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HomeMy WebLinkAbout020-1430-29-000Wisq~nsin DepaA;ment 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)]. Permit Holder's Name: City Village X Township Sienna Cor Hudson Townshi CST BM Elev: Insp. BM EIev: BM Description: ~~jj g Q ~^ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ;~~' -s-~r / 2 S-V Dosing r~ ~3 CMG Aeration Holding r _- TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~= ~__ Dosing " _~p ~. ..- ZG Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ Demand a ~,.,lc~ GPM Model Number p ,~ ~I ~. 1~ Ci `7 TDH Lift Friction Loss System Head TDH Ft -5• ~ .~ . ~ ~- 3 Forcemain Length ` Dia. ' ~ Dist. to Well ' ~ / "~ ~ ~ n ~ / lVo t , a County: St. CrOiX Sanitary Permit Na 430184 0 State Plan ID No: Parcel Tax No: 020-1430-29-000 Section/Town/Range/Map No: 20.29.19.2680 ELEVATION DATA STATION BS HI FS ELEV. Benchmark y. y : ~z. ~ S ~~ Alt. BM G ~5 9 S. 85 Bldg. Sewer 8. ~ qy 3 SUHt Inlet ~. S 4 3, o St/Ht Outlet ~ Dt Inlet ~ Dt Bottom ;; i 3 ` l F; s'. 7 Header/Man. Dist. Pipe C~-~-/3~--- ~ / ~ B t. S ~Srt~ ~~ N s~ 9. o 9-n j3.7 S 93.5 Final Grade St Cover ,,,~ ~, S ~~. ~ ~ 9 SOIL ABSORPTION SYSTEM v ~ N l •~ ~ ; .~. °b ~.-,„ -~-~~ : r~ ~ho___ BED/TRENCH DIMENSIONS Width ~ p Length 8' 7. S No. Of Trenches Z PIT DIMENSIONS No. Of Pits -~ Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: _'I-~ f =.1 ~: l ~-~c, O S _ Typg f ystem: ~J ~?G r VL/1~- e 6 h o~ "'~Ci / ~, °"" ~ N c ~ ~ ~- UNIT Model Number: S+ DISTRIBUTION SYSTEM / -rrz+t ~'- Header/Manifold Distribution ~ - x Hole Size x Hole Spacing Vent to Air Intake ~~ Length 9~ Dia t~ ..._~.. ~ Pipe(s) Length Dia Spacirig - ~~- --~_._ 'L ~ ~ ~ SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ..-- ~ j Bed/Trench Edges _- Topsoil ~~~ Yes ~ ~ No i 1 Yes ~~J No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~o / Z / ~ 3 Inspection #2: / /_ Location: 435 Wren Lane Hudson, WI 54016 (SE 1!4 NW 1/4 20 T29N R19W) The Glen Lot 86 Parcel No: 20.29.19.2680 1.) Alt BM Description = S o ~^-`t'h d ~a i ~` ~ ` 2.) Bldg sewer length = ~~ ~ J -amount of cover = ~ i ~' `~ w h t ,, ~ ; ~~ ~.. ,~ ore ~ ~ ,~ ~ ~ ~-'' 1! o P I to N1~---r 'C i -~z-~-3 - ~°-~ _ - --- _- _ --J --_- Use otherls de for additional in Yes ~I formation. o ~d ~ ~ _ I ~ ___ ~I SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. a - ,r ., - - .,_ _ + ~ ~ ~~ a ~,, `., ~ ~ l - ~ ~-~'b-ter i ~ ~ o L~ o Safety and Buildings Division County T ` ~ 201 W. Washington Ave., P.O. Box 7162 ~l esr ~seons~in Madison, WI 537Q7 - 7162 , Sanitary Permit Number (to be -Iled in by Co.) 4e artment of Commerce (fig) 266-3151 3 Sanitary Permit Application Stag Plan LD. Numbgt' , / Ia accord with Comm 83.21, Wis. Adm. Code, personal information you provide /t ID / V ~ tray be used for seconda ur oses Priv S O4 1 /'1 h Add if si dd ry p p acy ~ew,_s), ( )(m) ress} di Brent t an ng a Project ress ( ~: ~ ~ ~f 3s G(/ /l~ ~~~ I I A li ti P , . o -- . pp ca on n orraation -Please Prfnt AU Inforntati n y ': ~ ~. ~ ~~ •~ s t P Properry•Owner's Na me 3 ~''t-`!., e ~ ~ ~ ~ C 0 Parcel J1 ~~a, of Block li -~ ~ ~ ; ~ • e l.~ r ~ ~ Z p ~ Pro rty O w pe net's M a iling Address _ Property Location O / + ~ / ~ / ~_... 