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Wisconsin 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)].
ermit Holder's Name: City Village X Township
Unlimited Leasin LLC Hudson, Town of
ST BM Elev: Insp. BM Elev: BM Description:
/pd (b ~, I ~ ~ j
TANK INFORMATION 1
TYPE MANUFACTURER ~-• '^' CAPACITY
r
Septic ~~`~
in
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Aeration
Holding _
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic ~ y 7 L~ ~ (~
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Dosing 'S'~'.5
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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
ELEVATION DATA
county: St. Croix
Sanitary Permit No:
506399 0
State Plan ID No:
Parcel Tax No:
020-1035-80-000
Section/Town/Range/Map No:
17.29.19.1556
STATION BS HI FS ELEV.
Benchmark
Z,~
Paz.
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Alt. BM
Bldg. Sewer
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St/Ht Inlet i Z 6 t 73 ~~
SUHt Outlet
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Bot. System ~Q $ ~5
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BED/TRENCH Width ~ Length ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~ ~'1
4a ~ ~ ~"4,i4,~~,,~ .~ \ \ e__
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~"
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INFORMATION
CHAMBER OR ~
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Type Of System:
~d ~ ~~~ d f~ .:
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9y
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fJ t;;,,_. UNIT
Model Number: ,
Qu.L ~ `Y~
DISTRIBUTION SYSTEM
5 `~, 'Jr 1'o C^~,f114LL'~ c~.cr jac _
Headc~r/Na iif
r~ Distribution x Hole Size ,~,~t?,it° x Hole Spacing
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Length_ Dia Lengt
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ng
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SOIL COVER x Prassura Svctemc Only xx Mnund Or At-Grade Systems OnIV
Depth Over ~ Depth Over
t xx Depth of xx Seeded/Sodded xx Nlulaied
Bed/Trench Center f' 1 t ~ Bed/Trench Edges Topsoil ~ `yes ~ No Yes r _! No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 494A CTH A Hudson, WI 54016 (SE 1/4 SE 1/4 17 T29N R19W) metes & bounds Lot Parcel No: 17.29.19.1556
1.) Alt BM Description =
2.) Bldg sewer length = ~ ~ •t /' '"
-amount of cover = ~ ~~`"`J "`l t ` ~ t '^' f ~ t ,,~.~.t._.. /$'~o c~•~-- t.-~`l ~~~o...~~. ~ ~/~J ~~
7 , 1 . ~ rl a ~ ~P Q~ rjQ...
Plan revision Required? '~ Yes ~t No 1 ~~.,,/ f 1~~~J ~ / ~ ~,1~ j~
__.: ~ } ~ __ r . _ __ I
Use other side for additional information. _ # p
Date Inse ctpr's Signature Cert. No.
SBD-6710 (R.3/97)
i
Vent to Air un e
to .~-~- c ~-- `
~nlnr~rnnn-f-
commerce.wi.gov Safety and Buildings Division County
~ ~ 201 W. Washington Ave., P.O. Box 7162 st. CrOiX
~ sc o n s i n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.)
Department of commerce 5 0 ~ 3 ~' R
Sanity Permit A lication
t'Y PP State Transaction Number
l 148232?
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmenta Project Ad (if different than mailing address)
unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are
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ses in accordance with the Privac Law, s. 15.04 1 m Stats. am
I. A lication Information -Plea int All Information
Property Owner's Name ~ R Parcel #
X55 g
Unlimited Leasin , LLC -Tom Ber & Mike Kell 020-1035-80-000 .
