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HomeMy WebLinkAbout040-1318-00-033 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 578981 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 251/ 3 37 Permit Holder's Name: City Village X Township Parcel Tax Na. Creative Homes, Inc., C/o Nathan Hidde Troy, Town of 040-1318-00-033 CST BM Elev: Ins p. BM Elev: BM Description: Section/Town/Range/Map No: 4051' /M-73 I ToP 6r o p~ &"A j&Y'_ 11.28.19.2108 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1.! Gu ~ Gorki 12.~7J 0. /o?l. io1(.73 Dosing ~ !m E ~ A,,r Alt. BM Aeration ~/L o Bldg. Sewer io.70 `plot. `y Holding St/Ht Inlet 13.70 aSf'4•~I TANK SETBACK INFORMATION St/Ht Outlet 1q. p [05-7, 4q TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ly o 167-P Septic Dt Bottom /g, a ~oS~.By Dosing „ v% K Header/Man. Z, D lD(o p. jy Aeration Dist. Pipe Z ° loGf 07 &IJ Holding Bot. System Z 7 /069. /7 PUMP/SIPHON INFORMATION Final Grade r Manufacturer Demand St Cover ZoeI-L-M GPM ~abt. 7V Model Number 1 'C3 /_/29 JN T Co ~f. la 7 7`l TDH Lift Friction Loss System Head TDH Ft o q- Z L/ K 6 t4. SK 17- 1- o I ~O lDG . Forcemain Len th Dia. Dist. to well s S , 2 ylA SOIL ABSORPTION SYSTEM BEDITRENCH Width V I Length , No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. T uid Depth DIMENSIONS - SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR n~~ Type Of System: m 761 N/q UNIT Model Number: ~oua 17 S ti/~I DISTRIBUTION SYSTEM Header/Manifold Distribution Tole Size x Hole Spacing Vent to Air Intake I / w Pipe(s) LengthDia_ Length Dia Spacing (/~Z Zy SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 7 r Bedrrrench Edges ( a Topsoil 4 6) b Yes Efl No 0 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 ' Inspection #2: / f /_K!c Location: 712 Mount Curve Court Hudson, WI 54016 (NW 1/4 NW 1/4 11 dT28N R19W) Hills of Troy Lot 33 Parcel No: 11.28.19.2108 1.) Alt BM Description = IF W a $019X& 7D 0 rr/ Wii EaVj"W , 49 F)X S ojee,65" 09TO-6 Yo. 2.) Bldg sewer length = w ~ ~f N9C?- CLJ' Vg f:>e &W 'Pa& k (p~ r - pU.MP 5W/ fG>fl / U -amount of cover= j y$y Plan revision Required? ® Yes No ~J Q~17 Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County a~~~r4 Safety and Buildings Division l ('i K ~ 3 ton Ave., P.O. Box 7162 Sanitary Permit Number (to filled in by Co.) 2~1 W U~ ca hen--n. ` I~ Madison, W1 53707-7162 ~ 7'9 UNTY 7 M ELOP 5NT State Transaction Number Sanitary Permit Application 3 s~ In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ciz is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailirg address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15. 1 m , Stats. 1 n 1 1. A lication Information - Please Print All Information Property Owner's Name Parcel # o b~ Property Owner's Mailing Address Property Location / 71 ~ Govt. '7(' C City State Zip Code Phone Number Section g ffck + N; R E W IL ype of But tag (ch all that apply) Lot '3 Subdi iior~2~ame Family Dwelling-Number of Bedroo <<//6G////// ❑ Public/Commercial -Describe Use 6k ab ❑ City of p CSM Number 11 Village of El State Owned - Describe Use / own of ~ ak, If x 75 clw Ul. Type I Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ Replacement System ❑ Treatment/Holdmg Tank Replacement Only ❑ Other Modification to Existing System (explain) 13 List Previous Permit Number and Date Issued ❑ pert Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New i Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that a l ❑ Non-Pressurized ln-Ground ❑ Pressurized In-Ground ❑ At-Gmadc ❑ Mound ? 24 in. of suitable soil d < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/rreat at Area Informa "on: Design Flow (gpd) Design Soil Appli 'on Rate(gpdsf) Dispersal Area Required DM Area PrRe's System Elevation ~n C) ,4 67 (7n I VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a $ s Nca Tanks Fxiscng Tanks a V) A rn cn u. C7 F. Septic or Holding Tank i Dosing Chamber VII. Responsibility Statement- 1, the undersigned, a responsibility for installation of the POWTS shown on the attached plans. P1 tier's Name ) Pl Signatue MP/MPRS Number Business Phone N u;fi* Plumber's Address (Street, Ci Zip Code ` /V ountv/De artment Use Only 71 Fpproved Permit Fee Date sssue / - Issuing t Signature S 1f' l vea Rcas Denial IX