Sweet Grass Farm -Lot 39 ~D 1.) A M Descri tion = ~~ ~'~^ ~ ~~""`~ d~'~,~ ~- 4-~--: .) Bldg sewer length = ~•p _~ t ~ S 8 ~ • t D' -, (01.~~ am~,pun of cover = , ~ o~ ~~~ ~ I d-, ~~. ~~u ~ ?. D lL ~„ o,, ci.nQ.n.. Plan evl font equti~ed? ~ Yes ^ N Use other side for additional information. G SBD-6710(R.3/97) Date spector'sSignature Cert No. , ~~~~c~d -~" (~v ~ ~-~2o-/~v . - _ Sanltar~ Perl~lit Ap~Iicutian . ,_ 5 & Huiidi ,,,,, ~ Division in aecard with Comm $3.2I,'Wis. Adm. Code 20i `'~~ Washington Ava 7 ~ P ~ ~ ' ` Sec raverse aide for instructians.for completingthi5•applicution O l3ox 73(?2 ! ...i ~ ~is Q~i~ nls st~manx~~`i1fi~Gmm~-~rce. P PersoAal informatian you provida may 6c: usad'far secondary purposes ~ Madison, wI 53707-T30 (.~tll 11111 Lorslpktod fat1I1~ t0 COtl7ity If'AQ~ _ :... ... [I J1VaL'y raW, & 1',~:(~'1)(Irt)i. __ state 4tMr1Gi. ' ~ Attach com kta lans• to the cone co and fgr.ttte; ., fete. ou a er tlot ass than 8 -1 .~.i l in~nhes in at~r. -" Co 0 l Stute Sanihucy Pnanit Number ifravstoato pnovious apgh~oi-' Stai.e 1!'tyr. 31. D. xrnl er C. A n Itlformatlon -1'I sa Print alI Cnforruatiort Y,aw:utl~ t1: Pro w erNartio Ptv~xr+'y .~tcatian r l~~'~.lls.-.., l; 4 ~!! ld, 5 ~y Taq 12/gE ur,~' Property s utg d trot i~ iiri, ;er tack l gd ~ s ~ sT ~' ~9 City, State dip Code Phaae Ntunbet _ Subrli ~~is~ ur 1Vama ar CSM Ttunl6er r II. 'Type df Suitdiug: (checit al¢e) ~ lli f 73 2 F ^ 1 il l~ N d ~ ^ c':itj ^ ~''El : l; we nl, - e am raoras :_ ar Sr o. o ,-„ ~u" ^ Publ%t;/C:onunnrcial (drsoribe usa):" ~ ^ Stan;-Otivned ,/ Nra~'c;: F aril Pamal °i"n . s ~~~~~ Fi.I. T ~ of Permit: Check cal one box nn line A. C;heak box on lice B if a lieable ,~.~ _ 6. ^ than to ,~,) I. New 2. D Repiacement 3. ^ Replacamont of 4. S s S scam Tank Onl gxistin S stem ,v •~~•• 'B) b t U /~ / CC ISSU Sari Pnnltitwas raviousl issued V 1 ~ IY- Type of POwT System: (Check rill that apply) ~ / tla d d C~ (;a ~ e n a: sttucta O C] S31ndFilter ®-Noa»pressurixcd I:t-ground ou © !?ressuriGed Ia-ground ^ Folding Tank ^ Single Pass ^ ]:i r.' 'i l„inn ~~ ^ A~ de ©Atroi,ic Treatment Unit ^ Rzcircuta ' d t;~tl s`~~ 'V: Dis ersaUTreatment Area Inforzuation: 1. Design F w ) 2. Dtspcrsu Area . Dispersal Aril w pp art . Porwlshen Rata ~'f ~ ~iratxon •. FBlevation t a ~ // Required Proposed Rain (CsalsJduy/sq. tL) (MinJinch) ~ Q t0 60 SO ~ ~$"0 0 ~ 7 '/ ~ . d ~CIlS . Z 'V'Tj, Tattit Capacity in Total # of IKauufacturer Prafub Sita 5 reel Fiber- P lnformatian Gallons Gatlaas Tanks Con- Con- glass New Existing erete strutted Tanks Tanks _ ~' Z cSC) '~ /Z.1 O .Z ,~_ © ^ ^ ,_ ~. Q ~ ^ - 'ViII. Responsibslity Statement C, the underSl ad, assuinn res ansibili for installation afthc POW TS spawn an nd lams. _ Yiumber's nixie (pant s Si~1a stamps : ' r,~lness Phone uxrr er Lsilrns .' /~ zz ~~ ~.. I?