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HomeMy WebLinkAbout020-1437-14-000~ n ~ Q i ~ ~ n r_ °c ~~ j 3 ~ 3 d v1 ~ I ~ ~ I~ ~7' ~ ~ ~ r+ n ~ p~j m O ~~ d I' C N N ~t ~ • ~ a 7 3 y ~ y t J ~ N O "ry n i A I N~~ ~ v o ~~ ~ n ~ O ~ M ~ 7 -Ow O O ~ e - p1 C m % ~ 1 !r ~ m ~ A N o ~ ~. r. l d e ~ ~ I ~ c 3 ~ w O ~ ~ o'. o o I ~ C I c ~o ~ ~ C N N O O O A O C O ~ N Vt C7 ~ !~! C 3 o. n ~ ~ O Q z o O ~ c ~ --2I11 --2211 vai ~ o' ~ m ~ A ~ ~ j m I ~ ~ ~ ~ ~ ~n i Si ~+ ' ~ 3 ~ _° ~ ~ ~ O I a I .. z N Zoo o ~ _ D ~. I , ~~ I ~ ~ ~ o ~ y ~• ~ ~ y C ~ • N I W ~ ~ a ~ O ~ p Z W ` N j ~ ~ I ~' ~ m o, ~ A ~ .. I ~ '~ ~ ~ ~ N ~ a a ~ z ~ ~ A ~ O "•' ~ ~ (A I w m 2 ~ ~ A I ~ ~ I s,~~v+~~ c~y~;~mc» NO Vl aim Q~ ~ O v 1 1 ~ ~ ' ~ ~ _ ~ o. Q I ~ ° ' i I zn°' ~ f Fov_o = ~ - °-y m a, ~y oa''m ~ z ~ ~ a ~ ~ ? cn~-1• y am ~ n~ ~ ~ ` ui+' OC N ~ O f 0 a - ~ ~ N f v O n ~ ' < ? O O ~ ? S C I .y. y~ '~ ~`~fDp~ I ~ a y C O fD 7 ~fD 3 ! ti . .N ~ O1 4l, 0 i ~. y ~ 0 C 7 ~ a 0 `t 0 0 ~'~ ~f° ~ I ~ ~ o ~ ~ ~ ~~c~i3o~ I fi m.~ m, O ~ ~. n ~ 7cQ< N . y Q y y Q~p 'O ~ r. N I a C~ ~ ~ ~u = o I w obi a ~ a m ~ 3 '° ~ a O ~ ~ A ~ I! Op +~~+ ~ 0 , I A ti , ~ ~ y y ~ L ' V Pam Quinn Subject: O'Connell, Kelly Estates Lot 14, 463286 Location: Hudson Start: Wed 1/26/2005 3:00 PM End: Wed 1/26/2005 4:00 PM Recurrence: (none) ~I' ~. ~ ~ ~ ~ ~~ a...~ ~- (~ r~~ 2 (fib .:-, `~" ~ ~ ~ J ~ r 3- ~/ ~al~s'^~y„rp'" i Safety and Buildings Division County ~ m 201 W. Washington Ave., P.O. Box 7162 • ~~~~~~,n Madison, WI 53707 - 7162 Sanitary Permit Number (to a filled in by .) De artment of Commerce (608)266-3151 ` lD Sanitary Permit Appli Q State Plan I.D. Num~ In accord with Comm 83.21, Wis. Adm. Code, personal in d~ D may be used for secondary purposes Privacy Law, 5.0 Project Address (if Brent than mailing address) 1" I. Application Information -Please Print All Information " _ ~ `" 1 ~ Property wn 's Name P cel # Lot # ~ Block # r_ roperty Owner's Mailing ddress perty Location ~ ~~ 1 pl .~ ZU~ ~d.'r~. City, S Zip Code Phone Num r '/., ,,~_%,, Section .--~~J~ (circle gg~ T ~ N R~E ~V~ II. Type of Building (check all that apply) ~ . ; o> 1 or 2 Family Dwelling - Number of Bedrooms Subdivision a ~3lvi-Nomber ^ Public/Commercial -Describe Use ^ State Owned -Describe Use f S? ~ C r:~~ ^City_^V' age~To ship of III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) `~~ ^ New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration `-~~ Plumber Owner /~j ~ ~1 p / ~ Sr / ((l`// Ql Q (O IV. T of POWTS S stem: Check all that a Non-Pressurized In-Ground ^ Mound> 24 in. ofsuitable soil ^ Mound <24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Gr Ho 'n Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recircuiating Sand Filter ^ Recirculating Synthetic Media Filter hing Chamber Drip Line ^ Gravel-less Pipe ^ Other lain) V. Dis ersalll'reatment Area In o ~ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sfJ spersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Units Concrete Constructed Glass New Foisting Tanks Taoks Septic or Holding Tank Aerobic Treatmem Unit j, 1 t/V Dosing Chamber VII. Res nsibiiity Statement- I, the undersigned, assu responsibility for installation of the POWTS shown on the attached