Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-2001-19-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: .St. CIOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 579063 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2582775 Permit Holder's Name: City Village Township Parcel Tax No: D - oo / -19 - ou o Robert & Constance Nelson TOWN OF S MAR DL P3&3~~ CST BM Elev: Insp. BM Elev: BM Descri/p~jon yrnB Section/Town/Range/Map No: IT 11 gi IR CIA TANK INFORMATION ELEVATION DATA .17_ 8"8-3 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. r Septic -7-, S Benchmark Dosing Alt. BM Gis lwOpO ✓ ~0 C7 (red 114,15 '7 2 - 7 AfawhTu t Bldg. Sewer KI /2S Holding ~ - V ~ z'3 St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Ven to Air Intake ROAD Dt Inlet a( Septic 36 Dt Bottom Dosing A Header/Man. Aeration 3. 7 y 9. tSg Dist. Pipe 3 5 7 9 ~J Holding d Bot. System 4-7 PUMP/SIPHON INFORMATION Final Grade Z. 9 '2 2 "6 . C)% Manufacturer Demand St Cover O GPM 411w Ga0 -7 Model Number PE q1 V. 46 Af I' o v r Kp C/7• TDH 13- q Friction Loss System Head TDH • v5 6 Forcemain Leng`4o / Dia. Dist. to well 9J Z SOIL ABSORPTION SYSTEM BEDITRENCH Width / Lengt~d No. Of TLenche PIT DIMENSIONS No. Of P Z Inside Dia, Liquid Depth DIMENSIONS A a SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION T CHAMBER OR Ty f System: /b 5,7 f /jr A)#44__ UNIT ~viT Model Number: MO DISTRIBUTION SYSTEM AlaC44,_ Header/Manifold , % Distribution 1/13) t S/ z l Hole Spaci~ Vto Air ake r 3. 3 x Hole Size ~ Ix Length Dia / L Length- e SO s~ Dia /I Z Spacing 3 v SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S do 1 Mul ed Bed/Trench Center 17 Bed/Trench Edges Topsoil / Yes Fob~ No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~,~fl Inspection #2: Location: 1284 220TH AV~ G J~~ ~,Q 7~ I JM a ✓eA_ E p 5 t,.~ / SG~~ c, J 5 1.) Alt BM Description = 2.) Bldg sewer length = 115 - amount of cover 5 Plan revision Required? ® Yesy/No / Use other side for additional information. 16 ( 3 SBD-6710 (R.3/97) Date 4=~n~sepclor's Si ature Cert. No. Safety and Buildi Div' 'on C j2C1 e~ 201 W, Washington Ave., ox 62 Sanitary Permit Number (to be filled in by Co. Madison, WI 707-716 g CROIX COUNTY MUNITY DEVELOPMENT a yS 3 ~,oxr.~ State Transaction Number Sanitary Permit Application ~~7~ in accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a *anitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary 1 m ,Stets. ses in accordance with the Privacy Law, s. 15. 10 1. Application Information -Please Print All Information Parcel # Pro erty Owner's Name _ Q w 12 '-,t C~ Property Location Zbd f Property Owner's Mailing Address 61,F- 7 f ® f~ Govt. Lot - / (1 Zip Code Phone Number AJ C 'h, Jd,~ 4, Section City, State / sol circle one C~ 0 UL /lit T Z~ N; R __L___ E 61,93 n P# II. Type of Building (check all that a P1y) Lo" Subdivision Name droo ms or 2 Family Dwelling - Number of Be 6k &b Block# ❑ Public/Commercial- Describe Use ~at'~ ❑ City of CSM Number ❑ Village of ~ ❑ State Owned -Describe Use 9-Town of !`7~ o "Ix-) /b k ~o t7 0~~. III. Type of Permit: (Check only one box on line A. Complete line B if applicable) a New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) 4 List Previous Permit Number and Date Issued / Owner B. ❑ Permit.Renewal ❑ Permit Revision ❑ Change of Plumber Permit Transfer to New Before Expiration D n, O J r W. T e of POWTS S stem/Com onent/Device: Check all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil ❑ Pretreatment Device (explain ❑ Holding Tank ❑ Other Dispersal Component (explain) V ) . Dis ersaVTr ent Area Information: A r Design Flow (gpd) Design Soil Application Rate(gp Dispersal ea R uired ( Dispersal Area Proposed System Elevation 06 ° /YJ~ C~J e v 10 0 VI. Tank Info Cap ity in Total of Manufacturer Gallons Gallons Units New Tanks Existing 2 / C~ PEE y~ y~~ d rn ix ~7 Septic or Holding Tank Dosing Chamber t VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans Plumber's Name -(Print) Plumb 'Signature Mp/RQumber Business Phone Number Plbmbeift Address (Street, City, State, Zip Code) e c -r- uJd7~~f f C,c J ( K0 VIII. oun epartment Use Only FP$ ermit Fee Date Issued Issuing t Signature proved =~ren Reason for Deni tOLJ DL Conditions o fig; g~val 3) Lbw /~n. f r ppumumw aq lsnw swouiannbei MoWps 11V -Z / liQwrgd Aq pa hold ueld luawa6euew Jad se ` w` W.