~s'~6P'-6637 P Unltltll~6 Address (StrreL City, State, Zip CodC~ TX. County/i7epnrtment 17se Only _ DisapptoYSd Sanitary Permit Fen (Includes Gtnundwater Dote issued J rs ring Agent Signature Ma starnPs} D Approved d Ownertsivnn initial Adverse Surchari;e Pee} Determination ~~, „ ,~ X. Conditions of Approvai /Reasons fur Disapproval: r 3 Wis~nsin Department of Commerce SOIL EVALUATION REPORT Page ~ of~_ Division of Safety and Buildings County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. y1r Please print all information. a ewed by Date Personal inlorrnation you provitle may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 6- i'S-~ I Property Owner D Property Location ~'~ It ~ f ~eI1 Govt. Lot SW 1/4~W 1/4 S~y T~~} N R /9 E (or)® Property Owner's Mailing Address '" - 7X '" Lot # Block # Subd. Name CSM# ~ ~ S' ~ O S cS ~ SS.~ ~~ City State Zip Code Phone Number ~ P :P ~ ^ Ci ^ Village Town ~ ~ Nearest Road - . ~ . ~, ( ) . ~, . ,r New Construction Use:$ Residential / Number of bedrooms 'y _ Code derived design flow rate __ ~ __ GPD ^ Replacement (~ Public of commercial -Describe: ________.__ ____,__,____________.________ __ Parent material ~~.Gt~sC _ Flood Plain elevation if applicable c ~ "~' {t, General comments _ ~'Q' ~ ~~~ / / _ ~ ~ ~ and recommendations: ~~~; ~F~li(~ `~ ~l -~(~.C 6t~ ~ 2~/~~Q 1 Boring # I~I~~ Boring //a fFJ Pit Ground surface elev. ~S ~. ft. Depth to limiting factor ~ - in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary .Roots GP D/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o ~v~Ps/z - SL /a~G,~,C' ~f~ aw Ivy .~ , g .Z Bo~~g ~ ^ Boring D pit Ground surface elev.,~~. Z ft. Depth to limiting factor ~/~Z in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ z • r~ i~ yR yi s, c a~~l6X' as ~ , ~' , s' - trnuent iFl =BUD > 30 < Z20 mg/L and TSS >30 < 150 mg/L * E uent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S a re CST Number '~ i ~l ~sC Address Date Evaluation Conducted Telephone Number 37 Z ~ S T /4~•e f ~/.~ ,s~yoo S- /d= o ~ ?/.r =2tP~ ~G3~ ZT?^ Property Owner y `~'~ I S I Boring # ~ Boring Parcel ID # Page 2 of y ~ - ~ a rit ~~~~~,~~~"~~°°,~•. - "~-",,," ~~~~~~""y ~~~„'~ ,. Soil A lication Rate Horizon Depth Dominart Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2 _ loaf o y/G -- S ~ c, -- .7 /, ~- I H I Boring # ~ Boring ~ ~ uu rn ••• ~~. ~~ °~• •~~° °.° - `r" • „' ,•• •,• •'y ,~~•", ,. Soil A liption Rate Horizon Depth .Dominant Color > Redox Description Texture Structure Consistence Boundary Roots GP D/fP- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 l o-/D /oY 3/Z~ ~ L Bl~ /n Fr Rw v,G ~'~ . 9 ~ ~ ro ~ kQY/ ., ~ n+ c . ~ ,. 7 /, Z Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effuent #2 = BODS < 30 mglL and TSS < 30 mglL 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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S N ~ ~ n O (D ~ ~ d C d ~ S (D N p'~j C~ C d ~ m `~ m I ° o3i~~? y I n ~ ~ ~ ~ ~ (/i <, N O l ~ yy~v ~ ~ O m ~ °mc°-• I a ° ~° I w o ~ ~ ° m N `~ ~ ~ ~ ~ N ~ ~ O N a Q ~ O ~ y O N ~ a ~. <• (D N., y y o < z 1 O ~< 70. vOi O N, C 'D ~ 7 N 7 ~ Q N ~ C ~ ,~ a ~ ~ ~ i ago I ~ ~ ~ '~ I ~ y ~ i _ ~ ~ N fD ~ ~ d ~ a~ O I m I c O °o ~ 0~~1 3 ~ A '. ~ ~ !. ~ A ~ ~ i M M ' O W N N ~ I N fD I A N N O ~t ~ 'il a o a ~ rn ~~r- \ J W ~ ~ ~ O O 2 0 o ca 0 O O O ~ o_ ~ ~ O ~ ~_ B •°-'• ~ A ~ i ~~ I 7 ~ O 7C 7 7 ~ S N 7 V1 N C N fD n. C a W W a 3 °o a Z C 7 a 3 d o ~ n 3 C> ~? 