plans. Plum er' a (Print) Plumbe s Sign a MP/MPRS Number Business Phone Number Plumber s Address (Street, ity, State Zip ode) ~~io ~ VIII. Co /De artmen se Onl pproved ^ Disapproved Sanitary Permit Fee ncludes Groundwater Date sued I ing A [gnat M s) ^ Owner Given Reason for Denial Surchar Fee d~_ ~ ) t/Q~ Z 2 Q IX. Conditions of Approval/Reasons for Disapprov l a ~ ~J ~ ~~ ,., naacn compiere pwns tm me ~;ounry onry~ for me system on paper not tesa lean alt x I I inches in aixe '~ ~L.~ SBD-6398 (R. 01/03) ~\ ,~ ~~ ~"" ~~ y ~~ ,a Z~ 1\ V ~. ~ s py ~- ~~" U ~ , ~, ~a „~ ~ ~ a ~v ~ ~_~,~ \~. ~~ 4 ~_ C~ _4 C~ b n; I ~ ~~ z ~ P W ~- ~ ~ U \' W ~\ ~~ ~ ~1~„~ ~ ~ n R~_ S/ ~~ Wisconsin Department of Commerce SOIL EVALUATION REPORT I~ ~,Pp~? Page~of ~S~ Division of Safety and Buildings W `~/1" - m accoroance wiui t,omm ca, vws. i+am. ~.oae County er not less than 8 1/2 x 11 inches in size Plan must Attach com lete site lan on a p p . p p include, but not limited to: vertical and horizontal reference point (BM), direction and Panel I.D. fy ~ ~ ~~ ~~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~ ~ ~.~ ' `'~-TJ Please print al! information. R awed Date ur oses (Privac Law e 15 04 (1) (m)) Personal informatio ou ro be used for seconda id \ ~ ~~ p y . . . p ry p , n y v e may Property Properly Location - ! - Govt. Lot 1/4 ~ 1/4 N R ~or~ Property Owner's Mailing ddre Lot # Blodc Subd. N or'6S(dl#-' / ~- ip Code Phone Number City City village own Nea t Road L ( ) 2 r New Construction Use:, Residential ! Number of bedrooms Code derived design flow rate 1,~4~'I GPD ^ Replacement ^ Pubtic or cammeraal-Describe: Parent material c*~ ~ti~~-Sii Flood Plain elevation if applicable ~,, ~ ft. General cemments ~ ` ~ Q% s~~~~lY" . and recommendations: 5" ,~iy, F-,~ ~~~ c~-CX.S ~t.s ~~ / Boring # ~ Boring ~~, ~ 1 n ~ ~,~ -~ pit Ground surface elev. ~~, ~ / Depth to li ting factor,}/~~ _ in. Soil lipflon Rate Horizon Depth Dominant Color Redox Des Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. CoM. Color Gr. Sz. Sh. 'Efi#1 "Eff#2 3 ~ - i 7 _ _ ~ ~ f Boring # ~ Boring ~ pi( Ground surface elev.. . ~ r _ft. Depth to limiting factor >./~S in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 +3 ~ a e p 9 uent #1 = BcJD > 3tJ < 2Z0 mglL antl T55 >30 < 150 m * Emuent #Z = BpD < 3U mg/L antl r ~ < su mgrL CST (Ple P ' T CST Number ~ ~- Address Date Evaluation Conducted ~ Telephone Number Properly Owned=$1~'' Paroel ID # Page ~-~ of ~_ Boring # ^ Boring ~] pil Ground surface elev. ~ ~1 ft. Depth to limiting factor ~ in. -Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Raots GP D/fF in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. "Eff#1 *Eff#2 - 3 ~ -.~ ~ ~ 4 4 s 9 0 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil tication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/tt= in. Mur>seil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODe > 30 < 220 mglL and TSS >30 < 150 mglL * 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. SBD-6330 (R.07/OD) ~l f~, ~.c i `w ~, ~ ''~®`~~ ~ ~~~ ~ o~ ~j ~ ~~~~ ~~ ~, ~, ~' ~~ ©~~ 4 G ~ ~ Ce J ~ o "~ ~~ k o - - _ O ~ ~ _ ~ ~. h., U~ m ~\ G~ WI ~1~~ ~ ~ m> >, n 3 !