CondthIIAZIRitsons for Disapproval e J" AE efo 1: ataptictenk, mst t filter aril 3 ` /N~ a Al as-per m cell.m all v/maintained ~ a per tnmnegema nt plan provided by plumber, 6V%A t.,aw^Aok_ w . V t . bckt* ~erttf►tustb maiMairiad %A t'a~ wf *Dl1 tM pyr spoldab* owe / 6rdlrtafx~s. Attach to complete plans for the system and submit to the County onI on paper not less than g in x 11 inches in size SBD-6398 (R. 11/11) t. r'ec vii Ye-1\MV4,. PLOT PLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 NW 1/4 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1070.4' 1.4' sand lift! 5/3/15 4 DATE BEDROOM CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of spike in ground ASSUME ELEVATION 107.15' Filter Lifetime ❑ 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' Property Line Not to scale Wel l is to meet al I WDNR setbacks Tank is to be properly bedded and provided Pro 4 with lockdown covers with Bedroom approved warning labels House Huffcutt Combo Tank Grading is to be done to divert run-off away from system (rCou 1069' 8-121 A 4 B. M. B- 121C 1070' Area 15' below Slope syrstem is to remain 8-121 B 1068 undisturbed 1066 1/4" = 10' Scale Propertyl Lines 1.2 Acre Lot j' i UP Y pbPkR7:p?v DIVISION OF INDUSTRY SERVICES Z 0 3824 N CREEKSIDE LA ~ I s HOLMEN WI 54636 g lJ" Contact Through Relay ~Z P S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov . ~0 ssroNScott Walker, Governor Dave Ross, Secretary June 04, 2015 CUST ID No. 226900 ATTN: POWTS 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: 06/04/2017 SITE: Creative Homes Identification Numbers 712 Mt Curve Court Transaction ID No. 2543537 Town of Troy Site ID No. 812544 St Croix County Please refer to both identification numbers, NW1/41 NW1/4, S11, T28N, R19W above, in all correspondence with the agency. Subdivision: Hills of Troy; Lot 33 FOR: Description: Four Bedroom Mound System / 9% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1535513 Maintenance required; 600 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); 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 CONDO requirements. APP No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, DEPT OF stats. PROFESSIO The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF IN Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. SEE C • 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. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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 SHAUN R BIRD Page 2 6/4/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). - • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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. Siberard erely, Fee Required $ 250.00 This Amount Will Be Invoiced. M Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jeny.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm ea SHAUN R BIRD Page 2 6/4/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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 9 This Amount Will Be Invoiced. t~erard M Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm. i i i I Cover Page R~G~1v~~ i Shaun Bird MAY 2015 Bird Plumbing Inc. j'::4DUSTRY SERVICES 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/ 3/15 Owner:Creative Homes Location: NW1/4 NW1/4 S11 T28 N,R19W 712 Mt Curve Court Troy Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve / q ?O V <<Y 7-8. Maintance and Contigency plan Apt:- D 9. Filter Specifications and cross section S RANp Attachments: Soil T t ST~~S~c~ FS V/CC'S Shaun Bird S ~~FN 1 CF Signature License number 2 9 0 PLOT PLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125 NW 1/4 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1070.4' 1.4' sand lift! 5/3/15 DATE BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of spike in ground ASSUME ELEVATION 107.15 'Filter Lifetime ❑ 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" = 101 Pro a rt Line Not to scale Wel l is to meet al l WDNR setbacks Tank is to be properly bedded and provided Pro 4 with lockdown covers with Bedroom approved warning labels House Huffcutt Combo Tank Grading is to be done to divert run-off away from system Curare 1069' Court 8-121A B.M.A B-1210 100' Area 15' below 9% Slope system is to remain B-121 B undisturbed 1066' 1068 1/4" = 10' Scale Property! Lines 1.2 Acre Lot Mound System Cross Section and Plan View ' ' ' ' ' ' ' ' " - - ` Dimension Feet 777777777777777 A i t J B t t 77) D f t t 1.4.4•Y 1.1.1. 