'd N ~ l'"D J C ? N H ~ Q O _' V 7 O ~ N ~ O W W 3 <O N O O ~ O .~ O ~ O C 3 ~ ~ d cWO ~ m N y N N ~ ~ N A Z n ..a ~ C A ~ ~ ~ ~ i> _.~ Z .A ~ ~ ~ A d i.. A'+ 3~ C3 0 G3 T O ~• O H • .Sy„ fi a a fi t~ N °o w ti b ~ c~0 q tv ~ v ~k ~~F~ ~ Lo~C.E L.,~-6 ` ~ Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. `~ See reverse side for instructions for completing this application PO Box 7302 sconsin Personal information you provide may be used for second u oses ~ p ~ Madison, WI 53707-7302 Department of commerce [privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County ' State Sanitary Permit Number ^ Check if revision to previous application State Plan I. D. Number ~~ $ 93z I. Application Information -Please Print all Information Location: Prope ame operty Location P r C~ `` /l, ~ywd 1/4 (~ 1/4, S / 7 T~~,N, I~'E (or~ Property Owner's Mailing Address Lot Number Block Number City, State ~ d Zip Code Phone Number umber Subdivision Name or CSM N / 2- / II. Type of Building: (check one) ~/' ^ City 1 or 2 Family Dwelling - No. of Bedrooms : 7 ^ Village ^ Public/Commercial (describe use):_ ®To n of ^ State-Owned Neazest Ro I 1J3+~A 3 3 I x (Q ~ ~ S~ C Stx.X..s Parcel Tax Number(s) ' ~ . t3 r ~' - T III. Type of Permit: (Check only one box on line A. Check box a if a cable) ~j / 3 O U A) 1. ew 2. ^ Replacement 3. ^ Replacement 5. 6. ^ Addition to System System Tank Only Existing System B) Permit Num er Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) -jE- - OD , Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. Dispersal/Treatment Area Information: q~. 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. oil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) Elevation U~ S ~L~ J J~~ r ~) ... ~^~/ ~i d 9~ ~ VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks Z SGT -- /Z ~c~ / ~ ^ ^ ^ ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signature no stamps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Code) ~y },-, ; ; " , 3? Z /~~ s~T ~~<- ~1` .may -' " IX. County/Department Use Only ~, ~ ~~~~~C ' ' ~.,: ~ d ^ Disapproved ^ O Gi I i i l Ad Sanitary Permit Fee (Includes o dwater S hazge Fee) ~" Date Issued ,. ~~~1 suing Agent Signature (No stamps) pprove wner ven n verse t a ~ ~ ~ ' ~~ ( i Determination ;'~ - t . < • ~ ~ ~, ~ X. Conditions of Approval easons for ap~~r~ppval; '' UN Ffr~GE. ~ W ,~ rvx.~s,-F- ~ CaJ,C.Q. ~ ~ O ~ ~~~tnNt~sus~n?~ i s f~S~S~_'~ :, , ~ 1. SBD-6398 (R. 07/00) •, b ~ h l~~ ~-,__ _ _ -~l r _ _ _ _ - _ .~~__ '~~Scv NtiJS i u~~9N~~w Zz ~~>~ X07" 39 ~ ~ . ,; I I ~-C~-~ !~ S~ I `'~ ~a -^ L,j--- -•-;~ - ~~ `~ ~~'~' ~Itvs ~ s~ r~~ ~N~IS c/ ~~~ ~~ Zz ~~~/ ~~ /~ ~z /~Q .~.Q ~® ~~ ~c~~.e~.. ,~~-c Zrz-~}.