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HomeMy WebLinkAbout030-2141-00-018 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division County: INSPECTION REPORT sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 578971 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.o4 (1)(m)). - Permit Holder's Name: Oeverin Homes LLC, aka OeverI rPro rtie city Village X Township Parcel Tax No: CST BM Elev: Insp. BM Elev: cript ion: St. JOSe h, TOWn Of 030-2141-00-018 / 1 Sectionlrown/Range/Map NoTANK INFORMATION J CS 36.30.19.2068 NUFACTURER ^ CAPACITY STATION `l ~ BS HI FS ELEV. _ RHolding ELEVATION DATA J ~ s Z S Benchmark /Q1, /ez . d3 Alt. BMts Bldg. Sewer St/Ht Inlet (0.3 9'S TANK SETBACK INFORMATION St/Ht Outlet TANK TO N / WELL BLDG. e o it Intake 97' S ROAD Dt Inlet Septic i If z JJA- Dt Bottom Dosing Header/Man. Aeration 7 ( Dist. Pipe Holding 7, Z 9 . Bot. System 9.1 73: 1 Final Grade $ , L 93 1 PUMP/SIPHON INFORMATION Manufacturer Z , Demand St Cover LA-,, GPM I 6.5 Model Number X110 . $ TDH Friction Loss System Head TDH Ft Forcemai ength Dia. ist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH jWdth / Length No. Of Trenches DIMENSIONS 9a Z PIT DIMEN S No. Of Pits nsde Liquid Depth ,v SETBACK ' INFORMATION TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: S'o stem: CHAMBER OR 1)e `t :t d~~ I Z /VA- UNIT Model Number. DISTRIBUTION STEM S ` a HeadedManifold Distribution 2 7i k Z = 5 Pipe(s) x Hole Siz~ x Hole Spa ng vent t Air Intake 44 Length L' Dia Length Dia ` Spacing t.J ,L SOIL COVER x Pre Systems Only xx Mound Or At-Grade Systems Only Depth of xx Seeded/Sodded Edges Topsoil xx Mulched s No es No COMMENTS : (Include code discrepencies, persons present, etc. Inspection Inspection Location: 1254 84th Street New Richmond, WI 54017 (SE 1/4 SW 1/4 36 T30N R1 9W) Natalie's Ridge Lot 18 Parcel No: 36.30.19.2068 1.) Alt BM Description = r'► GBJ.Q~, I 2.) Bldg sewer length = (O3 - amount of cover = 7 Plan revision Required? Yes No 1~ 2. 7 Use other side for additional information. SBD-6710 (R.3/97) Date ~-Insepctoes Si ature - _i i Cert. No. ton lip" County / x afe *onWl Buildings Division S Q ` { a K t7 ~t 01 Wa ton Ave., P.O. Box 7162 Sanirv ~ Permit Number (to be filled in by Co.) r 4 a 53707-7162 1~ T '0-oNT5 MENT .~MMV Sanitary Permit Application State Trazisaction Number J - In accordance with SPS 383.21(2), Wis. Adm Code, submission of this form to the appropriate governmental unit A /\V/I~\ is required prior to obtaining a sanitary perrmt. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address ) the Department of Safety and Professional Semies_ Personal information you provide may be used for secondary purposes in accordance with the Privacy law, s. 15.04 1) m), Stats. q41 l J 1. Application Information - Please Print All Information Property Owner's Name Parcel 4 -0V -0/0 Property Owner's Mailing Address Property Location T 1; 3 C 1~ 0 C.~ 4,e~ S~A Govt. Lot City, State . Zip Code Phone Number JIE coon CJ rcle n # r II. Type of Building (check Al tha pl Lot TED_N; R E W y 1 or 2 Family Dwelling-Number of Bedroo Subdivision Name Block ❑ Public/Commercial-Describe Use i ❑ Cary of ❑ State Owned Describe Use CSM Number ❑ Village of MS wn of-5 af 6V w Z2 2,2- H W III. Type of Permit: (Check only one box on line A. C piete lin if applicable) A' yew System El Replacement System ❑ Treatment/Holding Tank Replacement Only ' E, Other Modification to Existing System (explain) List Pre ious Permit Number and Date Issued B. ED Permit Re ewai it Revision 11 El Change of Plumber El Permit Transfer to New I Before Expira Owner IV. Type ofPOAII'S System/Component/Device: (Check all that a iy) Nod-Pressurized In-C. ound ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. suitable soil Holding Tank ❑ Other Dispersal Component (explain)- ❑ Pretreatment Device (explain) _ V. Dispersal/Treatment Area Information: D es' Flow (gpd) esign Soil Application Rate sf) Dispersal