1.4•V . .4.4.1.1. 1.4.1. 11 1.1.1. 1.4.1• •1•L•M1• •J . •1.1.+•f•J•r 1.4.1.1.1 r.r•f •4• •r•r•r• 1.1 f•J•l 1.4•M1•1.1• J.r•r• 1.4.1.1.1.1. .r•r•r•r. f•r•r r.+• r•J•r f•J•r• 1.'.+. 2•r•+• J•r•r• r•r•+• fa•r.+. '••1.1.1.4•M1•1.1.4.1.1.1.1.1.4.1. t r•r•r•f•+• 17 1.1.1.1• 1 .1.1.1• 1!~f t 1. .11•M1•L•L•1.1.4•L•1.1.1.1 r•r.r•r•r•r•+•r•r•r•f•r•r•J•r•f.r•r•r•r•r•r•r 1.•`~f:f. E . +.?.?•?':'~?1?\ri?1?Lf f f r f f r. .1~•r•f•r r•f 1%%1S15 v1 11.1 1 •?L•4 1 1 1 1.1.1.1.1.1•L•1.1.1•L•1.4••.•1•Lf~f~j~fM1f~j~•,Lfij: M1•1j L '.?`.K 4 1.1. A t 2 . V •'4 •r.r• r•rv+.r.:.r•r•r.r•r.r•r•r•r.r•r•f•r•+•r•?•r.r•?•?•?• •r 1 r L•1 1 1 L M1 4 4.4.4.4•L•4.1•L•4.4.1•t• ••1.1.1.1.1.1• t 4.4.1.1.1.4.1.1.1.1.1. r.l.J.r.J%r+J•J.J•J.f.2.r.+ r.J.r.f.i.S.r.J.r.r.J.r.+.r.r.J. ~y4~~4/~p~ 1•:1':hJ.r.r.r+f.f.r.f.J.r. 1•L•1.1.1•L•1•L•V1.1• 1r~l:r:J•TiJ•t~l:r:J:t.r 1.4.L.1.L.1.4.L.1.1.1. 1.4.4.1.1.4K•1•L•L•1•L•1.1.1.1.1.1•L•1.1 ..L.1.1.4.4. S F •f:~• 4•M1•1•L• r.r•f•f•f•+•r•f•f.f•r• f• r.+•f•r•+. r•r• +•f•f•t•f•J•f•+•r•f t •f11~f•2.f.r.r.r.r.f.r.f.r.+.r.J.+.r. r.+.r. r.r.r.J. fN• t W G I t 7 LJ. t H U t I 1 t I T t t to t t K d i t L i ` W K B Z A-3- 7 Slope % L i - 1 = Topsoil = ASTM C-33 +r~ = Clean aggregate = 4 in. sch. 40 pvc •1?1.1.1 t i Cap Material sand fill 1/2 to 2 1/2 in. dia. observation pipe L_., Geotextile G H Fabric r.?.?.+.?.?So r,•~.1.~.1.1. r•+Lr 1.4:•1.1.1.1.L.1. . :::'F.r r•J•r•r•r•r•f• 1• 'L?1.1.1.1.1.1.1. J Ft 7D ::r:J ~if:r••J1r~11J4f~f•':::'' D E Plowed Surface 06_9L O Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07lgj Page of Pressure Lateral Layout Two Laterals - End Manifold 4 - Threaded Cleanout Lateral Turn-up plug Manifold M t' L Long Force Main Sweep 90 Bend Distribution Network S ecifications Pressure System Construction Lateral Diameter Z j ls are constructed of Schedule 40 PVC Manifold Diameter 2_ Latera Orifice Diameter pipe. Orifices are drilled perpendicular to X Orifice Spacing) a In. the pipe with a sharp drill bit and face down. L Lateral Length ~ Ft. Lateral turn-ups terminate with a threaded M (Manifold Len th Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter Z In. diameter lawn sprinkler valve box accessible Force Main Len th Cj Ft. from finished grade. • • • • • Grade • 6-8 Inch Lawn Sprinkler Valve Box Page of 03/051gj Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tani; Model Number sv Pump Model Number ~CZ Lzi Manufacturer Total Tank Capacity Ia2 s Alarm Model Number Max. Bury Depth Switch Type e Total Dynamic Head (TDH) - Feet Filter Manufacturer Elevation Head l Filter Model Number Distal Pressure Network Loss Minimum Pump erformauce Required Force Main Loss ` _ Z N zy. BY GPM, Ft TDH Total outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Deriice, Inlet Manhole Securely Mounted With Locking Device < b" Below Grade Sealed Watertight Weather -proof, Junction Box - Finished Grade Vent Min. 12" Disconnect Above Grade Means With Vent Cap Y Y,l,Y l~a> f:~ . ~ft+i : Y ~ > t taf Y 1 Y~Y t Yet Y; ~ Y t; : .•1 i t~f putlet Filter - _ _ Inlet Baffle ,f A Switch Se and Reserve Capacity Weep Hole Tank Volume = GPI B Dimension Inches Volume Gal. (reserve) A off Elevation C (alarm) B 2 ®6 d. Ft Bottom (dose) C Elevation D (dead) D Pt Total a i t 1.< a M1 i i'. i i i a s :'•t a; a; iiYt a a:: Y! >,l,Y, a>f . < .•f 1 t . >a,at.,a Yti ) t~f Yaia a a>~tit~Yi>y +f,Y; ;,s i>l fYayat:i a•:: t>aYi l <Y: >~Y > a t a y Y> Y Y i~Y, a i l , a, l f: i t ' The 'c/dose .tank is bedded and back filled in accordance with the GENERAL INSTALLATION. tiz of bury as spe~ified..by the manufacturer may not royal specifications. Maximum dep device (padlock) manufacturer s product app to a have an effective locking t fittings, and be exceeded without prior approval. Manhole covers expo the tank with watertigh at the inlet and outlet is of approved material, connected installed. Piping or sagging. The force main is sleeved with 4" Sell. 40 PVC to bridge the tank laid on stable soil to prevent settling or with NBC 300 and Comm 16.23. excavation and the sleeve. is sealed watertight. Electrical service comp Page of 02105 LJ , TOTAL DyN/,vic