Property Owner's Mailing Address Property Location
494A Co. H A ST. CROiX COUNTY Govt. Lot
City, State Zip Code Phone Number SE '/s, SE '/a, Section 17
(circle one)
Hudson, WI 54016 (715) 386-5094 T 29 N; R 19 w
II. Type of Building (cheek all that apply) LOt #
^ 1 or 2 Family Dwelling -Number of Bedrooms Na Subdivision Name
Block #
PubliclCommercial -Describe Use TOOL & Die Manufacturine ^ City of
Na
^ State Owned -Describe Use CSM Number ^ Vibe of
Z /~, ~ ~ ~~ 9,
1~1 3 ~e 5 ~J Ito ®'Town of Hudson
III. Type of Permit: (Check only one bog on ine A. Complete line B I applicable)
`~' ^ New S tem
Ys a lacement S stem
P Y ^ Treatment/Holdin Tank R lacement Onl
g eP Y ^ Other Modification to Existin S tem ex Isin
g Ys ( P )
B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
IV. T of POWTS S stem/Com onent/Device: Check all that a t
Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil
^ Holding Tangy k ~ Other Dispersal Component ^ Pretreatment Device (explain)
V. Dis ersa)/T'reatment Area Information: 18 Infiltrator " W 'chambers 20.0 .ft EISA /chamber + 2 air end c s 5.8 EISA = 371.6(1 s . ft.
Design Flow (gpd)
~ Design Soil Application equired (sf)
/ Dispersal Area Proposed (sf) System Elevation
'
136.5 gpd 0.4 in-situ soil .J 341.25 sq. ft. 371.60 sq. ft. ~ 85.00
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units °~' c ~o
New T
nk i
Tauk
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Septic or Holding Tank 750 75U 1 Wieser Concrete X
Dosing Chamber
VII. Responsibility Statement- I, the u ersigned, assu a responsibility for inst ti of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number
James K. Thom son 5--~ 30021 (715 248-7767
Plumber's Address (Street, City, State, Zip Code)
340 Paulson Lake Lane, Osceol , WI 54020-5413
VIII. Coun /De artment Use Onl
Approved Disap Permit Fee Date Is ued Issuing A Signature
yS0 . ~ ~~ l ~ 07
er Given Re n for Denial
IX. Condit~~~~~lteasons for Disapproval 2 \ bl~ 5
'1- ~ ~
~! J ~Y ~ ~~~~ ~
~
1. Septic tank, eH1ueM t~tmr;and
dispersal ceA must aB he servM,es /maintained G ~
as per management plait provided by plumber.
2. Atl'setback tequiremenfs must be maintained
as tale code / ordinances.
Attach to rnmplete plami for the system and submit to the County only on paper not less than 8 to a 11 inches in sine
SBD-6398 (R. 01!07) Valid thru 02!09
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commerce.wi.gov
^ ^
isconsin
Department of Commerce
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www.com merce.wi.gov/sbl
www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
November 12, 2007
OUST ID No. 30021
JAMES K THOMPSON
A.C.E. SOIL AND SITE EVALUATIONS
340 PAULSON LAKE LN
OSCEOLA WI 54020
ATTN: POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11/12/2009
SITE:
Accu-tech Tool & Die
494A County Hwy A
Town of Hudson, 54016
St Croix County
SE1/4, SE1/4, 517, T29N, R19W
Identification Numbers
Transaction ID No. 1482322
Site ID No. 732432
Please refer to both idenf-fication numbers,
above, in all corres ondence:with the atrenc
FOR: .
Description: Non-Pressurized In-Ground /Commercial (Office & Shop)
Object Type: POWTS Component Manual Regulated Object ID No.: 1161418
Maintenance required; Replacement system; 137 GPD Flow rate; 113 in Soil minimum depth to limiting factor from
original grade;
System: Conventional POWTS Component Manual, SBD-10567-P (R.6/99); Commercial System, Biofilter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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:
Reminders
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
component manuals listed above.
• The plumbing for this project discharges to a private sewage system. The approval covers only
domestic/sanitary wastes directed into this system. The Department of Natural Resources must be contacted
regarding the treatment and disposal of all industrial wastes.
• The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan
approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the
manufacturer's instructions and the plan approval, the plan approval and code requirements will take rCf~I`~!Prfi~
precedence. `~?
~~~M~~~
• The existing POWTS must be properly abandoned per Comm 83.33 Wisc.Adm. Code. pE RT!!",E'rdT ~
Q ~
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats. $~E CC}FiRE
JAMES K THOMPSON Page 2 11/12/2007
• Inspection of the POWTS 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. Stat
• Comm 83.22(7) A copy ofthe approved Mans 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.
Owner Responsibilities:
• Comm 83.52 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.
Comm 83.54(1).
