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~ ~n o ~ m f O ' 3 ~ ,~ b ~ I ~ 3 I 3 .. ^' i ~ O Z y "~` ~ O O N I n '''~' ~. T. y .~ O 7 Q 3 ~ ~ Q G " " m ~? W ~° (~ w 3 "~ ~ o < < ~~ ~ C ~ i co ~ ~ C ~ N ^ ~! ~ I (n W . N C ~ ~ ~' i (O CJ1 N N W O N Q O O CD ~ N ~ ~ N O\ O N d N N 6 y J v n ~ Q c c n o~ ~ i O Q O ~ N ~ o~ ~ O y y O. m o ~ '' m N a •°•' cn ~ ~ ~ can CD C\t y ~ I • • W Oo _ U7 N ~ C N~ mm . F W ~ ~ C ~ W C O~ O O C' ~ .~+ O ~ O N N O I m N '~ y O O O O a y .L] C 'o ~ ~ D = I a O O O C v Q b v v gy ~ ~ (9 ~ N ~ N ~ (D I N ~ _ ~ y U1 I O N ~ 3 ~ ~ i 3 .+ I O Z .P O ~ .. Z j Z I o Z Z A O ~ o D u o I N ` O N 6/ Q ~ ~ N N '~? I O ..~ ~ O ~ O ~ O .-. .~ ~ O @ i U ~ ~ y i ro c u = ~ C . S N . C ~ ~ Q. ~ ~ 7 ~ ~ ~ N ~ C y ~ ~ I ~ O_ W ~ o . 3 I ° i o ~ 3 y Z ~ O ~ ~ N Q ~ N C d 3 3 ~ p j Q. _ (D ~ ~ d (D Q ~ 3 N. ~ ~ ~I _ y N. .!~ j'30 y O f0 ~O O C O 7 C y~ 3 LV T C ~ _ 3 fl- y 3~ SU I ~ (~ p OZ G 01 j N S~ O- SU O N o. I n~ N Z I my 00 m r T N O o K C- y , u y n O N C X -O N n• O~ y 0 ~' y n : E N O y d tp 7 y p_ (D ~ 3 ~ I ff O `G O C -I y y m ~ ? o a ~ ` ~ ~~3 Q o m o~ p o 0 3 c ~~.j (7 y ~ - 41 ~ ~- ~ y d I ~ ~ ~ ~ 7. 3 I o 0 I o I o i I m I m 0 0 I o 0 n to O 'I 3 d c o ^~ : ° ~ ''' ~ c o . m ~ 3 ~ v m ~ ~ ~ ~ ~ c ~ .n ~ ~ m ~ 3 m ~ ' i 3 .. ^^ t ~ O N N ~, I~ _ ~ N . O (7 ! d N O fD , tD N ~ O 00 o w o 7 ~ N p N N ~ ~ O ° ' o j N . .. a '_ ~ _ r _ O ~ V '' ' .I O cD ~ '; I N N O O O 7 f/7 ~ ~ . .' ~ A ~~ ~ '0 ~ ~ pOj '. fl: O O O a ~ ~ ~ D ~ v' N '~ N to Uf ~ ', ~ o c ~-- , ~ m _o y d 'O ~ I X ~ _ ~ 0. ~ Cf - ~ C A " ~ ' y ~ ~ Z ~ Z i n D ~ ~ ~ N 'D O N (n C N N~ a n . N Q ~ ~ J N O .P Z n C J ~ M O. I ? ~ 7 .. 'I ZZ N ~ W a ° ~ ~ 3 < ~ a O z ~ o 3 ^' !(z m ~ ~ O ~ A C T C I 7 Q ' O m a~ 'K << R O i a I S H b 4 ~.l 0 o x a ~, b +~ ~ ~ ~ ~ II ~' v _._.____- . ' ST. CROIX COUNTY ZONING DEPARTMENT AS BUII.,T SANITARY REPORT Owner G,~.~f,'fG'" ~~ sro-.~~ ,~ra,~,j~ S Property Ad~ess ' City/State ~' Os ~~ ~~ ~`~a' ~ Legal Description: Lot /~' Block ,- Subdivision/CSM # ~ ~ x ~~~L~u~'t`.+~~- 1/a ~ '/a, Sec. ~, TAN-R /~W, Town of S ~ ~ PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer w~ ~S ~ Size ST/PG'~©~' Setback from: House ~ ~ Pump manufacturer Model -' Alarm location r- (HOLDING TANKS ONLY) Setbacks: Service road Meter location Alarm location ..---- SOIL ABSORPTION SYSTEM: ~'~~r~irf t~ ~,~~ C..~,°,r ~it1~' Type of system: ~7'r ~N «a Width 3 ~ Length f SG' •~ ~ Number of Trenches `~ Setback from: House g~' Well ~~ ~ ~ P/L ~~' Vent to fresh air intake 9~ ELEVATIONS: Description of benchmark 2 `~..~~ ~ /''~ 'q'' ~~'~ E~sr L,nT ~c+P.v~ Elevation i Description of alternate benchmark ~ ~~~ s ~+ ~=~~ Elevation Building Sewer ~l'l - ~`a ~ ST/xT Inlet ~3 ~-2 ( ST Outlet ~'-~ . S`~ f PC Inlet "" PC Bottom '`" Header/Manifold Top pf ST/PC Manhole Cover ~~• y Distribution Lines ( ) Bottom of System ( ) 9/ . 9~ . () () O Final Grade () ~~ • ~~ ( ) Date of installation ~/ ~ /~ Permit n tuber State plan number , Plumber's signature `ease number ~~~5`•~ Inspector Vent to fresh air intake r`- Water Line r--- Well i3~' O p NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW r---- ~ . i i ~ooo Gitt t,JifSGP ~L K~~fC ~ -.- --..._. ~~ ~ ~ _ 9s gg o ~, . ~ ~ ~~~ ,{ ', ~ ! 1 k'J i ~ I ~ t ~ /r'-'~ \ ~~ o/ C/Jr~"~ t ~ (~ ~ l.,oc Riau 'H ARROW NO ~~Z 6 '` Wiscorvsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division ' {NSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ^ City ^ Village ^ own of: aCasse, Richard Hudson Township CST BMElev.:- Insp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic - S Zp a Dosin Aeration olding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic ~ 3~ / ~ i / NA NA Aeration N Hol' ing PUMP /SIPHON INFORMATION Manufacturer Demand Model Number GPM TDH Lift Lriction tem TDH F F main Length Dia. Dist. TO ELEVATION DATA Coun ~t. Croix Sanit3 y3~r1njt No.: State Plan ID No.: Parcel Tax No.: 020-128b-50-000 STATION BS HI FS ELEV. Benchmark Z. ~ ~ 2, (U v Alt. BM ~ ~, - ~- Bldg. Sewer G , 3 ~ 7 St/Ht Inlet . St/Ht Outlet ~ ~' 3 Header! Man. q, S 3 Dist. Pipe Bot. System ~ Final Grade ~ St cover ~ ~ JVILA6.l. 1'lIV1V JTJICnrI BED / REN Width ~ Length -f3 ~~ No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN z DIM N I SYSTEM TO P/L BLDG WELL LAKE/STREAM LE G Manu ctu r. ~ ETBACK FORMATION Typeo m ' Ib~ ~ ~ - MB OR UNIT o e um er: < : ~ Syste ~ D1~ IBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing -Vent To Air Intake Length ~~ Dia. ~ Length Dia. ~~ Spacing ~ r ;~ > ~~ 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 Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes No COMMENTS: (Include code discrepancies,~persons present a c.) mspec>;ion try: Q- ~~ ~ ~~u=J~ -~-- ~ --• • Location• 573 County Road A, Hudson, Wl 5401b (NV~ 1~4 NE 1(4 21 T29/N R19W) - 2129191392 5t. Croix Industrial Park -Lot 15 • ,'~~, Y •, h a w~ l( ~ ~,~,~. w~ 1.) Alt BM Description = ~,'r`~'s (nc~ ~ ct~U~c ~iotr s",, ~~S ~,~,; (~ ~jc ~~ S~~c,(~~/ ~ ~,~ 2.) Bldg sewer length = ~ ~~~ ~~ Z n~or~ ~~ ~ c ~ c ad~.v -amount of cover = ~,,_ ) f tl•~P~wvl,bcr sfa~c~ ~1,~- I,t did r~ cake ac~bss 3~ 2 rare e(^.e,,,,~b~~ w~`(l /~c a/da'e~/ / any r-~af/1,..~ a~' sy.t~ti.. ~~~u~~~-.. ~ s•~e aLou~. ,Wa visio I~tu: ^ Yes [~, No I Use other side for additional information. Od ~ ` ~~ `~SBD-6710 (R.3/97) Dat pedor's Signa a Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: .. q1.~ -~ __~(. a -~-, ~.. -~ t _~~./ , _ ~.- ~,, s~. . ~.~ ~~ ~ ~ , ~_ z.. ~ ~= ~~ ;. ~® ~. s ~ ~~ ~~ __ uM __ .~M .w.®.~.. E :~ . a~ E a /~~/~ ~ k x ~._. E = of ~__ ~ s ~. ~®. _. ..~e ~ 4 E ~ @ ~~ ~ ,~. E ~ ~ ~ ~~ _~ j I ' ~ ~ ~ __.. -r - SANITARY PERMIT APPLICATION ~~scon~~n Department of Commerce In accord with Comm 83.05, Wis. Adm. Code • Attach complete plans (to the county copy only) for the than 8 vz x 11 inches in size. • See reverse side for instructions for completing this a Personal information you provide may be used for secondary purpose ' [Privacy Law, s. 15.04 (1) (m)]. County Safety and Buildings Division 201 W. Washington Avenue P O Box 7302 Madison, WI 53707-7302 ` C.IIQe i~ ~~' _ ~~ ~ ~c? State Sanitary Permit Number ~Fi~-n Y 3C~ 3 ~ t ~-- ~(~w, 4/ ~ ^ Check if revision to previous application ~~YY ,~ ~ i•-- tate Plan I.D. Number I. APPLICATI N INF RMATI N -PLEASE PRIN L F ~ 35~'S Property Owner Name i ~, ~ ~°• ~ ey ope Lo ~ E'~ T ~~ N R E (or W~ S ~'~~/a .