►Jr AP.I~M•t~ , *M aq rye Isnw Rao leslaoslp r ,pttll:l~l dt+~a '?luei.?l~S . • L 43"o ViUSAS Attach to complete plans for the system xnd submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) plot P/M G-C of 4o NG of TNT ~.'y, ( -rz 4;~ t w` i s c~1r~ 1 ,n m n I L;; 01 [7 t6 MIZ tsCoNsw , 31.58 ACRE--> Nom LU-T l 02 D18~ ~ D'~ Cs i o~S s~' 1~g1d 5 L e g -A 13EDR rat zp BIA -10~ ofPUC PIPS. 26' TD / ® I I "A130VL GzoUN .5eF7alr-'7 ,~sSUN,EL 'cr. ~~d Tb AR~~r) ftta II"A o~ G> out I~ 1~ q 'ZS 0 Locadon: Ems. I q ILI dr ~qqY' DIVISION OF INDUSTRY SERVICES ell o~ 3824 N CREEKSIDE LA v Q HOLMEN WI 54636 S Contact Through Relay X20 P S http://dsps.wi.gov/programs/industry-services `c www.wisconsin.gov A :;~'o ION N, Scott Walker, Governor Dave Ross, Secretary August 20, 2015 CUST ID No. 224832 ATTN: POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/20/2017 SITE: Identification Numbers Robert and Constance Nelson 193RD St Transaction ID No. 2582775 Town of Hammond Site ID No. 815588 St Croix County Please refer to both identification numbers, NE1/4, SWIA, S14, T29N, R17W above, in all correspondence with the agency. FOR: Description: Four Bedroom Mound System / 2% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1549369 Maintenance required; 600 GPD Flow rate; 28 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, 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 CONDI 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 IND 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. E CORRE • 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 ap rp oved 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 MARY JO HUPPERT Page 2 8/20/2015 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 This Amount Will Be Invoiced. rard 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 MARY JO HUPPERT Page 2 8/20/2015 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. i Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. yard 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 v t MOUND AND PRESSURE DISTRIBUTION COMPONENT DESI GNP Residential Application INDEX AND TITLE PAGE Project Name: ROBERT $ CONSTANCE NELSON Owner's Name: (same) Ownees Address: 36 Britten Path Hudson, WI 54016 Legal Description: NE1/4 of the SWIM, Sec_ 14, T29N, R1 7W Township: Hammond 10NALLY COVED County. St. Croix AFETY AND 'AL SERVICES Subdivision Name: Forest Ridge Estates JSTRY SERVICES Lot Number: 19 Block Number. NAI Parcel I.D. Number. 040 -1189 - 90- 012 . 3;;NCE Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings ,~~~~~QS'~'•~~ Page 4 Lateral and dose tank Page 5 System maintenance specifications MARY 30 * Page 6 Management and contingency plan HUERT Page 7 Pump curve and specfications D low = Page 8 Plot plan FALLS.:-* . RVER y c Designer: Mary Jo Huppert License Number 1859 - 007 Date: 07/27/15 Phone Number 715 - 426 -1775 Signature: Designed Pursuant to the Mound CornPonent Manual for POWTS Version 2.0 SD&10691-P (N. 01101), and both SSWMP Publication 9.6 Design of Pressure Distrib Aon N Ics for ST-SAS (01/81) and Pressure Distribution Cornponent Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: sand fN (D) cakxWom asstow a 400.00 Estimated Wastewater Flow (gpd) TaW 383-44-3 wrs~ sod treatir►ent for 1.50 Peaking Factor (e-g. 1.5 =150%) fmW coftim of r 36 inches. 600.00 Design Flow (gpd) 2.00 Site Slope 98.17 Contour Line Elevation (ft) 28.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/fe) Distribution Cell Information 50.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/fe) I- Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 11.76 ft !orifice 2.00 Forcemmain Diameter (in) 25.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 4.08 Forcemain Drainback (gal) 10.43 Vertical Lift (ft) 55.97 5x Void Volume (gal) 0.41 Friction Loss (ft) 60.05 Minimum Dose Volume (gal) 0.00 in-line Filter Loss (ft) 27.46 System Demand (gpm) 15.39 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter in. dia. options choice in. dia. o ions choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x GallonsAnch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal in (enter result in cell 1349) Dose Tank Information Effluent Fitter Information 800.00 Dose Tank Capacity (gal) Poi ok Fitter Manufacturer 22.24 Dose Tank Volume (gaUln) 525 _ Fitter Model Number Wei Manufacturer Project: ROBERT $ CONSTANCE NELSON Page 2 of 8 Mound Plan and Cross Section Views t 1/10 B J observon 61 K YLe•.••'S•L•S•S•L•S,M1.L•M1•1 ••S•1.L.i.4•L.4•M1.L.4.y.4.y.1•y1•yi,L•M1.S.S.M1.• - li1•l.l.l:~'•l.l..•.1,1•{.r•r,l•r•l• l•1 dYYY.1Y•l•l•l•1+l• r•{•{.{• L~vL•4.4" K•L•1 :5:~ ~i•L•4•L•M1 1 L•i.'.•S•1•M1.i'1•S•L••.•+b+M1~L L•4.1•iK+ •l"~` 1+1•.• l•r•. r+r.J..l.1' 1.r 1•l.l.d.{.lY.{~l•'l.{. ti t L 4.1.1'1.~,{/(y1•L•L•1:S:L+Y•.••.•1• 5 l•1•lY•l:{. !•t•1+l•' A l•1•rA/.° l.1•{. ,i•y :•L.S.4.M1.L.i.1.1.4.1.1.4.y.S.y •y.y.1•y. . l.r•1. 