4 s ~ ~ ) ,c 5 i U Cit State , . , , ect on ~ ,~ 1~ y, Zip Code Phone Number _ ~d ~`..~/~- SS' ~/3.S" 9S'a - ~3~ o?~ab' (circle o v ~~ ' ~ L /Q ~ ~ ~~ IL Type oP Building (check ell that apply) _ T N; R~_E o, ~ / 1 or 2 Family Dwelling -Number of Bedrooms `7 7'p Subdivision Name CSM Number ^ PttbliclCommercial -Describe Use `I ^ 5tate Owned -Describe Use ~ ~Q~~ it~ ~~~,sy, ~~,p~~~ ^City~^Village~Township of~~~~ i III. Type oP Permit: (Check only one box on line A. Complete lute B if applicable) A' New S s ^ Replacement System ^ Treatment/Halding Tank Replacement Only ^ Other Modiftcation to Existing System i$. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber pwner IV. Ty oP POWTS S stem: (Check all that a 1 ) Non -Pressurized In-Groutui U Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculatin S ntitetic Media Fitter caching Chamber ^ Uri Line ^ Gravel-less ^ Other (explain} ~d-~~j~-f i~C.~YS V. Dis rsaUTreetment Area Infor ation: Design Flow (gpd) Design SoU Application Rate(gpds Dispersal Area Required (st) Dispersal Area Propoa sf) ~ ` System Elevation ~ acl ~7 ~7 Ia- S ~~! Y~l VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber !Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing k ', l s~~ W a U ~ Tanks Tanks ~"'"" Septic or Holding Tank 1 e ~ Aerobic Treatment UNt Dosiag Chamber (~ ~,r~ O I/l/ ~„ , y" J c 1~. y` ~ VII. Responsibility Statement- I, tht: undersigned, assume responsibility for ation of the POWTS shown on the attached Plumber's Na me (Print) Plumber's Si gnature P/ FRS N u m ber umber Busin e s Phone N s ~/ ,e e4 ~L~iLC ..r~7P r / y p ~~ ~7 7 / / ~ * ` Q ~J ~ O U ~+ 2 C Plumber's Addre ss (Street, City, State, Z tp Code) / 7Q O~- ~ C~ p~-~ •-f~ ~ ~ l~ VIII ount /De artment se Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater ~ Surcharge Fee} ~ Dat Issued 7 /~ ~+ Issuing ent Signs o Stamps) ^ Owner Given Reason for Denial ~ ~ . ~~ /'SO 6 G~ .Conditions oP App~~ons far DisaRprovlal~ ~ ~~ /~ ~,y~- ~~ GJ ,~Q LcJ`T.~ I ~ ~~ l + d ' // am ~~ "t~l1.~t- ~ ~~,- ~ ~~, d( ~~ p~ / ' l ~ ~L~- 7i J S~,y~- (~S ` ~ CST -~ Grh~k ~ VhQ.lih Gt,~~~~G~:~" ~'3• 3~/, l"_ u.. (/ wttacrt camptete plans (to the County only) for the system oa paper nol less than 8112 x 11 lncltes is sue SBD-G398 (R, U1/03) S'~ e .tea`- G aY~ ,<o ~ ~~ ~.~~ ~-r~/,~~..~ T~~~,~ ~ ~ 1~~~.~-arr/ a ~f~,~ s't~ a ~~.f~~~~~.r-~ Zhd~~ ~11d® ,S'~P~ ~~ '~~ .~ .S~u,(e ? ~= y0 ,~ml~~~r~lea. ° G'~%,~ y'~ ~/ ~~ ~ B~.y ahs ~-,~v I ~ 1~• 1 ~o~c~~~vY~~ v ~ ^~U iC a --~ ~' r1cCC r ~~ ~ ~~~ ~~ a ~~~s°~ S ~tG ,`~'~ P~ A ~ . ~ 3X~s1s~~s' a~c~i~-~,b~~s?s7~/ _--_... -~ f~ ,~~~ ~~ ~ ~~ / ~8~y - a a] 1- ~ 1 a ~ m~~e .'1 ~,.+ C 4 ~ r } i }'~1~ ? I. ~ C i~ 'J 5 c 7 ~ ~.. T .'._ V' 1 f ~w ". i~~ ~ ~-~_~w~~.-...~' ~... * ~ ~J ~V ~~ ,,..- ~~~ CI VENT WIPE ~.~" 'MIN. ABvVE GRABS ~ 4iEA7hi~Rf~R44F >_ ~y' FROM Dt'~OR, WINDOW OR FUNCTION BOX MANMQLEgCOVER p~zESH AIR zN'rAKE WITH CQNDU_ ~! tpAD3,OCiC ~ E'IAIISHED GRADE •--------°'~ARNSNG LABL'L t~" C s RISER ~•-~~ ~ ~,,,,, ~ 4+ M I ~( , „ . N 6 ,r MAX . ~ ~ ~ ~ =;.~ ,; ~ INLET 1..