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HomeMy WebLinkAbout038-1241-04-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 572879 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, S.15.04 (1)(m)]. ~s V 3y Jr Permit Holder's Name: City Village X Township Parcel Tax No: Forder, Mark Star Prairie, Town of 038-1241-04-000 CST BM Elev: Insp. BM Elev: BM Description: CST I J G Section/Town/Range/Map No: IU J 17.31.18.1306 TANK INFORMATION ELEVATION DATA TYPE MANUFACTU `r1' 1,0CAPACITY STATION BS HI FS ELEV. Septic U 000 Benchmark 1 a 100.0 peshv 1. D"& Jo Alt. BM a1 ILL, TM L©✓ V V Bldg. Sewer 'oo Holding _ t Inlet 0 91 TANK SETBACK INFORMATION TANK TO tas / WELL BLDG. en Air Intake LOAD D4.1rHet- Septic C ~0% O L j Dt Bottom 13Q' J (~tJ OI,J .0 Dosing Header/Man. , rt/ 9p!,` Aeration Dist. Pipe ` tv Holding Bot. System 5 h) Final Grade PUMP/SIPHON INFORMATION 2. ~D~ • y Manufacturer -Z-0 I° I PM mand over O' Model Number 50 TDH Lift~. 2 Friction Los~52 System Head 3•G TDI~ ~t 1p$-7 3.) 9~• q JJ J .J Forcemain ILengthl&) Dia. _ ~t. to Well k=fie IULA G /D ~n /nS p~• SOIL ABSORPTION SYSTEM V iwied S 51CPA bet tepee, Or,• S BEDITRENCH DIMENSIONS Width Lengthct~ No. Of r ch@y~~ PIT DIM ONS No. Of P Inside Dia. Liquid De SETBACK SYSTEM TO P/L BLDG -r WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of S stem: E UNIT Mode umber: DISTRIBUTION SYSTEM o / 11 atl clbstd 6jw eSStic~,~ Header/Manifold Distribution x Hole Sizes / Ix Hole Spacing I VAir Intake f Length r-Dia Pipe(s) LengtDia Spacing 32i1 ~V N[ S OIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Jp&Kh Over Depth Over xx Depth of JSSeeded/Sodded Mulchedd / Bed rench Center Bed/Trench Edges Topsoil es ~ No I'Yes 0 No COMMENTS: (Include code discrepencies, personspresent, etc.) Inspection #1: Inspection #2: Location: 938 216th Ave Star Prairie, WI 54026 (SE 1/4 NW 1/4 17 T31 N ~18W)'(~Hidden Ponds Lot 4 Parcel No: 17.31.18.1306 1.) Alt BM Description = -j J ft~ COVQ /1 ,A /1 i~ ( D~ r 10kJ: 0-, / berm wled 4 bucke-1- USeel 2.) Bldg sewer length = Dd 1 r ilem0✓{ (puss')✓/ ✓OC t -AN 7 ~ - amount of cove OM t~eW Hr used owl sirAke ,A IroaAd Plan revision Required? Fr Yes /on. Use other side for additional informs J J SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Count ~ Safety and Buildings Division (fit 201 W. Washington Ave., P.O. Box 7162 I Smeary Permit Number (to be filled in by Co.) S Madison, W] 53707-7162 MAR 16 "t'la ~ 572- ~57 O 9Y. State Transaction Number „('~~l Application sb in accordance wt"~t S$3. ~ ts. A m. ode, su mtssion of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Appbcabon forms for state-owned POWTS are submitted to Project Address (if different than mailing address) I D i the I -partment of Safety and Professional Servies. Personal information you provide may be used for secondaryry purposes in accordance with the Privac Law-, s. I5.04(1) m), Stars. I. Application Information - Please Print All Information Property Owner's Name Parcel # O3~-17,41- 64-(500 Property Owner's Mailing Address Property Location 3 6 - F36C~ Govt. Lot City, State Zip Code (Phone Number > JAJ , Section T N; R or W 11. Type of Building (check all that apply) Lot # r 2 Family Dwelling-Number of Bedrooms Subdivision Name Block Oc a Public/Commercial - Describe Use 17«7 ❑ City of I ❑ State Owned - Descrribe Use CSM Number ❑ Village of X >41111 of, Z4~j~tJjr a III. Type of Permit: (Check only one box on line A. Complete line B if applicable) b~^ 4,. System ❑ Replacement System ~J Treatment/Holding, Tank Replacement Only I L.. Other Modlficarion to Lxisting System (explain) B• ❑ Permit Renewal El Permit Revision It JD Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner I IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground At-G, ade El Mound 24 in. of suitable soil Mound < 24 in. of suitable soil L Holding Tank ❑ Other Dispersal Component (explain)_- Pretreatment Device (explain) V. Dis ersaVYreatmentArea Information: --1 Design Flow (gpd) Design Soil Application Raze( dsT) DisspeerrsA AArea Required (sf) Dispersal Area Proposed i) System Elevation I VI. Tank Info ( Capacity in Total # of Manufacturer } Gallons ( Gallons ' Units New Tanks Existing Tanks I w E v p( P? aj a m m t i 1 ~ P,L•r4 C" ~ ~ i U m y ~ to I Septic or Holding Teak Dosing Chamber X- 64o VII. Responsibility Statement- 1, the undersigned, assn a 'Aponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' i tore MPlMPRS Number Business Phone Number c ,I r7 Plumber's Address (Street, .rty: te, "Lip Code) Z / 2-o ~S 1 g~'p'proved untv/De artment Use Oniv t pprov Permit Fee Date Issued Issuma. ent Signature er Given Reason for De iat PZ~ ' i IX. CondttSWAdIMOWNWasons for Disapproval L t. - peptic tank, ettluertt fNter and 3~ Play-~y ( la. J L 7,a rL: dispersal cell must all be services !maintained a as per management plan provided by plumber. 