~ /4/fro s~ i ~_~~ yxo \ i - ~ _ -~ I rw 0~e~ `. ~ _ ~ ,f ~,o s ~~., -^ bs ~- - ~ ~ -~ - G'L~ S ~\ ,,,/~ 6,.5. eY T~'~ eft °~`~ ~/ t ~~ con n Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road Page ~ of I.,~~.,.~~ C ra i~ ~ Parcel I.D. # APPLICANT INFORMATION -Please pri I " #ctrfin~tfon~ ~.,. ~ Re iewed by Date _ Personal information you provide may be used for second loses (Pri y Law s 15.04'(1) (m)). ~ 6 Property Owner '~ ~ ~ ~.~t-a• ,t""~ CY y-~t' ~l ~ U `° r ! ", .' Property Location Govt. (_ot ~(~ 1/4~(~J 1/4,S ~ G~ T z ~ ,N,R ~ ~ E (or~ Property Owner's Mailing Address ,~ ~- ~° 4 Lot # Block# Subd. Name or CSM# City State Zip Code q Phone Nur~¢bdc ,;~T'r `^~ity ^ Village [~' Town .Nearest Road r--~ 1 ~, ~bYl I I >,) I I SCI c~ l to T,('~ ~~y~ `~I 1 ~v cO sG rl i ~/c~-~ ~ e2 [~ New Construction Use: ~Residentiai / Numbf ~ f -I~edrooi"ns ~ Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow ~ C~ gpd Recommended design loading rate bed, gpd/ftz_LLtrench, gpd/ft2 Absorption area required ~_bed, ft2 7S~ trench, ft2 Maximum design loading rate bed, gpd/fl2~trench, gpdfft2 Recommended infiltration surface elevation(s) ~ ~• $~i G ft (as referred to site plan benchmark) Additional design/site considerations ~Lf r~~ -~r ~ n ~U G ~~''~'' O ~ ~ ~ Parent material U U-~GJ~- ~ ~ Flood plain elevation, if applicable ~~ ~- ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system [~ S ^ U ®S ^ U (~ S ^ U ~ S ^ U ^ S ~ U ^ S ~ U SOIL DESCRIPTION REPORT A\~.. ~ r.~0 J ~ ~ ZUrSD '~ ~~ Boring # Ground elev 9a yb ft. Depth to limiting factor ~in. Boring # Z Ground elev. 9y~ft. Depth to limiting factor .mil _in. Remarks: CST Name (Please Print) Signature Telephone No. a v~ ~lzu~ ~.~- Zy~- /GG~" Address Date CST Number Horizon Depth Dominant Color Mottles Structure i B d R ots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Cons stence oun ary o Bed ,Trench I -r I~ r 3I 2 ~" S~ I c ~~' ~ ~ ~ S Z ~6 ~ ~ m5 4s ~~ . -r ; Remarks: 3 ~Z-~f ~~ ~ ~ ~~ os ~,( ~~ . ~ ~ ~ 8 ~.y qz.y C~-{~-V~--- SOIL DESCRIPTION REPORT PROPERTY OWNER PARCEL I.D.# Boring # ~~ Ground ele . 9~tt. Depth to limiting factl ~_in. Boring # Ground elev. 9~tt. Depth to limiting fact r ~in. Boring # Ground elev. Sb:ZJ tt. Depth to limiting factor `'9 in. Boring # Ground elev. ft. .~ Page ~ of ,3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ~ Trench I o-~8 10 r I~ ~ k m ~ Ivy ~. S ~.(2 Remarks: Z II -4d y y i 1 2rrnb ~ ,-~ ~ ~. 7 --- . S ; . (P ~- y --_ O l,r~ I c s -- _ -~ . 8 `f5•b (. ~ Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/tt2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench ~ o-I Iv r31Z --, SL I ~ c. Ivy ~•s Z i7-99 1(] ~ - m US I c~ `- ~ Remarks: Depth to limiting factor in. Remarks: SBD-8330 (R.9/98) PAGE~_OF 3 NAME Si~~+ LOT#3 q LEGAL DESCRIPTIONSc~ '/4,Gw'/4,S lK TZy ,N,R/~( E (or)~ SCALE: 1"= /Ub~ O BM 1 ELEVATION IOC • U BM 1 DESCRIPTION N1A ~ ~ i n 1 y rr~1Ft (~er+rL~ BM 2 ELEVATIONS . ~ BM 2 DESCRIPTION ~; ~ ; r` ~~'' ~rcldc C' i~f c 2 SYSTEM