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HomeMy WebLinkAbout020-1450-08-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety ~;nd Building Division r INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. 'ermit Holder's Name: City Village X Township Grand Pro erties L.P. ~-- Hurls n, Town of ;ST BM Elev: Insp. B Elev: t BM Descriptio . `~i ~,?i ~ J'V1 7i (3`'j TANK INFORMATION EL ATION DATA TYPE MANUFACTURER CAPACITY Septic / Dosing Aeration ----- - Holding /~~ TANK SF~ACK INFORMATION TANK TO P/~ WEL BLDG. Vent to Air Intake ROAD Septic \ ~I (~ ~ ~1 Dosing tiQY Aeration - ~~ Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss 3 stem Head ~ TDH Ft ~, Forcemain Len Dia. Dist. to well County: St. CrOiX Sanitary Permit No: 499300 0 State Plan ID No: , Parcel Tax No: 020-1450-08-000 Section/Town/Range/Map No: 22.29.19.2878 STATION ' ~ BS ~ ~ .'~ HI ©d c~ FS Z ELEV. l ~ r-C~ Benchmark --_ (jttii '2- ~ ~~ ~ pia . ~J'D. Z o A U~w ~./ 9~~ 3 81dg. Sewer ~1~ 3 L . ~ (~ S t In~ / ' ~ ~ ~- ~ ~ St/ t Out t ,., ~ p ., / Dt Inlet Dt Bottom ~ Header/Man. ~. ~ Dist. Pipe~•; 1 , t ~a.7 eot.-~ t~ / 3. ~7 7~ Final Grade. ~ 3 r~ ~~ . 3 ~ .~~" S;t er /~ ~~,-~~ ~0~ YIti .ems ~ - /~~ y. q3 Still ~RSORPTI~N SYSTEM ~f` din f .~ ,n n ~ ~-- ~~ BEDlTRENCH Width ~ L t i No. Of Trend PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ SETBACK SYSTEM TO P/L BLDG WE KE/STR A LEACHING Man cturer~ INFORMATION HAMBER T e stem: Yp Y i. \ ~! 7 ~~ , , - Model Number: IIICTRIRI ITICIN SYSTEM Get 4 2>Ih9-e=t`t-(rn_ I ! 1tib01~ C7 ~/fi'f^f-. !~ 1'1 ~-~. Header/Man' old N Distribution x Hole Siz x Hole Spacing ent to it Intake U Pipe(s) ~ g ~ ~~ ~~~ Length Dia ° length Dia Spacin i C/lll ~"/l\/CD r.____..__ c~.._a_..-. n_i.. .,., M.....al !l. A~_Rv~.in Cvc4cmc (lniv 1 ~' // 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 discrepencies, persons present, etc.) Inspection #1:~/ ~ (// of 1 Inspection #2: / / Location: 650 Roberts Lane on, WI 54016 (NE 1/4 SW 1 4 22 T29N R19W) Hudson Estates Lot 8 `~~ Parcel No: 22.29.19.2878 p ~ , ~I r 1.) Alt BM Description = ~T ~~~~'~`- ~GU~ ,~,c~/Yt~- ~G - ~ ~ ~/~/ ~ ~ F! ~~ 2.) Bldg sewer length = ~ ~ -amount of cover =. /~ J ~ ~'~~ SyS -" ~~ °~ Plan revision Required? Yes No [0 1 / ~ ~ ~ /n /,~,~ Use other side for additional information. 7 010 ~ I `~" `~( Date Insepctor's Sig ature Cert. No. SBD-6710 (R.3/97) COI'11R1E'fC4'.Wj,C,jt)V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ~~~ n ~ ~ Madison, WI 53707-7162 ermit Number (to be filled in by Co.) Sanitary P Repartmettt oI COmtnerc6 p L~ ! ~ 3 Sanitary Permit A lica ' N umber State Transacti on pp ~r.