11, :5~`SM1`:5:• l•r•r,r•lYY•l•l•1.r.1.1•.•+Nd, ~~..L•y.4•S•S.i.y.yai.1.4. y.y.i.y r.lal.l. r•l•t•l'l••••r•1•l•r+rY•r:r..••r•.••l.r. L•i+•.•LvL•t.i•S•M1•Y1.4•S• L•L•i•i•M1• W S:1•L••.+M1+ K•y •S• •1•L.S•L•i.M1•1•S•L•S1.•`~1~1~1.1.1.1.{.Nl.{.l.l.lY.l.{:r.1.r•1.,*..•. 1.1.iv1•L•',*i'M1•i•S•M1•i•i•S••.•1+• •1.1.1• is -B - L Mound Component Dimensions Down slo a toe extension made. A 10.00 ft E 10.40 in H A5.48 ft K 7.61 ft B 60.00 ft F 9.25 in I It L 75.23 ft D 8.00 in G 0.50 ft J ft W 30.48 ft 600.00 (ft2) Dispersal Cell Area 1500.00 (fl j Basal Area Available 10.00 (gpdtft) Linear Loading Rate 6.00 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.61 (ft) (ft) - Dispersal Cep 99.34 {ft) Lateral 98.84 Invert Dispersal Cell Elevation D 4 4 98.17 (ft) Contour Elevation 2.0 % Site Slope Geotextile Fabric Cover o Shading K~eyl Q 1 Dispersal Cell see lateral details on Q Top" Cap 'd 1.5 ft r r.r'r• • •r•r- ••rY• -.r•r'l Page 4 for number, size, I/!I!!I Subsoil Cap 0 0 ~ •7 !1 G:S,:::~•jti 1:~.',.}".•••~~. S.L•i. and spacing of laterelS+ L.•,.y. • ASTM C33 Sand ; ~••ti~•a ~l .••af:. `Si ••iJ l 1:1~t L~ Laterals are equally 1.4• Tilted Layer ~ 0.5 ft Yp~l l.a~al . • sped from the 4 i•4~1 R.1.1• • L~1 i~S~1~i•1: slril~~•~ n ~r YYY•' .'.1: ::+rr•r•l.l•1..•.t•lr•r S 'd•r• iM1SMM1•M1 dilY ~YU{{lN S•1•M1•S•4• •L•HL+ Aggregate o L,S,ti,w•,~{r~r.l.r.rl lw'r•s` Centerline in the S-S 1• 1+1~ ~•D~•.• A distribution cell (AxB). Project: ROBERT $ CONSTANCE NELSON Page 3 of 8 End Connection Lateral Layout Diagram C*mw t1w W*r4ft cK a the A & B O nord ion 40 - rusa.aw wrbsll valor or dos:aout plea P ~ latwals art Feer+acal iF x-'~. ( r~w.z an7ea «tl.. dot~om of ass 6~erat S eawas spaeW Laterals 8.forcenon Sch 40 PVC per SPS Tattle 364.30-6 g Fdrec ~aonnrce:on+r:a etc er oneas eo w►.rWMd ae +M P~- Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 It Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ftzforifice 67 ft Lateral Flow Rate 9.15 gpm Manifold Length 6~ftfsec System Flow Rate 27.46 gpm Manifold Diameter in Total Dynamic Head 15.39 ft Forcemain Velocity Dose Tank lnfarmadon Loafing cover win, wanN WW Mid locking device acid t 1h Sealed watertigi Elediical as per NEC 300 and SPS 316.300 WAC 4 in. mire. Disconnect Tardc component is properly vented F-- Aftemae Quiet kK2fiW Forcemain diameter Weiser Manufacturer 2 in. Capacityl 800.00 Gallons Volume 22.24 gallinch A weep hole or anti- Dimension Inches Gallons B SW= device A 20.37 453.06 C B 2.00 44.48 j _ Pump Off Galion (g) C 2.70 60.05 T 88.91 D 10.90 242.42 D Total 35.97 800.00 Dose tank elevation (ft) 3" Bedding uncler tank. 88. Alarm Manuafacturer SJE Rhombus _r Note: Switches Alarm Model Number Tank Alert AB~r- containing mercury may not be used in Pump Manufacturer Gout _ this system. Pump Model Number PE41 Pump Must Deliver 27.46 gpm at 15.39 ft TDH Project: ROBERT & CONSTANCE NELSON Page 4 of 8 Mound System Maintenance and Operation Soecit'iolons Service Provider's Name Darrell's Septic Service~ Phone 715-425-1025 POWTS Regulators Name St Croix CountZonin~c Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Intduent Pardee Size 118 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Sod Absorption Component Size 600 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coldbrm >10E4 cfu/100 mL Service Frequency Septic and Pump Tank inspect and/or service once every 3 years Effluent Filter Should inspect and dean at least one every 3 yam Pump and Controls Test once 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure tested every 1.5 Mound inspect for ponding and seepage once 3 Other Miscellaneous Construction and MatWats Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6XQ, Wis. Adm. Code. 3. AN gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a maid board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erasion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lamm Threaded Cleanout Sprinkler Valve Box Plug or Bag Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: ROBERT & CONSTANCE NELSON Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54. VWs. Adm. Code Gefterst This system shall be operated in accordance with SPS 382-84 Wis. Adm. Cafe, and shell maintained in aoooriance with its' component manuals RAD-10691-P (N.01101), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Marwal Ver. 2.0 SBD-10706-P (N. 01/01 N and local or state rules pertaining to system maw and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pip tank sbandwIfflant 811811 be in aCCOrdarce with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and cowers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed v It upon the completion of service. Any opening deemed unsound, defective, or subject to failure rust be replaced. Exposed access opens greater than 8,anches in diameter shall be secured by an effective locking device to prevent accidents! or unauthorized eery uft a tank or component. Septic Tardk The septic tank shall be maintained by an individual caddied to service septic tanks under s. 281.48. Sthts. The contents of the septic tar* shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating oarMition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shalt be cleaned as necessary to ensure proper operation. The filter cartridge should net be removed unless provisions are made to main solids in the tardc that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. late nt liter alarms may indicate surge flows or an impending contamuous alarm. The septic tank shy have its contents removed when the volume of skrdge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a trite assessment mairdenanca personnel shall advise the &M" of when the next servlre needs to be perfunned to maintain less than me mnum scum and sludge accumulation in the tarlc. The addition of biological or chemical additmis to enhance septic tank perlormarm is generally not required. However. df such products are used they shall be approved for septic tank use by the Department of Commerce. BM TN* The pump (dosing) tank shall be inspected at least once every 3 years AN switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary, (Mound sand Prassure Digit Svstam No trees or shrubs should be planted on the mound. Plantings may be made around the rnomxd s perimeter, and the mound shell be seeded acrd mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (ether than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface wthin the mound and snow compaction in the winter will promote frost perpetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the maul system may not exceed 220 mgfL BOO., 150 mg& TSS, and 30 mglL FOG for septic tank effluent or 30 mgfL BODs, 30 mglL TSS.10 rmg/L FOG, and 104 ctu/100 mL for highly treated effluent. Influent now may not exceed ma*num design flow specified in the permit for this installation. The pressure Otribtr = system is provided with a flust g pout at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is perfornmed dt should be compared to the initial test when the system was installed to deternshe if odfic a dogging has occurred and N orifice caning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for affluent ponding. Pondahg levels shaft be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Cohtingsncv Pkut If the septic tank or any of is components become defective the tans or eomporent shelf be repaired or replaced to keep the system in proper opereft condition. If the dosing tans, pump, pump controls, alarm or related wiring becomes defective the defective canponert(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound comporm t thus to accept wastewater or begins to die *Ma waster to the ground surface, it wig be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. PrMrafbnmant IMits The information and sdredkde of mananagement and maintenance for pretteatirhent devices such as aerobic trentrnent units or disirdection units are attached as separate documents and are considered part of the overall management plan for this system. p I~t ~ Ct si~WC~ a'so~ Page 6 of 8 WrioULDS PUMPS rs~ble Em- -...JL pump PE mar S WARMS MGM r Corrosion tt~nc i r U T~ 104OF WRQ 60 Ht t ■ Cast hoe bode, UM*wous When • 115 and 23D nags M 7bmmpkksfki *ftaed ' SoNk UandIV N' iet m adeb =wmadc rtK ■ upper and b m nuidm pn spbaL • (IW6 klud&Aon. dol bA Ong APPUCAnM . A OwsoldL domadc niodek idnde a • 0143M design„ aonsoiudim ' senetrgdi carbon seed t Mrooris peroe w* _ bresomw w mmw sfimm 1 brananoe draft orcww 3 lip. 3 = APIs! ■ lbSoft HL w~e~ed foremdooous - qwadoL Gpmk . 53 GPM • ' i5 sbaddd poiedesign to N r MSillin th Mobs= e oraemng beet 25' 10M PE41 mour• WMANNY WMQ ofIMe WAIOL • lE~t • Quick Fmomw ' Madf m ca ow. 61 GPM • 111 S cord, 20= , Madiod • 29' TON ' pKdes r k dutyISt WM& W51 romp M31 llau-: gwAft Y 70 GFU • sa NP. 3400 RPM saw ~t is 11 madram METERS FEET best 3T 70N • 115 affil 230 portable and w i - , " .Medtat" anal i9 n*w% rfocas~~a,. nee amdc,OIWAardsbblm 35 +ir. se. aae .so • shide s stall bsiefmm 10 -.-z = z GFM • ' ; t Fr 25 fig. 20 SA 10 Tllsatti C 4 is to • . 