° ~ 1 ~' eo ~ so ~a so .. ~ (n ~ ~ > Z ~ ~ N C N N ~ • ~ 7 ~. ~ N ~ f.J (7 ~- N ~ ~ I~ n- ~ p n N OD y O V A n N o- 7 7 ~ p j -~ ~ ~ ~ ~ ~ ~ ~ ~ O I ~ 7 fB .~ ~ O Q ~ c 3 I ~ ~ cn v y ~ 4 ,. a ~. ` `° ~ `H ? W a c C ~ a o ~ ~ ~ o o `O m Imo, I O ~ v ~ ~ ~ rn ~ ~ 3 N ~ Z ~ ~ o t ~p oo~ nrcn p ~ a ~ ~ 0 3 a' a c p Z 000 Q ~ N ~ l~l C7 c l f/ fJl 3 ? m I ! V a ? ~ ~ ~ o ~ `G m ~ ~ ~ ~ ~ ~ ~ 3 d J 3 ~ ~ N N Q Fl- o .. N ~ ~ c ~~ ~ ~ o~~ ~ ~~ ~o~ N~ ~ ~ ~ • ~ ~ ~ y p ~ I ~ ~ d ~ ~ n N ~ C R W A I A Z ~ O O W N Q a (~ ~ T n j A i w ~p n a A~~ N W ~ N N I ai a d~ ~ 3 s Z a I ~, ~ s $ _~ ~ cn `~ 3 m ~ y ~ ? ~ A ~ o ny ~ ~ ~ ~ a ~ ~ c °' ~ sa v C am ~ ~ ~ y o a ~°-mm m v m ~ < ~ I ~ ~ _ mo 4 ~ ,~~ o. ~ a_O ~?c0 ~ ~ 3 ~ m ~ a~ ° ~ ~ ~ ~ i . ~~ w a ~ o~ (A y Q~ y 'd (D ~ N I > > ~ _~ y 3 a 1 7 7 ~ N :. .,1 ~~ O' ~ ~ ~. A O ~ ~ ~ d0 V ~ ~ ~ ti ~ O fl- Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. hermit Holder's Name: City Village X Township LaCasse Develo ment Hudson, Town of SST BM Elev: Ins BNJ, EI~ BM Des n: ~` - , TANK INFORMATION l/~nlV1 '~+'C ELEVATI N DATA TYPE MANUFACTURER CAPACITY Septic , A ,yam / _ (/C/~-~ ~ ~ ~ Dosing ~~ Aeration Holding ~ ~~~, TANK SETBACK INFORMATION TANK TO P!L ~ ~--- WELL BLDG. Vent to Air Intake ROAD Septic 4~or d .{. Dosing Aeration Holding PUMP/SI~ON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction L System TDH Ft Forcemain gth Dia. Dist. to well county: St. Croix Sanitary Permit No: 463286 0 State Plan ID No: Parcel Tax No: 020-1437-14-000 Section/Town/Range/Map No: 22.29.19.2719 STATION BS HI FS ELEV. Benchmark ,3~ Ia3~ ~~~~ Alt. BM ~~~ 3•~~- Bldg. sewer ~ ~3 SG ~„~p 6.~3 St/Ht Inlet 'S aL z• ss' ~. 3 St/Ht Outlet ! 'g~ ~~. O Dt Inlet r ~_ Dt Bottom ~~ ~---~ Head /Man. (` ~ ~~. Dist. Pipe Bot. System a~~ ~ ! ' ~ ~/ 7'~ Fi ~~ ~ p ~ - ~ 7 ~' ~ St Cover ,r t~ ~ lv~ l oa •a SAII ORSnRPTInN SYSTEM ~~ 2P/~ . ~e ~ ~ ~- ~~--~v~d~ BEDITRENCH Width Length ( o. Of Trenches PIT DIMEN No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ /„T1 ~(/V SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER ORAMBER OR t f 1~ /I'"' f' Type Of System: ~ ~ ~-~ 3 UNIT Model Number: ~ ~ ~~ a /!/ DISTRI6IJTION SYSTEM SW a-f,~.a~J111 non _. Head anifol~d/~~ ! % Distribution` _ t /'1~ ~ Pipe(s) ~ ! ~ ~ L x Hole Size x Hole Spacing Ventpto it I ke r ~ ~ ~~ Length Spacing Dia Length ~ f C(111 r(1VFR ., o..,~~.a c..~~e..,~ n.,~.. .... ~u.,~~.,.i nr A4_!_rarla Svs4oms F7nly Depth Over ~ Depth Over - xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ /„ Bed/Trench Edges Topsoil (,_~ Yes ~~"J No ~~ Yes ~ ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z~P / d5 Inspection #2: / / Location: 809 Heritage~Co(u`rt Hu~/ds~on, WI 54016 (SW 1/4 SE 1/4 22 T29N R19W) Kelly Estates Lot 14 P rcel No: 22.29.19~.,2~7~1~9,~ -` 1.) Alt BM Description = --~` ' ~• "",- ~(~~~~ ~(/WE~-.~- q ~ " ~ f~C~ ~ Sl! _ - " ~~l" 2.) Bldg sewer length = ~ ! 77 - amount of cover =~ ~ + _, j(~g /~ a iQ t ~ ~~c ~ _ ~~~~ ~ ~~ ~ Plan revision Required? +? Yes ~ ] No n ,~;-,~~~[. i~_~l ~~I ; ~ i ~~~~~~t~ Use other side for additional information. _.___. ' _.