~ ~ ),/ ~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the ap r ptael goLr" vernmental /-~/V' unit is required prior to obtaining a sanitary permit. Note: Application form ~ ate-owned POWTS are Project Address (ifdifferent than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ur ses in accordance with the Privac Law, s. 15.04(1)(m), Stats 1. A lication Information -Please Print All Informatio J`~ Property Owner's Name / p C ~"` E'v Parcel # Property Owner's Mai ing Address MAR 0 6 2007 ~ Property Location q p ~ ~ v ~ O Govt. Lot City, State Zip Code Phot~e-~lt~~lX COUNTY ~ ~ ~ -7 -7 /g ~_ /<, Section ~c~- ~ c ~_ (circle one T ~~ N; R ~ E o~V Lot # II. Type of Building (check all that apply) /~ ~l or 2 Family Dwelling -Number of Bedrooms Ck Subdivisio Name /d S~btu.: Block # 9 ^ Public/Commercial -Describe Use ~b J9.a•- P~a~ / ^ City of CSM Number ^ State Owned -Describe Use ~^{ Village of II ~ , ~ ~Townof /,tG2S~y,~ ZZ ~' ZZ t~(not, 2 ~ ~ 1[I. ype of Permit: (Check only o e box on line A. Complete line B if applicable) A. New S stem y ~~ ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner ~ IV. T e ofPOWTS S stem/Com onent/Device: Check all that a Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersal/CreatmentArxc Information: +r Z~ a f' Z E Design Flow (gpd) Design Soil Application R~te(gpdsf) / Dispersal Area Required (sf) / ~ Dispersal Area Pro~ed (sf)j Syste Elevation / / VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ~ ~ c ~ ~ New Tanks Existing Tanks //~~ /~ L Y / ~ /'~ ~Z ~ o a U ~ 2 rn H L rn ~ ~ w C7 R C% /~ D O J Septic or Holding Tank / Dosing Chamber VII. Respon ~bility Statement- I, the undersigned, assume res si ' ity for installaf of the POWTS shown on the attached plans. Plumber' N e (Pr [) / ~ Plumber' S atur / MP/MPRS Number Business Phone Number ~ - Plumber's A dress ( reet, City, State i Code) !~~ t_ ~ ~ VIII. un /De artment Use Onl Approved ^ Di p d Permit Fee Date Is ued Issuing Age ignature $ x/50 • °° 3 to a7 ^ O even Reas r Denial IX. Conditions of ApprovaUReasons for Disapproval ~~ (1 Jt `/I ' 1~~ ,_( ~ (`a ~ 0~+3~~- tea,, ~, 1J dL'ati. U VGt~O ~ ~ SY~T'EM QWNLR: a t R ~+ ~ „~,., . u .~ o-~.. 1. >c. Wtlr, el(!h,-etd tNter and Aa~•~~Q"" dhparssl cell must all be servi>res ~ maintained I ~ q per management lan rovided l b t ~ p p oy p um er. ~1 N ~ fai ~' ~~ fi 6J " _ _ T tuv"`-' o ~ ~ BDDnGaDtPt~~}~p~ Of~7i1~~157`d~he sysiem and submit i:o the County~rnly on paper not less~an S U2 x 11 inches in size ~ S ( - n SBD-6398 (R. 01/07) Valid thru 01/09 ~j ~ ~ci,~Q„ a rEc-~.. ~M.J3 ~ ~ p~ SP..~~J~.OC~ /~ , ~q~~ T~o~~r~i~s ~~ ~. ~ ,._;~s.~} Gti~-~ .'-~~?S .~.,~ '/ T:JiS'_ ~S~ ~ ~~- T~~~/jam ~~ ` `~ ~ ~- .~~ ~~~ ~ ..,- 10 ,~' ~/ \ ~,tiv %/ ;` ~~ / i ~, ~; ~' / / ~Bi%I:~ W 7'~ - / i~ / ~ 1, /. w i= 11 J ~I~SCSSn" /~ ~ ~ ~U~'~Jr til~~ .