~ r _ ,,~, , , ~ ~/ Property Owner s Mailing Address Lot mb Block Number ~ City, State ~ Zip Code Phone Number ame or CSM Number ~ Y B ILDIN (check one) ^ State Owned Ity ~ Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms ~ Town OF ~ III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ^~ ~ ~• ~~• , ^A dC ;j 70( 1 ^ Apartment /Condo O~'•0 ' ~ " 0 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/ Repairs 11 ^ Restaurant/ Bar/ Dining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ~ Office 1 Factory 13 ~ Other: specify ~,//Jrer`No~tf/r` IV. TYPE OF PERMIT: (Check only one box on line A. Check box online B, if applicable) A) 1. ~ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of S_ ^ Repair of an ______System ________ System _____________ Tank Only______________ Existing System ______^_ Existing System B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^Seepage Bed 21 ^ Mound Specify Type 41 ^ Holding Tank 12 ®Seepage Trench 22 ^ In-Ground Pressure !n 42 ^ Pit Privy ~~' dC 43 V l P i 13 Pi S r vy ^ au t ^ eepage t 14 ^ System-In-Fill ~"f _ j T VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min./inch) Elevation `' ~; s~,~ ;s-yc7 _ ~ - Feet ,9S ~ Feet VII. TANK INFORMATION Ca acct in altos g Total # of Manufacturer s Name Prefab. Site Con- l S Fiber- Plastic Exper. N E i ti Gallons Tanks concrete tee glass App ew x n s strutted Tanks Tanks Septic Tank or Holding Tank -, , - ,_ -• ^C ^ ^ ^ ^ ^ Lift Pump Tank !Siphon Chamber ^ ^ ^ ^ ^ ^ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (NQStamps) /MPRSW No.: Business Phone Number: Plumbe ' Address ( Street, City, State; Zip Code): ~ r IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved San ary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) Approved ^ Owner Given Initial Surcharge Fee) O"tS~ ~ ~ ~j ~ Adverse Determination X. ~UNUI I IV1V5 OF 1) st~.- ~o~wu'~~ao ~~ _~ .A._ U SBD-6398 (R. 4/99) ~~~[AL / K~~VK D15 P VE1 !n O. ~/0. I S ra-ie+,., wut.~2 .../ ~¢. • Y sue. ~-f ~ . t IMI,WW ~~ INSTRUCTIONS `' b 1. A sanitary permit is valid for two (2) years `Z~ _,,_ ~.' ,f ^ 2. Your sanitary~permit may tie renewed~bre t e e iratiort~~C~y and at a time of renewal any new criteria in the Wisconsin Adrt~i'nis#rative Code will k~~~'plica~~'~~ :; ~~ 3. All revisions to1this permit must be ~{~rovec~~ y the~e+~l~it issuit~tg~~uthority. 4. Changes i n ownership ar plumber r~qujtes ~tarxPe~mi~ Tr~~fer /Renewal Form (SBD-6399) to be submitted to the .~ . r~'` county prior to installation < ' ~'{_•~: = +:v '' ~_ / 5. Onsite sewage systems must be proper` J. tai~2i3~~The s~ .iftYtank s) must be um ~ ed b- a licensed um er vvhene'ver ~rF'~ip F~ , ( P P Y P~ P necessary, usual ly every 2 to 3 years. ` <o /~--~ •, ,-~ ~ ~. `~,~ 6. If you have questions concerning your onsite swage-~ysfem, contact your local code administrator or the State of Wisconsin, Safety and Bui~dirags•Division,-60&266-3151'. - ~ - - - - - - •~• • , To be complete and accurate~this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be instatied. `~ ~' II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ili. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),, address and phone nun5t~er, Wymlaer,mvs~sign application form. LX..,County ~ Department Use~Or~ly. .. _ . X. CountylDepartmentUse°Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following:'A) plot plan, drawn to scale or with complete dimensions, location of'holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required Dyttie~county; E) 'soil test data on a 115 form; and F) all sizing information. GRdUNDWATER SURCHARGE ~ 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can- effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. r Y I ~ - n ~ .. , y ... ,~Y _.. _ .. ~. .. ~ ~ "'r - .. _ v. r ^ at- ;~ s ~ < - - : p : ~ x ,... s' •~.r ~ y' ~F isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 23, 2000 CUST ID No.224757 ATTN.• POWTS INSPECTOR ZONING OFFICE MARK E STAHNKE ST CROIX COUNTY SPIA 33$ COUNTY ROAD A 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/23/2002 Identification Numbers Transaction ID No. 323575 Site ID No. 194418 SITE • Please refer to both' identification numbers, Site ID: 194418, Dick La Casse Development above, "in all comes ndence with the.; en St. Croix County, Town of Hudson NW1/4, NE1/4, 521, T29N, R19W FOR: Description: Commercial Non-pressurized In-ground Soil Absorption System Object Type: POWT System Regulated Object ID No.: 669029 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. Since the system is being installed so deep, it is recommended that vents be installed at both ends of each trench. This should help promote the oxygen transfer process that is needed to maintain effective dispersal of the effluent. Note: Due to the excavation of the existing grade over the top of the system, a surface water runoff diversion must be constructed to help minimize the possibility of storm water runoff concentrating over the top of the system area. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • 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. CAUTION: Wis.stats 145.135(2)(b) indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000. Thus depending on the type of system and your design, this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after 3uly 1, 2000. There is a potential for a law suit that may delay the effective date of the code so this status may or may not change. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. MARK E STAHNKE Page 2 6/23/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, erard M. Swim POWTS Plan Reviewer -Integrated Services (608)-785-9348, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state.wi.us DATE RECEIVED 06/13/2000 FEE REQUIRED $ 120.00 FEE RECEIVED $ 120.00 BALANCE DUE $ 0.00 WiSMART code: 7633 v ~0.5~~ ..-r~.t/~L %%r.~t 7r.7 Fi ~f~~4J 1T+~(` ~~itl L ~{ ~YS% ~~ ~~oJr ~ r ~ L~iP~ ~x ~~.~fR~=t ~'~`~'"S ~ Du ST/~'~/-E[, r'.~-,PK l,~t.k'r',cv~t ~cl~t~rr~.rrt~:~ ~l';V~ .~bv4 ~~ /Pig ~~ """`""`,","'`"Yrwr See Pa a 45 $ L+rtirPlN Za n r ~~ ~Or 9 ~ L ~ ~1~- -- ~ n ~ A i s~ 1 V 1~ N,~ q PJI~,a~a I Z WILLOW RIVER M STATE ~ PARK ge ' = ~ d Hunler ~~ e c ~ 3 ~ rn ~ Ridge Ln ~ d~ a `' ~ ` ~ v ~ Fe°a ¢ v Shmlk ~~ Lnke ., ~O pC ~t ~ i q AJ ' ,~h+~nn~a Rtl McCutcheon Rd S y6°, ~ '15 -~ D y 3 ,, m ¢ .~ Holden E ~ rn v Ln ¢ ~/Qr m t ~"ce~ ~ a a o~ ' A 1. ~aee.r U 2 Zane Gr mcr ~} t ` rrai/ • 72• .U •te\\D ~( 12 /~ ~ I l L//J ~r `~~E /j //~` 7LJ/ r ~~'~ N ~ ~°ru n,na Ln w 2 nwwan9Dr ~ a ~ Zo O (Will) ~ fJSne C rrl 7 nun iPA O 2 5 « a nd 0. l n . . ~~ ~ ~Y / / ~ ~ p, ~ ¢3 _y Q ; s,ogec iraa '°~ D ~ny+~ LZ ¢ ?~ Bfadley 2~ KIt Ln ~ c o ~y anYi,on nu L~I1n0iorrnftlG y y4. 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SY ~ /.~fE~rs' o6~~%aJ ~tqc ~~~cF~`FO ~r~e~oGSo r~ I, ' ~~~Eo ti.~ u J 3 L.~Jr~T ~z~~~:~~ - ~. r.~' ,, I i ~~ ~~ ,, ~, ,, I~ ~~ B~ ~~. Ora w~sE~ fF ../off y~ ' °t i.~o' not tr~d° r; R-o atn~ dabs ~ .saps A in. Q e o~ai tt+s m '( is P~ up5lrs~m 82Z~+ ef-d pyumbing ILHR uWnitta ' Ses sect{o~ to hihs@ Dlurnb;n{~• h ik to dBte~N1e t s ~ ulred a ip ovnl Is req L ion' ~S" ~~a , i I' I I ~V ~ /i'rN ~!~ o /~f('Ty ,~ ~.~I r~ /.~f+V'ccfy~G4P,r - ~ ~ S,P~,~ /,r.~C i -EXISTJNL Qrr<N ~ /V•~. ~~T rc~/ln~i21Q 1 ~ % ~cT, ~~ ~ E~~v. = boo. ~' g S s~~a~ 2f3 . SEA COR~SPONDENCE 93.'?~ ---~ . ~a' '~ _ ~ Wl d av, , n/c~c.cs ~~41Pkr.~1 ~ r~P~ ~n15 a,{,.FTc ± /~5~ rP£C,~~ ~~~al fed ' pQ~- . ~"~So/~ ~s Pr/ ~ ~tQ ~,~, w~« _ ~CT1A6 Stk.E.q Yivvrit7' ~~T~12C ~~a_ ~ASr ~~~~~~-Y ~.,~E I r~'7' I 5/07. ~ /.~/ ~ K ~ ~ ~ lam' 1~~~ Dc ~/E~ c~ {~~'/E/~J'~ r ` - / /~/~lJ ~. ~~L 1 ~/~ s~Tion~s ~ Ala Fir/~~v ycFS ~~x 20 F ~o~ Y~Op~ ,J~i'~/.lls D JC ~D ~ y~D ~o~n.~~?~~~c ~~r ~2~~ODino,~1 rjSo ---- ~~v>D~s~~ ~ c,~.~~ ~s~,~ P~~~~. L~cQ~ r~ ~ooo ~.~cca,~ T vii ^~D~~~f7I~GO ~fnLC S L~D x olC7 ~ ~ ~ ~ /c7CJ0 s4. ~T / j Oo S ct . ~. ?~ No sE~ ~ ~a 1.N ~cr~.~Tb/~ ~, D~ c,>~.v ~~7 f~-« fl ~i~~rk c ~ rY /~ca,~~~ // P~-.u c ~5 r ~" Cr~.9-irlrSc~~'S ~av ~ ~ /~ 9o s ~. ~ . ~PP/~o~lE[i yENT L~(P T i 16' ~~~ ~~,tx„,l,1,+, ~ ° Ae~~E ~,v,sN ~kA4E MA1(! MuM (~O` A~~~ ~s~Aml3[R Q ~Q~~J~,ti ?o finl!