'tetruera o °o to 20 4°• 5o co- ,a P~o3 08 M (,hiAAAXF ° 10 is /N%Jrp g of open owner -r2,~a~ ~ r~ ~ ~ vv Tv c~IrJ ~ GBzcUoep& nu ty h11S ~o itl Still , a o SAD o _ r LID a 77. w 7'Y OR~ 13~ DR~Ty~ 'j ate-- Z-70 TO -rop pF BUG PIPE, WELL TD F3~ •>TD ® 11 60V&C-?oLm SEPT/C 7s+.A1K~009 vS5 11N.EJ= !C ~~5n Tb I~R~ir} r fEt~ ll'A'E:OV ~ C--~p uN i~ Joo,19 Q _ o Site Location: Etl"- ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 7'4/v C C- k&ZS e ti Mailing Address Property Address 9,qS ~'93 "CFA`- IZ14 Oq A4 ati (Verification required from Planning Department for new construction) City/State f4P2,7,tZd/U-b ~ - Parcel Identification Number LEGAL DESCRIPTION Property Location Ar E V4, SW V4, Sec. 29 N-R / 7 W, Town of nz ~22U~v ~ Subdivision Lot # Certified Survey Map # , Volume ..Page # Warranty Deed # Volume . Page # Spec house ❑ yes no Lot lines identifiable k yes ❑ no SYSTEM ~NANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensedpumper verifying that (1) the on site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days three Meira on date. 7 21 4- SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty dee a ded in Reg'istyr of Deeds Office. /rz7 /5 SIGNATURE OF APPLICANT DATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department.****** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed /V Ac. h 89!38'57" E 600.97 7 'Ic LOT 19 ° ru. 155732 S. F. o 3.58 Ac. i $3 42'x- f 266:' E 754.46' i LOT 18 14 40 66 455 S. F. ~ ~ ~ 1 1 , 1.53 Ac. (a OF 314- "'01 ca y. v. LOT 15 l ' m. M - LO T 16 ~--f ~ 76257 S. F. ~ e~•on'nK' w 347.22' _ 68048 S. F. I # 1.75 Ac. N .a.wot wwre ms re ewe.r~..~I .cas.+.m.®~re.a,.ralaw+ +aw°°+wa~s SMIIGH HN GRAN* $ QOB F4 uOsFi~ I ! -----------------------------i--------------- I I I I 9S 5 5 I I 0 I ~ I 1 ~ 1 I cell We ZIA I I I I I ~ I I I I i i I ~ I ~ 'a aIj ' I ~ isle zsh I I 1 ~ I -----------I E3 01 z ~g .iri.irMWria6w ® W z O L~ r-~ mII~{{ 2 ~64a~17 l5 1 IGVVd MS LTXTT NO OaLNRH dl NOlt.7/Kl3t/ 37VJ -nm :31ON • .P+ ,~•~va,..e..on..o ':)U► SSWOH uosweD rl~ ISL167MUOS" QlUUOJ @ Qi ~..u sn x-av avmm F ,IT iR G oil Immomm I F : a 5 Alit .c.woewwsr..w s ..wF' a :VIII Ste! uojauv~o •~s~`..~ .:u u[e~tsuva 'g ~ 'fit ~IIPaiPIw9•fAprfMq 7L'MfI/A K a° `1 +~,s+~aeos[ LKGRN 2p4g3 @ qoe d tf1 M PAn6att'mpWpmeyV 'A aAiVMe~Me~aowMq~q~NaLL Ytl°~11Q'I~(LP~d ¢sev y ~ ear d q~~33883~ e$~Ol a p(°W~, x a~ 9 it ]Elm x Ilk 9~ t 9 " ~~~~6 ~ .z k rg f z' z ~ k s d t N3db`d 3ZISLTXTT NO 03LNIb4fdf1V~311~/K73t/376"JSd7b~/ -MaV L 1N15 s► SOIL EVALUATION REPORT v~ 710MMp' n9m&OWENT Page of in accordance with Comm a5, wis. Adm. Code Attach complete site plan or! paper not less than 8 1/2 x 11 Inches In size, Plan County CROIx Include, but not limited ~Z: vwoml and horizontal reference point (8M), direction andt T~ percent slope, scale or dimenelons, north arrow, and location and distance to nearest road. P O. (PC N dhta Please print all Information. Re wed by Date Personal Information yav provide may be used for secondary purposes (Privacy Low. s. I5.04 (1) (m)), Property Uwner Property Location OF Tti A) W 4 A iUD !vr Irr ZFJIj LLA E 114.$W 1/4 S Pf T 2-4 N R ! yy Property Owner's Mailing Address Lot # ( Block # Subd. Name CS&W 111-4 W, 9NVt'StW 15T, Gary State ~ O X5'1' Rt UC.~€5T~F~.S Zip Code Phone Number ~A U.5 W= S`1<OZ City Village 9 Town Nearest Road (115 Itzb-1180 Hit Mo i e.r./t E VOReplacement w Construction User Residential / Number of bedrooms _ Code derived design flow rate GPD ❑ Public or commercial - Describe; matenat _ t t''~- ~'`JA~---- Flood Plain elevation if appHcackr CoomVl9ents n - * Mid +ecumrrrertdations: /v1l3tt,UD S~laTE 1 .Ic;i `S t'1 ~ Ii. 1. UPC*Tq>.e W-0-I5 Ory LOADIP-I& "1ZA-vC Borg #❑7l Boring t`L{ Xsi Pit Ground surface elev. ry, Depth to limiting factor Soil Application Rale Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ffl in. Munsah Qu. Sz. Cont. Color Gr. Sz. Sh. 'EH#1 'EtT#2 0-1 z 0w z/.-- - st 1 -rn r O -S A-co .S 0A 1L- i yt241 3 1 -30 77-5 VK as of -CO 0, p. 4 30 3$ YR 3 5 S ( V - 0,7 2- 6 ~46 - - 0 ES` 14 Z U tf0 t fa r. I I Boring If ❑ Borng L ) KI pit Ground surface elev. , 11 b ! (t, Depth to limiting factor._ Z- In. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SOD GP~Af n Rate In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 •Effk2 Sill - J r as -c 46 0.9 - o ie z s~ 1 _ a!o r^,(,_.s 3tr os 0~ Sl as f o Ltl-L 3~ S1 q ~ 7 3 - -m C - Oro tIr s ~ dl -m .Z 1. 2 sh 0.4 0. E e5° 10 a " ) - Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < ISo m IL ,C CST Name (Please Print) g Efluent #2 = 800,:5 30 mgJL and TSS < 30 mgrL All 30 N C. r_ STE r ~ csT Number _ _ Z Z 7- Address Dae Evalua' ducted Telephone Number Av SFALLS1 WT 54022 O~ 05-OZ_ 7tS H26-V17.S" ~y RrV 1ST : i J - -o►~ i 75 SEC. t4 AM.fIl, wr v,o~ /l'~ f~ j~py G V RuKNV ASSN, AMb 100-Od $M#! 