1 2. AtlseW00 requirements must be mairltalh6d, as pwappHcsbler Code /or dinances. /b 6C6 1. J (.)'S.c. Attach to complete plans for the system and submit to the oun~ ty only o apex notes than 8 i . x 11 inches in size SBD-6398 (R.. i li I-) ~ ~(;t<►,~ PLOT PLAN PROJECT Mark Forder ADDRESS 938 216th Ave Star Prairie Wi 54026 NW 114S 17 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SE 1/4 SYSTEM ELEVATION 99.0' DATE 1/16/15 BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 MOUND HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 384' Property Line All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. del I is to meet al I W D N R setbacks 3 acre parcel Scale = 1/4'1 =1 0' Pro 3 Grading is to be done to Bedroom House divert run-off away from system 457' Property Line Huffcutt Combo Tank Drai nage easement B.I' 1. B-1 B-2 100' ~ 99 98' 96' 18% Slope B-3 Tank is to be 135' properly bedded and provided with lockdown Area 15' be Iove covers with system is to remai n approved undisturbed warning labels 387' Property Line 383' Property Line 216th Ave r,coPy ac; r ~vF~ARTArE t~ DIVISION OF INDUSTRY SERVICES 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 Be Contact Through Relay y P s www.dsps.wi.gov/sbt 2 w of _ h" www.wisconsin.gov CINJAV Scott Walker, Governor Dave Ross, Secretary January 27, 2015 CUST ID No. 226900 ATTN: PO JfTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/27/2017 Identification Numbers Transaction ID No. 2503456 SITE: Site ID No. 809729 Mark Forder Please refer to both identification numbers, 938 216TH Ave above, in all correspondence with the Town of Star Prairie agency. St Croix County SE1/4, NWl/4, S17, T3 IN, 918W FOR. Description: At-Grade Object Type: POWTS Component Manual Regulated Object ID No.: 1521045 Maintenance required; 450 GPD Flow rate; 42 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), Pressure Distribution Component Manual - Vet 2.0, SBD-10706-P (N.01/01, R. 10112); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the above referenced component manuals. In the event this soil absorption system or any of its component parts malfunctions so as to c health hazard, the property owner must follow the contingency plan as described in the approved :plans. In Wi ~ {A.LY,, e must comply with the operation, maintenance and monitoring duties as described in the apPli g cat~EQ manuals. A copy of this information must be given to the owner uPtat zunrpltfitrf► t ihOEM. OF SAFETY' PROFESSIONAL All holding/treatment tanks are to comply with SPS.384.25(7)(a). PROFESSIODIVISION OF IIVtf~AL~► Maintenance information must be given to the owner of the tank explaining that periodic ng o ,`ie filter is required. Access to the filter for cleaning must be provided per SPS 384 product approv co ditio A Sanitary Permit must be obtained from the county where this pr rjctl is IM-1teal rn ° 1r1$ with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SHAUN R BIRD Page 2 1/27/2015 Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsib t ies: • SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of corisu-uctioWiristallation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. )04Q~~When You Receive That Invoice, Julia A Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2, Integrated Services Payment Submittal. (262)397-6005 WiSMART code: 7633 julia.lewis@wisconsin. gov - JAN 2 2 2015 Cover Page INDUSTRY SERVICES Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 1/16/15 Owner:Mark Forder Location:SE1/4 NW1/4 S17 T31 N,R18W 938 216th Ave Star Prairie Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01 /01) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test 12. Filter Specifications V Shaun Bird Signature AND RVICES License numb 900 RY SERVICES ~E SPON FENCE PLOT PLAN PROJECT Mark Forder ADDRESS 938 216th Ave Star Prairie Wi 54026 SE 1/4 NW 1/4S 17 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 99.0' DATE 1/16/15 BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark 384' Property Line All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Wei I is to meet al I DNP setbacks 3 acre parcel Scale = 1/4" =1 0' Pro 3 Grading is to be done to Bedroom divert run-off away House from system 457' Property Line Huffcutt Combo Tank Drainage easement B.M.' B- B-2 100, 991- 98' 96' 189 Slope B-3 Tank is to be 135' properly bedded and provided with lockdown Area 15' below covers with system is to remain approved undisturbed warning labels 387' Property Line 383' Pro pert Line 216th Ave At-grade System Sloping Site Cross Section and Plan View E Dimension Feet t .1.1.1.1.1.1.1.1.1.1• A ot- 1,1.1.1.1.1•.