Area Required f Dispersal Area Propose , f) Svstem Elevauo DL V C- -7 , Drr 1 _2 Z ; d VI. Tank Info Capacity in Total # of Manufacturer ! ^ Gallons Gallons Units ~1'kh~q New Tanks Ezhg Tanks /o o 1"i ' ~ m Septic or Holding Tani: ! Dosing Chamber ! I VII. Responsibility Statement- I the undersigned, assum s risibility for installation of the PORTS shown on the attached plans. Plum er' Name (Print) Plumbe ' are MP/MPRS Number Bu siness Phone Numbeer~ 71 Plumber's Address (Street, City, State, Zip VIII. County/Department Use Only Approved •sa roved Permit Fee~j Date u~e`d Issuing Agent Signature ❑ O "al S IX. Conditions of Ap t a ~i(~ pr rid 2 eb V)' dispersal cell must be_porvlced / maintained J ~ i ~G C f as per-management plan provided by plumber. l f h MwnnC 2. All setback requirements must be maintained 1,20w ft Q-✓ as per applicable code/ordinancesr ~~-~t/~ G77b/1 Attach b complete plans for the system and submit to the County only on paper not less than R In z 1 binches in sue SBD-6398 (R 11111) PLOT PLAN PROJECT Oeverina Homes ADDRESS 143 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 NW 1/4S 36 /T 30 N/R 19 W W St. Jos ph COUNTY ST. CROIX SYSTEM ELEVATION 95.0/94.8' 5' below qrade ' 10115 BEDROOM 3 ATE CONVENTIONAL XXX IN-GROUND PRESSURE C VENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons L T TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. sameasbenchmark All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Scale _ 1/4" - 10' 491' Property Line Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 4' Long 12" 34" Grade at System Elevation Pro 3 Bedroom 1 House 30' 2-3' X 90' Cells with >3' spacing S 84th St. not enough slope for contours 30' B-1 1% Slope B-2 Vents 0' 44' B-3 10' 38' 24 ' 143' 45' 00 q I PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 NW 1/4S 36 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 95.0/94.8' 5' below grade 5/28/15 BEDROOM 3 DATE CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION (~T . LIW=- Filter Lifetime Filter ❑ BOREHOLE O WELL - H. R. P. same as benchmark All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Scale = 1/4'1 = 10' 491' Property Line Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 12" 5.6ft^2/pair of end caps 4' Long 34" Grade at System Elevation Pro 3 W Bedroom House 30' S 84th St. not enough slope for contours 30' B-1 I% Slope B-2 Vents 44' 0 ~f B-3 r 143' 45' 10' 33 8' 9, RECEIVED =-.Y, ~-f- l ~r Safety and Buildings Division `1 201 W. vydS11111YED11 XV0 P.O. Box 7162 Smit Number (to be filled in by Co.) r X COlNTY Madison, WI 53707-7152 ~j Z~ I DEVELOPMENT ~t- Sanitary Permit Application State Transaction Ntunb~r Nl In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if differ t than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary s-&-. purposes in accordance with the PrivacyLaw, s. 15. 1 Km), Stars. L Application. Information - Please Print All Information asl ~ ~ Pane( # Property Owner's Name / ~ 2 z°vPl-l~ V ✓ L-) r 1411-40 Property Ow='s Mailing Address Property Location / 7 Pr 1 I Govr Lot lJ 4, ' on rtY. State r Zip Code Phone Number IO N; R E II Type of Building (check all that aPP1Y) Lot 1?7 Subdivision Name or 2 Family Dwelling -Number of Bedrooms 1 Pf 1~ O~~ lock# ❑ Public/Commercial -Describe Use V ❑ City of CSM Number ❑ Village of El State Owned -Describe Use wn of ~ ~ 4 2 D~sl~tl~uTloN L~'t.l_S w I III. Type Check only one box on line A. Co plete line B if applicable) o - _1X A' New System ❑ Replacement System 0 Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) 2- 3'x(.OtoJ Lis[ Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision El Change of Plumber ❑ Permit Transfer to New ✓ Before Expiration Owner A 2 Com nent/Device: Check a l that apply) ! Non-Pressurized In-Groan ❑ Pressurized In-Ground El At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < in. su table soil o Other Dispersal Component (explain) 11 Pretreatment Device (explain) V. Dis rsaUTreat eat Area Infornformatio ~ e Deign Flow (gpd) Deli Soi ~ppli ati Rate(gpdst) Dispersal oquired ( Dispersal Arca Propo~sed System Eleva[io # of VL Tank Info cGallonsm Cral10. Un # of its Manufacturer S q New Tanks Existing Tanks J j $ p ° t Septic or Holding Tank 1-11, fl Dosing Chamber VII. Responsibility Statement- the undersigned, ass r ponsibility for installation of the PORTS shown on the attached plans. Phmtber's arc (Print) Plum Si afore MP/MPRS Number Business Phone Num Plumber's Address (Street, city, state, Zip !