2- SPIKE h3 -Tat-Q -10 ~T'E-- ! f'~i408UE m+CGUUC ~WeP~ t t g I X 121 N.B. 155732 S. F, Ac. & g , I B. 3:58 -A~. Qww~ - V, No R . - Y - - ter- -r - .r r.-n... r -w r ~ ~ 277 , LCIT i w Wisconsin Department of Commerce SOIL EVALUATION REPORT Page J_ of DivWon of Safety and Buildings In accordance with Comm 85. Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 Inches In size. Plan must county T, CR t include, but not Ilmitsd to: vertical and horizontal reference point (BM), direction and Parcel 1.0 . percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. Re awed b Date n Personal infom,atton you provide may be used for secondary purposes (Privacy Lew, s. 15.04 (1) (m)). • ` ^ l 11 Property Owner Pat V,-*-N Xp&*At,- Property Location of T E IJ W ` 4 A MD A N E 114.,$W 1/4 S 11f T N R )7 W Pigiierty Owner's Mailing Address (Lot # ( lock # Subd. Name or CSM# I t t L{ LJ, O~J ► St elrV ST . D Rt~E~STfl"C~S City State Zip Code Phone Number ❑ City ❑ Village RI Town Nearest Road RWER FANS WI: 5-f oz (-71S Lf2- --480 HAJ14MDA?Q i e.rf . E New Construction User Residential / Number of bedrooms 14 Code derived design flow rats _ (000 GPD ❑ Replacement ❑ Public or commercial - Describe. Parent material _ ft LL QWT vJA5:)A_ i Flood Plain elevation if applicable X). A General comments andrecommend ations: pAC)uL,UD SySMA . V1 `SAAD FiLL_ O 0.4 LOADW& 'RA-VIE 12, Q Boring # ~Boring R _ }ar' pit Ground surface stay. _Q L%q ft. Depth to limiting factor g in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sr- Cont. Color Gr. Sz Sh. 'E"l 'Eff#2 1 0-11- 1)" 1 ZIZ. S+) -m r 05 0-ca .S- 0.8 Z 14-17 My~ 1 ZF ~b 5 0.5 34 .q Wo 3 117-30 75YK4 - 51 1 _L d s CLS * -c 0. 0. 4 30-M . Y2 3 5 5 41 14-01 0,-7 1.2- 6 - f~11 - - - - F.S` abpzws Z 3 it Ave 46 C/a r 1-91 Boring # Boring Pit Ground surface elev. `f7, cos ft. Depth to 11m8ing factor In. Sol Application Rate Horizon Depth Dominant Cob Radox Description Texture Structure Consistence Boundary Roots GPDM In, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Sit L - 0 z- `t 1 ZLM oao rrky o s tt 0.57 o,X 3 -?:Q 2y 51 Z - 4..s o. o. z0-z-3 51 a~lb -m r✓ - 01`4 D. $ 2.7- Z 15 3 5 O dt r-5 -m .Z 1. Z SY 71cz f is 5 49 /A dsh - 0.4 0. E tcs~ to a r. Effluent #1 =BOO.' > 30 < 220 r11glL and TSS >30 < 150 mglL ' Effluent 02 - BOD < 30 nrglL and TSS < 30 mgfL CST Name (Please Print) Signature CST Number r A SO H LL STt✓ 224932- Address Date Evaluation Conducted Telephone Number W9815 690+``Aue, R(%)EA FAuS~ WT 54022 ® T-0-5-02- 0%s) 142.6-\-17,5 Rc-~ttsi~o : oR-t4'-o2. P.~ ts~p : I 1-z4-ofF ([.:uT Page Property OwnerParcel ID # n Boring # l Boring elev. k. Depth to limiting factor 69 in. Rate T (urs z3f;L`+~~ Pit Ground surface son on Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Gr. Sz. Sh. hV 1 'EtfiF2 In. MunseN qu. Sx. Cont. Color Z Z L 2~r tr (~tr 1 ' 2i~-co 0 z ~ _l~ 312 - s1 3fat>ol5 ds 3 lw-z,l 10 t ~ ►~sbt< C 5 zv{-co 0~'7 1.2 4 21-50 1011 y IS t tin-LS ~r 0-Vj 24-7 it Z s m 0,7 5 1,2 0-69 to (lotfo&-- F 4`f Boling If E] Boring _ - 1 L _ In. ~j aTZi + o pit Ground surface elev k. Depth to 1 factor son lication Rate Horizon Depth Dominant Color R escriptlon Texture Structure fence Boundary Roots GPD/ f 'Etf#1 'Eff#2 in. Munsell z. Cont. Color Gr. Sz. Sh. 1 p-8 wvfc~: L -m v ~r 3~ os o. 511 Z>~_N1 ,r ra -fo ors 0~ 2 - 1o~tR 3 1b-18 0 4 ` L~l ' St t 2i- abK Fr 0.S o.5 0~ L} q-ZI _ ~(2 1nYey o KL-t1 % 1 Z.-fab)( fr CW Zv -ca 0. S e M3 -l. sb m~ V - 0. 14. 04 t s vra Boring # Boring Ground surface elev. --M-Mr- ft, Depth to llmidng factor _Z g in. ❑ Pit Scti 'tattoo Raba Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/if in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •EtIV f 0-q YK~z - L Z~ 3J--to ,5 z Q-tt, p Z - L Z~-mab ZvF- 0.5 3 It,-22 10`40Y13 611 -m sb t4r Z4[-,n S 0'Q tit 2g-4 7. Y S M Mt i Z.f~ m lltor~l --'ia.tiaTlFlCtJ ~5 - F .g 4P >ao s 3 Effluent #1 = BOD, > 30 1220 mg/t. and TSS >30 1150 mgA ' Effluent #2 = BOD, 30 mg/l, and TSS 5 30 mgll 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. sao•9x" MUM psT RtoG€ ~sT~ LOT s ~ N "1Oi AVG. SEC. 14 B/M4f! I = PVc PiPr. /f ~ TZ9~3 KmW ABWS e-4MUA3A 5uR>~1c.E - AsS~ b t DO-00" $M# Z sPrf(E fN -Tlar6 1l "AeDdE e4WUAM> ~v . SuR~A~E- ta0.t9 co, 2. COMO U.+rt C,tNS!> RplkstD: CA- t~-uZ Rt~ltseo : l r-24-0Y _ _ - 57 E 600-91' 1 1 m X 121 J.6 00 N.B. 155732 S.F. XL q~t 1.5 \q ~iV 3 A c N 8-h N.B. 3:58 -A c-. - - CIO est. _ - - 00 - 61 - LOT- 2i- ~1 $ I /121423__S,F~ y. B: 121423-S.F.