~.._ 1` ~--~'~ / ~ ~ < < ~, w~F,TER TIG"riT SEALS T~GHT', `~ APPROVED A SEAL ~ JOINTS '~JIT~s ~,~_. ; o BALM APPRQYEf~ PIPE ~PPRt3VE'a B , ~ ~pN 3' 4NT0 'IPE 3' `,;"~"'" a , ~ SOLID SQIl. )NTO 5t}LID `,~ ~ -~'"OFF j ~'~` RISER EXIT itltl. P~1MI~ OFF ELEV . FT . -----~ PERMITTED ONLY ~ I F TANK MA~IIJFACTURER Ii.AS APPROVAL 3" APPRO'v'ED BEDDING UNDER '~ANK CONCRETE PAD SpECIFLCATIGNS~, S WF'TIC i DdSE TANK MAv'1~I"ACTURzR: ~~ NUMBER DO'jES ?ER DAB'. ~- . ':Arlie S Ir2~: SEPTI w a GAL . DOSE V OS.,UMi:. z NC LL~DI..'~`G -'""" DOSE 8,_„_,_ GAL. FLOwSACk: l~ •~,~,. G:~L. A u~RP~1 MANU~'AGTURER: ue ',a.~,.~,,._ -`~" MOAEL NUMBER ~ ,~?~ t1 S~n~ITCH TYPE: ~, yYJerc PUMP MANUFACTURER : f~ v ~,l.S MOD£L ~It1MBER : _~,~ ~/ SWITCH TYPE : _y~i_~~ ~. REQti_RED DISCxARGE RATE _,~~vFM CAPACITIES x~ - ~~ 8 - Z u= ~ FUMP ~ ALARM WIRT ~~rG IP~CHES - ~.-`~vd ..-~ AL' INCHES = y'~___, G~1L` zNCxES = ~~8 ~~~. INCHES = _,1.~1,,.~.,_,,,_GA L As DER ~~~.R r~.z~ wA~ VERTIOA:. E IF'FERENCE BET4~iEEN PUMP OFF AND E.Z STR.2 BU T I UN PINE I.~ FEET + ~.INIMUM NETWORK SUPPLY PRESSURE .. ' z EEC, + (,~(J FEET FORCE;MAIN X ~>~U FTI1C0 :'T. FRICTION FACTO"t? /.$'7 FF,E`~. °"'~"" T.OT.~L DYNAMIC: HEAu - ~ S ~'Ez'I ..~.~::.-Z-- Ih~TERPdAL DIMENSIONS OF CT.iMP TANK: LE.Iva?TH `- ~ WIDTFI '-"_,_; DIAML"1'ER ~ . LIQUID i'~'P'I`F~" ~~ '` a r~.Qr'a..//~.~y ~ ~, SIGhEDs __~.,.~%-r'"~f LzCENSE'~ NUMBER: ~~_~s~~~ ~JA E. , ~~~~~ z~a~ . . t. (~ 1 c~) APPLICATIONS Specifically designed for the following uses: • Effluent systems - •Homes • Farms Heavy duty sump • Water transfer • Dewatering SPEGiPtCATtONS Pump: EP04 • Solids handling capability: s/-0" maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size: i'h" uPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C}continuous 140°F (60°C) irrteermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: s/~' maximum. • Capacities: up #0 80 GPM. • Total heads: up to 31 feat. . • Discharge size: l ~° NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA N elastamers. • Temperature: 104°F {40°C} continuous 140°F (fi0°C} interrnittent. Y9 l~J ~71iW0 • listeners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single ptease: 0.4 HP, 115 or 2301#, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 U, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord:l0 foot standard length,16J3 SJTO with three prong grounding ping. Optional 20 #oot length, 1813 S,iTW with three prong grounding plug (standard on EP05). METERS ,FEET 14F gr . a ~ x v s ; z 5 y o a a 3 GPM Goulds pmt-- ~ uF ~ . Submers~bie Ef~[uent Pump ~~ 3871 EP05 • Fully submerged in high grade turbine owl for lubrication and efficient heat transfer. Avaltabie for automatic and manual operation. Automatic models include Mechanical float Switch assembled and preset at the factory. FEATURES ^ EPl14 impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. tt EP05 Impeller Thermo- plastic enclosed design for improved performance. ^ CasiRg and Base: Rugged thermoplastic design provides superior strength and C4rroSi4n- fe5lStanCe. ^ Motor Housing: Cast iron for effaent heat transfer, strength, aitd durability. ^ iNotor Cover. Thennaplas- ticcover with irrtegral handle and float switch attachment poirrrs. ^ Power Cable: Severe dory rated oil and water resistant ^ Bearings: Upper and lower heavy duty bail bearing construction. AGENEY LISTING Canada standards Assoclattan (CSA listed model numbers end in "F"or "AC".) CAPACrfY t.~"~x~ . ~ -,: w..w+. 