- -_J ~ ____1._ _' / L __ > Date Insepctor's S nature Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division 201 W W hi County S ` m m . as ngton Ave., P.O. Box 7162 ,S~O~~,~ Madison, WI 53707 - 7162 Sanitary Permit Numbef (to be filled in by Co.) De artment of Commerce (608) 266-315 J ~ 2 Z Sanitary Permit Application ~ State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provi 0 may be used for secondary purposes Privacy oject Address (if different than mailing address) I. Application Information -Please Print All Informatio .~ Property wner's Name JAN 0 4 2 0 0 5 P e 1# Lot #/ Block # -1.. _ a} Property wner's Mailing Address Property tion ZONING OFFICE .' ~~ ~~ ~ ~~ City, Stat Zip Code Phone Number '~ Section ~_ '' ~- - ~~ ~ ,~,(circley~ 3i/ T N R E II. Type of Building (check all that apply) / y~~s..r f ,~.' ; ~ -- or2FamilyDwelling-NumberofBedrooms /f _ _ ubdivisio Name ~'9IvFFtornbee v ^ Public/Commercial -Describe Use t^Otri+,N r - ^ State Owned -Describe Use Cs~.St Q ^City Villag ownshi of III. Type of Permit: (Check only one box on line A. Complete ' e B if applicable) OZO - ~ ~ - I ~'"~ • 2~t' `4" ~ New System ^ Replacement System ^ Treatm~t/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWYS S stem: Check all that a 1 Non -Pressurized In-Ground ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Sing(e Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatm ent Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Ch r ^ Drip Lie ^ ravel-1 s Pipe ^ Other (explain) V. Dis ersaVl'reatment Area Information: Z Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requi~(sf) Dispersal Area Proposed (sf) ystem Elevation C , .5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units w' ~w~ A,_ / d'U Concrete Constructed Glass New Existing EJ ~- l ¢ " "f't ~~ Tanks Tanks f ,~ y w~ Septic or i-folding Tack r (/ S Aerobic Treatment Unit Dosing Chamber VII. Respo ibility Statement- I, the undersigned, ass a responsibility for installation of the POWTS shown on the attached plans. Plumb am (Print)' ~ Plumbe s Si MP/MPRS Number Business Phone Number Plumber's ddress (Street, City, S ,Zip ode ~ )~ VIII. Coun /De artment Use Onl ~j Approved ^ ved Sanitary Permit Fee (includes Groundwater Date. Issued I ui Agent Signatu (No Stamps) ^ Owner rven Re or Denial Surcharge Fee) ,~,}1{p- ~ ~ ~ a ~~ 1X. Conditions A p va val ~ SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. wmpere pwna tro we a.ouory onryi rot me system on paper not teas t[wn airs : r r mcaes to atze SBD-6398 (R. 01/03) M /81r tl.~ -r~ _ v •MC ~ `~ / ,~~` • p^ , ~~ '4 i ~~ w ~~. _ ~~s """~~~ - ~ ~ ~ `"~f'\I _ 9 ~~~~ _~ ~ ~ ~ ~ ~~ ~~~~ ~~ c ~~ ~~~~ ~~ ~~~: _._I ~, ~. ~~~~~/,~ G^,~?Y f .' t5., \~ ~~ v ~~ ~ t ^ ~ vl ~~ \~ ~: ~, ~~~ ~ ~~ ~ r ~~ '~ \~ ` ~~ ;~ ~.~' ~ C~ ,M 1~~ °' ,~ _ ~_, 4 .~ ~._ + I I __ ~ 1 ~~ ~__~~ ~ I ,,; - ~_ ~ 1~no~ -~ ~~j~~~ M ~~ .~~'.~~ ~~~ _fi~ \~~ ,L ti+! .~ .8/ ~;l o ~I ~ ~., J ~~ S `"^ ~- .~\ J \ ~~~ ~ __ ___ ~ ~ ~~ti ~~ ~ ~~~ 1~ .. l ~ ~[[\~~ ~ ~ v / . 11 r ~~ 1~~ ~- Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Cou Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must include but not limited to vertical and horizontal reference point (BM) direction and 1220 ;`~~' `; ~ inn/ Pag 1 of 3 teal Sal Service _._ _..... ..;~1~.I t.C{~UXe.~ percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Pending Pease print all information. R ~ By Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1} Im)). O Property Owner Property Location Reliant Developers LTD Govt. Lot SE 1/4 SE 1/4 S 22 T 29 N R 19 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 9900 Valley Creek Rd. Suite 135 14 na Kelly Estates Citv l.(?OO~CR~cJ. State Zip Code Phone Number City ; ~Ilage Town Nearest Road I MN 55125 651-731-3174 Hudson Heritage Ct New Construction Use: '~; Residential /Number of bedrooms ~ 4 Code derived design flow rate 600 GPD _ Replacement Public or commercial -Describe: Parent material outwash plains and stream terraces Flood plain elevation, if applicable na General comments and recommendations: System elevation 92.75ft, trenches spaced and depth to code 6.75ft below grade Boring # __' Boring 118 l~ Pit Ground Surface elev. 99.50 ft. pepth to in limiting factor . Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 'Eff#1 *Eff#2 1 0-10 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 10-23 10yr4/4 none scl 2msbk mfr gw na .4 .6 3 23-53 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 4 53-84 7.5yr4/4 none Is osg mvfr cs na .7 1.2 5 84-118 7.5yr416 none ms osg ml na na .7 1.2 ti ' ~ ~~ «' Boring # ..~: Boring ' ! 118 iV , Pit Ground Surface elev. 99.50 ft. pepth to limiting factor in. Solt Application Rate Horizon Depth Dominant Color Redox Description Texture Stuucture Consistence Boundary Roots GPD/ftz 'Eff#1 •Eff#2 1 0-13 10yr3/3 none sil 2msbk mfr cs 1c .5 .8 2 13-24 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 24-34 10yr4/4 none scl 2msbk mfr cs na .4 .6 4 34-69 7.5yr4/4 none sVls 2msbk mfr gw na .5 .9 5 69-84 7.5yr4/4 none Is osg mvfr cs na .7 1.2 6 84-118 7.5yr4l6 none ms osg ml na na .7 1.2 - tmuent 4f1 = tsw 5> 3u < zzU mg/L antl T55 >30 < 150 mg/L "Effluent #2 = BODS<_30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatu ~ CST Number David J. Steel C~ 248956 Address Steel Sal Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 10/22/2002 715-246-5085 Property owner Reliant Developers LTD Parcel ID # Pending Page 2 of 3 Boring # ' Bonng ~/ Pit Ground Surtace elev. 99.30 ff. Depth to limiting factor 118 in. ~~ gpplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= 1 0-10 10yr3/3 none 2 10-20 10yr4/4 none 3 20-45 7.5yr4/4 none 4 45-118 7.5yr4/4 none *Eff#1 'Eff#2 sil 2msbk mfr cs 1f .5 .8 scl 2msbk mfr cs 1vf .4 .6 sl 2msbk mft gw na .5 .9 ms osg ml na na .7 1.2 I 1 Boring # 'Boring * Effluent #1 = BOD S> 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = SODS ~ 30 mg/L and TSS <30 mg/L The Department of Commr-_ _ - .._ _-a..--, .. " : .,- - ..... _ -_- _ _ Boring # - ' Boring ~ , Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel CST-POWTSM Lic. # 248956 ~~v `~ (~ i`~ ~~ /ate ~~ 5~~ N ~ ~~s ~- ~~ 7 ~~` ~.; G~ ~~ (,~ . l~ 22~ Reliant Developers LTD SEl/4,SE1/4,S 20,T29,R19W Town of Hudson, St. Croix Co. Kelly Estates lot 14 1564 Cty Rd GG New Richmond, WI 54017 (715)246-6200 (715) 246-5085 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil test was conducted. Legend 1" = 40'/ Benchmark EL 100.00Ft op of '/2"pvc pipe Alt Benchmark E1.98.90Ft Top of/2" pvc pipe s~o~- ~~. ~/~~ ~Q{_F ^ =Borings Boring Elevations B1 =99.SOFt ~ B2 =99.SOFt B3 =99.30Ft ` B4 =OO.OOFt ~~~~~~ ~~ S ~~.