•.,1,1,1,1,ti,1,1,1.1.1.1.1.1••..1.1.1.1.1.1 1•~ 1 1• I ':.:tif'~fLftid':•,'•■f"~f"••r'~1,"~~"••1,L•r'•rh■•,•..•,'ti..'~~+f~f,Lr•,~f`fJ•,"•f71•~~~~4.r~":~':r:fir~%'~~'~i:r:~":~'~t~rt1 ( B i {~.~'.•1•'ti 'L j,4~: ~:1':.•"~r r~l r r~r ~~+`t~r~r:d'•:!'L f'•alti j r"~.'L~tir"~f'~rtij'~~,yf'~1,~~,:l:ryJ~J~r+r• I 1 /6 B / J ' r.r•r•r•r• • • • • • r r r r r r r•r•J•J•J•J•J+r J r+ 1.1.ti,.1.tid:l ,".r'■~'2,j,L~,'~.`'~lL~':~1':1':1'~~l':J~r rti.`~f~rtitil ti 1• +■•h.•L 'L o f J•r•l •f J J 1' J• I ~•l•r•r•r•r J J•r r J 1'•r•r•t r• ~ I. 1.1.1 jtit 1''LJ'.~'~J~R~J~J~a ,f~%f~.•`~1'~1'~1~J~2'~ry~'q '..•.•'L 1.•'L S•~. i L •.•5~•'..'~■+.•4 i~ •.•5~• / (i/ •J•J• •~.1.1.1.1 1 1•1•'.•'r 4 1••L 'L•'t•'. 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Existing GENERAL INSTALLATION: The at-grade area is staked out along out and plowed with a vegetation is mowed and raked off the site. The basal area (L x staked plow depth moldboard or chisel plow. Plowing may not proceed if the ssoil is wet enough of the hands. A B area is form a 1/4 inch soil wire when a sample is rolled between the palms care must used covered by clean aggregate deposited overhead by a backhoe. het psoi cap is placedwhen placing the aggregate to minimize compaction of the plowed ssurface limit erosion and protect the entire at-grade is seeded and mulched to promote vegetative growth, from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/051gj Page - of Pressure Lateral Layout One Lateral - End Manifold .4 Threaded Cleanout Lateral Turn-up Plug Force Main L Long Sweep 90 Bend Pressure System Construction Distribution Network S ecifications Lateral Diameter 2 In. Laterals are constructed of Schedule 40 PVC Orifice Diameter z_ In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) r,2 In. the pipe with a sharp drill bit and face down. L Lateral Len ot) h Ft. Lateral turn-ups terminate with a threaded Force Main Diameter Z In. ceanout plug and are enclosed in a 6-8 inch Force Main Length Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade Q.•• 6-8 Inch Lawn Sprinkler Valve Box Page of 03/05 lgj Cross Section And Pump Performance Specifications Septic-Dose T~ _ _ Pump Manufacturer _ l ank Manufacturer Pump Model Number Tank model Number l Alarm Manufact=r S otal Tank Ca ity T l Alarm Model Number L - Max. Bury Depth - Switch Type _ ---------r- - Total Dynamic Head ('TDH) - Feet- - Filter manufacturer - Elevation Head Filter Model Number Distal Pressure ~ Network Loss Minimum pimperfarmance Required d Force Main Loss ~ GPM: aQ Ft TDH Total outlet Manhole Njin. 4" Above Gracie With Manhole Min. 4" Above Grade I,.wking Deg ice- Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight securely Mounted Weather-proof junction B'X- Finished Grade Vent Min. Disconnect 12" Above Grade Means • With Vent Cap t 1 _ Outlet Filter Wert Baffle Inlet _ A 1/477 Switch Se*gs and Reserve Capacity Weep _ Tank. Volume GPI Hole B Dimension Inches Volume Gal. (reserve) Ai X. Off Elevation C (alarm} B 2t (dose) C 3 5 - Bottom ;a x• (dead) D D Elevation Fi • 8 . -7 Total . a•a 'i:i • a ~ . i , a . a t . a . t . a a , . < t t t t t t•t a 1 1't i•:t Irl I•i 1'i :I•I•r•s I•~ . Lk-~`a GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufavt1uer,s product approval speeificstionsr Maximum depth of bury as speaiflod by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch• 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical Service complies with NEC 300 and Comm 16.28. 02105 U Page of T.~r,i r'YNAMIC HEAD/CAPAC'-1TY _ PER Wti'1'E • CAPACITY CliRVE EtiT AND OLwATERIN---' HEAD - -T-- 153 011 MODEL 152/ 153 Mop 152 i i LilErs F10 J ~ r_ - r 251 1 77 29 t I 50 5 t o 69 120 I J 5, 231 i 70 153 11 10 ! .3 23 1 1 I ~f _4_67 12 40 15 1 44 1c7 52 9,' -1 2- °.34 120 42 - - - - - U 30 2, B7 3, 1 z5 1 42 20 I 40 ¢ ''lt hKl! . -14m 38 44.0 ft) 4 I 10 i i i I ~ 100 0 20 40 60 80 r.