1102 + 2 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Sal Service County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Crobt include, but not limited to: vertical and horizontal refererrce point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north anow, and location and distance to nearest road. ,_ ~ pen Please pri ' ~. 'boik ~; ; Reviewed ~ e iy pu~eS (Privacy Law s. 15.04 (1) (m)). Personal information you provide may tre ed for ~tRra I~NW~ [, Property Owner ~ ry r ~.; -u r f ~ ~ ~` ~ roperiy Location ' ° •- " Sienna Corporation __ °-' out. Lot SE 1 /4 NW 114 S 20 T 29 N R 19 W Property Owner's Mailing Address tiot # Block # Subd. Name or CSM# 4940 Viking Dr, Suite 608 ~ ;, 86 na The Glen _ City State Zi ?h~'Nrim~er ~ City Village Town Nearest Road E4~~'rKl MN 55435 ~$Z-Ff3S-.ZBod' Hudson Carmichael Rd. New Construction Use: ~/' Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applicable na General comments and recommendations: System elevation 94.90ft, trenches spaced and depth to code 3.50ft below grade ^ Boring # Boring 96 Pit Ground Surtace elev. 98.40 ft. in. Depth to limiting factor Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fta 'Eff#1 *Eff#2 1 0-10 10yr3/3 none sil 2msbk mfr gw 2f .5 .8 2 10-30 10yr4/4 none sicl 2msbk mfr cs 1 f .4 .6 3 30-96 7.5yr4/6 none ms osg ml na na 7 .8 Boring # .__; Boring 96 fri Pit Ground Surtace elev. 98.40 ft. Depth to limning factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz "Eff#1 `Eff#2 1 0-i2 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 12-20 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 20-96 7.5yr4/6 none ms osg ml na na 7 .8 tnruem ~ r = rsvu ~ su < uu mgiL ana 155 >3U < ~ bU mg~L "Effluent #2 = BODS < 30 mglL and TSS < 30 mg/L SST Name (Please Print) Signature: CST Number David J. Steel ~ 248956 4ddress Steel Sal Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 9/7/2002 715-246-5085 Property Owner Sienna Corporation Parcel ID # Pending Page 2 of 3 Boring # Boring 90 96 . Depth to ft limiting factor 96 in ~ Pit . Ground Surface elev. . . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP *Eff#1 "Eff#2 1 0-12 10yr3/3 none sil 2msbk mfr cs 2f .5 .8 2 12-26 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 26-96 7.5yr4/6 none ms osg ml na na 7 .8 R~ri~~ ~ Boring * Effluent #1 = BOD 5> 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 Boring # Boring _ ,_ .. ... _ .. ~~ , _ _ \•' 1. ,. -' '~1 '.•',•t ,.tli; ~,J^ _ `J ,~ ~ r ~ '' 1 i 1 t ~ G~ • '._ ~ ~ ~- __ ~`:., ,, \, 'R a\ •; ;• .k , t' 1 t i ~ r ^_ . _` .' /- ap •'t •it ~ ~r~7 r , /' ~ : °I ~:~.`_ .r-r at;,• rtr;'t•`, :`;, `~ -~ -._ •,- r Jr ~ J, t - _ ~:. .: J 7 _... •• /' 1..j~,.'A~~~+.+ .`'ij:1 it k I,_Ir ~' ~~'' :1 •t -_ \ / ••' S.\.. _ - __ .f _, • ~~ 1 ! 4r t JI. Aa I . 1 1, ' ., S- _ t ' J ,,,t .S..M1~'/ fxf.'1 'jfl ~•t{~J 7. •~i • y • J l eSI- 1'\ . ~ J 1, .1. 1 .. ~ J /J %~ e , -_~/\ - ~~ `t ~+{rr~~1 ! • i ~• i': is _ ~~_•'k %Y,,, _ 'i i, ~1'O! - - _ `~~ •\i:illrl rif ,i w, 't ~ ^~ t 4;' ; ° t ~, ~ li f7r. '~s-:~~ a5e.-' --3~'..ta;'.:'.\::.' ;+IS f ~ .,~+~ r _ 1'n*__ __. ' - ~. ~, .~ - '• 4 ,;;; ~. „,_-~;~:~_~:,' __ . a _-,.•;::~,•: `:',,.. ~, ~'3•'-': =~ 'gam--- ' \\` ~' \. r JIt •i`•t 1 . • .• a ~~.\t`'~ .• frl~-~• - - \ ^.Zh:-~+~~+ - •`id~.~` ......•- .