ELEVATION ~~(, ~f C' ALTERNATE ELEVATION b$• O y ~ ?, p o CONTOUR ELEVATION~~~- i Y - T- r~ ~Z 0 Q~'"•~ e t'+3 , v h ~ ~•F • ~ bS a r ti • w~ v ~/ 03/30/01 FRI 14:24 FAX 715 386 4686 S'T CRX CO ZONING f~j001 Plrivate Qnsite Wastewater Treatment System Man~g+~i~rrent Pian ~epti~ Tank And Gravity in-Ground So4i Absorption ~~~c ns~ponent Pursuant to Comrn 83.54 Wis. Adm. Gode each Private Onsite Wastea~v .Ker Treatment System (POWYS) shall include information and procedures for maintaining th~~~ +s'irstem within the parameters of Comm 83 and 84, and the conditions of approval by the de~;~ ,irtmerrt, agent, or governmental unit. The approved plans and permits for system are on file ~~~ the county coning or health department. This management plan complies with Comm 83,54, Wis. Adm. Code, .r~i rcl the In-Ground Soil Absorption Component Manual for Private Qnsite Wastewater "!•reatment : systems SBD- Septic Tank Com anent Sail Absor;j~ icm Component Design Flow -Peak (gpd Maximum Influent Particle Size (in} c? ~- ,,, - ~'I;f8 Maximum BODE (m /L , ~ r?0 Maximum TSS (mg/L) ,_ ,I ~0 Table 3: Maintenance Schedule ,~~ Septic Tank Inspect andfor service once every 3 year:rf .~ Outlet Filter Inspect once a ear and clean at least or+c ~ ev®ry 3 years Soii Absorption Gomponent Inspect once ev®ry 3 cars ,._ ,_. S®ptic Tank The septic tank shall be rnairrtalned by an individual certified to service 5~~ptic tanks under s. 281,48, Stets. The contents of the septic tank shall be disposed of i~~t accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chan°~k gars, grease interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Pa,n bible Restrooms). The operating condition of the se ti and outlet filter shall tae assia .~;sed at least once every 3 years !5y inspection. Th outlet fine shall be leaned as necssr~s ~;~ to ensure paper operation. The filter cartridge sho a remove un ess provisror~~ sire made to retain solids in the tank that may slough off the finer when removed from Its ear closure. if the Table 2: Soll Absorption Component -Limits of Rgllable Ops~r ~1:lon 03%30/01 FRI 14:25 F'AX 715 386 4686 ST CRX CO ZONING f~J003 f* , AAanagement Plan for a Septic Tank and Soil Absorption Compyo ~F3nt Plantings ofdeep-rooted trees and shrubs directCy over or within ten trw~ yt of the component should be avoided since roo# intrusion into the component may al;r. E~t~tlct wastewater flaw. 3 03%0/01 FRT 14:25 FAX 715 X86 4686 ST CRX CO 20NING [~p02 . ` ' •"'' Management Plan for a Septic Tank and Soil Absorption Comp~~ ~re~nt filter is equipped with an alarm, the firer Shall be serviced if the alarm is acti~~a :sad canttnuously. intermittent filter alarms may indicate surge flows or an impending continuous, ~~liarm. The septic tank shall have its contents removed when the volume of scum and sE~a~ Igoe in the tank exceeds 1t3 the liquid volume of the tank. If the contents of the tank are not r. ,:rnoved at the time of an assessment, maintenance personnel she!! advise the owner of whys 'I the next service needs to tae performed to maintain less than maximum scum and sludge accia 'Halation in the tank. Manhole risers, access risers and covers should be inspected for wat~~ ~ 1;ightness and soundness. /~-ccess openings used for service and assessment shall be scale ~ watertight upon the completion of service. Any opening deemed unsound, defective, or subjl!