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.55 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/instal lation/operation.
In granting this approval the Division of Safety & Buildings 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 to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely,
~,~~~~~ ~
Charles L Bratz
POWTS Reviewer II ,Integrated Services
(608)789-7893 , 7:45 am - 4:30 pm Monday -Friday
charles.bratz@wisconsin. gov
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
WISMART code: 7633
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M.
V ° '.w.
~r,
Nov ~ ~qJ-RESIDENTIAL CONVENTIONAL POWTS DESIGN
k~.~°~t~~~-~~ y~'~f Accu-Tech Tool 8~ Die Manufacturing
;~~"~~~ .
INDEX AND TITLE SHEET
Project: Existing Accu-Tech Tool & Die Manufacturing
Contact: Tom Berg & Mike Keller
Address: 494A Co. Hwy. A
Hudson, WI 54016
Site Address: 494A County Hwy. A, Hudson, WI 54082
Legal Description: SE114SE1/4, Sec. 17, T29N, R19W.
Tn of Hudson, St. Croix County, WI.
Subdivision: Na
Parcel ID Number: 020-1035-80-000
Plan Transaction Number: Unassigned
Index and title sheet Page 1
System design calculations Page 2
Site Plan Page 3
System Cross section Page 4
System Management Plan Page 5
Attached soil evaluation report Page 6
Design: Jim
Signature:
Date:
License Number: 30021
Phone No.: (715) 248-~j67
~::aY
7~~ERCE
:~U DINGS
JNDEN
System Design Calculations
JOB DESCRIPTION: Accu-Tech Tool & Design, Inc., Office & Manufacturing facility, 494 Co. Hwy. A, Hudson,
Tom Berg & Mike Keller - (715) 386-5094. Replacement septic system to serve existing tool design & manufacturing
facility currently serviced by hydraulically failing drywell. Propose to install new Wieser Concrete septic tank and two
(2) subsurface dispersal trenches. Sizing based on owner statements of seven (7) employees all shifts, no floor drains,
no kitchen or break-room facilities, and no retail space.
ABSORPTION AREA SIZING:
I. Total daily wastewater flow: _ 'T6 Sn (;nd
(7 employees, all shifts) (13 gal. /employee) = 91.00 gpd
Total daily estimated wastewater flow = 91.00 gpd
Total daily design flow = (91.00x1.5 conversion factor) = 136.50 gpd
2. Existing grade elevation: ~_ 18' ar R-t
3. Depth to limiting factor: >1 R„ (elev. = 81.51')
4. Proposed system elev.: R5 ()0' (ZZ" below grade at B-X)
5. Infiltrative capacity of soil at or within 36" of system elevation =1) 4 /ca ft
6. Absorption area required: 341 5 c ft
136.50 Gpd design flow / 0.4 Gpd = 341.25 sq, ft.
Infiltrator "Quick 4 standard-W ' EISA per chamber = 20.00 sq.ft, EISA/pair end caps = 5.8 sq. ft.
341.25 sq.ft. - (5.8x2 pair end caps) = 329.65 sq. ft chamber area required
329.65 sq. ft. / 20.00 =16.49 chambers required
7. Absorption area proposed: x'71.60 c = ft
(18 chambersx20.00 sq. ft per chamber) _ ~6o_nn c~ RT~A
(2 pair end capsx5.8 sq. ftlpair) = 11.6(1 S4- ft F.iRA
Number Of trenches: ~ 9 infilttatnr ``{,mirk 4W' unjtc~ch`t R chamF,Prc tntat
trench width (A) ~_R~'
trench length (B) 4(1.0'
trench spacing 6 ~'
Total system area w/ 3' trench spacing: 2n 43'x 9R (x)'
SF.PTTC: TANK CAPACTTY•
1. Design wastewater flow = 136.50 Gpd
136.50 gpd/ 75 gpd =1.82 gpd person equivalency
2. Minimum required capacity:?R~1 Ctallnnc
(136.50) + (11.61 x 2* x 1.82) + (46.77 x 1.82) = 263.88
*(Requires a three year maintenance cycle)
3. Proposed septic tank Capacity & Manufacturer: 750 gallnnc - $(jecer C.nnrretP W75(1-MR
Polylok PL-525 eflluent filter to be installed at outlet of proposed septic tank.