/i A 5 LU l 7// s ti VIII. ountv/De artment Use Onro. Permit Fee Dam Iss d Issuing Agent Si Approved ~ roved 5 ~ l (f Owner or Denial 1 V IX Conditions of 5ry~1 ~KrDisapproval /1 ~Ovc~ n~~ / OA jArt:~1/ r✓D1~I 1. emetic tank, effluent filter and gWpersal cell must be serviced /maintained P.[~J I~,~Qwa as per management plan provided by plumber. 2. All setback requirements must be maintained 0,A_ aL4- l (k. as ptftc" Did submit to the County only on paper not less than g 12 x 11 inches in sae SBD-6398 (R. 11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Dater 5/28/15 Owner: Oevering Homes Location: SE /4 NW1/4 S36 T30 N,R19 1254 84th st. St. Joseph Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet Signature License number #228W PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 NW 1i4s 36 iT 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 95.0/94.8' 5' below grade 5/28/15 BEDROOM 3 DATE CONVENTIONAL X00C IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 ,BENCHMARK V.R.P. Top of 2" pipe Cm ASSUME ELEVATION-AAO Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Scale = 1/4" _ 10' 491' Property Line Vent 16" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 1271 5.6ft^2/pair of end caps 4' Long 34" Grade at System Elevation ►l1 Pro 3 W Bedroom House 30' S 84th St. not enough slope for contours 3 0' 44B-1 1% Slope B-2 L -t Vents 0' ' B-3 10' 3 8' 24 ' 143' 45' Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 100.0' Vent Grade Vent 3' 4" ~~30/37Septic 3 5' Long 1 S' Long 1 36" Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A 16 chambers per cell B System elevations: A-95.0' B 94.8' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ c , J t ? Mailing Address Property Address /01 S (Verification required from _ UWA4-~V- i Planning & Zoning Depart ment for new construction.City/State Parcel. Ide ntI ion Number 030 - l! ~ fj ficat LEGAL DESCRIPTION Property Locatioxj ~E.- ,N Ya i Seo. b T 3b N 1Z j~_ W, Town of Subdivision Lot # Certified Survey Map # 1--- Volume Page # Warranty Deed # --Jo LZ-65 , Volume ___.w'"____ ,Page # Spec house Yes rw Lot lines identifyabl o no SYSTEM MAINTENANCE AND QW.-IER CERTIFICATION Improper use and maintenance of our Septic maintenance consists of um rn out the septic y eptic system could. result in its premature failure to , the system can affect the fern pion of the se tank ever handle wastes. I roper y three years or sooner, if needed, a licensed pumper. What you put into responsibilities are specified in Co septic tank as a treatment stage in the waste disposal l system. Owner § mm. 83.52(1) and in Chapter .12 - St. Croix C:oun maintenance tY Sanitary Ordinance. The property owner agrees to submit to St. Croix County Plaruling &Lonvng Department a certification form, signed by the owner and by a master plumber, journe Yman Plumber, restricted plumber or a licensed pumper verifying that (1) the on-sit d by the wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessa less than 313 full of sludge. ry), the septic tank is I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the De Certification stating that your septic system has een m aintained must be completed and returned toethe St. Cr~ pate of W County Wisconsin. Planning & Zoning Department within 30 clays of the three year expiration date. I/we certify that all s nts on this form are true to the best of my/our knowledge I/sire andare the owne s o