~c'i to failure must be replaced. 1=xposed access openings greatEr than $-inches in diameter sF~e it be secured by an effec#ive locking device to prevent accidental or unauthorized entry into the 1a~nk. No one should enter a septic or other ~atment or balding t trek for any reason Nrlthouf beingr in full compliance with OSHA statl~l`< rr~s for entering a confined space. The atrnasphere within the septic c r other treatment of holding tank may confaie lethal gases, and re~i~ .rr of a person Irom fhe interior of the tank maybe difficult or impos;~~li pile. Tank abandonment shah be in accordance with Comm 83.33,1Nis. Ac'{r •i. Cade when the tank is no longer used as a POWT5 component. 5oi1 Absorc~ion Comeonent The soi! absorption component serving this structure is designed to asp Sept domestic wastewater from a residential facility. The limits of operation of this compon~!.r t are shown in Table 2. The longevity of a soil absorption component depends greatly on profat r and timely maintenance, and system use within or below the limits of reliable operration. ~ :~c~od water conservation practices by all occupants and the installs#ion of water conservirt 1 plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by insp~3 ;~ian at least once every three years. The inspection shall indude recording the levels of I;n ending, ff any, in the observation pipes, and a visual inspection for any evidence of surface se~i~ atag® or discharge from the component. On steeply sloping sites. areas of erosion should be id~,~i ufitied and reported to the owner for repair. The surface discharge of domestic w~rstew~!ut .r or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the sail absorption component should be avoid+~ i particularly during winter months. The compaction or removal of snow cover over the ct~~n r~ronent may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair anti! weather conditions improve. In general, soil compa~a 1c~n over this component will redusx diffusion of oxygen into the soil and dispersal cell, whin ~ may lead to more intense, and earlier, organic Dogging of the soil. ~ / ~.l . .~~~y'~ 2 04/10/2001 0B: 03 7152686637 GILLE TRUCKING 01/08/01 SON 16:30 :F~~ 715 386 4684 9T CRX CO 20NING ~~ CRl)IX C(?UN'I'Y SEPTIC TANK. MAINI'HNANCE ACs'RBEt~NT ANb OwNERSHiP CBRTtFiCATION FORM Ot!vaedBuyor `~~`~ `~ ~-~- ~ ~ r~-~~~ Mailing Address ! ~.._o i J ~ `j-~('~,~`~'" ~ ., ~~'. GI,LI~ _ I ~ ~~ ~ Ads ~~ ~ - f (Vori~~~ down r~e~qu~ited tbta Phmaigg Departamot is taeur Col~ttctio~ .,_ t~ty/State ~U~Q-S 2~1. r,.w.~G..