~` rJJ Bela? - i'' i ~ ~~ a• .," ~ •+ r ~+ - -__ , ~• ~k.! } _ _ K __ - _ __ YV '~y J ~ _ - a _ - _ _ ,7 ~ 1 '- ~' _ ~g-_ " ...r °~I ~ 1 ~ -- "1~ •iitl...a...a• .` t~"~I~=.~J•- .~~ 243r• i '136"- ~ ~~ ```~ `~` c 1: ~1 t [ / ~~ ^- ~ llta •M.tltt ... •- 1 i i ~ •.\ .+ ^yr. -~+., :1 7 :i11I, 1j~1:f1~~`! f+7!•t ''J'. ` \ 1 '. .. . ! fir, J. ` ~. 12 \ 1 / 1l \~ ti::•:1.••. \ ~ I ~^~.+ ~^.. IJ`fSl' tt t 1 ! 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I4t ~~~ ..'~M ~•~~ t\ " is r':~r.r,7,f;'Ixet •tl'i",t i' ,J.JI -- ~ ~~` - '1's r Jr itll.l.lt 7t, 1 +! ~ 11. ~ ,~ /• __ i I.~'.•. +I. ! ! \ _ .``~ • -~_y ~ `. I ~ ~ JJ . . b - t l . + t t n ~~Y Wisconsin De artinentofCommerce SOIL EVALUATIOW REPORT ~ e '1 V~ 3 P „ h ,, a9 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code ~' `~' Steel S 'I County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. CrOOc include, but 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 I.D. pending Please print all information. R By Date Personal infwmatbn you provide may be used for secondary puryoses (Privacy Law, s. 15.04 (1) (m)). ~ Property Owner Property Location Sienna Corporation Govt. Lot S 1/4 NW 1/4 S 20 T 29 N R 19 W l Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 4940 Viking Dr, Suite 608 86 na The Glen G2.0- ~ ~{!'~-OZ. ~2`I City State Zip Code Phone Number City, Village ~ Town Nearest Road E~,~~xc MN 55435 95z-8as'-?..$6& Hudson Carmichael Rd. New Construction Use: yi Residential /Number of bedrooms 4 Code derived design flaw rate 600 GPD Replacement _~~ Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applicable na General comments and recommendations: System elevation 94.90ft, trenches spaced and depth to code 3.50ft below grade Boring # `~ Boring 96 in. Pit Ground Surface elev. 98.40 ft. Depth to limiting factor Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft: •Eff#1 'Eff#2 1 0-10 10yr3/3 none sil 2msbk mfr gw 2f .5 .8 2 10-30 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 30-96 7.5yr4/6 none s osg ml na na ~ .8 J L! 2 ~S ` ~ ~ -_ ~ ~' ~ _, '}~~ Borin 2 Boring # ~ g Pit Ground Surtace elev. 98.40 ft. Depth to limiting factor 96 in• Soil application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft= 'Eff#1 'Eff#2 1 0-12 10y-3/3 none sil 2msbk mfr cs 1f .5 .8 2 12-20 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 20-96 7.5yr4/6 none ms osg ml na na 7 .8 ~ ~~, ~~~ tttwent #1 = E3ou ~ 3U < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS< 30 mg/L and TSS <~0 mg/L SST Name (Please Print) Signatu~re~ , CST Number David J. Steel ~~~""-~ 248956 4ddress Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 9/7/2002 715-246-5085 Property Owner Sienna Corporation Boring # `=:: Boring Pit Ground Surtace elev. Horizon Depth Dominant Color Redox Descripti~ 1 0-12 10yr3/3 none 2 12-26 10yr4/4 none 3 26-96 7.5yr4/6 none Parcel ID # Pending Page 2 of 3 96.90 ft. Depth to limiting factor 96 in. ~~ Application Rate n Texture Structure Consistence Boundary Roots GPDIft' 'Eff#1 `Eff#2 sil 2msbk mfr cs 2f .5 .8 sicl 2msbk mfr cs 1f .4 .6 ms osg ml na na 7 .8 Boring Boring # _ ... ` 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. ff you need assistance to access services or fir;>j Boring Boring # _ ..