NEF.D/ AP.AC~ 7Y PER UINUT[ EFF LUEN- AND D-yWERING HEAD CAPACITY CURVE I MODEL 152 153 i I,/,ODEL ; 52 ,53 LitefS 1,G' . I Liters i '77 29 50 69 j p1 - I 'LG~ I I 3 6, 23170 153 ,01 12 40 152 ,5 I 4.6 I 53 201 61 23, I C4 ,07 I 52 y7 a i 20 n 29 42 5y~' 2 6 J4 i 30 30 2 S, Jc 5 20 i 40 1 r y1 n Fir ,C7- 4-1 10 i - i 0 60 8o 100 20 GALLONS 320 3 27/32- 4 5/B LITERS 0 g0 160 240 ° FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS O 3 27/32 • Timed dosing panels available. lied with e Electrical alternators, for duplex systems, are available and supplied - an alarm. • 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[allations. See FN1420. - • Over 130"F. (54°C.) special quotation required. 2 1521153 Series I 1521153 MODELS _Control Selection 4 3 t/o Model Valts•Ph Mode Amy S-j,lex _ Non 8l Duplex r .5 t _ 2 or 3 1 1152 115 ti 8.5 Included r 1 BN152 115 1 A S K2064 uto 2or3 E152 230 1 Non 4.3 1~ BEi52 230 1 Auto 43 lncluded l -N153 115 ? Non 10.5 ; 1 2or3 J SELECTION GUIDE or 3 ~ E1153 115 1 Auto 10.5 nclu:ed 2 o piggyback ~ 5.3 2 or 3 ~ 1. Single piggyback variable level float switch or double variable level oat OlziE153. 230 230 1 1 Non Auto 53 Included 2 or 3 Switch. Refer to FM0477. - 2. See FN10712 for correct model of Electrical Alternator E-Pak. All . Variabie level control switch 10-0225 used as a control activator, specify duplex (3) A CAUTION installation of controls, protection devices and wiring should be done by a qualified 3 licensed electrician. All electrical and safety codes should be followed including the most or (4) float system, recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO. P.O. BOX 16347 LouisvOe,KY 40256-0347 Manufacturersof.. SHIP T0: 3649 Cane Run Road ~j~MPS j7NCf /999 Zo \ \ Louisville KY 40211-1961 Q![aUTY (i PUMP (502) 778-2731' 1 03624 t~IU~P l~. FAX (502) 774 http.jlwww.zoetier.com 0 Copyright 2000 Zoeller Co. All rights reserved. ' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Septic Tank Capacity al ❑ NA Owner Permit # Septic Tank Manufacturer NA Effluent Filter Manufacturer Z~ / ❑ NA ber of Bedrooms ❑ NA Effluent Filter Model f ❑ NA rNumber GN PARAMETERS Pump Tank Capacity 6~ al ❑ NA of Commercial Units mated flow (average) aVV Pump Tank Manufacturer NA Pump Manufacturer Z-1 0 NA I Design flow (peak), (Estimated x 1.5) allda Soil Application Rate aUda ne Pump Model GlJ Z ❑ NA ~ Monthly average' Pretreatment Unit ~A Influent/Effluentguality ❑ Sand/Grdvel Filter ❑ Peat Filter Fats, Oil & Grease (FOG) 530 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (60D5) 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality NA Monthly average" Dispersal Cell(s) 530 mg/L ❑ In-ground (gravity) ❑ n-ground (pressurized) Biochemical Oxygen Demand (BOs) of Total Suspended Solids (TSS} 530 mg/L [I At-grade ❑ O er. Fecal Coliform (geometric mean) 510` cfu/100ml ❑ Driine Maximum Effluent Particle Size Y inch diameter • Values typical for domestic (non-commerclal) wastewater and septic tank effluent Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency At least once every ❑ months ear(s) (Maximum 3 yrs.) Inspect condition of tank(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every ❑ months ear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months ear(s) At least once every 0 months76year(s) ❑ NA Inspect pump, pump controls 8~ alarm ry Flush laterals and pressure test At least once every ❑ months ear(s) ❑ NA Other. At least once every ❑ months ❑ year(s) ❑ NA O10r At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS of the following licenses or Inspections of tanks and dispersal cells shall be made by an individual carrying one certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to h nck the effluent effluent on thes in the observation pipes and to check for any ponding of effluent on the ground surface. The po 9 of 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 (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at irervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. page - of START UP AND OPERATION ane POWT5 check treatment tank(s) for the presence of painting products or other chemicals thclt For new construction, prior to use Of dlar damage the dispersal cell(s). If high concentrations are detected have the contents