~_~ / 2.7/9- Acs//~ ~N 2.7~4Ac\` 1 - / N 82 3057 R 6 1 - -121' - - X 1215.6 ~2PLI ,1-n ~3~ 1 N.B. 155732 S.F. 00 -1 zU - - - ,x.58 c. _ L ~-z-1 - X B. .3-:5a-Ar. 1204.6 / - / 00 \ 210. F" OK g5 76257,S-.F.-- 1-.-7!!r / / - - 1 i At, N.13.--Fl 30 i ' N.B. 1.64 ~ Q r./ 80' RADIUS TEMEDRARr F=8 REMOBVED E 9 EASEMENT(TQ ~EMO E-ASTERL i - - -v~ NB 6884& 'S.F. / T v EXTENSI ROAD. i / - I . _ 6"' ^ N .B. 1. 121. go ai ' ryri Z E 155. zD Iv JQ co- -1183.5 \ ID rro- - P-B60 o P-86 pp C ~~0T i, , j -01 LOT` -ts Parcel 018-2001-19-000 12/03/2004 12:56 PM PAGE 1 OF 1 Alt. Parcel 14.29.17.883 018 - TOWN OF HAMMOND Current XX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner MARY PAT ELSEN ' ELSEN, MARY PAT 1251 CANYON RD # WISCONSIN DELLS WI 53965 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 945 193RD ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.580 Plat: 1961-FOREST RIDGE EST 1/30 018/03 SEC 14 T29N R1 7W PT NW NW & PT NE SW Block/Condo Bldg: LOT 19 FOREST RIDGE ESTATES LOT 19 (3.580AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-29N-17W NE SW Notes: Parcel History: Date Doc # Vol/Page Type 02/13/2003 709439 2140/268 WD 01/14/2003 705829 9/46 PLAT 2004 SUMMARY Bill Fair Market Value: Assessed with: 271,200 Valuations: Last Changed: 07/16/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.580 46,100 0 46,100 NO Totals for 2004: General Property 3.580 46,100 0 46,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~ r Wisconsin Deparlment of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings In accordance with Comm 85, Ms. Adm. Code Count' f Attach comptote site plan on paper not less than 8 ill x 11 Inchos in Liza. Plan must ' Include, but not IImitsd to: vertical and horizontal reference point (8M), direction and Parcel ) D percent slope, scale or dimensions. north arrow, and location and distance to nearest road. P~NO1f~2`a Please print all Information. eviewed Dete < Penonoi In(on'oatlon yov provide may be Loud for secondary purposes (Privacy low, 15 04 (1) (m)). Property Owner ^ - Property Location 56-: or- M IG /J W 4 A WD A Q t-.LA N E Ira SW va S I`f T Lq N R~ 7 W Property Owner's Melling Address Lot lock # Subd. Name or CSM# -L I ( Lt W 0%J t'bl OIQ ,c , o tS( 2iZ3aEbSTATES City State Z)p Code Phone Number Q City ❑ Village K Town Nearest Road f WEP, FALLS wr Syoz (115 112 b-L180 N~ AAD i a.rlt: E New Construction User' Residential I Number of bedrooms Code derived design flow rate _(000 GPD Q Replacement ❑ Pubilc or commorcfal - Deso lbe. Parent material i LL avJA 5AA_ _ Flood plain alevatlon if applicable h• General comments and recommendations: M 0 U-)3 1) S4ST15A a (*1 '!5 ANQ T: I L{--_~' S0, l•z ' 0.4 WADING 9-A-IFin 51 JkU, e tss 57j' A ~ ~S 1 cuo a( AAt Boring is ❑ Boring L_ ~J Pit Ground surface slay. fl. Depth to limiting factor 3g " in _ Soil lication Rate n /X~ } Horizon Oep(h Dominant Color Redox Description Texture Structure Consistence Boundary Rools GPO ~I &01 n. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. _ 'Eftiti 'Eft#2 , Q 1 0-1Z ,4tZ~Z- 51) -rn in& 0-5 0- .S 0.8 0S 41q Gtr OL 00' z 12--17 "if- - Abb 5 5 .1-t 0-(o - 1 51 --f ~1 3 17-30 -7.5 gK - d 5 0.5 J-r- 0, Z 40~~ l 4" Fs~ Boring tl ❑ Boring Pit Ground surface elev. _qlje~ ft. Depth to kmfting factor In. ~tr ~~on Rate Horizon Depth Dominant Color Rfadox Description Texture Structure Consistence Boundary Rools GPDpP In, Munaell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Efttt1 'E"2 1 0- 0 2 SI l U r a„s . 6 0.9 2 012 Z : ab S rf 0- 5 r S - Z-0 10'4P-'4 5 . f 0.,s zo-z 3 5l -m - 014 Or 5 12.7-73Z Vqi_ s 0 dt -m 1. Z- 7 (o ?-.5Y 34 y 5 d 0.4 0. d 7 BW MM&9,54~ M=10 111465 10 a r. 2 d QQ _ 12 Effluent tt1 a BOD > 30:S 220 rng/L and TSS >30 < 150 mgll Effluent 92 -/BM ~ 30 and TSS < mglL h0 CST Name (Please Print) r y Signature CST Number y Y fS r~ nn -10 H t-L STEf< 2Z 3Z Address Date EvoluaGorl Conducted Telephone Nurnbsr w9%75 69o~~AUe. ~&vEFL,FALLS WT 5402Z 0> 0$-02 -7+s `42.6-VIES REVts~n : oR-(~-oz r I I Y (Lb-T 1 - Owner • r. _S~L _ paroal 10 II Pepe 171 Boring N ❑ Brxing Rq (W Z3t♦ N)R pit Ground surface elev. Depth to limiting factor ~~!9 in. Son Ap~l~on Rate on Depth Dominant Color Redox Oescription Texturr Structure Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 Eff1t2 I l L z - L Zq r jfr -d-Va- v5 4-14 adz _ s fa1o15 d Z+~-co 0 3 14-ZI 10 i s MSbt< C 5 a+{-co 0 1"Z 4 21-n for ti/ 1 F'_ 0 2r 7 11Z 5 a-69 a 5 M 0 40 Boring N y❑p Boring P- (OTL4 pit Ground surface elev ft. Depth to factor-. /(a- In. Soil Application Rate Horizon Depth Dominant Color R escriptlon Texture Stricture lance Boundary Roots GPONf In. Munsell z. Cont. Color Gr. Sz. Sh. 'ERtrt 'Ee#2 APT t p-8 .0,1 t-a/s 1. -m v fr o.s 0, Z - tovR Sl I Z~- r a -co .5 0, t l.