~ '' ~,{ ;% ;! ~~~ ,~~ ,,~ ~~ i =~ ~~/_- ti G'~ // ~~ ~ X qo ~ ~/~;-~s~~~~/ :~~~ ' i .~ \\ ~ ~ ~ l ,~' ~~t°~.~a T~~fo~~~rrEs ~~ ~~,~,P6.~f ~.~/I s~~s ~.,~~ .s~~ ~,~ G ~- 7~9~1/ x°i9uJ Jory,~,~a.~y" - ~~( ~~~~~ to ~ ~~ / ~~~~ E ~ ~x~;;~ f ~r~~~ a // ~l~sr: .~~~ ~ / / ~ L~ ~-c iL y~ / - w~~ ~~ / p~~clH tJd~ / ' r ~~q ~ ~'C 9~ ~~ D r / =~ s~.- -~._ --, ~/ ""'"'"""' HUDSON ESTATES LOCATdD IN TNd Ndl/I OF TN6 SA//~, PART OF TN6 Sd1/t OF TNd SI-1/I, PART OP TNd NII//I OF TNd S1I//I, AND PART OF TN6 SIII/< OF TN6 SII//, ALL !N S6CTlON Y2, Td9N. R191I. TOIPN OP HUDSON, ST. CRDfX COUNTY, IIISCONSIN. D[AINAG[IlN[TA[lY i.MW ~y eVf+tri 9lY y Y i xe I~ i i ~ i ~~ ~ i ~ 1` m ~~ ~° w w ..a ose'_i+aiw - a ~Nr vT~nxv M~i+o ~~ ~~_ ~ uM suT R>.~ tni. vt. w'[ d e ~~ ~f w~tr[ ner ~'T? eve WY ~'3r I ....~ eAROR ~~ I r ~o ~~ e~ ~~ tw ;. ~„ :y IINPLA7T4_Il I.ANf~S ~ wT_~x t,y uNx SURVEYOR: PREPARED FOR: As INRIA ANJ PROPIRi[S LLC SYNDLIND SURVLTWD Twit PoV,WD ST. ,SID INIw =,R~T IRbsDN. w S.D25 DSW, SW16 C_S_M_. 1_N VUL 11 PG. MTS LOT ti LOT 71 x ooe0AC lro y y +an Aas tk'j rx~w~ ~ S Le.aato ta. n. }q L0T9 o"r.. ut.~.o Y.` f R .. , i d a,n..o. n. s SA.D.. otaw I.IYf 9 JCT. .. .. ............. G ~ . JrS a _ i ~ROnwrs Lu/[ ` ~ \ \ t ~, .~;'r s i i. .,.. ~1_~ .,~~ ~ LOT[ Lr~ / LOT to jk ;L ~. - j [~ w'n L[.o.-ut.w~/ - ~ e L J ~ .,~Ar.~ ~T /fix ~w J ~~~~4 ~, z,' i~.a...... qty w~_ID u.o rt.r: y, ~ • r ~ li e.On Aae[ \ 31 t ~~ 1¢ s $ \ ~y 3 / n.sr w I ¢ __ ~ § 'ten mM + # ~ Cp p0@i$Ty / 1 ~ +a+wt v.a• n ,/O ~ , rr~. ti. +.e 2 ~._'- ,a ~ ~ z ~µR b~ ~ sw~Ta • ~ ~L LOT t~T . ~ . $ ~ 1 N ti P // / t`L. 16 fx/~.uJ' •4 a.o~ntx ~A 'O IAT II y \ y f .n raven §. • + `~~ rr ~~ oor ~.ao. -.+YO ~ 1p4y . ~ oAM M. Grp \~ ~ ~ ~ :d ... .. t. L 5 LDT 11 ~ ~, ppigp il~[ ~ `~~^$ 9/ /\ SEE SHEET 1 sw..~.. ~d I.DT 17 •~t"'w'+v UNPLATTED LNIIIS N Totw..w.AnuR+R cetmD.n ~> awDa Dock 7738l0~ ~""a" a..nnaw...a-o,K.aR« ~ v ^[DSta•e aoro pp .~~ O~ A4 ~[~ ~~~ ,~~j{~{ •~{],~ OMMrtTQaoWxxY PLANW.O AND I.ONWO ~ O R[BOLVIIDN Q wniGND er ~ O ~~ r ! w[ St, aaV mmR Rln~o xY io+ro taw M1{ 4a.~ N4__3-4y R -~i/v'7~---1~~~ot win: or s sNUn ~~ ~~ T ~ . Kv.°° w /. > uo a[r~e[x ~~ m[ ~: PROw~trir owntElt: c~a ~. rr SOIL AND SITE EVALUATION 1205 page ~ of 4 ~aRCa. t.a.# 'tom Sc6rt-itt REIPORT MEMO Discontinuous silt inclusions were observed in B1 with redox features. The redox features in the silt are present because the smaller particle size of silt holds onto the water stronger than the surrounding sand, it even has a stronger hold than the force`of gravity trying to pull the water down. The water That flows into the silt inclusion will not seep out until the silt inclusion is completety saturated and cannot hotd any more, then the force of gravity can start tE3 make the excess water start to