of th4a may impede the treatment process operator prior to use, tank(s) removed by a septage servicing System start up shall not occur when soil conditions are frozen at the infiltrative surface. the backup or surface discharge to will . tanks may fill abov e normal highwater levels. d hmay er power th restoredp the excess wastewater efflu ltt the During power outages pump operator prior to restoring p discharged to the dispersal cell(s) in one large dose, overloading the cell(s) an the controls to restore normal levels ents To avoid this situation have ber tar P - of the pump tan remove b a Seta OWTS Ma ntainek to ass'istinymanually operatf operating the effluent pump or contact a within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within he PO 15 feet down slope of any mound or at-grade soil absorption area. nation of the following from the wastewater stream may improve the performance and prolong the life nt the . dental floss; diapers; disinfectants; fat; foundation dralin P duc►~S Reduction elimination , grease; herbicides; meat scraps; medications; oil; painting antibiotics; baby wipes; cigarette bulls; condoms; cotton swabs; sets pump) water; fruit and vegetable peelings; gasoline; line; 9 , pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service is ansll Aing sieps hall be taken to insure that the system is prope) y and safely abandoned in compliance with chapter Comm 83.33, openings sealed. • Ail piping to tanks and pits shall be disconnected and the abandon d pipe of o ertby a Septage Servicing Operator. • The contents of all tanks and pits shall be removed and properly disposed • After um ing, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with s(I)II, p P 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 comphim lacement replacement system: utiliz absorp ❑ A suitable replacement area has been svrom dand isturbance and ecomopr the lo action and shouldenot be infri ged upontby equ~ed a will result The replacement area should o protected f f ect the re Repltacement systems mustecomply w th the rule{ in the setbacks from existing and proposed structure, lot table rand eplacelme Faareailure to for a new soil and site evaluation to establish a salts ~ effect at that time. ❑ A suitable replacement area is not a vaiesbble due to t setback and/POs~smitations. Barring advances in POWTS techno ogl/ a holding tank may be installed as a last replace site has not been evaluated to identify a suitable ~ failure of the POWTS a soil and site available aoo>ding tank may be installed as must be performed lthe suitable last resort to place must may be with the reconstructed in effect foat that llows tg ~removal of the biomat at the infiltra~live rules in ce. Reconstructions of such systems Mound and at-grade soil absorption systems <<WARNING>> INSUFFICIENT NOT SEPTIC, PUMP AND OTHER TREATMENT TANKS TANK UNDER ANY C RCUMSTANCES./ MEATH MAY RESULTYGEN R S,CUE OI A CONTAIN LETHAL GASSES ENTER A SEPTIC, PUMP OR OTHER TREATMENT T PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTA{NER _ _ ~ ------i--° POWTS INSTALLER ~ !lam E Name Name Phone Phone SEPTAGE SERVICING OPERATOR PU ER LOCAL REGULATORY AUTHORITY _ , ame Name - ~V_ Phone /J d This document was drafted in compilance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. i _ t t- ~ { t ~ P t I o W I t - i k ~kl t Cv r CO 3 > . W 4 r t , i I Wisconsin Department of ommerce r EV~ LUATION REPORT Page 1 of 3 . gg- Division of Safety and Buil ings J0 in accordance ' Comm 235,Y ms. &m` Jade County ST. CROIX Attach complete site pla on fi"rt ~IIrif2 x 1 inches in size. Plan mus'C include, bttt not limited : verti k aYtBtdlM ~dFf2Kr6feren J)oint (BM), direction and Parcel I.D. percent slope, scale or dIMMMons, north arrow, and location and distance to nearest road. - 33 Please print all information. R ewes b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). f 17 & Property Owner 0Property Location LEONARD & ARG T DELAURIERS Govt. Lot NW 1/4 NW 1/4 S 11 T 28 N R 19 ©r)© Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 706 Coulee Trail N33 Hilts of Troy City State Zip Code Phone Number ity E]Vtuage ■ own Nearest Road Hudson, WI 54016 ( ) Coulee Trail New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement E] Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable N A ft. General comments Mound System 1.34 ft. sand fill 0.4 loading rate plow depth 12" and recommendations: (If pre-treatment system - 0.34 ft. mound sand 0.6 loading rate) Z& I fee -tCvtJa i P co lv4 a` ~Y a Boring # n Boring Q Pit Ground surface elev. 1070.40 ft. Depth to limiting factor 27 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDffF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-5 10YR3/2 - sil 3fgr mvfr as 3vf-m 0.6 0.8 2 5-15 l0 - sil 3fa&sbk mfr cb 2vf-m 0.6 0.8 3 15-27 10YR4/4 - sicl 3fabk mfr as lvf-m 0.4 0.6 4 27-36 7.5YR3/4 f2d 7.5YR4/6 sl Om mfr as lvf-f 0.2 0.6 Horizon 2 has some Imp]. B Boring # Boring ~>'p oAi1~ 0-)1 hv'L' El pit Ground surface elev.1 Depth to llUng factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Cola Gr. SL Sh. •Eff#1 'Ef1#2 1 04 10YR3/2 - sil 3fgr mvfr as 3vf-m 0.6 0.8 2 4-9 10YR3/2 sil 3fabk mfr cw 2vf-m 0.6 0.8 3 9-22 7.5YR4/4 - sl Imsbk mvfr aw Ivf-m 0.4 0.7 4 22-25 10YR5/6 - c 3fgr m fi cw 1 vf-f 0.2 0.3 5 25- - isbr - " Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:< 150 mgA- ' Effluent ##j2' = BOD < 30 mg/- and TSS < 30 mg/L CST Name (Please Print) nature Q f~ NIL, CST Number Mary Jo Hollister - 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 05 - 03 - 05 (715) 426 - 1775 r I r Property Owner DeLauriers (Lot N33) Parcel ID # (Pending) Page 2 of 3 a Boring # Pit Boring Ground surface elev. 1066.83 ft. Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDA'f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eft#2 1 0-10 10YR3/2 sil 3fa&sbk mvf . as 3vf-m 0.6 0.8 2 10-17 10YR4/4 sicl MR mfr cb 2vf-m 0.4 0.6 3 17-20 IOYR4/6 ci 2fabk mfi cw lvf-m 0.4 0.6 4 20- lsbr F-I Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Horizon pti Soil Application Rate Depth Dominant Color Redox Descxi on Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 ❑ Boring # S Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil iption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF in. Mtmselt Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 Ett#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mgA- • 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-9339reg(R.07/00) i Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, St Croix County, Wisconsin Lot I"=40ft Legal Description 2 ft contours R.14 W 1 tGwAj Qr"TIZby Backhoe pat OP OF f x/4.0 ON PEE r, ELEVATION Q~ .P,}tE ° P \ f jy~ B-121A / 33 .1 .40 B-1210 \ L. JOW. 83` ® J ON p1PON ~ \ \ ~ 34 a ST. C ROIX C OI JN'I" SEP'7'7(: `l"AI~I< 1VIAIlv'~['EN A_l~'(E 1 iCr 2 r MI ENT' AN1) OWNFRSf1I11 CEJUIPICA`1'I(~N 1''z)I2M Owner/Btt ye;r l Mailing Address Property Addres, (Verification required fhonr Planning c5-. Lonintr [)epartn(-mt for new c-onst c iolr.) ClLy/State Parcel Identification Nui Cher 65.6 1313* 'bo - a3 _ LEGAL DESCRIPTION Property Locatiorjvv-)'/ , , ix , sec, W' Town. OF Subdi- vision Lot 3-3 Certified Survey Map # `'c lrrnit: -Page - - Warranty Deed - Vtirlurnc Page #1 Spec house Oil() Lot line; identifiable o no SYSTEM MAINTENANCE AND OWNER.. CE improper use and maintenance ofyour septic system could result in its pr;~matu.re failure to handle wastes. Proper maintenance consists of pumping out the septic tams every three. years or sooner, rl needed, by a licensed pumper. What you put into the systern can affect the function of dre septic tank as a treatment stage in the wasie disposal system. Owner maintenance responsibilities are specified in §Connn. 83. `i2(1) and ur Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to subirut to St. Croix C'ounty Plaruung & Zon Irrg Departincnr a certification tonal, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (l ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspcc ion and purriping (if necessary), the septic tame is less than 1/3 full of sludge. 11-we, the undersigned have read the above; rectuuenrents and ag'Icc to nmZintairi [lie private sewage disposal system with Ow standards set forth, herein, as sci by the Departruent of(:)mmierce and the locpartrnent of Natural Resources, State of wiscoi.rsm. Certification stating that your septic systern has been rnairuairied rijust be conrplete, I and returned to the St. Croix Comity 1'lainrintr. & Zoning Department within 30 clays of the three year expiration date. 1/we certify that all statements on t~hi form are roue to the best of my/our k uowledge. Uwe arrdare the owner(s) 01,111C property described above, by vufi.re f a war anty decd recorded in Keg;rster of Dee, Is Office, Number of bedrooms J r ~,7 51Cr 'A'I"iJIOF APPLIC AN I (S) DA,,ri .l.