-- 0 1/a GALLONS 7-- 5/5 LITERS 0 8C ,60 240 320 - _7/~z_-.•-'_"""I`- 71-32 FLOW PER MINUTE - - -1 FA CTORY FOR SPECIAL APPLICAT IONS CONSULT IONS } 27132 Timed dosing panels available. lied with Electrical alternators, for duplex systems, are available and supplied an alarm. j Variable level control switches are availab:e for controlling single phase ` systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. Sealed QWik-Box available for outdoor ins:ailations. See FM1420. • Over 130°F. (54°C.) special quotation required. ~ 2 7F 777 1521153 Series 5 t/S control selection i52t153 MODELS _ 9,Sim Iex SK2084 I Model YottsTPh ~4 np r2 or 3 Non 6.5 t i N152 115 1 8.5 Inciu.3ed~ I BN152 115 1 Auto 20r3 E152 230 1 Non 4.3 4.3 Inclu'ed 2.0 3 1 BE152 230 Auto r SELECTION GUIDE N153 115 t Non 10.5 t _ _ r ` back variable level float pggY SN153 115 1 Auto 10.5 Inclulea- - z2o.3-1 1. Single piggyback variable level float switch or double t_f _ - E153 230 t Non 5 3 Indutled ! 2 or 3 switch. Refer to FM0477. cal Aftemator E BE153 230 1 Auto 2. See FM0712 for correct model of Electris a conro -Pak. du lex 3) A -CAUTi-ON-71 a ualified 3. Variable level control switch 10-0225 used as a control activator, specify p ( All insttliaHon of controls, protection devices and wiring should be done by the most or (4) float system. Iicenttd electrlaan• All electrical and safety codes should be followed including c Code (NEC) and the Occupational Safety and Health Act (OSHA). recent National Electri RESERVE POWERED DESIGN For unusual ccnditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.U. BOX 16347 Manofacturersof. . Louisville, KY 40256-0347 SHIP T0: 3649 Cane Run Road Q,rr PpS N~f /939 Louisville, KY 40211-1961 /j aw. (502) 7782731.1(600) 923-PUMP Mg FAX (502) 774-3624 httpafwww.zoalisr.corn ~fJ~lr/ © Copyright 2000 Zoeller Co. All sights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION SYSTEM SPECIFICATIONS Owner n/!Gf Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ NA 3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units Pump Tank Capacity al ❑ i Estimated flow (average) aUda Pump Tank Manufacturer ❑ NA ❑ NA i Design flow (peak), (Estimated x 1.5) aVda Pump Manufacturer ell Soil Application Rate J allda /ftz Pump Model ❑ A Standard Influent/Effluent Quality Monthly average* Pretreatment Unit Fats, Oil & Grease (FOG) 530 mgiL ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: ! Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BODs) S30 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L t-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line 0 Other: iMaximum Effluent Particle Size in dia. ❑ NA Other. ❑ NA Other: xslA_l Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency Month( linspect condition of tank(s) At least once every: ❑ r (s s) (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (h) of tank volume O NA month(s) linspect dispersal cell(s) At least once every: ear(s) (Maximum 3 years) ❑ NA oath(s) Clean effluent filter At least once every: 2y; ar(s) ❑ NA Inspect pump, pump controls & alarm At least once every:, CJ,m s) 13 NA ar sj -yertth(s) l9ush laterals and pressure test At least once every: o a th( ❑ NA 6ther. At least once every: ❑ month(s} ❑ NA ❑ ear(s) 13ther: ~ NA MAINTENANCE 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 immbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall 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 or more of the tank volume, the entire contents of I:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 14,11 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 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. Page of START UP AND OPERATION arntin roducts or other chemicals the4t For new construction, prior to use of the POWTS check treatment tank(s) for h'hh concentrations are detected have the contents of hilt may impede the treatment Process servicing prior to use~rsai cell(s). 