( Parcel Idontifioation Ntumhcr Q ~Q _ ~ ~r1 ~? -' LF.tt~~AI. AEBCRIP'TIC~~P~ . Proporiy Looaflon .~„ c',:, ,~ y,, Sec. ~ T__~J R W, Town of ~ ~1~-~ S O {~. -~ Subdivision ,~ j~~~ ~ C~~S S ~ (~'` ,~.- apt # ~q..~ C.nrtliied Survey Map k~ _,. _ -Volume ~ .. Psge ~~ _ ~ 1 warranty Dt'ea # ____,., .,. ,Volcano _ ~ ~~ ~ , Pago ~!~ _ 3 C) Spec Souse ^ yes CC~l~ic~ Lot lines identi5able ~ ^ x~~c 01/01 X1002 55 !I _ ~©© 5;;~ Imptopot use atuH tnab: hcoaacoof your kptuc ttntom could moult in Lts pnmatut+s ~lttro to hand a wanes. Pivparmainocaaacc ead9lsls of puaq~iag vut tLo t:c; rt:'ra tonic ovary iLroe Y~ or aooaer. if needed by a i[eenaed pamper. ' wbst you put iaton the system Dees affect the fvactitm of the s ~1tie ta~ak as a staff is qte ~raate disposal system. The ptnpary owner a press to submit W St. Qoix 2attitlg 'Departmestt a oettifioation form, a hued by the oamnc and by a ~P,~~Y~ I~l~ sr..~bcr, t,eNdctsdpluta~ero[a tloeasodptm~pecva~-ia~~at(1) tbo t~«ni ~swrasleMatasdisposel 1a in Pml>~ oP'~'a~8 condition; t,,ad/or (T) after ioa sad P~P~S Cis' may). ~ ~Ptie tapir' i ~ mess titan, U3 !Wl of oludge. U~. rho aaderaipmd hart nm~ . ~I?be afore requlre:~Mt aa~d agree to maintain the privates searngc d~ ~ tai:y~n wrath ma sta~da:ds mt t?b~,, hcrcin, as set by the I ei~artateut of Cotntnecee and the Depactmept of Natural Aeeov3ves~ $t:9A ~~ of Wiscoasia. t7ert~eation ~~8 that Y~ >~P~ sYetott.i .I s~ . boos maiatalnedtnnst bt: Meted and rentrnexT to thz St, t~utx C~o imty Zaaiog tJ~oe within 30 dsya of the tbiaa 9ratie o. date. ~ .... ~(~ _. _. elz APPLtCAt4` ' - __ :.- _ ~ DATS QwNRR C R1TF~~a.-~.~C S~~ I (wo) certitj! that all : Cs,tetnontq va this tbrm aro true Ou the beat ot'ta3r (our) knowledge_ I 1 ero) tus- (~) the owner(s) at true p~opcrgr above„ k y virtue of a watnaty deed reootded la Regisoor' of Deeds Office. S 1VIiD Op APPLtCAtT ' r ..... _ `, DA1'B Aqr ~z:mtion that: ll r ani~oprasented afay :emit m the ~Y peta~it 1>art~ cavokea by Nip Y.odn~ Depa~ent. •k Inetuds rrttis this ttppUtata urge : atamred wamaty deed seao- the 1Zcegiatoe of Daads ot5ea a Dopy of the eertitied tattYey map if >,e[Inmce V made Id the waK: unity deed •• • . • ..1~73PA(,.398 ;~.,. STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED Document Number This Deed, made between ___ _, Grantor, and PF_TFR J GFEE@JE and EVI3bYF1 -r*-,. 6R££P}$, hushand_?t1d trriEe-, ---- _~_ Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In ~ Srp i x County, Suite of Wisconsin: Lot 39, Plat of Sweet Grass Farm, Town of Hudson, St. Croix County, Wisconsin. /~ ~- 36466 K TNL EE'N H. WALSH k GISTEk OF DEEDS S CkOIX CO., WI RECEIVED FOR RECORD 1-D9-2oo1 lo:oo An WARRANTY DEED XEMPT 9 CERT COPY FEE: OPY FEE: TRRN5FER FEE: 161.10 ECBRDING FEE: 10.00 PAGES: 1 ae~•omm ~ nree Name ar~~ )d~tLLEY BANK, N.A: St. roix Falls Branch 2 02 218th Street PO Box 1106 St. C oix Falls, WI 54024 020-1376-39-000 Parcel Identifiratio Number iPIN) This 1 homestead property. (is) (is no } Exceptions to