<tl ~ q/QE C~R~~SeQ Side View E~E~(gTJa~~4 T enlc N lgd fro,.. r£Q So, c `t`t5T ~~ ~ --- - - - :- _ X c s~ .~ ~1S / ')i ~I / ~E ~ SlOFC..~i.JDc'~ }-/!GN ~,4?ACIT~ ~vpEl End View 15° - 9i. 9s ~~ -3a• .i "'~"" Z $ I ~ I --- o -- -- -- __ __.._.._ I 1~~ $N` ~ II ~ ~ ~ 1 i ~~ i 1~~~~ i ~~~ ~ ~ i ~ l ~ ~ ~ ~ 4 _I~ I ' , ~ t I ~~ ~ I I I T' .9t ~ Q _.J L I i ~ I 1 - -----• ' W~r---=----s--_t ;s+oi I I _._._ ~ Ali _ _ ~ ~ r........-_a ~ I 1 ( ~ < , M, _ , ~ I ' j ; =I~ Q~ ; ~1 1 , I .i i 1 ~ ~ i I, ~ 4 I ~---_-_--__~ ,,~ I ' ~ - ~ I ~ .,~. _ . _ . ~ ~ ~.. -. _ . ~______J I --I . ~ -I ~ ~._....._..._..__.-.._--J ~ ~ ~ I I eJ ~ "+ Wisconsinpepartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings - - Page ~ of Bureau of Integrated Services in accor~~~v~it~ iC~t~3.09, Wis. Adm. Code ~„`~ "` Attach complete site plan on paper not less than 8 1/2 x es in ~~r~r~n ust`~~~ County include, but not limited to: vertical and horizontal refers ~°c~'~'~!' 'int (BM , [>~t~~i ~d ~ '~^ .~~ ~ x percent slope, scale or dimensions, north arrow, and lo~ `" _ and distance to nearest roa . _ Parcel t.D. # (~a ~~N .~ ;~ Z~~ ~ ~ 2 ~.~~9./9.~39Z APPLICANT INFORMATION -Please print~/I-~formals-7~~Fc~x R~ Re iewed by Date Personal information you provide maybe used for secondary purp~,is~, rivaG+~-;,~~ ~~ ~~4 1 (m) ~~ ' /_ ZQ ~~~ r f O PropertyrOw,ner/' ' J w,, ~. ` Pr ation p LXl CA~S~ i~US i Q~'t N L~'1 ~S~.fi ~ J ~ , 1 c~v~jl.~ ~ /(,~ 1/4 /1f ~ 1/4,S Z l T ~ ( ,N,R / 9 E (or) W Property Owner's Mailing Address ~°~-- ° oft# Block# Subd. Name or CS # ., ~3 I~ Si C(Zdl~t ~l~(~USTIQIAL ~A~'~ City State Zip Code Phone Number ^ City Village ~( Town Nearest Road ~ _ ~ (his) ads -~- ~N CT~1 A 1i New Construction Use: ^ Residential /Number of bedrooms Addition to existiny building Replacement ~] Public or commercial -Describe: Q/- TrT~,~zcs/o;<<r~ Code derived daily flow'~D~ gpd /'~ ~',.~ Recommended design loading rate O •7 bed, gpd/ftz d~ ~p~ trench, gpd/ftz Absorption area required / /S" bed, ft2;-'~-,~-trench, ft2 Maximum desi n loadin rate bed, d/flz Q, 0 ~{{ g g ~~ gp trench, gpd/ft2 Recommended infiltration surtace elevation(s) ~ ~. 7J ft (as referred to site plan benchmark) Additional design/site considerations ~ ~ - `rE ~ `i"O ~~ ~ ~ Parent material L1~1 to l~ l./ld•~l~ l Flood plain elevation, if applicable iV/ ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U _ Unsuitable for system ,~ S ^ U ^ S U ^ S ~(U ^ S ~ U ^ S (~ U ^ S ~ U SOIL DESCRIPTION REPORT Boring # j Ground elev. ~~ft. Depth to limiting factor 2.s_G.l~: Boring # ~.. Ground elev lora.4 ft. Depth to limiting factor ~ f2 3~ irk Horizon Depth Dominant Color Mottles xtur T Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color e e Gr. Sz. Sh. ry Bed ,Trench /~ O- (I Ot / -'' ~ ~ M c f ~' C S /-Z~ ~ . - 5 ~ L ~ ~vt ~ b nT r ~- 5 ~ p .~2 ~ .3 - ~o~ 3 -- 5 1~i5 n, c.S - ~ e .~' e ~_,~ ~ ~ s~, rns r - o. ~.~ Remarks: Q 3 I - L_ ~ M c~ /h r C S ~ D. .S - ~ /DyQ4 3 `` S6 fhS -- 0.7 4. 9/. S ~ of~---_.-----~D , Remarks: SST Name (Please Print) Signatur Telephone No. l ~vE~ Jo~I~vso ~ - ~~ ~ o 4ddress Date CST Number ~' aSa>\, S9-OrC FVtsEb 6 -22-06 ~2Z7~'7 SOIL DESCRIPTION REPORT PROPERTY OWNER Page ~ of PARCEL LD.# Boring # E~ i Ground elev. /or7. t ft. Depth to limiting tr Boring # i~ Ground elev. ~~ft. Depth to limiting factor ~ ~~~ Boring # ~L Ground e ev. .5 ft, Depth to limiting factor ~ '. Boring # Ground elev. ft. Horizon Depth Dominant Color Mottles Texture Structure Consistence B nda Roots 2 in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ou ry Bed ,Trench ~11_~ _ L M r CS ~ p ~'~L 1 A - ? - S -- Q I- ~ 3 `~ S r L l rn sbk r 5 ~ , P - 64 /aY 3 ~-- 5 C- /h S n~ - .a.8 M ~ Tlf nJ ~t5-r'T'On'I ~~ 153. Lf~ tjNLy /N TNr~ Remarks:T®P ~ ~ n Q >P~f`A+~S TO f3~ ~(C.C s01~T- ~,Q lN~i 14~~1~ - ~ / -- ~ ~ Wt Cr M~r r s S-3o ~ ~ 4 3 -- ~-L ab~ r C,S -- ,S o.~ -4g ~ ~ 4 - SCE rho rh -' ~a ,8 (o Remarks: Horizon Depth Dominant Color Mottles Text Structure Consi nce t B da R ots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ure Gr. Sz. Sh. s e oun ry o Bed ,Trench Q X 4 3 --~ 5~ L M a b~ >m r ~s s b.6 B - ~ ~- 5G m 5 - .7 ~~ .~ Remarks: Depth to I limiting factor in. Remarks: SBD-8330 (R.9/98) • ~ ~ r ~, J J ~Z .rr~,: .. Q ~, ~ ', I ~. ~. •L I. . . ... , NL f ~ '. \ Q ,;h , ~,, i ~zN ~ ~ ~.,+Q ~~ ~ I i d F. Z ~ V , :. ~ ..~ ~ '. ~~ ~ I R ~7 - ~- - . _ , i, 1 ~ ~~ ~ ~ ~ -. ,r J o Vj i ~ ~ ' ~ 3 ~ a ,. ._ ~r ~ ~~p1 N 1 ~ . .., ~ Q ~ I" Q ~ G ~ 1 1 ~ ~ ; Y ' M L~~ ~ SC ~ ~ c' ~y ~ .o ~ ~ h W ~ ~ a ~ ~ U a y I ;~ ~ ~ , Q ~ ~ ~ Y _ , . w .... _. ... ~ o . ~ r ~ ~ N1 ; ~ ~. M ~r '~ u ~1 J ldJ - J "\ ,~ ;~_ t ~ ~ ~. ,~ ~~` ~~~_ , •, ~,ti ?..~ rrnxrurr^ -- .r ,, _ ___ -- ~Y ..... ~ t~. ~ ~. -.. . .~ June 22, 2000 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715) 386-4686 RE: Soil test for LaCasse Custom Homes -Lot 15 St. Croix Industrial Park On June 21, 2000 staff conducted an on-site verification for the soil test submitted by Harvey Johnson (conducted on June 7, 2000). This lot has been significantly graded and altered since the soil test was conducted. Staff could not visual~determine the location of the borings previously dug. Anew pit was opened that appeared to be in close proximity to boring 3 as indicated on the plot plan. The following is a list of conditions observed by staff. Due to time constraints and the possibility of an unstable nit wall, staff did not record a full boring description. ~, ' ~ O fill 0-50 in. ~a~y ~ ~, (~O - 5~°~" * top soil/sod was observed at 50 in. '~~ > in-situ soil 50-74 in. 74-83 in. mottles Sil 1 msbk G 0~ - ~-- ~~' - ~ 3 3 ~ "depth of mottled horizon varied from 7-12 in. ti r .~ 83--120 in. S/COS Osg ~ ~/'a[~ ~~ir~- I have spoken to Gary Zappa and have requested that Harvey Johnson return to the site to verify the conditions he found and extend the boring to a depth at least 4 $. below the mottled horizon. He will then re-due his soil test before submitting an original to the county. The correct modifiers/terms should be used to describe the texture and associated structure. S ~ on Sonnentag Zoning Technician ,~. ;. ,. 1101 Carmichael Road Hudson, WI 54016 Phone: (715}386-4680 Fax: (715)386-4686 Fa~c To: Gerry Swim From: Jon Sonnentag Fax: 608-785-9330 Date: June 22, 2000 Phone: Pages: 2 Re: Soil test - St. Croix Industrial Park Lot 15 CC: ^ Urgent x For Review ^ Please Comment ^ Please Reply ^ Please Recycle •Comments: .~ ;, ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer _~,~~~ Mailing Address ~ ~~' ~ ~ y- ~;~/~ /~.~~-~.~~ ~ ,~,,~ . ~~~~ ~' Property Address ,~,~,~~ ~'~~ ,/~~ ~, ~7~i.,l~rt),.~.~ .~~ ~`I~,d 6 (Verification required from Planning Department for new construction) CitylState , `~ r~, ~ Parcel Identification Number L'~.~ - /016 - .S to - coo ca LEGAL DESCRIPTION Property Location //s.r `/4, ~~ '/,, Sec.. ~~, T ,ter. N-RAW, Town of ~~,~r~..,,; Subdivision , ~~ : ~~ ~ ~ ~~,~'./'.rT~in. c. !/i%~i~K ,Lot # ~. Certified Survey Map # ,Volume Page # Warranty Deed # ~~O X1`1/ ,Volume __?