**Aiiy information that is misrepresented may result in tire sanittrry permit being revoked by the Planning. & Zoning Depart ijum. '"*Y Include with this application a recorded warranty deed tiom the Regisre: r of ] u ds :Afice and it copy of the certified survey map if reference is niade in the warranty deed. (REV. 08/05) J ~ EXHIBIT A Legal Description Lots 2, 11, 13, 14, 15, 16, 17, 19, 24, 25, 26, 32, 33 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 48, 52, 53, 54, 55, 56, 57, 58 and 59, Plat of Hills of Troy in the Town of Troy, St. Croix County, Wisconsin. Parcel ID Nos.: 040-1318-00-002 040-1318-00-011 040-1318-00-013 040-1318-00-014 040-1318-00-015 040-1318-00-016 040-1318-00-017 040-1318-00-019 040-1318-00-024 040-1318-00-025 040-1318-00-026 040-1318-00-032 040-1318-00-033 040-1318-00-034 040-1318-00-035 040-1318-00-036 040-1318-00-037 040-1318-00-038 040-1318-00-039 040-1318-00-040 040-1318-00-041 040-1318-00-042 040-1318-00-043 040-1318-00-044 040-1318-00-048 040-1318-00-052 040-1318-00-053 040-1318-00-054 040-1318-00-055 040-1318-00-056 040-1318-00-057 040-1318-00-058 040-1318-00-059 2 of 3 I OF THE NW 1/4, THE SE 1/4 OF THE NW 1/4, THE SW 1/4 OF THE NW 1/4, THE NW 1/4 OF THE NE 114, iE NE 1/4, THE SE 114 OF THE NE 1/4, AND THE SW 1/4 OF THE NE 114 OF SECTION 11, ALL IN T28N, R1 ZOY, ST. CROIX COUNTY, WISCONSIN, INCLUDING LOT 2, CERTIFIED SURVEY MAP, VOLUME 16, PAGI 3ER 683753, AND LOT 1, CERTIFIED SURVEY MAP, VOLUME 9, PAGE 2427, DOCUMENT NUMBER 4764c. w OUTLOT 5 0.521 ACRE a 259.86' C55 304.39` 3 398.45' 22,706 S.F. W 536. 6' S 87°30'52" E 2681.78 . ' ~iN o ` ~ 17Q0.76' (BLOCK CENQTH) 7 c H 80°00.00„ W •i_,~_ 340• ' nE~~'~~z o o / 33 i R=80' \ - ~1??0 7T - - 1.422 st - -r` _ Rs 61,934 S.F. i n \ C50 S 0°pp.0p„ N?33 1.218 ACRES E f:`` ,Og~ 6 ~ p e X53033 S.F.CID G S 7s pQ.6 v N ~3 3Q,~ °"6410, •\9 Cs2 ~i 6 6 0 ,s° E S '13°3~'-p0'~ 1•\ .8 j/'^•-•-7 C63 M 40(/ 0 00"'`~. ~ssp• t7V 6 6g~`'~ ty U \ ` 34 \ uni cv ! i o µ 1 W ,~31p 6630, p0 (/Rvj k.956 °0 i i' , ~1; 1226 ACRES i w . ! a t C r / 31> 0U14 _.-.-._.5307 S.F. 3rJG~~S /6": !1.003 AVCRES! ° t I 2p~ ,9q. l 6 6 v 143,704 S.F. 37 i!o \ 64,'~ S 6 3~6i 'uo\ N 86°00' 00" w \0 koy 44 ir,w 3zs.st' i 7.176 ACRES °o." ;1-- 1.000 ACREo °ci 51,210 S.F. 43,561 S.F. / 38 LJS. sr• t_ % i 2 43 46. i8' O' ! p 1.065 ACRES ry d 164.8 320 _.J 7.°96 6 A ACRES ! N ^~o Ssn.~>• Y W dap. 46,386S.F. j 0' _ j 47,760S.F. M g3; 1 Opp. tp N ( Op~•~ / t 9q. 3~"••' 1 1 % S' t2 . 175 15210' L..r.~ ! h 2 45 S 45,715 .050 ACRES %3??3 04 >3S G~ O V' 00 j / 13? p.Op., of ( 1 ! 78 3p'' 00.; e, 56.1 721 1 o a . j >p 0• JO SO 0• ..f ° 1 i I I t • 256.77• ! I a S / o°'. 26' a 1 ory j n w 633.-, x. 1300'00., % >S~ °o: o° G6 R=BQ' w I I _ I 1 w I x _ ! / i i 41 40 t rN 491' /Q 1.184 ACRES I o 11.001 ACRESI o w I I F - I 39 l ! ta' !v \ 51,553 SF, I 14' 589 S.F. j °o 1 1004 ACRES j o, rc 1 11,733 xACRES E N15 9 65 .31' 93.80' I ° ' w o . oar . 43.741 S.F. . 04 g 56'S7, 9'23• 159.11 C73 ca \ \ ` ` I ° I 1 I °oo N 49,353 xS.F. ! o ! 1 N 78° 85' 4 00"00.. 164.95' °0 1.---.-.-.J z 1._.-.-.-._.J ° L.-._.- ! ro! ! r . I Op 81°00' 00" E A / 0 z z ~ n f - \ol S 81°00' 00" Ns 2 140 55' \ 1 37.3 17 4' 151.75__ 2.00' x219.OQ' ,_J ! 531 315''° c> -Z CREST CURVE N so°oo' 0011 w 560.09' x I ! j i 46 ~~\o c>61 r i 1.566 ACRES , X00 \ g5~ 1 y• > N 90"Cal CO" E 580.09' M r I 68,222 S.F. , /p 47 1.109 ACRES >-•0. ~!h 8 ° C79 90.09 132.00' 132.00' x I C79 S _ _ _ _ 48,299 SF.i ?e., ° o 8` - \ ` i i~y1 ~j 48 i~$ `~N80°52' 47•• n Q, I S 84°30' 264.38' M 1$t % g0 ! 1.007 ACRES r-------- r . N , m - 43.868 S.F. //~o~oi/ j n I w I 1 w I I or m I 53, ,t o o! 0 1 `j o o I, w t I c I 1.031 ACRES o' o w 44,891 S.F. i v o SQ' M 74 36 32, 49 I = i 50 51 ioa i 52 i I 50` ' 02,. ' 1.002 ACRES o ° c 1 ' > f u° W / n ~5 I° M I° ra I Q~ j - m r o 43,645 S.F. I - o I C,~ I o ro c~ k' • a ro v Q o N 86°00'00" E A ' `m s\ I o f pyF. o i Qh' 1° I Q h' l 0 251.40' 1 I a®` sp Ys, •\SSa°oo' op"i E o( I°°°~° ~r~~..