(136.50x2.088 "magic number's = 283.92 gallon rrapacity required on 3 year maintenance cycle.
(136.50x1.9332 "magic number's = 263.89 gallon capacity required on 2 year maintenance cycle.
Pg. 2 of 6
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./~- - - '
Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD-10705-P (N.O1/O1). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with.
Septic Tank
Septic tank servicing mechanics comply with Comm. 83.54(i)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be < 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank conterrts shall be removed when the sludge and scum in
the tank exceed i /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Slats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water
tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of
service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater
than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October-March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contingencv Flan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715)
248-7767 or the St Croix County Zoning Department at (715) 386-4680.
Pg. 5 of 6
Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must County
include, bul not limited to: vertical and horizontal reference point (BM), direction and ------ -
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel LD.
Please print all information. Reviewed By
Personal information you provide may be used for secondary purposes (Privacy Law, s 15.04 (1) (m)).
Property Owner Property Location
2088
Page L of
A.C.E. Soil 8 Site Evaluations
St. Croix
020-1035-80-000
- - -_
Date
Unllmrted Leastn , LLC -Tom Ber Govt, Lot ____S_E 1/4 SE 1/4 S 17 T 29 N R 19 W
------ -
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
4.94A-County Road A _ _ __ _ _ __Na i __ ___ Na
--- -_
City State Zi Code Phone Number
P , Ci Villa e
__., b _ ~ 9 /~ Town Nearest Road
Hudson i WI ~, 54016 ~ (715) 386-5094 Hudson County Rd A
__ New Construction USe J Residential /Number of bedrooms 0 Code derived design flow rate 137 GPD
V Replacement /I Public or commercial - Describe:O __
ffice & li ht manufacturin
Parent material Glacial OutWash
--------------------- ---- -- ----_ --- ._-___ Flood lain elevation, if a livable
-- -- ----- P PP Na
General comments
and recommendations: Site suitable for conventional dispersal cel l at 0.4 gpd loading rate. Recommended system elevation to
be 85.00'.
a Boring # _ Boring
~%' Pit Ground Surface elev. __ 92.18 __ ft. Depth to limiting factor __ ~ 128"_in. -
Soil Application Rate
Horizon Depth Dominant Cobr Redox Description ~ Texture
~
~ Structure Consistence Boundary Roots ; PDlft'
In.
Munsell Qu. Sz. Cont. Color
'
Gr. Sz. Sh.
~ ' _
'Eff#1 _
'Eff#2
1 0-20 j 10yr3/2' none ! sil 2fsbk ds cs 2fmc ~ 0.6 0
8
.
2 20-33
'i 10yr4/4 ~ none fsl
2fsbk
dh I cs 2fm,1c -- _
3 -r
33-51 '! Oy ~ none sil ~ ---
2msbk r-- r --r-----. T
~ dsh ~ cw ~, 1fm -----
0.6 __ _ _ i
0.8 ~
-- ---- 1-- -+
- -- ----,- ---- -i
- ------
f ---t -r ----
4
---- 51-60 ; 7.5yr4/6 j none Is
--I--
' 0 s9 ~ dl gs 0.7 1.6
5 - -T--- ----t------
' 60-128 i 10 r5/4
Y none s ----
'
0 t----7------Y
~-----I
dl --- - ------
sg
- - ~ -
--
--- 0.7 1.6
~ fi
--.-
i
-
i
---
o~-mil condiitons from 98" - 128" observed b
use of hand au er borin throw h bottom of soil eva
Y 9 9 9 luation pit.
-
,
a Boring # J Boring
iVi Pit Ground Surface elev. 90.85_ _ ft . Depth to limiting factor --~~ ~ 3~__in. Soil Application Rate
Horizon Depth i, Dominant Color ~ Redox Description Texture Structure Consistence ~ Boundary i Roots ~ B PD/ft'
in. ~ Munsell Qu. Sz. Cont. Color !
Gr. Sz. Sh.