~ ~ ,Page # ~35~ Spec house ^ yes ~ no Lot lines identifiable ~J yes ^ no SYSTEM MAINTENANCE 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 masterplumber, journeymanplumber, restrictedplumberor a licensedpumperverifying 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the 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 da f the three year ex iration te. ~ l~6 / Oo SIGNATURE OF PLICANT 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 describe ab e, by virtue of a warranty deed recorded in Register of Deeds Office. ~~ lal6 / o c~ SIG A OF LI ANT 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 wanranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ., ~,.....,,.,~ ~~r wlauuNSlN 1''Uti!!( 1 - 1099 WAAAANTY DEED {- ------ This Deed, made between ...$~~.tlk..GC(11.X.-Yenture:a, .............. a t{innesota.~eneral._partne-rg_t{~.p .................. ............ ..................................................................................................... ........................ ........................................................................, Grantor. and..LaCasse Custom Home s.i,_Inc,t,,,,,,,,,,,,,,,,, .......................................................................................... Grantee, Witnesseth, ?hat the said Crantoe, for a valuable consideration...... ...... ........................................................................................................... eenreya to Grantee the following described rte{ estate in ...~i:.,...~I.Q1.fii ............. County, 8ta4 of Wleoonetnl ' . I i~~ , ? 1 *, :: REGISTER'S OFFfCE ST. CROfX CO.t hll Reed ~.,r R:te^,r4 JUN ~ 5 1~~~ i 8:30 A '. neTV11M 10 ~~ 'Pa: Parcel No :................................... Lots 14 an 15, t. Croix Indu=trial ?ark, Town of Hudson, St. Croix County TRANSFER ~'~, FEE Thte .-..is..no[,__,_,_,,,,_ homestead property. (Ie) (Is not) Together with all sad ^ingulsr the hers ~itsmenta and appurtenances tfiereunto belonging; Grantor ........................................................ And .................................................................................................. warrnnts that the title to good, indefeaelbta in fee simple and free and clear of encumbrencee except easements and restrictions of record and will warrant and defend Lhe name. ~J Dated thu ...... day o[ ...... ~.:`.~ ................:..............._............., 19.9$.... .................................................................... (SEAL) ..................................................................... (SEAL) ...5~,~~t..G.x4.ix..Y~~tuz A .......................(sEAL) ...... .... . re ry artner ............................ ....~............................... (SEAL) G. Craig Christensen, Partner AUTFIHNTIOATION Signature(s) ............................................................ authenticated thin ....._..day of ........................... 19....._ TITLE: MEMBER STATE BAR OF ~1+iSCONS{N (If not : ............................................................ authorized by ~ 7()8.(18, Wie. Stets.) ~J/)~f~/Tfi{S IN RUMEN7 WA pgAfTED 8Y ............................................. .. . (Sienatures may be authent[csted or acknowledged. Bot~. ~~, FY~~E ,.~ '... . ., . -: r a~ .~: '~ ~`~ .. :~- .M! p .~. ti =s ;. ~; }~~:~ * r.ty ,~; X44 ~;: ~~ , ~~ r. ~•. ~;; ±' AOgNOWLEDQMHNT ~ STATE OF tiINNESOTA ~~. ...........~NH~yx13...........County. _ Personal) came before me thu ..... 1.[~......day of ........................... ~".,~....., I99~8 ... the above named ..... GxeBoxy..~...li<1[YeY..rzAll ................................. ......G....Gx~:[g. Cbx~s.tel}sen ................................... to me known to be the pe so .s yyr~.the foregoing Instrument a a w ~b+~HgNp 'y NpTARY PUBLIC • hSINNESUTA ................................. .. O a,.3h 2000- . • ....1~- /-~ ............................................... . Notary Public ..............1~.-~st.rt........County, ~~*_ My Commission ie permsnent. (f not, elate ezplrntion y ;: :~ ti ,+~ •• ~ : w, M ~ ~1 O Ul ~ 00 M In ~ ai ~ o ~ ~ rn ~ rl N .-~ t0 ~ O v M l0 Q1 0 N lf1 lC1 I~ ~f M r-I 01 r-1 r-1 N r-1 W W 3 W ap M '-I v i0 v rl In u~ U1 rn O ao M i~ O O iD O ap O Ul O M N In ~O cn ~t z 07 cn ~ v 0 N 0 .--1 0 0 v c~ u1 r, 0 ro 0 v 0 rn 0 v M v co rl °o o° °o n r`i M r'i M t~ ID ap t0 N N .-i I~ Q 0) v ~o I I M U1 `U W O } Q ~ ~ NI ~_ 0 W W ~ JJ ~ VJ ~ Q F- O / r O - l \ __`` 1v ~ ' F W ~ ~ Z ~ ,~ ~ = , j W f- V d ~ i . ° a ~ ~. Z ~ ~ u Jy m; ~ :~ a~ M M W a = 01 F- pp z OO Q I W F- a ~ V_ M O o .- ,££ M W ~ _ NN ~ M ~ M tV ~O ~ o ~` Z ~ ,Sb ~ p_I O N W .~ 3 1 a ; p ,OS ,££ W = 1 H ~- to 2 ,£b I i r n 0 a H I m rn ai ,09 ,££/ ~1 F- 1 JI JI al ~1 1/11 i F- u I N ti ti N N N Z O F- NI u DI W ZI N QI J I lL O ~I w 1 tt F-1 ~ Q~ W JI Z al W zl = ~I ~" W, O ~ ? j~ J ~ 0 F- ~ ~ ~ Z Z 3 „11 ,IUoIUS 1, ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner ~~ ~A+L.~r4~5t~ ~CVtLm,griE~>E Property Address 2~S Lrr Rn~ City/State ~ a So.~l w~ Syc~/ !i Legal Description: Lot >~ Block _ Jv1~.? '/a ~ '/a, Sec '° Subdivision/CSM # ~, TS',~N-RAW, Town of ~l. ~I,19.139 a SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer ~/£Sc~ Size ST/PCa~/ Setback from: House ~ Well ~~P/L ~-?`s Pump manufacturer ~ Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: ~~~ Width 3 ~ Length ~ Number of Trenches ~_ Setback from: House o' Well ,/~~ P2 ,?'~ Vent to fresh air intake ~' ELEVATIONS: Description of benchmark ~'i~-tStl ~oaP i~1 ~•® ~f10i noel Elevation 1~•c~' Description of alternate benchmark Elevation Building Sewer ~~• ~~` ST/HT Inlet C1:2 .?7 ~ _ ST Outlet ,O / PC Inlet PC Bottom "`'~ Header/Manifold ~ • ~~~ Top of ST/PC Manhole Cover - ~~ ~ Distribution Lines ( ) Bottom of System ( ) ~~ * ~~ ~. Final Grade ()~!~- $~ri~VL. ( ) Date of installation / / / Pe mit number `t~J~.'~ State plan numbers ~ 7~.~ Plumber's signature ,/ cease numbero~Sj`~/S~ Date/ //g/ Inspector ~~'/nJ rt,~Acb~ ~A-t1 Complete plot plan a Vent to fresh air intake Water Line NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if appli e. 1 AN VIEW I i ( a ~hb~ I ~ I f ~' C ~t ~Gt~t DING ~ 3 3 ;,~ ~ ' ~ s - - - - I I I ~~ ~r~ ~ ~ Q ' ~y - + -~ ~' 4 !~ Ewe .~- ~ ~O art-o,~ ~~ ~` I - g,~vu~~+-1 ~+eK v w ~~~ ~ ~ ~ ~ I ~ R ~= i 30 -~ 4 0~ ~;,~~ w,ES~t SEPnc ~,u~c w,T~ INDICATE NORTH ARROW y2-Sr~a.~Re'~~s~'~P ~~ /~tll ~ <aa Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Dwision INSPECTION REPORT GENERAL INFORMATION -- (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(rn)). ',Permit Holder's Name: City Village X Township LaCasse Custom Homes Hudson Townshi CST BM Elev: I Insp. BM Elev: BM Description: f Q'0 • D CSD • t~ ' -~ik:5la~ ~e~~lal~- tOr~ = ~ g l TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL 0' Vent to Air Intake ROAD Septic I ~ ~~ o. ~ z~s =--- Dosing Aeration Holdi PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift 'cti oss System Head TDH Ft Forcemain L gth ist. to Well SOIL SORPTION SYSTEM ,_,;,yt ~ n.,,,~~ county: St. Croix Sanitary Permit No: 420520 0 tate Plan ID No: Z = Tncwts ~ /D •~ Parcel Tax No: 020-1286-50-000 STATION BS HI FS ELEV. Ben ~ma~ ~ ~'lE~~ {-Jw 3• ~ D3. 1 ~ ~ • t7 Alt. M Bldg. Sewer SUHt Inlet t~•~) g2,S'"1 t SbHt Outlet ~ l • 3 S' `T2.35 r Dt Inlet Dt Bottom Header/Man. /!. ~~ T 5 Bot. Syst m Final Grade ~.~ 6tc St Cover ~ n- BED/TRENCH DIMENSIONS Width Zt J Length V~~ 1 No. ~ renches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYST EM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR ~fac}Ur~ ~ 5~~~ /) !