warranties: easements, restrictions, rights-of-way a of record. Dated this ._-_~ a i~ day of December 2000 1 `-1 !J~-N-L~I ~ J (SEAL) ~ h-l~ ~ ~-' . Richard O. Stout ~ Janet P. Stout Signature(s) AUTHENTICATION (SEAL) authenticated this day of (If not, me known to be the ~ s~'r authorized by §706.06, WIs. Stats.) instrumen d aclgie, KERI THIS INSTRUMENT WAS DRAFTED BY - Janet P, Stout 1353 Awatukee Tr Hudson, WZ 5401 6 Notary P blic. State of I My co missign lis penman (Signatures may be authenticated or acknowledged. Both are not __ J~. necessary) ' Names or persons signing in any capacity must be typed or printed below their slgnawre. STATE 8AR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1998 covenants '~ (SEAL) (SEAL) ACKNOWLE GMENT State of Wisconsin, S5. St. Croix County. Personally came before me thi 22nd day of D 2 0 0 (S ,the above named to .~~~i(~ted the foregoing l~SCONSIN J. BAST f not., state expiy?tfon„date: Wisuons:m Legaf Blank (q., IrtC Milwaukee, Wis W .. MIN BUILDING -'~ c eLev.: sPS1.o ~ ~ LOT 42 ~ 2.17 ACRe8 044817 s0 FT C1 w I ( C24 ~ _ _ h ~ ~ . a° ;~ ~ •. w " ! ~ LOl i .• 2.84 A • . „0778 / w 8~3~E ~ ^ N Q.)T ~ .,. F ~ .1 ~ ~ ~ : LOT 41 ~ C2 ~ 2.081 ACFIes ~~ 81~4s aQ Fr . • I a I ~ ,P O sea°'°e'se"E 421 I a ~ I~ .08 I ~ ~~ I . I o, I I I I ~ I ~ ;~ LOT 40 ~ i ~ ,~ ~ 2.1s Acores I a ~ l0 02716 SQ FT ~ . I ( ~ I 4 CORNE ; I ',TION 14 =e.00r _ ~'ei'1~.1,2i.7e' I BENCHMARK TOP OF ALUMINUM GAP ~ I . Q i~ ELEVATION = 911.01' • USGS 1929 DATUM _ • I I~ I ,. Z I ~ I ~jj I I v l° ~.~ ACpl~ 811-27$ sQ FT i ~ I Q f~ td I~I ~ ~ Q ( q~ I~I __. 111 5 .T._._ ,~.~ N.W.L. = 0: ~ i • LOT 51 $ I 2.2s Ades eases eo Fr . i -._._ ~ • ~, • N.W.L. _ ~.O ( I A I LOT 52 . 111 2.11 AR:REB ~ I I I 01se4 eo Fr • e ncnO ! ~ ~n d C C ~ F C ~ p K ~ ~ '9 A •'• ~j ' A 'B C A7 ~ ~ ~0 1 C 41 + ~k A (~ 3 3 :,: ~: ~ ~ ~ p ~ ~ (A 4t T. Ti N Z ~ W ~ c _ A N 'C Q p 7 7 CD ~ ~ p ~ O ~ . ' O 01 c ~ ~~~ O O N N '~ ~ W N 3 fD ' ~ p ~ -+ v ~ ~ -'~ o ~ i N` d M1"' p O ,"` Q' Q' c C p~ n LJ fD ' I -I p ~ N W W bba v A~~ fD ~ 7 ~ O O ~ ~ ~ ~ 7 UI A ~ O ! O O ' C p N N d ~ T 'I ~ ~ ! su ~ m to Z D y ~ c. o m '; c~i D a ~ ~ ~ ~ ~ ~ zz = '* 0 0 rn ~ ~ r- ~ ~ r J : r. ~ d W ~ A Z N N I n r to o ~ ~ ti' ~ 3 ~ a ', ' ~ ~ i ~ , ! ~ ~ i o Z A o ' 0 0 0 ~ ~ o - - ' ~ N D ~ N ~ ~ N N ~' A !j ''i W ~ ~ h V ~, N 3 O ~ p- v vo m ~ ~ ~ ~ = ~ ~ v ~ ~1 N a ~ ~ ! I Z I ~ ~ Z t i ~ sm ~ ~ ~ O D o ~ ~ m 1 t ~ ' ~ ~ ~ m c a ~ co ~ , ~ ~ p~~ a N ~ O c '' /~y y Vii :2 OD N O N' '. V fD a N ~'p ~ ~ C ~ (D a ' W d a ~ ~ M~6 ~ ~ N 7 ~. O » ~ ~ _ A Z p j 3 ~ y O ~ n 'D n ~ N ry 7. 'O c a - A . Z j N N <. m O O I ~ N a; G)'O ! ~ ~ 7 A ~ N m W ~ v pmc °_• ~ ~ a ~ Z _ ' ' ~ p "b ! p : j Z co p ~ ~ A fD '~ A _~N~ y i ~°~~' ~° a a it w ~ ~Zd ~ ~ m a v c I' ~, ~ °-o < Z a N y > N p ~i< S4 fOA CD N. C ~ ~ n V d fD "Tl ~ S C 7 G - 3~"a 7 ~ t A ~ 3 N ',r I ~ d , i 7 d (p O -1 A O N O = ' n "~ to O f0. N ~ ~ 0 N ~ ~ N ~ O O- N ~ N fD fD a O V ~ O- N 3Z i ~ ~ O p O rn O ~, N ~ ° f o a