'Eff#1 ---__
'Eff#2
1
- 0-21 I 10yr3/2 ~' none ~ sil ;
--t-
; 2fsbk ~ ds ~, cs 3fm,2c '~I 0.6 0.8
-
------+---+
-
~ ___ _
2 21-37 10yr4/4 none ; fsl
- 2fsbk dh ~
cs 12fm,1 c ~I,
0.4 ~
0.8
-i --- ------- -- r------
~ - --~ - ------~----1 ------ *-- ~--
3 37-53 'i 10yr5/4 none ! sil ~ 2fsbk j dh ~ aw ! 1fm 0.6 '~ 0.8
----
-_ 4 _ -~-
--~- -----------r - - --- --
53-60 ~ 7.5yr4l6 ' none Is
r
---------
0 s ~
g
-
+---------~-------- ;-
-- dl gs ', - ----
_
0.7
_ - - - __
1.6
5
_ - --~-- --
----- --- - ---i- - ~- - r-- ---- -
60-113 ~ 10yr5/4 none ~ s ~ 0 sg
_;_._-
~- ~- ----+-- ---f-
---
I -li------
-t------r-
--- dl - ~ -
-----
t-- ---r-
--
0.7
---
-- _-
1.6
,------
l
I Soil condiitons from ' - 113" obs rved by use of hand uahand ger boring th ,~
rough bottom o soilf evaluation pit II
---
- ---- -
'Effluent #1 = BODs> 30 < 220 mg/ and TSS >30 < 50 m Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signa~ re: CST Number
James K. Thompson _~ S'---~-- 36p2 ',
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 7/26/2007 715-248-7767
~, Property Owner Unlimited Leasing, LLC -Tom parcel ID # _ 020-1035-80-000 Page 2 of 3
Boring # J Boring -'
/_I Ph Ground Surface elev. 91.05 ft. Depth to limiting factor > 116" in.
Sod Application Rate
Horizon Depth
i Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots =
n. MurueU Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'Eff#2
1 0-45 Multi-colored none fill na na aw 3fm,2c 0.0 ~ 0.0
2 45-60 10yr3/3 none Ivfs 0 - dh gw 2fm 0.4 ~ 0.6
3 i
!60-78
10yr3/6
none
fvfs
0 -
dh
gw
2fm
0.4 ~ 0.6
4 ~ 78-96 10yr4/4 none {vfs 0 -- dh cw 1 f 0.4 i 0.6
5 96-116 1Oyr5/4 none gr Is 0 sg dl - - 0.7 1.6
~,
i
Soil condiitons from 100" - 116" observed by use of hand auger boring through bottom of soil evaluation pit.
Boring # J Boring
J Pit Ground Surface elev. _ ft. Depth to limiting factor in. ~ gpplication Rate
Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
__
I
1
i
i i
i
i i
j
I I
i
^ Boring # J Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in.
Sod Application Rate ,
Horzon Depth Dominant Color Redox Description , Texture Stricture Consistence Boundary Roots
i in. Mansell Qu. Sz. Cont. Cda Gr. Sz. Sh. 'Eff#1 'Eff#2
I --
i
i
I~
i
--
'Effluent #1 = BODS> 30 < 220 mg/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.
SB0.8330 (R.07/00)
A.C.E. Shc & SIOe Evaluatlons
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Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings in acx;•ordance with Comm 85, Wis. Adm. Code
Atlach compete si6e plan on paper rqt less than 8y: x 11 inches in size. Plan must County
include, lwt not limit to: vertical and horizordat reference pant (BM), ~ I.D.
peroerd sbpe, scale or dirnemsiorrs, norM arrow, and location and distance to
P/ease print aJi infonr>!atYon. By
Personal irdortr~alion you provi~ may be used for secondary PwPoses (Privacy l.ew, s. 15.04 (1) (m)).