- _ Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 SE1/4,NW1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot # 86 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil test was conducted. N ~,e e~ ~~~ ~d~/ TAP o~ yi`' ~~ ~'~ p= C3ar~~,yS // ~driY~S ~(B/G.f70/~S a~= ~FfI tfo~ 8z= 98, ~f ors' ~ &$ 4- l-~' ./Y 3~ s~! ~' ~~~ ~,~ !S~ ~'~ 5 -~.e ~--- 4r;•So~F+' 3G' ! ~o, !o' ~'bwa'~, Fof' i...' nt ~- FROM Sc~,umaker Plumbinq FAX N0. 7153863121 Jul. 18 2003 12:11PM P4 " SEYI~C TAl~II~ 1~C8 A~RgBMSN'~ . AND . OWl~.tSF~ CBRT~+iCpTTON FORM OwtterBuycr S/F~J~1A Co~PQ~~ o Mailiag Address ~~,~ ~ K ~ ~.1b- ~ ~ Su l~ ~~ ED r~A~ /'7h.~ ~• ~3 S P~ropenty Addr~ ~~ (VetltvedticasRquierd fsgm P{aea~6 Dep~mest fer m~ ~ty/Stacr, FIUD-SohJ lv~ Paiul Ydaotificatioa. Numbed - LRGAL ~FSCI~''[i_ON ACo Lxatzo~, ,.,.~~ ~, ..L= ~, Sd_ ZD . T Z~ ri~R~..W, Town of ~(/L]~5'O~ P~~' r p~ Suhdivisiua TNT -~L N I~t # _ O ~o Ccrtifi-cd Survey Map # ValuRne .Page # w,t~ey Deed. # _ Co Co _ d.BO ~ _ Valwae ~ ~ -Page # r 3 3pac ~3puse ~ y©s ~ ao Lot liars idr.nfifi~ble ~ yes ^ no ~'~~ ~Ai1~TENAIIL ~tupcr use a~ eF3'o~ appdc ry`tem could mrvlt is i!= peeRRStWR fas7s~ to hatictLaevasfes ~oprY ao~a of p«piag ovt tha jcpt~s taak ovary tlakae y~ at smocL iF ncaded by +a Sir.~sed pt~ ~ Y°~ W~ mae tine ~ ~ r$rst thb Ftiri~0litin of fbe rcptie Am1G ae a 'le~.®ent sls~e m i6e o+e~t9e sy~- 'ibe ptopetry o~aa ages w ~abmit to s~ ecoia 7.oaia~ ~etimrat a r~6~tion fficm~. ~ by ~t varna aad by a m~rpl~r3av~c~eYRylaPiutab~.~i ~QedPlnaaLesori yeeeted~fY+~ tb+tt (1)1he aa~i~~P°'~ ry~ is is P~ opastiag eepdirion iadJa[ (Z) ~~' +~ P~pi°S (if )' the >fcptie t~ vi Ica t~ V3 A~, of dadga Dom the vadessig~,ad have ~-sd the alms tCgpitsale~l4 a®,Q to malatslia the p;iVlie aCWf~ ditl+~l ~m ~+~ the e0mdardY as [aeth, b~ia~ e-c ect by ttto ti~attmcat eF sad lily Depat<mcAt of Nattaal Betootcaca, State of'W~~ ~°o ~~ ~St~u septic tys~ ~ba•'4 be comPletrd ss~d ieK~aes1 to the St t~oi: C~cmty 7aw8 Cffict ~fidua ~ 0 shs¢ r~° - aat~ _ ..~ _ DATE er..ttiFy ghat all ,/~ o this form are true fv [be bsyt ei 1my (ems 1meWltdige. I (a4) am. (eie) Qio oW>~(s~ of scn sbov leme a o+airanty decd rata;ded m $pFyster of Deets OfSae. Z .z - _ ~ ~ . ~ DATB A\ay iaCocma6on tl~lE is Bois-~pts~eneed iaay zesvie in the taaia~y P~~t ~ ~wl[td by ehe ?~toi~$ D~'!~°t' *~c~r. ~• include ~i,th this spplieotioa: a s®,mpod aar[astl- deed Flom the Aogiete[ of Demos o>~ a ~.oy~ of t'!tie c~d5ad surrey map i[ srfete~oae is Qlaeto to the wacsaa~]- dcrd TOTAL P.02 POWTS OWNER'S MANUAL & MANAGEMENT PLAN FiIE INFORMATION Owner ~ ~ ~.~ ~ ~~ Permit # !~~ ~~l~ ~ uearvn r~.~~ • •:•,o ~ O NA Number of Bedrooms Number of Public Facility Units DNA Estimated flow (average} ~ a}/da Design flow {peak}, {Estimated x 1.5} ai/da Soil Application Rate al/da Ift~ Standard lnfluent/Effluent Quality Monthly average` Fats, Oil & Grease IFOG} 530 mg/L Biochemical Oxygen Demand (BODE} 5220 mg/L ^ NA Total Suspended Solids {TSSI 5150 mg/L Pretreated Effluent duality Monthly average Biochemical Oxygen Demand IBOD,1 530 mglL Total Suspended Solids ITSS} 530 mg/L O NA Fecal Coliform lgeomatric mean) 510` cfu1100m1 Maximum Effluent Particle Size Ye in did. ^ NA Other: O NA "Values typical for domestic wastewater and septic tank ernuent. ^wuereiuerur_F ttcWFeu~E _ Service Everrt Inspect condition of tankts} Pump out oontenta of tankls) Inspect dispersal cellls} Clean effluent finer ~ ~~, ~'~ Inspect pump, pump controls & alarm Flush laterals and pressure test Service Frequency Page of tiF 0..monthta} {Maximum 3 years O NA At least once every: 3 ~ ear s} When combined sludge and ~>*ci~m equals one-third lYs} o tank me O NA At least once every: At Least once every: At least once every: - At least once every: .