~ for ~~ ~ `N ,s3 l~in~ . ~~ ~ ~ .4 ci, 3~~ ~3 ~~ ~~ ~ ,'ne ~ ~~ ,,~ca I V t J~ ~` iI .t \~ \`Iy 1 ~- ~ \ w L~. ~.i` ~~~ I w t ~• •~ „-_.•c_w~ yw-' ~~' . ~ ~ ~/ I i ~ r / ` ~ 1 err\~' ~`~It,, I• N ~'~ \,~~ +, `` }`prj ~i'~ r y~~wl r ~ ~ d 1 I ~ . - `•'~ ~ i s 70. 7 I to 41r~'`' t ~ '` r i,/ r~ 4 I~> . 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K_, -- u• QED AG-RE ~~,~~ ~T,oc~so lml~tss,.nc n Ir- 1 t ^~ ul r ~. -r'• ~, i ~- 1 r 1 T I /'\ A I I Y_1~._1~__x-__J1_1..._tie_1_ ~ -~ -j'~-1~ --_.C~ _~L_1/__! _L_! `1_lY >o ,( I ~t'1i n m n O ` J `," , I ~ -1 -a ~ ~ OC Sin r_IZ*t ~D ;p .'D ( ~ ~;~~. 1.1~ ~f 7~ ~~o ~ yo x°~ ~~ b d ~ ~~" oD L _ _ f z = Oz Om ~ ~ ~ ~ - 'Dt'7V1 rip Z.. ;~ ~~ V ~ ~ S S ~Vi 8 NF~ m r 1~ ~ R ~ n X I• ~ ~~ ~ ~ ~ 6~E ~ ~ ~~ r ;~ ~ ~ N m 7 .. r.-t~ 0 Preliminary Plat of KELLY ESTATES ~~ James R. Hi~~, lwlw -, tt» seYWo.t Waw a tnr swl..ew wo,a, I• to. s°•u~...t a..t« N m. twm«n Ouat«. M fn S•elkn 22, Te.n 7Y ibrU- Its~q• 1° iTyt, Twn N MyMen, St. (.rol. Ce•My, Mi•eenin DI °\Il1~DC / ntMt.IfTDC / MIDt,I" POWTS t~NER'S MANUAL & MANAGEMENT PLAN,,.,. , FIt.E INFORMATION -~ s / / Owner ~ ~ ~ ~ Permit N 3 neernu oeaennGTFaC Number of Bedrooms Q NA Number of Public Facility Units NA Estimated flow laveragel al/da Design flow Ipeaki, (Estimated x 1,51 al/da Soli Application Rate al/da /ft~ Standard Influent/Effluent Quality Monthly ave rage* Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD6t 5220 mg/L ^ NA Total Suspended Solids tTSS1 5150 mglL Pretreated Effluent Quality Monthly ave rage Biochemical Oxygen Demand IBOD6) 530 mg/L Total Suspended Solids (TSS- 530 mg/L ~NA Fecal Caliform (geometric mean) 510° cfu/t00rnl Maximum Effluent Particle Size Ye in die. ^ NA Other, ^ NA *Values typical for domestic wastewater and septic tank effluent. Pane ~, of~ SYSTEM SPECIrICA r runs y Septic Tank Capacity.. ~ ~ l al O Nl~ ._ ~ Septic Tank Manufaaturer ~~~ ~ ~ ~ ~ ^ ~'~' - Effluent Fitter Manufacturer ~ ^ N~~. Effluent Filter Mode! ^ NA Pump Tank Capacity al ~N`"_~ Pump Tank Manufacturer ~ ~~~~ ~ Pump Manufacturer ~ ( ~' NA f Pum Model p .~-NA _ Pretreatment Unit . ~ NF ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland O Disinfection 0 Other: 1 Dispersal Celllsi ^ NF' fi'~In-Ground (gravityi D In-Ground tpressurizedl At-Grade Q Mound ^ Drip•Linu Q Other, Other; D Nfi Other: ^ NA Other. ^ NA I MAINTENANCE SCrtEDUt.e Service Event Service Frequency Inspect condition of tank(sl At least once every: ^ monthls) " (Maximum 3 years} earls! ,. ^ NA When combined sludge and scum equals one-third lY=) of tank volume [7 NA Pump out contents of tankls) Inspect dispersal cellls) At least once every: ^ monthlsl''` (Maximum 3 years? year(s) Q Nh ~ __( Clean effluent filter At least once every: ~ ^monthls) ~ ~year(s1 O Nt•. _~ ^ monthlsi ~-.Nf. Inspect pump, pump controls & alarm At least once every: ^ bar(s1 ~. Q monthtsl. ~: , ~Nh Flush laterals and pressure test At least once every: ^ aerial , Other: At (oast once every: O manthtsi Q ear(s) Q NA Other Q 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; Septag® Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any creaks or leaks, measure the volume of combined sludge and scum and to check for any beak up