9 tank(s) removed by a septa9 operator 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 result in the backup oh surface discharge of will nlt discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may h rotor prior to restoring power to the effluent this s rucontachtaa ve the of the pump tank removed by a Plumber contentsor POWTS Maintainer to assist in ma ua itay operating the m p controls to restore normal levels effluent pump 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 wit n 15 feet down slope of any mound or at-grade soil absorption area. rove the performance and prolong the life of the POWT~> Reduction or elimination of the following from the wastewater stream may imp 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 produco; pesticides; sanitary napkins; tampons; and water softener brine ABANDONMENT Wisconsin following steps hall be taken to insure that the system is propefiy When the POWTS fails and/or is permanently taken out of service and safety abandoned in compliance with chapter Comm • 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 compli.o replacement system: should been evaluated and may be utilized for the location of a replacement soil absorption i ❑ A suitable replacement pot cted from disturbance and compaction and should not be infringed upon by requfiled The replacement ent area p setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result the ruief for a new soil and site evaluation to establish a suitable replacement area, Replacement systems must comply effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologic a holding tank may be installed as a last resort to replace the failed POWTS. -the site has not been evaluated to identify a must holding tank may be installed) as ed to locate a suitable replacement area. Ifnno replacement area lsuavai able a0 ~ be perform a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the tNOmat 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 P OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. / DEATH MAY RESULT. RESCUE ENTER A SEPTIC, PUMP O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER - Name - Name Phone / , j Phone E - I LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR PUMPER F Name Name a'Y? / Phone -9 Phone 7j~ ' ~U - f, This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. F i FILTER ARTRIDGE INSTRUCTIONS Installation STEP 2 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered tank through outlet or solvent weld (glue) additional rnpipe onto the outlet the 9h th pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length the support k end is not tilneeded to be the meth d 'lulil utilized, of doinch pipside s pp rt, If to the optional supplemental proceed to step four. is not STEP For installations zontto the filter case. f side support method solvent t weld the /4-inch pipe utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insertthe filter cartridge into the case, pressing down until the filter locks into the bottom of the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning _ clockwise 901. Maintenance 1. The effluent filter should be cleaned every time the septic tank is kx t serviced. ~ a !f'~ll a 41 x 2. Open the outlet access opening to inspect the tank and filter. - 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the . cartridge from the case. and out of the case for cleaning. +ax 5. Slide the cartridge up 6. If a VRS switch connected to an alarm is present, the switch` „b should be removed by turning counterclockwise 900 and cleaned with water only. 7n' 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 900, 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case, 10. Replace and secure the access opening on the tank. BEAR OPtST.TE'° FILTER CARTRIDGE - Fi1'E-YEAR IMdTED WARRANTY 5cd, .1o- 71?.cr ~a ~G,.< . n BEAR ONSITE'" Filter case -t.ife:i me Lim itecl Warm n.:y K..,•a,:,. r;, i c J Pu._.. S -Wln' ME < ;r2 ~.i: <i;,'T':8 •`d' ,1, •r ,t J ,.,,:ere... r" . l-. '1 all (.'x:11<i^f t,1! ii' < Y ? ~C t all "J rd 4 ie F r ~1 rr P 7."1 6` f h9s. "nom JL .d 1 lug - t: e a a -.na, s a1 z.,, , u ...5':E O. 'el✓- GI'11e 101 ldU1 i t shell tr'e i , t'n 0, .'t ,r rE c..a...c... " cwacmcM. . ..acme.. -a- { O/RECRON D/ST { O/RECRON O/5T. IF 0IREC770M DIST. IF D/REC17001 O/ST { DIRECTON DIST. { O/RECROW DIST { D/RECRON DIST. IF D/REC770W &S r. IF DIRECTION 0/5T. GI 5687727"E 756.01' G9 NI148'39'W 44.67 HI N8877271W 71.96 11 52076J8E 107.87' 17 115779J871 J481 JI 58448'71'W 166.83' J12 56J7J70E 3169' J25 N09J739-W 24.29' JJ4 5J079021W 5957 02 5109454E 6577' 010 NJ142'19'W 62.13' H2 S097J•J9'W 41.5J' 12 55021'/1'W 46.58' /8 NJOJ652 E 5840' J2 N5079J5'W J388' J13 N535202E 671' 324 N00JJ'D5'W 4037' JJ5 NBJJl20'W S0J5' TABLE-DRAIN) GJ 505J7J/'W 166.56' Of/ N0446'02'W 1572' HJ 5200JJ2E 21.96' /3 SO/44:T8E 5524' 19 N027929'W JO/9' JJ 5610145'W 24.49' Jl4 N893601E 40.87' 375 N077651E 1924' JJ6 5730Y05'W 