-- At least once every: ~* {Mturlmum 3 yei~} ^ NA f O NA ^ NA ^ NA O NA ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the foNowing licenses or certifications: • Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. TanM Master Plumber, inspections must include a visual inspection of the tanks} to identify any missing or broken hardware, identify any cracks or lea s. 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 cellls} shall be visually inspected to check the effluent levels in the observation pipes and to check for any pondins of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a fatting condition and requires thi immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equaia one-third,lY3? cr more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed;of tit 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, pretreatmen units, and any servicing at intervals of 512 months, shall ba performed by a certified POWTS Maintainer. A service report shah be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls! for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal ceil(s}. If high concentrations are detected have the contents of the tankls! removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells! in one large dose, overloading the cell{s)-and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Saptage Servicing Operator prior to restoring power to_the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore norms! levels within the pump tank. Do not drive or park vehicles over tanks and disperse{ cells. Do not drive or park over, or otherwise disturb or compact, the area within 16 feet down slope of any mound or at-grade soil absorption area. Reduction or eNmination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting Products; pesticides; sanitary napkins; tampons; and water softener brine. 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 chapter Comm 83.33, Wisconsin Administrative Coda: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covero removed and the void space filled with soil, gravel or another inert solid material. CONTIN{3ENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: ^ A suitable repiac,Sment area has been evaluated and may be utilized` for the location of a replacement soil absorption system. Tha replacement area should tae 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 wilt 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 that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. nd site ^ site tank ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biamat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL QASSES ANDIOR INSiJFFICIENT OXYGEN. DON T ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS onurrc urcTer r t:a ....... . Name ~ L~ ~~ 'Cn ~~-`... Phone l - ~ c~. POWTS MAINTAINER Name Phone