- _ +npC~tndK ~,. Type Of System: C~~ t 32 fl ! t ~ ~~ "-.~ UNIT Model Num r:~t DISTRIBUTION SYSTEM (4~~0. P/L~ Header/Manifold ~~ Distribution x Hole Size x Hole Spacing Vent to Air Intake Q~5' Pi (s) .w 1 Length Dia Leng Dia Spacing 1 SOIL COVER z Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~] No ]Yes ~I No ~~COMMENTS' (Include code is repe ies, p rsons prese t, a .) Inspection #1: ~~ /_~/ bL Inspection #2: 7~T'~ `L ywJ . W~ :,~ 3r°~r~ars 5.~ . Location: 573 C unty Road A Hudson, WI 54016 (NW 1l4 NE 14 21 T29N R19W) St. Croix t are .9.19.1 1.) Alt BM Description = ~,~~s~""'9~' ~~~• ~• 2.) Bldg sewer length = 2, 1~•~•y t2.3~ (& 2 q(• 3Z' -amount of cover = 1i•`EZ y2 .yo ~ /• ~ 3 .~'~iwl•~ q ~5~g~.,,~-•1,~...-F•-~..~.~, [t,~.,aQl1~ ~'~') 9Z.z~'= 1~• `~ -L ~{l ttJ)_ 29 ~~ ~ ~ ~IN~~~tl~... ~ ~ ; -- -- - -- z Ili. _ ~}I ~ - -;-- , ~-- I n e ulred . ~ ! `. ~~ l Use other side for additional In Yes No ~~ ` ct! ~ t ~ ~~ S formation. ice, S __ _ _ _ ___ ~_ SBD-(~10 (R.3/97) I t, at`e ,,~ , Insepctor's Signature Cert. No. - Sanitary Permit Application Safety & Buildings Division - ~ In acrford with Comm 83.21, Wis. Adm. Code 20l W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 5'CallSfl!T personal information you provide may be used for secondary purposes Madison, W[ 53707-7302 Department of Cvrnmerce [privacy Law, s. I5.04(1)(m)] (Submit completed form to county if not state owned. Attach com fete fans to the coon co onl for the stem, on a er not less than 8-1/2 x 11 inches in size. ~~n, State Sanitary Permit Number ^ Ch n to rovious application State Plan I. D. Number Leo / 20 SZ O ~ __...°° ~' ~ o - ~ I. A lication Information -Please Print alt Information '° `'° Location: Property Owner Name Property Location ~~ i ., r, _ ~ c) o _ T ~,' +~ ; 1/4 /VL~t/4, S ~./ T 9,N, R/~E or property (hvne~s Mailing Address Lot Number Block Number City, State Zip Code on -~---6 - Subdivision Name or CSM Number II. Type of Building: (check one) ^ Ctty ^ Village ^ 1 or 2 Family Dwelling - No. of Bedrooms : _ » Town of ®public/Commerciai (describe use):_ ~ ~9" '~ ^ State-0wned ~// Nearest Ro< 2 ~3 ~~c G~ rfZt SAS l P lTaxT Z ~! i ;' x b2.ta' -~-rekc~cO.lU~ ~ 4ta~ c.~.cli v - III. T e of Permit: heck onl one box on line A. Check box on line B if a licable A) 1. ®New 2. ^ Replacement 3. ^ Replacement of 4. 5• S stem S stem Tank Onl B) Permit Number ^ A Sanita Permit was reviousl issued IV. Type of POWT System: (Check all that apply) '>E ~ ~ l ~ ® Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ At- de ^ Aerobic Treatment Unit ^ Recirculatin, V. Dispersal/Treatment Area Information: ~ ~ n ~ ti r: Proposed 7'~~..s / - - ~ . VII. Tank Capaci in Total # of Information Gallons Gallons Tanks New Existing Tanks Tanks VIII. Responsibility Statement I. the undersigned, assume respot Address state, to ^ Constructed Wetland 5°~~~"S ^ Drip Line ~ (~,,,~ ^ Other: ~_ Rate (GalsJday/sq. ft.) (Minlinch) - ~ - ~/ Manufacturer Prefab Site Steel Con- Con- crete structed ^ I ^ of the POWTS shown on the attached fans. tamps); ivlP/IVII'RS No. ---- . _ ~~23,3 glass Elevation 9~. ~~'~ Plastic IX. County/Department Use Only ' Sari Pemut Fee (Includes Groundwater Date Issued Issu' g Agent Si (No stamps) ^ Disapproved ~Y Approved ^ Owner Given Initial Adverse Surcharg Fee~s~, ~ Zq ,~ Determinati n . Conditions of Approval Reasons for Disapproval: ~ysQ,~.S .~ /~- nnMGMr+.^^ti ~ t)1. Seti~ (,euell d:~(~6( Ot11tel r`^~°`^'"`'"" 1 .(?' -/ c.v.~- fie. QclL~ S S-rtM,~ -b w.2~¢JC~' µs~u ""u'"^'` cOt.,4r ~an~: '-- S~--S~` 1. ~.~.o-t~-~Q9~ ~~tiru.•ri.~-. _ _ __ ' i ~" I ~_. \~ .~ 4~3- {,' ;e ,ti ~. \' ~, ~ .~ wu latc LJiFSt~P SFOTIGT't~l/~C r-~ r1 N .Z•~E3tE /{ /13c~ !XG(-~- ~~7- 7ciLTE~' ~ - - - ... LY _ _ ,~ - - ._ - ' Sanitary Permit Application Safety & Buildings Division ~/ ~ (n accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse si;ie for instructions for completing this application PO Box 7302 ~SCOI~SfII Personal information you provide may be used for secondary purposes Madison, WI 53707-7302 department cf Corttmerce [Privacy Law, s. 15.04(1)(m)] (Submit completed forth to county if not state owned. . ..... - -_---~- ___-- _-'--~ t_-.~._ .-....-... .... never nnf Ices than g-1/2 X 11 inches m StZe. ,` I. A lication Information -Please Print all Information Property owner Name _ ? G ~., ~' 2 3 property Owrtec's Mailing Address City, State ~P Code - II. Type of Building: (check one) ~ 1 or 2 Family Dwelling - No. of Bedrooms ® public/Commercial (describe use):_ D~~ /`,~iv/tEirv~rr~ ^ State-0wned >~; ~ ~~r ` + ~~SC~r 2 ~~ 3 III. T e of Permit: heck onl one box online A. Check box on line B if a livable A) 1, ®New 2. ^ Replacement 3. ^ Replacement of 4. S t S stem Tank Onl L,ocation• Property Location / /y l/4 /V~l/4, S ~,/ T~ 9,N, R/9E (or~ Lot Number Slock Number ~~ sion Name or CSM Number Subdiv i / ~ ~j (/JnZX ..~GttlfT /1zAL /NR~C ^ city ^ Village wn of ~ To c ~ ~ l~uD r yn/ Nearest Road ~4- rTr ~2a/ 1 b PuT ~~6`~:YO n ~ n 6. ^ Addition to s em Permit Number uaw raa~w B) tt ^ A Sani Permit was reviousl issued ,.,,~ ,~,, IV. Type of POWT System: (Check all that apply) '~ ~ -1 ~ ^ Sand Filter ^ Constructed Wetland 7"~t~~5 ® Non-pt+essurized In-ground ^ Mound ^ Pressurized ~_~~d ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other. tt Area 2. Disper, ~~ ?_ VII. Tank Information New Tanks VIII. Responsibility Statement I, the undersigned, assume respot City. ~.,,.~l..........,.,,.. .. ------~~--- ft. rnJinch Proposed Rate (GalsJday/sq. ) (M~ ) a - . ~' in Total # of Manufacturer Prefab Site Gallons Tanks Con- Con- .., Crete strutted for installation of the POWTS shown on the glass Elevation 9~. ~o IX. County/Department Use Oniy ' Sani Pemtit Fee (Includes Groundwater Date Issued [ssu' g Agent Si Mo GPs) ^ Disapproved ~Y Approved O Owner Given Initial Adverse Suroharg Fce) S~ ~ Z9 ,~ Detertnina ' n .Conditions of Approval Reasons for Disapproval• ~,,.5 ^^~~•_/n~ /' ,~ /~- n~.~ tt~~ .Q r Sw,1 C,euer Q over r~n#ti ~'b` t~ ~ / Q' ~4' . -- ulLsas`~ ~ `~ ~e ~~ s,~s-4-ems -b ~~' ^^°~u'~t,t..w` 'M°•, ~' _- (VJ S . a ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDO #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary September 25, 2002 CUST ID No.222373 GARY T ZAPPA 715 SIXTH ST N HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/25/2004 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Dick Lacasse Development 523 County Road A Town of Hudson St Croix County NW1/4, NE1/4, 521, T29N, R19W FOR: Description: Proposed Non-Pressurized In-Ground POWTS Object Type: POWT System Regulated Object ID No.: 871291 .Identification Numbers Transaction ID No. 788942 Site ID No. 650700 Please refer to both identification numbers,. above,;in ali comes ondence with the a enc The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • This plan utilizes Infiltrator leaching chambers. The gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and ch. Comm 83 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • 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. • Comm 83.22(7) - 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. Note: The plumbing for this project discharges to a private sewage system. The approval covers only domestic/sanitary wastes directed into this system. The Department of Natural Resources (WDNR) must be contacted regarding the treatment and disposal of all industrial wastes, including those combined with domestic/sanitary wastes. Proof of the contact with the WDNR noting specific approval conditions must be presented to the county before the sanitary permit can be issued. P.U.W.T.S. Conditiosially ~~ovE® ` GARY T ZAPPA Page 2 9/25%02 Owner Responsibilities: • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce . state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 ,i `f {~ ~~C~ fC ~ ~i(~~r/ L')'~r `T Y} F ~.v~A~ 1TY' ~L~itl L ~ ~ 7 % t~i~~ . Y 6`~,~ c c t n ~~~ ~x ~c~/}}.