property described above, e a warranty deed recorded in Iegister of Deeds Office. r() f the Number of bedrooms ~ ~IGNAT OF APPLICANTS U DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zorung 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) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 0eJC' in Tank Manufacturer: ❑ NA Permit # e tic ❑ Dose ❑ Holding Volume: (gal) DESIGN PARAMETERS Tank Manufacturer: n ❑ NA Number of Bedrooms: ❑ NA [I Septic ❑ Dose ❑ Holding Volume: / (gal) Number of Public Facility Units: J. NA Vertical Distance Tank Bottom(s) to Service Pad: (n) Estimated (average) Flow :gc (gal/day) Horizontal Distance Tank(s) to Service Pad: 1014 (ft) Specific servicing mechanics must be provided if vertical is >15 feet or Design (peak) Flow = (estimated x 1.5):!6-0 (2V (gal/day) if horizontal is >150 feet. Specmc Instructions to be provided on back. In Situ Soil Application Rate: (gal/daytW) Effluent Filter Manufacturer: t ❑ NA Standard (Domestic) Influent/Effluent Monthly average Effluent Filter Model: 111 Fats, Oil & Grease (FOG) 530 mg/L Pump Manufacturer: Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L Manufacturer. (BODs) >220 mg/L ~A (TSS) >150 mg/L ❑ Mechanical Aeration ❑ Peat Filter Pretreated Effluent Monthly average ❑ Disinfection El wetland Y g ❑ Sand/Gravel Filter ❑ Other: (BODS) 530 mg/L Soil Ab ton System (TSS) 530 mg/L In-G/ NA Fecal Coliform (geometric mean) 5101 round (gravity) ❑ In-Ground (pressure) C3 NA Maximum Effluent Particle Size i in dia. NA ❑ A - rade ❑ Mound ❑ Drip-Line ❑ Other: Other. NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ When the high water alarm is activated Inspect condition of tank(s) At least once every: month(s) year(s) (Maximum 3 years) El NA Inspect dispersal cell(s) At least once every: ❑ onth(s) (Maximum 3 years) ❑ NA year(s) Clean effluent filter At least once every: month(s) NA ear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) INA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) Other: At least once every: ❑ month(s) other: ❑ year(s) MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certificate ns: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system 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 treatment tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005 (02/05) START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sani4ry napkins, solvents, tampons,'and water softener brine discharge. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems 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 (pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant 7 repla Z-'replacement nt system: uitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. Name Name ~w Phone Phone J SEPTAGE SERVICING OPERATOR PUMPER CAL REGULATORY AUTHORITY Name Name ` Phone Jr - Phone J This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) 8 (3), Wisconsin Administrative Code, . { I Vy a O ~ ; <D C ) D ° ~ O 7 ~ a N A j N `VD O d 3 (D o A ° A Q { 7 p~ S If~~111 '~t~EEI i } k w i a N }t k fA, _ E,' 1 of r aY J}.. i 's> gap I g I ax G° ~ 6 I Iil 5 I III S I ~pp III I/ i2 ' '-8 - - ¢ iii ik x ^ ~ I I I N~ 8 j z III ~I~3n I III ~ Nlil I 6;. III 3 I Y - K I] - po V O o ~v f~S ~ _ _ , s MMS.SSSS S El It. 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Z. 0 ' y 10 rO CO m1w \ a Q QWgYin za~roTB IYIWO22y \ 2 =mayy J C W \t i L \ W 7$ ORTH-SOUTH 1/4 UNE N0099'19-W 5267.71• UNPLATTED LANDS B NO0°19'19'W 1527.26' - 28248 66 322.12' 53.4q 64.30 \ 2416.80' 1.98• g k $ k BLOCK 01ST - 83200' 33• 33• K8 1 U Y~ i I I 6 6' Y I ~ O e Y ~ s'w 2 yoQ `1'~i1 ' v W~ 70'_...1. = W 3 1 to m C7 Z zaQa la 4 I I A Ldp I ~cpe }y m ` \ 45 E-m vz gs w F-n ~1 1 Ohm I W E-` 1 Opm J.1g OSNd +A r1S3J ti ~R 1 x1 y } 7S. I I / '1 j g!! 48- +96' 50019Y9'E 309.70' EET n 84TH STREET- 1.96' NJ N0099'19'W 310.24' tJ/~~•,~ {~1y r`o 100 0 It t2 • a 33 133 2-A 0 < 1 1 3AW0'~' 50192'31'E 369.88' H~~ I I I O ~aj ( 11NI01'FI K71-~ 80 ,1~ 