SEPTAQE SERVICINQ OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY f Name Name '(~ ~ 2 r~ J ~ N i Phone Phone ~ ~ ~~ 3 ~ O d This document was drafted in compliance with chapter Comm g3.2212libiltltd)d~tfi and 83.54{tl, (21 & i31, Wisconsin Administrative Code. `~i •! STATE BAR OF WISCONSIN FORM I - 1998 66E'a080 ~ ! WARRANTY DEED 7n , .. KATHLEEN H. WALSH oocumem Number ;;, Yn,. ~ "! i~~P)Ir,I 6'~3 ~? kEGISTER OF' DEEDS , '• ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Bane Corporation, 12-21-2001 3:10 PH a Minnesota corporation _ ~ ~ ~ MARRANTY DEED `~ ----- _, Grantor, ii CCOPY FEE: ~:' and Sienna Corporation a Mi„ i CDPY FEE: ;, *teso a corpora inn - -~ TRANSFER FEE: 9E63.y0 _ __ RECORDING FEE: 17.00 PAGES: 4 - Grantee. ' Grantor, for a valuable consideration. conveys to Grantee the tollowing ~i described real estate In St. CroiX _-.,_ County. State of Wisconsin ; I' (the 'Property'): '~ weco~crny Mat a q ------- --- ~- See Attached Exhibit A Name and Retum Address (~ni~r~tl -~ ~~ 6`1~ 5me.+arr ~Dr+~ ~%~.i-Fr/ ~n • ,. ,: i~(i vine 'b~nka. U-IU 553 O ~' 20-1048-30-000 Parcel Mantifitation Number (PIN) This 38 nOt homestead property. (is) (is not) 20-1048-60-000 20-1048-90-000 20-1049-90-000 20-1050-00-000 20-1050-80-000 ~~ 20-1052-20-000 ~~ 20-1052-70-000 i it ;` '~ Together with all appurtenant rights, title and interests. ~; i Grantor warrants that the title to the Property is good, indefeasible in fee simple and tree and clear of encumbrances except !' See Attached Exhibit B. Dated [his 20th day of December 2001 i ;; Bane rporation _ (SEAL) (SEAL) by l Jo M. Nassef i Its C ief Executive Offic (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT ' Signature(s) Minnesota State ofiMtstrottstrt- ' ~ ss. 1`.``.~ti` `I Counry authenticated this day of Personally came before me this Z :' ll ~ day of ' December ,2001 ,the above named John M. Nasseff, Chief Executive Officer of Bane Corporation, a Minnesota corporation '' T[TLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be a pe , ?~ ,~ who executed rite foregoing ' authorlud by §706.06, Wis. Stars,) Instrument and a n~ same. THIS INSTRUMENT WAS DRAFTED BY ~ HARRY E GAI.LAHER Lockridge Grindal Law Firm ~~ ~ -rcoo..gaaianev9tcetmsmg , i nn LTa e b in t n n e ~,A nu.e-So.u-t.h- _ \ ~ ' Minneapolis, MlV 55401 Nolarp'~ublic.stateorwisconsin ~y contmisslon is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not January 31 , 2005 ) ' necessary.) _,::. - -- Names of.... _.. persom signing in anyupant must bet ~-~~~ ~-~~-- ~~ ~~-~ ~~~~~ - Y YP~ or ptmtad below their slgnantrc. .._. .._ .. .. ' WARRANTY DEED STATE BAR OF WISCONSIN Wisconsw, Legal Bienk Co., Ne. - FORM No. l - 1998 Miwaukee, Wia. : ~ I ~ I ~~~ . ~ I ~ ~ ~ . I I ~~ I ~~ I ~ I I 1 I i I ~ 1 j 1 ~- I ~ A® ~ ~+ i ~ I ~ _ - - ~ .~ 1 ~ ---'_'~ __, ~ r I ~;~ ~. ~ , I ;~ 1 ~ ~ ~, ;~ ~N ~o 1 ' 1 ~ ~~ I ~i ~~' ~~ ~ I gl '"~ ~ ? Z ~ ~ 1 1 ~ ~~ 1 ~ ~~ ~ ~~ ~ ' I .V ~ t i 1 _ - ~ ;~ I ~~ ~- , ~ I ~~ .~ r ` '~ ~, ; ~ roc 1 ~ ; ~ _ ~` ;' ~ ~ 1 ~ i ~ x~ '~ ~ ,~ ~ ~ ., F _~ I _~ ~ 1 C7 ~ ~ --- :--1 ' ~ '~ ~--. I -~`~ --'' ~ ~ -- - ~ 1 ~ - i - ~ ~ m _ _ ---~ =-~~ `- _` = = ~~' ~- ` 1 y~ i--`-- --'"--` p ~ ,,, 1= ~ _ ~ ~~ 1 k i ~~~ '~ ~ ~ i ~ ' ~-- ~~ r - ~ ~ Z ~ • t i-~ .-'~ ~ ~ SEE SHEET 6 -~