39.61' EASEMENT IV C4 5265809E 4120' G12 N68J8JOT J226• H4 S7J78'45E 20.65' 14 55020WW J0.59' 110 N4855'17'W 54.54' 14 578JJJ2'W 2517' J/5 N7649'Def .57.88' ✓26 N/J50 WW 66.58' JJ756/:T8'061W 3030' or D/RECl10N M. G5 56138.16E 64.57' GIJ NOJ28'ISE 21.58' H5 5737845E 1TJB' 15 57179105 E 20.06' /11 N8045:T8'W 76.22' J5 N582441'W JJ JS' J16 N644547E 48.03' J27 N1350'J81W 26.62' ✓J85JTJ456'W 5091' KI 560V026'E 4i 06 N7549'OBE 5660• 014 N4152J4'W 79.02• H6 N75J4'4!E J9.18' 16 5782127E JJ4.77' 112 N59T7827E 26&6J' J6 N1472291W 3282' J17 N450I76-C J1.29' 28 N4834411W 2818' JJ9 S17VMSB'W 52.29' H7 N5I4459 E 91.62• J7 N29T1421 E 2570" ✓I8 N695707E 45.37' ✓29 5887727E 51.49' ✓40 N882420'W 67.53' K7 5602149'W 6: G7 N2474J7E 4294' G16 N887Y27'W 15100' KJ SO4J529'W 6: GH NO6'492f f' 6047' Gl 5867717 E' 21!.37' H8 N8877'2YW 81' J8 N8579'OJ E 19.11' 319 N695Y0]E 6. 19' JJO 5887727E 6510' 341 NJJ:78•J1 E 2557 K4 54501761E 4: H9 SJ69530'W 813171' J9 57704116E 39.05' 320 5450176E 6. 18' JJ7 512231271E 9361' ✓47 N3J:76J7E 25575' K5 N775074E 2: N88°17'27•W 2224.92' J10 56079109E 4652' 321 N587J51E 51.79 JJ2 SOJ76'24 E 59.74' ✓47 NJJJ8JIE 48.37• K6 NOOV026'W 72 ill 57/74'14'f 6GJ' J22 NWV2'OJE J9.16' JJJ 56176'49'W 20 10' K7 NOOVO'26'W 15 CIS c BLOC'( OmT.- 1313.80' 890.74' C16 HI HB \ J '135.78 H8E-967.0 ~I Z EASENEGE \ 1 i 384.80 e 0 957.0 \ \ \ I / DRAINAGE HVE-9520 1I I I I EASEMENT C' '.1 1 /`ry Ill 1 / / / h I 1 r DRAINAGE / ORA/NACE I IrL \ \ \ LOT EASEMENT h' ^q 14 EASEMENT;/' I,E \ S I 11 '.1151106 50. FT. 5~ I HVE-95LO ~lY ^p^~1 I J')' \ •LB.0. ./969.0 \ Fy-\\I 3.30a ACRES Nn2swaw~. 144075 50. 1T. \0 fl1 L&0. . 959.0 L13:0. sea.0 1 L7 1 / HNE" 8520 \ \ %6 1 9 P50 y/ , ~V ~18 XY~E- 95k0 DRAINAGE \ _ \ \ Q J / FASEMENi 2' \ \ S\ ~AA52MENT ,ryJ Af3 Jf5/ =8 Jf0 - - ` \ \ \ \ - ` \W f ✓l4 CIO NftflYO•~/ 4f&!f' 967P8-~.- . - - . - - . 'l set46'zl •1/''Wee8~~6~f```.~~~40```' - - - ~i ; - - ~8~µ 16'w 1' 1.18 970.9 _ ccTH pVENVE 11 21v C8 .-Nl 88r24'i0•i 4249Y I \ \ ` P1 . CB T/P 40•fl•f MI T\ 961.8 fIP - - 2725 - - 'H6E~ 9519\\ 21 955 _34274'- . - - . N 80' M !j I ORA/NAGS EASEMENT T/'~ $ 1\\\'EA~eAA-Oj %1 Fr. \ Pl`P11 \ V SfAI P7 P~6 Q r0 o Fcl N6 115 I 1\ ` H.-934.0 BE E ON 1 DRAINAGE \ PBS f~ 01, \ _ EASEMENT 1' OF THE .73 _ \ q7, I J 4 ^ ..........................\DRAINAGE I h7`y ~ EASEMENT O' LOT 7 ; i.. ; 2170 ACRES m o H%E.96&0 ul 941521 SO. fi. LOT 6 1 ACRES 20300 T~.S o $ L11.0. 988.0 8 9 09e 50. Ft. 8&426 I g 1-8.0. - 950.0 5% FT. LB.0. 9 970..0 0 \ \ 0/6\\/q 100 181.15' BLOfSf Mc1~ +me O17 ~ - ••r~ •e• I ST. C.ROIX. till rNT' SEP'1'I(' 'FANK. VIA N I'.I N ANC:E) LGRFEMI'NT AND OWNERSHIP CFRT)_F1('AT1E~~N FORM Owner/Buyer Mailing Address 41)""Palt ` G Property Address3 l_6_ _ (Verification required from Planning cS'r. Znent fi tr new connlruction) City/State Parcel Identification iNltraber _~r 3 LEGAL DESC R PTIt) N ~~t Property Location.~~~___ , , Set:/ 7 _y 'I' 1 VV Town of - - - Subdivisioli G/U - - - - _ _ Certified Survey Map # Page vc, [11tile Page It Warranty Deed no Sptc house ayes no l:ot lint,. identifiable. 0 SYSTEM MAINTENANCE AND OWNER CERT114ICATION. Improper use and maintenance of your septic system could result in_ its pr smatare failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, i) needed, by a licensed pumper. What you put into the system can affeet the function of the septic tank as a treatment stage in the waste disposal syst:erti. Owner maintenance responsibilities are specified in worm. 83.52(1) and in C hapter 17_ ~>t_ Croix. County Sanitary Ordinanca;. The property owner agrees to submit to St. Croix County 1'iat)rung LOnisg Department it certification form, signed by the owner and by a master pltunber, journeyman plumber, restricted plturther or a licer;sed pumper veri.f0ug that (1) the on-site wastewater disposal system is in proper operating cotidition and/or (2) after inspec iorr and purnorig (if necessary), the septic tail} is less than 1/3 full of sludge. 