or ponding of effluent on the ground surface. l`he dispersal cellls) shall be visually inspected to check the effluent levels iin the observation pipes and to check for any pondini~ of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the: immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y31 or more of the tank volume, the entire contents of the tank shall be removed by a Septaga 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 512 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.. t3MW 1410 7 }~yr~.~~,; PaQ6 ~ Of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanktsl for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal celllsl. 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{sl In one large dose, overloeding the oellts! and may result in~ths bwkup or surfao~ discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septape ServicinS Operator prfor;to rot-toring 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. Uo riot drive or park vehicles over tanks and dispersal cells, Do not drive or park .over, or otherwise disturb or compact, the aru within l5 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; herbicid~s;;:meat~ scraps; :medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the followiny steps shall be taken to insure that the systdrn 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 ~e~led,,r„ • The contents of all tanks and pica shall be removed and properly disposed of by a Septape ,Servicing Operator. • After pumping, ail tanks and pits shall be excavated and removed or their covers remOVed and the void space filled wi[i~ soil, gravel or another inert solid rnatorial. CONTINC3ENCY PLAN If the POWTS fails and cannot be repaired the following measures have bean, or must be taken, ,.to provide. a coda 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 prptect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area.- Replacement systems rnusi comply with the rules in effect at that time. © A suitable replacement area is not available due to setback and/or soil limitations, 4arring advances in POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS.-~--~~°~~- ~ - -=-- ~-• ~~ - Q The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area,. If no replacement area is available, a holding tank may be installed as a last resort to replace the failed POWTS. ,.., ..:, ... :.... ~l Mound and at-grade soil absorption systems may be reconstructed in place following removal of the t>iomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULTr RESCUE pF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS ~. • . ire rr , riri? POWTS INSTALL R POWTS MAINTAINER Name ~ >% ~ ~ Name . i Phone _ S "` _ Phone 5EPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ~a ! ° ~ , a' :~~{ ij~ .~' Phone ~^ ._S ;r ,. ~,',~ r,. ~ ;'his document was drafted In eompllance with chapter Comm 83.2212)Ibit1)IdJ&(f! and @3.6411), 12) & t31, 4Ylaaonrain Administtative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~.. ~lC~ s ~.~. ~ -e J~c~~w,Pv~ .~-w'~ Mailing Address ,~7~ l„ ~/ ~~_ /~ ~ S~1yt--, [,~ ~o Property Address O ~~ c c.