~f'T"ct r'~E`S ~ Du 57-~i~c C'~~i~ ~~r'>a-fiz.:~t ~c~nrrJytl~:~(`' ~lt~>U~ .FwO CO !PA oT ~ /~` ~t Cis v.~:J Gc1 r S'~t?/,~.e .,r,....~......~...,..--sscu.un~, See Pa e45 _ ~'Z+'rklr Fdlla Zo n r ~~ _ _ _ _ Pr S ~ ~~ ~ boon%dm _ _ _ _ _ _ _ _ _ .. 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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of ~~_ Fli_:-.IiVFrORMATION ~3 Owner _ r _ Permit i}rSIGN PARAMETERS Number of Bedrooms ^ NA i i iVumber of Public Facility Units - ^ NA , S Estimated flow (average) , ~-- gal/day Design flow (peak), (Estimated x 1.5) gal/day Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average Fats, Oil & Grease (FOG) 530 mg/L I Biochemical Ox e ygen Demand (BOD) 5220 m g/L ^ NA Total Suspended Solids (TSS) _<150 mg/L Pretreated Effluent Quality Monthly average ~ Biochemical Oxygen Demand (BODS) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) <_104 cfu/100m1 Maximum Effluent Particle Size %s in dia. I^ NA Other: BI NA Values typical for domestic wastewater and septic tank effluent. SYSTEM SPEC{FICATIONS Septic Tank Capacity O gal ^ NA Septic Tank Manufacturer _ 2 ^ NA Effluent Filter Manufacturer - ^ NA Effluent Filter Model ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA ! Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ) ^ Mechanical Aeration ^ Wetland i i ^ Disinfection ^ Other: Dispersal Cell(s) ^ NA ® In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other: a Other: ~ ^ NA Other: ^ NA Other: ^ NA 11/i411VTFIJLINCF SCI-IEDtII F Service Event Service Frequency inspect condition of tank(s) At least once every: ^monthls) (Maximum 3 years) ® ear(s) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ®NA Inspect dispersal cellls) At least once every: c~ ^monthls) (Maximum 3 years) oC, ®yearls) - ^ NA C1ean effluent fitter At least once every: ^ month(s) ®year(s- ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) ^yearls) ^ NA Flush laterals and pressure test At least once every: ^ month(s) ^yearls) ^ NA Other: At least once every: ^monthls) ^ year(s) ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or 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) io 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 cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pondiny of effluent on the ground surface. The ponding of effluent on the grouhd 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 l%31 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 chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <_12 months, 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. GMW 14/01) Page ~ of ~. STAfitT UP•ANO OPERATION i=or new construction, prier 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 cell(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 cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of affluent. To avoid this situation have the contents of the pump tank removed by a Septage 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 normal levels within the pump tank. Do not drive or park vehiples over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the 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 andlor 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 Code: 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 covers removed and the void space filled with soil, gravel or another inert solid material. CONTWGENCY 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 replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at 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. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure o.f the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <1tVARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT 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 POWTS INSTALLER Name ;."_ -° _~ -_ , . J s /' - cf.'_i .SIG ~ /1 Phone / , f7 S ~s G -- ,-'" SEPTAGE SERVICING OPERATOR {PUMPER) Name ~~ _ /~ r' "°' Doles' , Phone !~,~: izd>~a POWTS MAINTAINER Name T .~ Phone 6 _ / LOCAL REGULATORY AUTHORITY Name .~: , Phone ~- ~ _ 0 This document was drafted in compliance with chapter Comm 83.22(2)(b-(11(d1&(f) and 83.5411), (2) & (3), Wisconsin Administrative Code. Wisconsin Departmt;nt of Commerce C~ivision of Safety and Buildings SOIL EVALUATION REPORT ~.....,.,,i.~...b ...,rl, r~~.mm Ar. Wic Arlm C`.t~ria 1553 Page - t of -3 -- A.C.E. Sal & Site Evaluations - - County _ _ Attach complete site plan on paper not less than 8'/: x 11 inches in s¢e. Plan must St. Croix "---- - --- include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north anow, and location and distance to nearest road. . . -50-000 _ ____ __ _ 020-128 6 Please print all information. _ _ _ Reviewed gy Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location INC. LaCasse Custom Homes Govt. Lot NW 1/4 NE 1/4 S 2t T 29 N R _19 W , Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 573 County Hwy. A 15 __St. Croix In ____ __ _ City State Zip Code Phone Number ~ City Village ~ Tov<m Nearest Road Hudson ~ WI 54016 715-381-5405 Hudson Co. HwyA VJ' New Construction Use: Residential /Number of bedrooms _ ___ Code derived design flow rate 900 ___ _GPD ~ Replacerrtent /_f Public or commercial -Describe; warehouse/office building addition _ ___- Parent material Glacial outwash _ - Flood plain elevation, if applicable na _ __- General comments and recommendations: Install two trenches at elev. = 92.75' or higher using 42 high capacity leaching chambers. Boring # Boring > 150" i i R i 1/ Pit Ground Surface elev. 99.23 ft n. . pepth to limiting factor cat on ate Soil Appl Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 D/ft2___ *Eff#2 1 0-14 10yr3/3 none sl fitt 2fcr ds cs 3f 0.0 0.0 2 ~ 14-35 10yr2/1 none sit fill 3csbk dh aw 2f 0.0 - - OA - -- 3 ' 35-39 10yr5/4 none s fill 0 sg ml aw - 0.0 _0.0 _ 4 ~ 399 10yr'3/4 m2p 7.5yr4/6 sit fill 3csbk dh aw 2vf&f 0.0 0_0_ _-._--- - 5 j r --- 49-58 ~ - 7.5yr4/6 none - gr. Is 0 sg ml cw - 0.7 1.2 6 ~, 58-150 10yr5/4 none gr. s 0 sg dl gw - 0.7 1.2 Redox features described in H#4 disregarded by Comm. 85.30(3)(a)2. Gravel in H #5, 6, 8~ 7 comprises approx 15%f horizons. a Boring # Boring >155" i i R t i on a e n. Soil Appl cat Pit Ground Surtace elev. 100.84 ft. Depth to limiting factor Horizon ~ Depth Dominant Cdor Redox Description Texture SWcture Consistence Boundary Roots GP "Eff#1 DIft1 `Eff#2 1 ~ 0-14 ~ 10yr3/2 none - sit fill - 2msbk ---- dsh cs 2f,1m 0.0 0.0 2 ~ 14-26 10yf3/3 -- none siclfill 3cpr dvh - cw 2f,1m --- 0.0 ----__ 0.0 ---_ j 3 ~ 26-32 ~ 10yr4/4 none sit fill 2msbk ml ani 2f8wf 0.0 0.0 4 ', 32114 10yr5/4 none silfill lmsbk dh cw 1f&vf 0.0 0.0 5 ~ 44-50 7.5yr4/6 none Is 0 sg ml cw __ 0.7 1_2 6 ~ 50 83 ~ 10yr5/4 a r. s 0 sg dl gw - 0.7 1.2 7 ~ 83-155 10yr5/6 none ~ . s 0 sg dl - - 0.7 1.2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TS >30 < 150 mg/L Effluent - BODS < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Si ature: CST Number James K. Thompson ' ~ _ 3602 - __ _. _ -- -- - - - ----_---- - Date Evaluation Conducted Telephone Number Address A.C.E. Sal 8~ Site Evaluations / z Z 5/24/02 715-248-7767 340 Paulson Lake Lane, Osceaa, WI, 0 Q ~~d Property Ovrner , LaCasse_Custom Homes, INC. __ - Parcel ID # 020-1286-50-000 ---- -- _ -------- -- ---- Bordng # ~ Boring /_J Pit ~ Ground Suface elev. ____ 98.79____ ft. Depth to limiting factor > 148" in Horizon Depth Dominant Color Redox Description Texture ~ Structure ~ Consistence _ _ Boundary 1 0-20 10yr2/1 ! none ~ sil fill _ -- 2fcr dsh cs _- ---- 2 20-24 10yr3l4 none sl fill j 2msbk dsh r t I gw 3 24-36 10yr4/4 none ~ sl fill --~ 1msbk ~ -------_-_ dh I ~-------- aw - - ___- _ 4 36-53 10yr5/4 ~ none gr. s 0 sg dl w g 5 53-148 10 r5/6 I none I s Y - _ - - ---- 0 sg dl --- - -- ~ I i I ~ Grapnel in H #4 compose s approx 15% of ho rizon Boring # J Boring /J Pit Ground Surface elev. 98.36 ft. Depth to limiting factor > 147" in. ---- -- _ _ _ Horizon Depth Dominant Color Redox Description Texture I Structure Consistence Boundary F 1 0-10 10yr2/1I none ! sil fill ~ 2fcr i dsh cs T --- - -_ -- -------- a---------- 2 10-21 10yr3/4 none ~ sl fill ~ 2msbk mfr gw __ - - - -- - --- --- - -- -- -- - --- 3 21-30 10yr4/4 none I s 0 sg ml j cw ..._. T __._- _.. _. _- -__--"7 ___. i 4 30-59 10yr5/4 i none iI gr. s 0 sg dl gw T---- - 5 59-147 10yr5/6 ; none gr. s 0 sg dl - Gravel in H #4 & 5 comprises approx 10% of horizons. Page __2_____of __ 3 Soil Application Rate Roots _. _-Sa2~tff_- -- _ `Eff#1 `Eff#2 2f 0.0 i 0.0 -t-- - -- _ 1fm ~ 0.0 0.0 1 of&f ~ 0.0 0.0 - T_ - _ ~ -_ _ - 0.7 1.2 - 0.7 1 2 _.- - - I - r _. ~ ._ _ - Sntit .4pplicalen Rate 2f j 0.0 ~ 0.0 1fm ! 0.0 0.0 - ( 0.7 ' 1.2 --- ~ .____- t "-__. _~0.7 1.2 -r -_ _ ` Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 L + ~ Effluent #2 = BODS < 30 mg/L and TSS < 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. Borng # J Boring 1 Pit (~rrv ~.,~r c ~.f.,,.~ „i,., , a n.,...~. ,,, r.,..:.:-- `--•-- 9~. ~ ~:on zpk- z/~. a~~ Co. ~/~y. 't4 „ O \~ ~ J \b \\ ~~ \~ ~\ ^ ~o,l e/a/Ka~o~ ~, E • E7e~/a~~o>-~ -~ ,C~ ~lc~f C.ct.S~m /Y~rr[c~S ~ ~t~ 573 ~• may. ,4, f-(wds~.,, ter. /off /S SE Croix Z,~dusf_.~:a-l ~." 5 ~ ~ Crp ~ k ~o ,~ c,Jr. a ~ SSe (,~2ie [toc~,se 6F~ce bu,"~~,'„~ 7 ~'lvar. Assµ.Ked etev: -(oo.cv~ 79.0" ~~ok~ 83 ^ i ec`?. o0 ,~ - • ! 7. Oo' ^ a~ ^ ~ ~ ~ . ~. . ~ T,o aF /off S~tn~e . g i CIe% = 95.69 ; ,3 0~ r ~j as ~V(\3`1 Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in srrmlanrn wi4h l'rmm RS Wic Arlin C:rc1F± 1553 Page 1 of 3 AC.E. Soil & Site Evaluations ~~ Attach complete site plan on paper not less than S'/: x 11 inches in size. Plan must St. Crobc include, but not limited to: vertical and honzontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north crow, and location and distance to nearest road. 020-1286-50-000 Please print ail infonratYon. By Date Personal Information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ Property Owner ovation LaCasse Custom Homes, INC. Govt. I_ot NW 1/4 NE 1/4 S 21 T 29 N R 19 W Property Owner's Mailing Address M ~Y i ~ 2 # Block # Subd. Name or CSM!/ 573 County Hwy. A 15 St. Crobc In City State Zip Code hone~urIX <;U v"f C ~;~J ~Ilage Town Nearest Road Hudson ~ WI 54016 715~11fS~(~FFI E Hudson Co. HwyA 1/ New Construction Dce~ Residential / Nurr~er of bedrooms Code derived design flow rate ~ R~lacerrtent ~ Public or commercial -Describe: warehouse/office building addition Parent material Glacial outwash Flood plain elevation, if applicable General canments and recommendations: Install two trenches at elev. = 92.75' or higher using 42 high capacity leaching chambers. 900 nor GPD goring # -j Boring ~J Pit Ground surface elev. 99.23 ft. pepth to limiting factor > 150" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 "Eff#1 *Eff#2 1 0-14 10yr3/3 none sl fill 2fcr ds cs 3f 0.0 0.0 2 14-35 10yr2/1 none sil fill 3csbk dh aw 2f 0.0 0.0 3 35-39 10yr5/4 none s fill 0 sg ml aw - 0.0 0.0 4 39-49 10y1314 m2p 7.5yr4/6 sil fill 3csbk dh aw 2vf&f 0.0 0.0 5 49-58 7.5yr4/6 none gr. Is 0 sg ml cw - 0.7 1.2 6 58-150 10yr5/4 none gr. s 0 sg dl gw - 0.7 1.2 Redox fesxures described in H#4 disregarded by Comm. t35.30(3)(a)2. Gravel in H #5, 6, 8~ 7 comprises approx 15 of horizons. ~~ # J Bones ,~ Pit Ground Surface elev. __101.84 ft. Depth to limiting factor > 145" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIftz *Eff#1 *Eff#2 1 0-14 10yr3/2 none silfill 2msbk dsh cs 2f,1m 0.0 0.0 2 14-26 10yr3/3 none siclfill 3cpr dvh cw 2f,1m 0.0 0.0 3 26-32 10yr4/4 none sit fill 2msbk ml cw 2f&vf 0.0 0.0 4 32-44 10yr5/4 none silfill lmsbk dh cw 1f&vf 0.0 0.0 5 44-50 7.5yr4/6 none Is 0 sg ml cw - 0.7 1.2 6 50-83 10yr5/4 none gr. s 0 sg dl gw - 0.7 1.2 7 83-145 10yr5/6 ne gr. s 0 sg dl - - 0.7 1.2 * Effluent #1 = BOD ~ 30 <_ 220 mg/L and TSS > < 150 mg/L uent #2 = BODS< 30 mglL and TSS < 30 mg/L CST Name (Please Print) Sign CST Number James K. Thompson ~- 3602 Address A.C.E. Sal i£ Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson take Lane, Osceola, WI 20 5/24/02 715-248-7767 Property~Owner LaCasse Custom Homes, INC. Parcel ID # 020-1286-50-000 - Page 2 of 3 ~I ~`•~ tr~ ,,,` ~~ ~5 ~' Boring # Boring - --- ~/ Pit Ground Surface elev. _ 9$•79 ft. Depth to limiting factor >148" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots i 'Eff#1 'Eff#2 ~I 1 0-20 2 20-24 i 10yr'L/1 10yr3/4 none none ~ sil fill sl fill 2fcr 2msbk dsh ---- - - -- . dsh cs -- -- - gw 2f -------- 1 fm 0.0 j 0.0 --- r ---- -- 0.0 0.0 - - ---t- 3 124_36 ~- 10yr4/4 none - sl fill - 1 msbk dh aw 1 vf8~f ~ 0.0 ~ 0.0 4 l 36-53 _ 10yr5/4 _ none gr, s _ 0 sg dl gw - 0.7 ~ 1.2 --- ____ __T-_ 5 153-148 ~ 10yr5/6 none _ s 0 sg dl - - 0.7 ' 1.2 i Gravel in H #4 comprises approx 15% of horizon. ~n9 4 Boring # Depth to limiting factor > 147" in ft 98 36 . . __ . ~i gpplication Rate 1~ PR Ground Surface elev. - Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots p i, 'Eff#1 'Eff#2 0-10 10y2/1 none stl fill 2fcr dsh cs 2f 0.0 0.0 -_ 110-21~ - 10yr3/4 ~ ------ none ------ ~ sl fill ----------- 2msbk mfr gw 1fm 0.0 ~0.0 ----- -- --- -- ---- r-- - 21-30 3 10yr4/4 none s ~ 0 sg mi cw - 0.7 1.2 - 4 30-59 ~ --__-~- 10yr5/4 none -- gr. s 0 sg dl gw - 0.7 1.2_ ~ 5 ! 59`7 ~ 10yr5/6 none gr_s 0 sg dl - - 0.7 1.2 - _ i __ -_-~-- ~ _ ~ _ ~_- ---- Gravel in H #4 & 5 comprises approx 10% of horizons. Boring Boring # ~ Depth to limiting factor in . . ~ Pit Ground Surface elev. ~ - __ _ Sod Application Rate Horizon I De th Dominant Caa Redox Description Texture Structure Consistence Boundary Roots _ p •Eff#1 'Eff#2 -- ----+-- i --- -!-- - -- - ---- ---- I I ------+-- . ------- ~ I i --- ~ f---------- ---- - -------- - - -- ~-- - - - }--- - ' 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 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. . -~ ~. Hwy. ~;~ „ ~~. av~ O 9B. G Con ~ok,.