11we, the tmdersigned hrove read the above reyuirenurnis and agrekc to mairtaut the private sewage disposal system with the standards set forth, herein, as set by the .Department of C:on inerce and the .pupa*_tinciit of Natural Resources, State of Wisconsin. Certification stating that your septic system has been riutintained mast be conrplett r land reitrrrred to the St. Croix County Planning. & Zoning Departrncrit within :30 days of the three year expiration date. 1/we certify that all statements on this for are uuo to the best of iuy/our k nowledge. Uwe andaie the owner(s) of the property described above, by virtu f a warranty ec.d recorded in Register of lleer;ls Office. Nurnbe f bedr SIGNATURE{ OF APPLICANT(S) DA ***Any information that is rrtisiepiesei ted may result iii the sanitary perrciit bt.ing o woked by the Plaining & .Zoning I)eparixnent. Include with this application a recorded warranty deed f.iorn the Register of Deeds --,ffice and a copy of the certified survey map if reference is made in the warranty de-ed. (REV. 08/05) 1007334 BETH PABST REGISTER OF DEEDS State Bar of Wisconsin Form 2-2003 ST. CROIX CO., WI RECEIVED FOR RECORD WARRANTY DEED 02/02/2015 10:13 AM EXEMPT # NA Document Number Document Name REC FEE: 30.00 TRANS FEE: 111.00 THIS DEED, made between TTR Development, LLC, a Minnesota Limited PAGES: 1 Liability Company **The above recording information ("Grantor," whether one or more), verifies that this document has and Mark Forder and Nichole Forder been electronically recorded & returned to the submitter ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following Recording Area described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Properly") (if more Name and Return Address Mark Forder and Nichole Forder Return t0: space is needed, please attach addendum): 1157 Hidden Lane #202 ' New Richmond, WI 54017 I Global Closing 1895 Plaza Dr, #10( Lot 4, Hidden Ponds, St. Croix County, Wisconsin Eagan, MN 55122 l _>C.iLi Il lCevv~ i 038-1241-04-000 Parcel Identification Number (PIN) This ~S ftik. homestead property. (is) (is not) Exceptions to warranties: Declaration of Protective Covenants and Easements, Dated April 5, 2006 Dated December 23, 2014 JENNIFER GODBOUT TTR Development, LLC Notary Public-Minnesota ~wr My Commission Expires den 31, 2D15 (SEAL) (SEAL) * Thomas Barry, President (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) ss. authenticated on Washington COUNTY ) * Personally came before me December 23, 2014 the above-named Thomas Barry, President of TTR TITLE: MEMBER STATE BAR OF WISCONSIN Development LLC - (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stet. § 706.06) instrument and acknowl the saine. THIS INSTRUMENT DRAFTED BY: * Jennifer L. Godbout Global Closing & Title Services Notary Public, State of Minnesota 1895 Plaza Drive $100, Eagan, MN 55122 My Commission (is permanent) (expires: 1/31/15 ) (Signatures maybe authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. St. Croix County 1007334 Page 1 of 1 (715)24&3010 0 ~ ~ 3] l~ ryli~~ - i NOTIC@ 11 -1 prip - r' Oevering Homes M _ r „I 1 + 141&Pl-a3 1+n ELEVATIONS j z 704 SO. Fr. 975 SO. Ff. 4e4 50. Ff. 1952 S0. Ff. Al ++r•~a' GARAGE LOWER LEVEL BONUSROOM RNISHED K1 (715)248-3010 w< ....s<u.o•w.».mn ' I I r-- ,~.m.,a..,em~o - wwww k e mmwuwrto i x ys y NOTICEI 1..1 I y i i I : II i t s 'IµIr- 1 I` I~ l u l I I I I I.I I.~ I ' I " i i. l ws.. I I s I ' i ~ ~I o~~w,a I I e I a I I I I I I I I i BRACED WALL LINE e. ao.~mn PANEL DETAILS Oevering Homes WO-Plan #3 FOUNDATION a A2 W'(715)248-3010 I g~ 9 7 0 4 s ,.m. .o , I I I I I I I I le I I 0 „a~~ I I I I I BRACED WALL LINE PANEL DETAILS Oevering Homes B'. s0. FT. MAIN LEVEL 74164P1-B3 MAIN LEVEL o.,, A3 Property Owner _ Parcel ID # Page of F3~ Boring #❑I Boring ing Pit Ground surface elev.' ft. Depth to limiting factor-,/;- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 I 0-8 to ,31z - s /0 , Z 1 - S s i ni 14 rj ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BODS > 30 1220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 mg/t- 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. SB0.8330 (R.W00) Page of Parcel ID # Property owner _ 3 ❑ ~hn9 / m. Boring # Pit Ground surface elev. . D ft_ Depth to limiting factor ~ icatian Rate a GPD/ff Texture Structure Consistence Boundary Roots Horizon Depth Dominant Color Redox Description •Eff#1 'EfW in. Munsel! Qu. Sz. Cont. Color Gr. Sz. Sh. Boring # Boring ft, Depth to limiting factor in Soil ication Rate 0 ❑ ❑ Pit Ground surface elev. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM Sh. 'Eff#1 'Etf#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. A ❑ Boring ft. Depth to limiting factor in. a Boring # Ground surface elev. Soil Rate ❑ Pit Rood GPD/fE Texture Structure Consistence Boundary Horizon ')epth Dominant Cd Redox pescription. Gr. Sz. Sh. 