Properly Owner RECEIV Property Location
Unlimited Leasi , LLC - Tom ise Govt. l.ot SE 1 SE
Property Owner's Malting Address 1 1 2007 of # Block # Subd. Nan
494A County Road A ®~ T Na
City State iP Code PhoneXXN J City J Village ~ Town
Hudson Wi 018~T' ~(~1'S) 385094 Hudson
2088
Page 1 of 3
A.C.E. Sal 8 Site Evaluations
St. Croix
4 S 17 T 29
or CSM#
Na
Nearest Road
Ra a
19 W
New Construction ~~ ,J Residential / Number of bedrooms 0 Code derived design flow rate 137 GPD
/~ Replacement !~ Public orcommercial - Describe:OlTice & light manufacturing
Parent material Glacial Outwash Flood plain elevation, if applicable Na
General comments
and recommendations: Site suitable for conventional dispersal cell a 0.4 pd loading rate. Recommended system elevation to
be 85.00'.
.._~
goring # J Boring
/~ Pit Ground Surface elev. 92.18 ft. Depth to limiting factor ~ 128" in. ~ ppp~yoa Rate
Horizon peph Dorrrirrarrt Color Redox DesaipUbn Texture Stnxture Cor>sistena3 Boundary Rods
in. Munseq Qu. Sz. Cord. Color Gr. Sz. Sh. `Eff#1 '"Efl#2
1 0-20 10yr3/2 none sil Zfsbk ds cs 2fmc 0.6 0.8
2 20-33 10yr4/4 none fsl 2fsbk dh cs 2fm,1 c 0.4 0.8
3 33-51 10yr5/4 none sit 2msbk dsh cw ifm 0.6 0.8
4 51-60 7.5yr4/6 none Is 0 sg dl gs - 0.7 1.6
5 80-128 10yr5/4 none s 0 sg dt - - 0.7 1.8
I
or conditions rom 98" - "observed by se of hand auger boring #hrough bottom o soil evaluation pit.
a Boring # J Boring
~/ Pit Ground Surface elev. 90.85 fk. Depth to limiting factor > 113" in. Sotl ~ Rate
Horizon Depth Donrinard Golor Redox Descripiorr Texture StnxXure Consistence Boundary Ross
in. Munsal Qu. Sz. Cont. Cola' Gr. Sz. Sh. ` ff#1 "E
1 0-21 10yr3/2 none sit 2fsbk ds a 3fm,2c 0.6 0.8
2 21-37 10yr4/4 none fsl 2fsbk dh cs 2fm,1c 0.4 0.8
3 37-53 10yr5/4 none sil 2fsbk dh aw 1fm 0.6 0.8
4 53-60 7.5yr4/6 none Is 0 sg di gs - 0.7 1.6
5 60-113 10yr5/4 none 0 sg di - - 0.7 1.8
~ ~~
I condiitons from -11 " o use o hand auger boring through bottom o soil evaluation pit
' EtflueM #1 = BODS> 30 < 220 m and 7SS >30 < 50 Effluent #2 = BOD <_30 mg/L and T5S < 30 mg/L
CST Name (Please Print) Signa re: CST Number
James K. Thompson ~ ~- 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conduc~i Telephone Number
_ 340 Paulson Lake Lane, Osceola, wl 5ao2o 7/26/2007 715-gas-776
Property Owner Unlimited Leasing, LLC -Tom parcel ID ~ 020-1035-~80-000 Page 2 of 3
firing # _J Boring
/J Pit Ground Surface elev. 91.05 ft. Depth to limiting factor > 116" in. ~ q~~on Rate
Horizon Depth Dominant Cobr Redox Descriptan Textuns Stnx~ure Consistence Boundary Rods
in. Munsetl Qu. Sz. Coat Color Gr. Sz. Sh. "Eff#t1 *Etf#2
1 0-45 Multi-colored none fill na na aw 3fm,2c 0.0 0.0
2 45-60 10yr3/3 none Ivfs 0 - dh gw 2fm 0.4 0.6
3 60-78 10yr3/6 none Ivfs 0 - dh gw 2fm 0.4 0.6
4 78-l;!6 10yr4/4 none Ivfs 0 -- dh cw 1f 0.4 0.6
5 96-i 16 10yr5/4 none r i~ 0 sg dl - - 0.7 1.6
I6
Solt r~ndiitons from 100" -116" observed by u of hand auger boring through bottom of soil evaluation pit.