~ 132.00'.1. Z ~p5. ( I .a' I I n•~`? I ° b I 5/1i ! ii ° ' I P ® o ❑li~IIIIyIi~II~iII ~~i~Illlllllll P ® 4 IIII~~ j!jlll ~ ~ i I,61 IIII' I' I I ill IIII: I ~ I I i l IIII Illli ~ I r, ,~lli~~!j! ® Il it ! 1 1 1 1 1 1 IIIIII'I'i! I II I 4 i ' I I I` I'lll'I ~I ~I"'lll l l~ ,I IIIIII III I I I( I I'lll' lily I i II llllljll~llllllljl I I I ~ c: I 1'11 1 1 11'1' ILI'~ L ~ ~ , I I ~Luiliiip7 u. A C]~~ a jl~ljjjj F ~ I y' I C7 I ~ a~ ill l' I I'' l li I I I j ` ❑ I ❑ ° ® o I I s g H r o n 4 ~.6 u' oo E3 Y ~f E j m d ~pFv € :J:dS. G d S iYAms i~' o^' ZO c d D o o f "o y' m w ~I 1 Z 51 (D 3 m (7 1. z. x.rc zz.a Rm I I y 1 I I I T g I I - - 1 I I °Io I~IIIIm`w 9x 1J -J-_- 11 ° ~ Z I L 1J 11 ~ ~ 11 11 11 _ ._..o 1 ~ I I I i I I i I I I I I I i II ~ I n~ ~ I I it I I zo mO I I I I I s 9 a n 4A;P'eEy sm SiL li ipVIM? oT. O W m e p OHM. o~n m ° 4 st 83 30 J i I j I I ; I j I I j I I I I I I I I r~vaew U I r_---- E i wwre I I S 9 a a I I ;I F" I I S I I I ` CC a I I I I I I I~~) I ^ CJ/ IrJ ® PPPIa 9 _ S I LLJJ 9 I I ° vL I I I I I ~ I I I I I I I I ~o I I p -Tw s 5 _ o~$e mt as; ;qf ;°96is deg{oE ~ ~ 3~ o~g ooa 'f ~3 3 ~S ~ v -p" - W m a R;F C F I V E s Wisconsin Department of ommerc Ce EV LUATION REPORT Page 1 of 3 Division of Safety and Buil ings ,i r (I(l ~ in accordance wit Comm 85'`Ws. XAdm." e ° County Attach complete site pla on p1pTer(d" ~T1~2 x 11 inches insize. Plan mus ST. CROIX include, but not limited t : verticaZ&d1NB20hi erence oint (BM), direction.and Parcel I.D. percent slope, scale or dlMisristo-ns-, no arrow, and location and distance to nearest road. _ _ 33 Personal information Please print all information. R iewed by Date f you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l l / O~ Property Owner 0Y Property Location 0 LEONARD & ARGRET DELAURIERS Govt. Lot NW 1/4 NW 1/4 S 11 T 28 N R 19 E (or) W Property Owner's Mailing Address Lot # Block # Sub-dd. ;Name:or CSM# 706 Coulee Trail N33 Hills of Troy City State Zip Code Phone Number ity Village own Nearest Road Hudson, WI 54016 ( ) Coulee Trail New Construction Useo Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement El Public or commercial - Describe: Parent material - loess over till Flood Plain elevation if applicable ft General comments NA and recommendations: Mound System 1.34 ft. sand fill 0.4 loading rate plow depth 12" (If pre-treatment system - 0.34 ft. mound sand 0.6 loading rate) F1 Boring # El Boring Pit Ground surface elev. 1070.40 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10YR3/2 sil 3fgr mvfr as 3vf-m 0.6 0.8 2 5-15 10YR3 - sil 3fa&sbk mfi' cb 2vf-m 0.6 0.8 3 15-27 10YR4/4 sicl 3fabk mfr as lvf-m 0.4 0.6 4 27-36 7.5YR3/4 f2d 7.SYR4/6 sl Om mfr as 1vf-f 0.2 0.6 Horizon 2 has some Imp]. - El Boring # ~ Boring 1065.54 ~G~ - U~1 ` ~ ~(!-n 7Ld?~i Pit Ground surface elev. Depth to IAing factor in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 04 10YR3/2 - sil 3fgr mvfr as 3vf-m 0.6 0.8 2 4-9 10YR3/2 - sil 3fabk mfr cw 2vf-m 0.6 0.8 3 9-22 7.5YR4/4 sl lmsbk mvfr aw 1of-m 0.4 0.7 4 22-25 10YR5/6 - c 3fgr m fi cw 1 vf--f 0.2 0.3 5 25- - lsbr * Effluent #1 = BOD, > 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) Si nature CST Number Ma Jo Hollister Q ) ,W5Z~L 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, W1 54022 05 - 03 - 05 (715) 426 - 1775 Property Owner DeLauriers (Lot N33) Parcel ID # (Pending) Page 2 of 3 Boring # Boring Ground surface elev. 1066.83 ft Pit Depth to limiting factor 20 in. Soil Application 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 1 0-10 10YR3/2 sil 3fa&sbk mvfr as 3vf-m 0.6 0.8 2 10-17 I0YR4/4 sicl 3fabk mfr cb 2vf-m 0.4 0.6 3 17-20 10YR4/6 cl 2fabk mfi ]wit 0.4 0.6 4 20- Isbr ❑ Boring # -J Boring a 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # Boring F] 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD5 < 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-8330Test (R.07/00) A Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, ,S. Croix County, Wisconsin Lot z;~, 111 = 40 ft. Legal Description 2 ft. contours - xigv,j, T0V;A1 or--rw = Packhoe pit f V i BEN H M~ fi00 OF 1 1/411 IRON PIPE ELEVATION 7 -I 33 B-121A \ EL nom-40 I B-121c f t/4E /jl f r &Z0 (A,AJD J yK {may. @ E- Cam-: b 7Z)I 8l, v8 <54 f S \ a6 s I 0 34 \ o