'Eff#1 'E1'f#2 in. Munsell Ou. Sz. Cont. Color ' Effluent #2 = BOD,'_ 30 mg& and TSS _ 30 mglL • Effluent #1 = SOD, > 30:s 220 mglt and TSS >30:s 150 rttglt. The Department of Commerce is an equal opportunity service provide andtat yer. i you need aTTY ance2o acces services or need material in an alternate format, please contact the department 608-266-3151 or 608--8777. saD-suo (re.6A)0) Soil Test Plot Plan Project Name Mark Forder Shaun d Address 938 216th Ave Star Prairie Wi 54026 C #226900 Lot 4 Subdivision Hidden Ponds Date 6115 SE 1/4 N W 1/4S 17 T 31 N/R18 W Township Star Prairie Boring G Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation 99.0' *HRpSame as Benchmark 384' Property Line 3 Acre Parcel Scale is 1" = 40' unless otherwise noted 457' Property Line Drainage easement B.M.* B-1 B-2 ~ 100' 98' 96' 18% Slope B-3 135' 387' Property Line 383' Property Line 216th Ave ~ •VisConsin $ IL ORT #1778 page 1 of 3 . m. Code p De artment of Commerce in a rd~~~E Division of Safety and Buildings Steel's Soil Service, Inc. County Attach complete site plan on paper not less than 8% x 1 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal refers ice point (BM), direction and ~a percent rcel I.D. 3 slope, scale or dimensions, north arrow, and to tionS-01 t0JW" test ro d. - QC, ~ Please rintall infonnati ZONING OFFICE P Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / I $ !75 Property Owner Property Location TTR Development, LLC Govt. Lot na SE1/4, NV/4, S17, T31N, R18W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 775 Prairie Center Dr. 160 Flagship Corporate Dr 4 na Hidden Ponds City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road Eden Prairie MN 55344 952-746-2707 Star Prairie 216Th Ave ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Flood plain elevation, if applicable na ft. Parent material End moraines and ridges of ground moradnes General comments Mound design, system elevation 91 based on contour line elevation 95.25ft. and recommendations: r 5 PA J OCA i t-- GLi nti Boring # ❑ Boring ❑ pit Ground surface elev. 95.55 ft. Depth to limiting factor 36 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 1 0-7 10yr3/2 none I 2msbk dfr a 2c .6 .8 2 7-36 10yr4/4 none sl 2msbk dfr gw is .6 1.0 3 36-54 5yr4/4 f1f 7.5yr5/6 sl om mfi na na .2 .6 F2 ] Boring # ❑ Boring ❑ pit Ground surface elev. 95.55 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -EfW 1 0-6 10yr3/1 none I 2msbk dfr cs T2c. 6 .8 2 6 -29 10yr4/4 none sl 2msbk dfr cs .6 1.0 3 29-50 5yr4/4 none scl mfi na 0 .0 - Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L - Effluent #2 = BODS <_30 mg/Land TSS <30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 8/23/2005 715-760-0347 SBD-8330 (R.07/00) f?roperty owner TTR Development, LLC Parcel ID # pending Page 2 of 3 r / F3 ] Boring # ® Boring Ground surface elev. 87.25 ft. Depth to limiting factor 23 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 0-4 10yr3/1 none I 2msbk dfr a 2c .6 .8 2 4-23 10yr3/2 none sl 2csbk dfr gw 2f .6 1.0 3 23-38 7.5yr4/4 f1f 7.5yr5/6 sl 2csbk dfi gw if .6 1.0 4 38-60 5yr4/4 f1f 7.5yr5/6 sl om mfi na na .2 .6 F]Boring # E] Boring ft. Depth to timitin factor in. Pit Ground surface elev. g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/it2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # Boring F-1 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 • Effluent #1 = BODS> 30 220 mg/L and TSS >30 a 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) Steers Son Service, Inc. f STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel TTR Development, LLC. 994 200` St. CST-POWTSM Sw1/4,NW1/4,Si7,T3ix,R18w Baldwin, WI 54002 Lic. #248956 Town of Star Prairie, St. Croix Co. Direct 715-760-0347 Hidden Ponds Lot, 4 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 N 1" = 40' t ♦ = Benchmark Ele. 100.00 ft f Top of 3/4" pvc pipe Y t j = Alt Benchmark Ele. 100.10 ft Q'~-O Top of 3/4" pvc pipe a = Borings Boring Elevations B 1 = 95.55 ft B2 = 95.55 ft B3 _ 8725 ft Z B4 0.00 ft Q-.71 ~~7 r 2 wn r6 l - • UU , f(yh O ,...n- •1 t ;4\ X ti. t f F yi V , W ,r . tt 4 'tt t t+ V f........ CA .1 4 ' O f` f' s s r ~ X o LT1 r f ` t.,t,,h 4 ~"•t ~~M, { X r-1Po N) /•t V , t't (J X J i t Qa ODI CO ` fO VS 4} f ff i r t+4 r" n X f` ..•-.•n.: '4. `T' 1 (>•'f f •n 0) f \ w- l ` f'~D~. r U \r , (r ~`a \ 4 , oy ~,4 t+~.1`' •'(0 Q • t t+ (.0 -0 (A CY) (.0 00 f N i 4 , CF) if fi L 00 nN " , X LA t t • i t .M1 00 \ `4t tt t, y 00 r r : 0) f ~ f 61 ♦ 4 tot, t4 •t Jr` ` y O t].J CY) 90 < t . Q n X t t Z 4 i t~