Boring # -~ Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Sofl pppHcatlon Rate
Horizon Depth Dominant Cdor Redox Deacriptan Texture Stnxxuure Consistence Boundary Rails
in. MurrseN Cw. Sz. Cont. Cdor Gr. Sz. Sh. *Eff#1 *Eff#2
^ Boring # --~ Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. ~ ApP- Rate
Horizon Depth Domk>ant Odor Redox Description Texture Stnx~une Consistence Boundary Rools
in. Muraetl Qu. Sz. Cont Cdor Gr. Sz. Sh. *Eftt~1 *Eff#2
* Effluent #1 = BOD S> 30 < 220 mg/L and T'SS >30 < 150 mg/L * Effluent f~'t =GODS <30 mglL and TSS ~ 30 mgJl.
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 608-266-31 S t or TTY 608-264-8777.
SBn.a3so (R.o~roo) A.CE. 9oN & 510e E+~ak~atlo~u
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
,/
Mailing Address `~~7 ~ ~. T,
Property Address ~~'~~-
(Verification required from Planning & Zoning Department for new construction.)
City/State . /`f~- °~S ~~, ~~ ~- Parcel Identification Number C~.~ "~~O3S ~D~-~-~
LEGAL DESCRII'TION , /
Property Location 5 ~ i/a , 5 C 1/a ,Sec. 17 , T ~ N R~W, Town of h`~-t~~~
Subdivision _~'~G~ ,Lot #
Certified Survey Map # ~ Q ,Volume i ,Page # -~
Warranty Deed # ~~~9d1 , Volume ~ ~~/ ~ ,Page # ~~~
Spec house - ~no
Lot lines identifiable es
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 113 full of sludge.
Uwe, 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 Comnnerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms ~4
SIGNA OF APP ICANT(S)
~~ / Z/ ~7
DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV.08/05}
~~
u; 271sP yos
STATE BAR OF WISCONSIN FORM 15-1982
ASSIGNMENT OF LAND CONTRACT
DOCUMENT NUMBER
Assignor, whether one or more, for a valuable consideration,
assigns and conveys to:
Richard A. Carlson and Genevieve A. Carlson, Trustees, or the
estate in and to the Vendor's interest in that certain Land Contract as
hereinafter described; and
Jenn~- Carlson Ammerman. an undivided 1296 right, title, interest and
estate in and to the Vendor's interest in that certain Land Contract as
hereinafter described ("Assignee").
X62'989
>~ATHLEEH H. MALSH
REGISTER OF DEEDS
ST. CROIX CO., MI
RECEIVED FOR RECORD
12/20/2004 10:i5A?!
ASSIGNMENT LARD CONTRA
l:ziat~T ~
REC FEE: 13.00
TRANS FEE:
COPY FEE:
CC FEE:
PAGES: 2
RETURN TO: ~/
Sjoberg & Tebelius, P.A. v
Woodhill Office Park
2145 Woodlane Drive, Suite 101
Woodbury, Minnesota 55125
Telephone: 651-738-3433
Facsimile : 651-738-0020
Tax Parcel No.: 020-1035-80-000
Said Land Contract was dated the 31st day of Mav, 2002, and executed by R&G Real Estate Trust, as Vendor
to _ limi e~ ~g sg~i' g,, LLC, as Purchaser on lands in St. Croix Countv, State of Wisconsin, together with the
indebtedness therein referred to and all the interest of the Assignor in the Land Contract and the lands described therein,
which Land Contract was recorded in the Office of the Register of Deeds of said County on June 7. 2002, as Document
Number 681184, in Volume 19067, Page 476.
The Assignor covenants that there is now owing and unpaid on said Land Contract, the sum of Three Hundred
Two Thousand Eight Hundred Thirty-four and 73l100ths Dollars ($302,834.73), and also interest at seven percent (7%)
per annum from November 1, 2004, that Assignor is the owner of the above described interest in the Land Contract and
has good right to assign the same, and that the condition of the title of Assignor's interest is the same as the time of
recording the Land Contract.
This is a complete assignment of the Vendor's interest in the above described Land Contract. The Purchaser
under the Land Contract is instructed to make all further payments to Assignee upon receipt of a copy of this document.
This is not homestead property.
(is) (is not)