- \, \~ C \3\ Q~ ,Qe~ ~ ~ss~ ^ ~;1 e dalcca'Eia~ A, E • ~ler/a~~o>-~ -~ A I S~Q-fie: ~ ~~ 5~0~ ,C_ Q ~ s~ (~,5~ ~S -~il~ 573 C'p. Nay. ,4, N~s~, ~i. ~o~ ~~ 5~ . Cro'X T,i dus~/ili./ ~. n ~ n E, ~e.c . 2l~ T , c~ flu- dson, S~• C'/'O~X Ce.~ cJ~. ~a Ca ssc ~~~-~K,S~ 6F~''ce bu.'ld,~ 3tnc1, wta/'K~ Top of ~,~:s~~ ~ ~' l ovr. Assu..-..ed a (eu: = lao.a>' ~~ 99. o' ~~ou~ B3^ i a~, oo ' Sfo~K f ~'~ r po' ^ 84 ^ ~ ~~. a.rK. ~ Top of''/ot S~iS'e• 8i E~ev: = 95.69; 3of3 Wisconsin Department of Commerce Division of Safety and Buildings ~- • SOIL EVALUATION REPORT in accordance with Comm 85. Wis. Adm. Cade 1553 page 1 of 3 A.C.E. Sal & Site Evaluations - --- -- ~ County • Attach canplete site plan on paper not less than 8'/: x 11 inches in s' must St. Croix include, but not limited to: vertical and horizontal referee and D Parcel I percent slope, scale or dimemsions, north arr to nearest . . 020-1286-50-000 Please print all i nna "on. ~ ~ 0 Revievued gy p~ 4 (1) (m . ; 3' 5 Personal lnformatan you provide maybe used for ndary pu (P~c~a ~XG C s Ca ~yL lon 19 W 29 tom Homes, INC. ~ G~~O F u sse La NW 1/4 NE 1 N R /4 S 21 T Property Owner's Mailing Address ZC ~ Lot # Block # Subd. Name or CSM# 573 County Hwy. A 15 St. Crobc In City State Zip Code Phone Number ~ City ~ village {~' Tawn Nearest Road Hudson ~ WI 54016 715-381-5405 Hudson Co. HwyA New Construction Use Residential / Number of bedrooms Code derived design flow rate ;_ f Replacement Public or canmercial -Describe: warehouse/office building addition Parent material Glacial outwash Flood plain elevation, if applic~le General comments and recommendations: Install two trenches at elev. = 92.75' or higher using 42 high capacity leaching chambers. 90U na ~ru ^ ~ Boring 1 ~~ # ~ Pit Ground Surface elev. 99.23 ft . Depth to limiting factor - > 150" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 DItt= *Eff#2 1 0-14 10yr3/3 none sl fill 2fcr ds cs 3f 0.0 0.0 2 14-35 10yr2/1 none sil fill 3csbk dh aw 2f 0.0 0.0 3 35-39 10yr5/4 none s fill 0 sg ml aw - 0.0 0.0 4 39-49 10yr3/4 m2p 7.5yr4/6 sil fill 3csbk dh aw 2vf8~f 0.0 0.0 5 49-58 7.5yr4/6 none gr. Is 0 sg ml cw - 0.7 1.2 6 58-150 10yr5/4 none gr. s 0 sg dl gw - 0.7 1.2 Redox features described in FI#4 disregarded by Comm. 85.30(3)(a)2. Gravel in H #5, 6, 8~ 7 comprises approx 15°h of horizons. 1 ~~ ~~y~~~1 9 ~~~ ~ `~r \~ . _1 Boring Z Boring # ~ Pit Ground Surface el~r. 100.84 ft. Depth to limiting factor > 155" in. Sal Applicaation Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP 'Eff#1 Dlft= 'Eff#2 1 0-14 10yr3/2 none silfill 2msbk dsh cs 2f,1m 0.0 0.0 2 14-26 10yr3/3 none sicl fill 3cpr dvh cw 2f,1m 0.0 0.0 3 26-32 10yr4/4 none sil fill 2msbk ml cw 2f&vf 0.0 0.0 4 32-44 10yr5/4 none sil fill 1 msbk dh cw 1 f&vf 0.0 0.0 .5 44-50 7.5yr4/6 none Is 0 sg ml cw - 0.7 1.2 6 50-83 10yr5/4 a r. s 0 sg dl gw - 0.7 1.2 7 83-155 10yr5/6 none . s 0 sg dl - - 0.7 1.2 * Effluent #1 = BOD 5> 30 <_ 220 mg/L and TS >30 < 150 mg/L ~ ~, Effluent ~#?f BODS < 30 mg/L and TSS < 30 mglL CST Name (Pl~se Print} Si ature: CST Number James K. Thompson 3602 Address AC.E. Sal 8< Site Evaluations Date Evaluation Conducted Telephor>e Number 340 Paulson Lake Lane, Osceola, WI. 0 Q ~~ -2 2 5/24/02 715-248-7767 1 1 •~ Stake of.Wisconsin 1 DEPARTMENT OF NATURAL RESOURCES October 14, 2002 Baldwin Service Center Scott McCallum, Governor 990 Hillcrest Street, Suite 104 Darrell Bazzell, Secretary Baldwin, Wisconsin 54002 WISCONSIN Scott A. Humrickhouse, Regional Director Telephone 715-684-2914 DEPT OF NATURAL RESOURCES FAX 715-684-5940 R.W. LaCasse LaCasse Custom Homes 573 Country Road A Hudson, WI 54016 Subject: On-Site Sewerage System Dear NIr. LaCasse: The Department does not object to installing the proposed floor drains in the office and warehouse facility that you are proposing in Hudson Township. However, as noted in the Department of Commerce .approval letter and in accordance with s. 283.31, Wis. Stats., the release of any »ondomestic wastewater into the floor drains is unlawful unless it is discharged under a permit issued by the department. Please contact me at (715) 684-2914 if you have questions or concerns. Sincerely, Peter W. Slcorseth, P.E. Environmental En~nneer c: Bob Baczynski - BSC Gary Zappa -Zappa Brothers Excavating, 715 Sixth Street North, Hudson, WI 54016 www.dnr.state.wi.us Quality Natural Resources Management www.wisconsin.gov Through Excellent Customer Service Rec~led' Patter ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address 5,.~' C7y .~~ / y' ~~~~,.r'v Property Address sJ~ (~}- /f'r,~ /4 ,/~ v.,i . ~/~. ~5~~'U/~ (Verification~requ~ired from Planning Department for new construction) City/State ,~~ o~ h/~ . Parcel Identification. Number ~~~; c, -ate ~E - ~~o - o ;, ; ~ LEGAL DESCRIPTION Property Location ~'/,, ~ %,, Sec. ~, T ~2~N-RL~W, Town of /~~ Subdivision ~jT (:zaz~c 1ivnt~r7~,-~~ /i~~k ,Lot # ._~. Certified Survey Map # - ,Volume t ,Page # Warranty Deed # S~aYyi ,Volume /~~ ~= ,Page # ,_?~S Spec house ^ yes ~ no Lot lines identifiable Ll yes ^ no SYSTEM MAINTENANCE 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 masterplumber, journeymanplumber, restricted.plumber or a licensedpumperverifying that (1) the on-site wastewaterdisposalsystern 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 maiptained must be completed and returned to the St. Croix County Zoning Office within 30 ~day%s of the three ear expiration date. `Y` ~ ~ / Z1/ '® SI NA 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 descr' d above, by virtue of a warranty deed recorded in Register of Deeds Office. ~~~~ /U l 2~l v Z. SIGNATURE 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 r T ~~ 4 S~Q~=~1 .~anau unat Ur 1YlJl:UN51N !''ORD1 i-lOBA . _ WARRANTY DEED ThiB Dead, made between ..,.SAj,Rk..GXR1,X..Y.enkuLes,.............. ,_a Minnesota..general„~artnerst;~,p,,,,,,,,,,,,,„__„ ...................... ........................ ........................................................................, Grantor, and..LaCasse ~ust~m Homes.;„In~,t,,,,,,,,,,,,,,,,,,, ..............................................................................................., Grantee, Lv11;R8998~h, ?het the said Grantor, for a valuable consideration...... :onveya to Grantee the foilowlnr descrtbod real estate in ...SC.e...C.t:_9.i~...___...... County, Stab of R-isoonstns ' /T~~ REGISTER'S ~ OFF(CE ST. CROIX CO., wl ~u+v o 5 198 RwlsfK of lle.de enueN ro ~1N1 Ta: Pareel Nos ................................... Lots 14 and 15, St. Croix Industrial Park, Town of Hudson, St. Croix County TRANSFER $ 3/Fl Lo FEE This ...,is..not , .,,, homestead property. (Is) (ii ootj Torether with all tad sintular tfie hereditamenta and sppurtenanees thereunto belongin`; And...,. Grantor wsrrants thst the title I^ rood. indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record and will warrant and defend the ssme. r Dated this ..............G!~~~..................... day of ...... ~.:!.~1...!.....................................:............. 19.98.... i rsEAL) ...Sr~.~AC..G><R~X..ZI~AC17'/ ~5 .......................(SEAL) i ~~~ ,~~