~ ,~--~ ~ ~ ~ Z (Verification required from Planning Department for new construction.) City/State LEGAL DESCRIPTION Parcel Identification Number D 2D - ! ~3 ~ -/ ~{-OUO ~. Z~/ 9 Property Location 5 (.cr 1/. , ~'/4 ,Sec. 2~ x- , T Z~~N R~W, Town of ~~ ~~''~- Subdivision 1°f ..~, L L ~~ S' ~ ~~ ~ ,Lot # ~. Certified Survey Map # -- ,Volume ,Page # Warranty Deed # ~J~~~o ,Volume 2 S3S ,Page # Spec hour yes no Lot lines identifi le yes no ~9s- . 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. Owner maintenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal 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 Department within 0 days of the three year expiration date. ~~/~ I ATURE OF APPLICANT DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the Wiest of my/our knowledge. Uwe am/are the owner(s) of the pr pe de ribed a ve, y virtue of a warranty deed recorded in Register of Deeds Office ~~ `z /~/~ SI TUBE OF APPLICANT DATE ****** .Any information that is misrepresented 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 and a copy of the certified survey map if reference is made in the warranty deed. . .. _ , ~ ~ V V tJ ~ i ~,7 ~ ~ J ~- G7 KATHLEEN ,H. WALSH ' REGISTER C)E' DEEDS ST. CRDIK CD. , MII STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FDR RECORD WARRANTY DEED 03/29/2$0~F 09:I0Alt Document Number WARRANTY dEED THIS DEED, made between ,Reliant Developers, LLC, Grantor, and EXEMPT ~ - LaCasse Development, Inc., Grantee. REG FEE: 11.00 Grantor, for a valuable consideration; conveys and warrants to Grantee TRAMS FEE: 4@74.00 the following described real estate in St. Croix County, State of Wisconsin: GDFY FEE : Lots 2, 3, 4, 5, _?, 8, 9; 1 I, 13, ~ 15, 16, 17, 19, 20 and 21, Plat of Kelly CG FEE: pgSEg; Z Estates, St. Croix County, Wisconsin. ~~ Recording Area Name and Return Address: Edina Realty Title, Ina 400 S. 2na St. - Su1te 115 Exceptions to warranties: Hudson, 6VI 54016 Easements, restrictions and rights-of--way of record, if any. 423495 020-1060-30-050,020-1059-90-0 Qp Parcel Identification Number (PII~ This is not homestead property. Dated this 26th day of March, 2004. Relic evelopers LC B~ * ick Toston, Chief Manager, Reliant Developers, LLC * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. . authenticated this 26th day of March, 2004 TITLE: MEMBER STATE BAR OF WISCONSIN ,f (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Peterson, Fram & Bergman -Steven H. Bruns 50 East Fifth Street, St. Paul, MN 55101 Personally came before me this March 26, 2004 the above named Ric oston, Chief Manager, Reliant Developers, LLC torYne^Icnown to b the person(s) who executed the foregoing instrument and ackn ledged the same. Notary Public, State~f Wiscons M commission is a °Ii'"~i}I!'~ ate: ii4i2oo7 ~____ JUDY LARRI~U~~ ) (Signatures maybe authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature State of WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 !~ N ~ la.----.._y~ ~ t 3~r J 33 /- - - - -.. --' '`~ '~'. ~ \ .'~ ELEVATIC I / ~ J ~ ~ ~~\ _ _ ..e.e.4.... Z ' ~.~ e I>nt.~ eE ~ 1; -, e e (BLES J ~ J ~i` ~ __ _ ~` .~ ES. I ~ `-- J WV '30' rl ~ ~'•=~ i I O N J ~ '~ w 4 ~ o'- M ;`-_N( .6B 18 ~ 123159 S.F. ~ w b M ..i of ~ ~ a° Jo (2.827 AC.) o~ ~ ~ ~ ~ ~ a VC 104728'' S,F. {2.404 AC.) 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