0 2i O a 1 d J g J I C1k ' i` ~ mm ` x ~~yyyyy~~tt~~g tai I I I 1I ~ \5 T a a I /I o aN o k96• F n y0 r ` 1 1 ' .,..75 I 0 ~i 14 ~y W p r Y ~I qq ~ m~ n f~~l1j~ p~ F < 31li'luLl'. N , ~ m I I 0 5 r~ I o J rf' " 25, e 1 n 1 2 W 1.96' I 3 m° I S00'00'00'W 1145.70' b h g °n g = 140.76' 490.76' 500.28' KIS N ~3~n~ngh N ~ °i 14 JUU 4 3 N N N N N W mIW.7Z~t~$$ I F F Fm w aaWO~s"ns'ns°nnn O O O ~ b $ F'~~"ar rqq J A J J O~~ + _ E y c 2 L 2 SEE SHEET 1 SEE SHEET 2 J 1' .IOW\~V~cTi ~~a THE BEAR. ` APR 2 9 2005 1335 Wisconsin Department of Commerce SOILLE 6""ANVON EPORT Pie 1 of 3 Division of Safety and Buildings ` - ZONING OFFICE in accordance e Tom Schmitt Attach complete site n on pa County plan per not less than 8'/: x 11 inches in size. Plan must St. Croix include, but rat limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. ©3 / , ` ~O~ 1 f) Please print all information. Revie ed By Date d Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). d Property Owner Property Location Grand Properties, LP Govt. Lot SE 1/4 N W19 S 36 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 18 Natalie's Ridge City State Zip Code Phone Number City Village V Town Nearest Road Somerset WI 54025 715-247-5900 St.Joseph Cty. Rd. A New Construction Use: be Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash (stream terrace) Float plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area 1 is 96.0'. Slope is 1.5%. Boring # Boring se Pit Ground Surface elev. 100.03 ft. Depth to limiting factor 110+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz •Eff#1 •Eff#2 1 0-14 1Oyr3/3 none sl 2fsbk mfr as 2vf .6 1.0 2 14-24 1Oyr4/4 none sl 2msbk mfr gw 1vf .6 1.0 3 24-36 1Oyr4/6 none sl 2csbk mfr 9w 1vf .6 1.0 4 36-49 7.5yr4/4 none ms Osg ml cs .7 1.6 5 49-62 1Oyr5/6 none grms Osg ml cs .7 1.6 6 62-110 1Oyr5/4 9 none grms Osg ml 7 1.6 4. Boring # Boring be Pit Ground Surface elev. 100.03 ft. Depth to limiting factor 115+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffz -Eff#1 *Eff#2 1 0-12 1Oyr3/2 none I 2fsbk mvfr as 2f,1vf .6 .8 2 12-24 1Oyr4/4 none sl 2msbk mfr gw 1vf .6 1.0 3 24-38 1Oyr4/6 none grls Osg ml a .7 1.6 4 38-69 1Oyr6/4 none vgrs Osg ml cs .7 1.6 5 69-115 1Oyr5/4 one gcos Osg ml .7 1.6 Il 11 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 4/20/05 715-247-2941 i Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 H Boring # Boring ✓ Pit Ground Surface elev. 99.98 ft. Depth to limiting factor 113+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots s GED "Eff#1 'Eff#2 1 0-13 10yr3/2 none I 2%bk mfr as 2f,1vf .6 .8 2 13-19 10yr4/3 none sl 2fsbk mfr 9W 1vf .6 1.0 3 19-26 10yr4/4 none vgrls Osg ml cs .7 1.6 4 26-60 10yr5/4 none vgrcos Osg ml cs .7 1.6 5 60-113 10yr5/6 none grs Osg ml .7 1.6 d rt ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF 'Eff#1 'Eff#2 F-I Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots z 'Eff#1 'Eff#2 " Effluent #1 = BOD ? 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 608-2644777. Page 3 of 3 Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Grand Properties, LP Thomas J. Schmitt, CST 227429 Address: 712 Rivard Street 1595 72nd St. City, State, Zip: Somerset, WL 54025 New Richmond, W1.54017 Phone: 715-247-2941 Subd.Name: Natalies Ridge Lot No.: Legal Description: 2SEl/4//4A/4 S36 T30N R19W Township of St. Joseph, St Coix County 1=11 Soil Boring A Bench Mark El. 100.00' Top of 2" pvc pipe Alternate Bench Mark El. 10• 0 Top of 2" vc pipe Slope= S~ Contour Line El. Scale 1" = 40' ' ~I9, a~ E-~ 00 y ~ 14 This soil report was done to fulfill a zoning requirement. It may or may not be in a location suitable for your use. N N OT 9 3. 5 A (3.0 A LOT G~ 3.0 ACS. s .95 AB.iz L.B.O.= 923.1 ci . i \ H.W.L.=92 LOT 1 . 22 AC. (2.94 AC.) i...' I 918.8 6~ ode ~ ~ RAD = 80' N 3 475' 918.8 \x 918.4 . ~ U 9 4~ ~ i LOT 918.2 17 0011 AC 917.7 6l x916.6 ( 1 A x i L EO.= 16.5 i i W N 2 N / T 6 x 918.3 3.013 AC. , / (2063 x L.B.O.= 16.5 - - H.W.L.=914.5 917.8