~t 5r ( zf abi< Tr kS 3 I6-i8 ti tt t'1 y z~ablt w zY -c0 y 'Z! Vx I11)VN-,4jja IZIA& S X13 In Z-'lZOA,2 v cr Boiring ❑ Boring P # Pit Ground surface elev. _ q$, .5kp h. Depth to timlting factor 8 in. Soil A iaatbn Rate Horizon 0 th Dominant Color RadoK Description Texture Structure Consistence Boundary Roots GPDAT in. Munsell Cu. Sz. Cord, rotor Gr. Sz. Sh. 'Efflfl 'E11102 10 149, Z1Z L 7- 0'~L_ AS z R-lt, loxf-yr L z rnab Z~ - .S O's 3 t . tuVa`+l3 511 2.1-M 3b rn(r 2r<-ten .S 0-2 t 2 - 77~ YAK 3Jy 5 M Mf + ZJG- m M, P (F1OO-t 54s2V%'t1FiG0 ~5 vJ O►J o 5 3 4 Efftuent Nf = BODE 30 1220 mg/l and TSS >30 < 150 mpti ' Effluent erg ■ 800,:E 30 mgrl and TSS 30 rrVL The Dcparimcni of Commerce is an equal opportunity service provider and cmptoyer. if you need ossistanec to access services or need matcriat in on aitemate format, please contact the depanment at 608.266.3151 or TTY 608264-8777. sru.tyo tx.uoo~ .i/ Z \ z i z I I \ i N * co ip /01 I \I rn I W 1 n cn \ X ~.~5 \ 11~ ~~n 1 1 1!~ ~DYI /D .16 n/ / \ \ \ I 1 2 R ~.0 ` co -------r-- 60 1 1 \ 1 \ \ o ' \ \ I z \ \ I 1 \ \ i ~I n~ \ I \ 1 11 1 1~ Dl \ Irv iy i \ \ , I cp 00 1, ~ 1 ( ~ jai ~ i ~ \ xo No >1 CA N -ti 4z I rn\ 1 \ n I i I I \ I I co 1 II N <o i ( \ I \ J i I 1 \ I - \ v omIE JI \ I I l z \Z a \ o z~D\ 1 it w 1 c~J rn Im 1 /z m n C \ \ ill \ / % -01 cyl cn of I \ \ I 4-06 I I 1 1 i 1\ 1 II 1 II ~ I N IN ~ I ! 1 / l 1 \ 1 \ \ \ ~ \ 1 II \ ~ 1.~ l 1 I j I j 1 IHVN8- \ \ \ \ \ \ \ I \ 1 I 1 1 I I I I C13NMQ \ \ 1 \ \ I \ 1 1 1 I 11 I I I I c 4 p' lab~ Y d let, 'y ; X,"FV PROJECT: d FOREST RIDGE ESTATES cf -s, w hp 0" S N SEC. 14 =PVC PIPG B" Tz1N~ Kr1w AgWa GI> cl ` swc . Pry . As~ug,© IoO.C d ~ I t' `A t~tE ~u~u suRrF+cE - `oz.. zr 1 L.t Nom' cq- t~-o2 5'l" 6oo.g1 _ _ 111 . k~ 65 CL 65 Ac. ca.. - 111 11 4. 45 J ` 277..61' . -.LOT Act, )-h-rz Property Owner ~ 1 I v b Wo- ID Page g _ of Boring R(LOT2-0) Boring # ~ pit Ground surface elev. ~ R. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Desc lpt o Texture StNCture Consistence Boundary Roots GPOAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # Boring Fi~Horizon TLit' Pit Ground surface el it. Depth to limiting factor y) 1; ication R Depth 54~ominant Color Redox Description Texture Structure Consistence Boundary RooPO in. sell flu. Sz. Cont. Color Gr. Sz. Sh. 'E(f#2 Q-8 L Q.S 0L g-) 4~ t_ - sb w4r S 414 -co D,5 0. 3 tti-~ti Qu y - 51 i z.~-r» s cc-m o s o, U 7,s31 1 a~ trf -M ,y I Z S 12.6--53 7, 5y 5 S CA 14-m 0-1 L 3 4 7, 5 l 5 s I 0-W I~ m 0,7 Z cZd 7 H1-t{I. 7.5yr,31 -7 4 is sbK M4, 600 t0.7 I,2' P P t- V Syr god ~b r,% M nt N Boring # ✓ P 5~ (t oT t } Pit Ground surface elev. pth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture S clure Consistence Boundary Roots GPOXF in. Munsell Qu. Sz. Cont. or Gr. S Sh. 'Eff#i 'EMQ DID t,10T (A55- 0 ~ti t) 17-043 Effluent #t = BOD. > 30 < 220 mg/L and TSS >30 < 150 mgA. ' Effluent #2 = BODE < 30 mg/L and TSS :5 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. sao•u~otx.aoot Prop Owner i__~ LLfl Parcel ID # Page of Ff-49 Boring ng i'd surface elev. h Depth to limiting factor ~~!9 n soil Application, Rate (lbt )R Pit Ground Horizon De Dominant Color Redox Description Texture Structure Conslsten Boundary Roots GPDO •Eff#1 'Eif#2 In. Munselt Qu, Sz. Cont. Color Gr. 5z. Sh. 1- 2~c t' {Cr I aB Zz Z- 44 2 ~ S 'FAbI G,5 $ Z.i~ `C0 ~ 3 14-z1 to ~f3 r 1 s bl< v~r C s z~(-co 0.-1 1,2 4 21-50 lOV y~ IS try-LJ ~r Q~ 2~~. 7 1,2 S trrt O • ~ 1, Z 5 0-69 tovt~t 10tto a4RQj ❑ Boring ~q g tf ! k Soli Iication Rate Borin(~TU5 3)0 Pit Ground surface ale k Depth to limiting factor In. Horizon Depth Dominant Color Ra x Description Texture Structure Consistence Boundary Roots GPD/ff Eff#2 'Eff#1 ' in. MunseB Sz. Cont. Color Sz. Sh. 1 p-8 ~oyR ~/z _ L -m m,l ~r 3 0,5 0. 2- ►ov~a/ Sl1 Z~-~ m r a5 3-tA 0, ' 611 Sol Zf abIS fr 0.5 3A0,5 0J 3 I6- t8 ov o 4 26 y IV-Zl M44 Invrcuc]`c, o K-141 ;1 Z-C able CW z~ -w s Ad S -2 2~l~ M3 -t ~b mJ~tr 0,t{ M14 r 4L U I 7- om S M r, l~ ❑ Boring P Bori~Vg 1 cca~tt Ground surface el v. _ ft. Depth to limiting factor 2 in. C 20~ ICJ Pit Soil A Iication Rate Horizon Depth Dominant Color Redox Des Texture Structure Consistence Boundary Roots GPOIFP n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 f n-q \1RZ/ r _ 1- Z r 34 -co Z Q-IL o z L A-Ma 1 Z-4- 0-5 , 1 - tovQ`+/3 5►1 msbl mfr+C-m .S 0,8 Ll zg-4 7. V 314 S M Mt i 2\) -m (110rL1 1IRgStYtGd 1 S - v~ OlJ1E No 5 3 Effluent 01 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- Effluent #2 = BODE < 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. SUP-1330 (K 6100) i-