flow. This is why redox features (mottles) are present in the inclusion. The oufinrash sand that the silt inclusion is deposited into showed no signs of seasonal saturation or high groundwater. ** INSTALLERS** When a ift inclusio (silt ball} is encountered, the chambers that are installed in the silt should not be counted. More chambers shout a added to the end of the trench in sand to make up for the lower gpd/sgft rate of the silt. This way the 0.7gpd/sgft rate of the sand can be used and the system is only enlarg as needed. ,-. __ ~-~dT"E'~ ~ew~ CSC Sc~ ~ tT ~l S ~ lt- ~ ~nc.k~au~S .~~ ~f- t D'~, t'^ ~ `~-~S S ~ cQ ~1t i S i~-y~ , .~~ p,nSt_ t S C.A~s.~.. `~ `~i`'` S t S ~ r "'~ C E-l~ps~ ~-~~S _____~ l r Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach can ete site Coin pl plan on paper not less than 8'/: x 11 inches in s¢e. Plan must St. CfOIX include, Lwt not limited to: vertic~ and hor¢ontal reference point (BM), din3etiar and Parcel I.D. percent sbpe, scale or dimemsions, north arrow, and location and distance to nearest road. 6 Za Please print all infor-nat5ion. Re ' By Personal inforrnatgn you provide pfgr_~ndarY ourooses,iPrivac Law, s. 15.04 (1) (m)). Property Owner ' _ .. .,. .. Property Location r 1192 Page 1 of 3 Tom Schmitt ~Q~-60~ Date , , Grand Properties, LP Govt. Lot SE 1 /4 SW 1 S 22 T 29 N R 19 W Property Owners tYtailing Addr A ~ ~ ~ ~ 2 ~ 04 Lot # B~clc # subs. Name or csM# S cr` ~, tS 712 Rivard Streeet, Suite 30 ' u 8 CSM PendApproval5~ City a ~r};Pt~On~~V~xnber J City ~ village 1l~ Town N~rest Road Somerset ~ 54 G ~9RE~=f247-59 0 Hudson Roberts Lane New Construction Use: Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD _f Replacement Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, if applicable /V~ General canments and recommendations: Area is suitable far a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area I is 92.0'. ~~ # ~ Bonng ~' Pit Ground Surface elev. 94.55 ft. Depth to limiting factor ~ in. Soil Application Rate Horizon Depih .Dominant Color Redox Descripton Texture Structure Consistence Boundary Roots GP Dlftz 'Eff#1 ff#2 1 0-6 10yr3/4 none sl 2msbk mfr as 2f, 1 m .5 .9 2 6-14 10yr4/4 none I 2msbk mfr gw 1 m .5 .8 3 14-20 7.5yr4/6 none Icos 1 msbk mvfr gw .7 1.4 4 20-96 10yr5l6 none ms Osg ml - - .7 1.2 I .r 3~ Borin i 2 Boring # -.~ 9 Pit Ground Surtace elev. 95.30 ft. Depth to limiting factor ~ in. Soil Applicatiai Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ffz 'Elf#1 'Eff#2 1 0-5 10yr3/3 none sl 2msbk mfr as 1f .5 .9 2 5-10 7.5yr4l4 none Is 1msbk mvfr gw 1f .7 1.2 3 10-24 10yr5/4 none grms Osg ml gw .7 1.2 4 24-96 10yr5/6 none ms Osg ml - - .7 1.2 J .l ~~ 'Effluent #1 = BOD 57 30 <_ 220 mg/L and TSS >30 < 150 rhglL 'Effluent #2 = BODS <30 mglL and T55 <~0 mg/t. CST Name (Pl~se Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New RichmondLW) 54017 12/30/03 715-247-2941__ rty Owner Grand Properties, lP Parcel ID # Page 2 of 3 a B~In9 # J Boring tl~ Pit Ground Surface elev. 90.15 ft. Depth to limiting factor 95 in. Soil Application Rate Horizon Depth Dominant Color Redox Descriptio ure Structure Consistence Boundary Roots *Eff#1 `Eff#2 1 0-7 10yr3/3 none sl 2msbk mfr as 2m, 2f .5 .9 2 7-19 1t3yr4/4 none sl 2msbk mfr cvv 1f .5 .9 3 19-27 7.5yr4/4 none Is lmsbk mvfr gw 1f .7 1.2 4 27-95 10yr5/6 none ms Osg ml - - .7 1.2 3 ~ 3 .4-t-f- /'i'( . /~ ~ SyS~~ $ G •7 rp i, ~, eonng # Bing _f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Applcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *EfflE2 Borng # -~ ~~ ,J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descr~tion Texture Structure Consistence Boundary Roois `Eff#1 'Etf#2 * Effluent #1 = BOD ~ 30 < 220 mg/t_ and TSS >30 < 150 mg/L * Effluent #2 =GODS <30 mgiL 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. ~'e~ ~ll`~.~ Page 3 of 3 Conducted by: Schmitt Soil & Site Evaluations Thomas J. Schmitt, CST 227429 i 595 72nd St. New Richmond, WI 54017 Phon • 715.24 .29 ~ BM El. 100.00' %,D a t Alternate BM El. 0•aO Slope = i- Scale: 1" = 40' --.~ ~,~ Conducted for: Name: Grand Properties, LP Address: 712 Rivazd St. Suite 100 City, State, Zip: Somerset, WI 54025 Subd. Name Hudson Estates Lot No. ~l/4,~1/4,5:22,T29N,R19W Township of Hudson Contour Line El. ._.. yv. ~~ ~3~ ~~i Al~~io bl~ I i/ / ~~ ~ ~` ~~ {~r~jo©s~~( ~'aa.cl c~oh~~ ~~ ~38, ~.~~' This soil report was done to fulfill a Zoning requirement. It may ~ may not be in a location that is suitable for your use. No permanent lot markers were in place when the test was conducted. RECEIVED FEB 2 3 2004S01 EVALUATION REPORT Wisconsin Department of Com rce Division of Safety and Buildings ST. CR IX CO NTY ,,,,,~,acc@r~,agee with omm 85, Wis. Adm. Code 1192 Page 1 of 3 Tom Schmitt LVivnvv vi ~ ~~~ z - County Attach complete site plan on paper not less than 8'/Z x 11 inches in size. Plan must include lwt not limited to: vertical and horizontal r f i t BM di ti d St. Croix , erence po n e ( ), on an rec percent slope, scale or dimemsions, north arrow, and location and distance to nearest road . Parcel I.D. Please print all information. Reviewed By Date Personal infomratan you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Grand Properties, LP Govt. Lot SE 1M SW 1/4 S 22 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ~~~ ' 712 Rivard Streeet, Suite 300 ($, 3 ~ FSFnf ~ S CSM Pending Approval City State Zip Code Phone Number J City J Vllage /~ Town Nearest Road Somerset ~ WI 54025 715-247-5900 Hudson Roberts Lane New Construction lJse: ir" Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD _J Replacement J Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area I is 92.0'. Boring # J Boring /~ Pit Ground Surface elev. 94.55 ft. Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz *Eff#1 'Eff#2 1 0-6 10yr3/4 none sl 2msbk mfr as 2f, 1 m .5 .9 2 6-14 10yr4/4 none I 2msbk mfr gw 1 m .5 .8 3 14-20 7.5yr4/6 none Icos 1 msbk mvfr gw --- .7 1.4 4 20-96 10yr5/6 none ms Osg ml -- --- .7 1.2 Boring # .J Boring Pit Ground Surface elev. 95.30 ft. Depth to limiting factor 96 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ffz *Eff#1 'Eff#2 1 0-5 10yr3/3 none sl 2msbk mfr as 1f .5 .9 2 5-10 7.5yr4l4 none Is 1msbk mvfr gw 1f .7 1.2 3 10-24 10yr5l4 none grms Osg ml gw ------ .7 1.2 4 24-96 10yr5/6 none ms Osg ml -- ---- .7 1.2 * Effluent #1 = BOD y.~ 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <~0 mglL CST Name (Please Print) Signature: ~ CST Number Thomas J. Schmitt ~ 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 12/30/03 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 Boring # J Boring 1/ Pit Ground Surface elev. 90.15 ft. Depth to limiting factor 95 in. Sal Application Rate Horizon Depih Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-7 10yr3/3 none sl 2msbk mfr as 2m, 2f .5 .9 2 7-19 10yr4/4 none sl 2msbk mfr cw 1f .5 .9 3 19-27 7.5yr4l4 none Is 1msbk mvfr gw 1f .7 1.2 4 27-95 10yr5/6 none ms Osg ml ---- -- .7 1.2 ^ Boring # ~ Boring _f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots s *Eff#1 *Eff#2 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * 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. ~ .'~ I -, ©~~ /y~ ~~ `~°~ jY~~ ~ ~ ~ ~ '° ~l/C ~O~,~Q ~'~ - ~O'~- f~~ ~ g`t 6~+ / /~ p~ . Yl pY ~~~~~P~ ~ ° ~~ /' PY I f'6 ~ B~ m~ p6 PC~o-~©so~ `t~"~ ~oa.~ ~~~ ~`~~ 13~ y~ j,., r a ~~ 6,~3 ~ ~ob~~s ~~.~ raw r"k y ~ : ~ f r~e~ !°i~o~A~,-1~i P,~' ~u; f{ ~~ See r, f,~~ ~ ~. 5~~~ ,!"" /Y~ sw y r ~ `~aq r~v ~~ ~t2vn 56~.+p o 1~- ~i~Ia~ esTm ~z7y-~~ 1I9~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of FILE INFORMATION Owner 's Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ^ NA Estimated flow (average) gal/day Design flow (peak), (Estimated x 1.5) ~ gal/day Soil Application Rate 7 al/day/ftZ Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (GODS) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODS} 530 mg/L Total Suspended Solids (TSS) 530 mg/L (f~NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size Ys in dia. ^ NA Other: ^ NA *Vaiues typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity al 1~IVA Pump Tank Manufacturer ANA Pump Manufacturer ~NA Pump Model ~ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ~ NA Dispersal Cell(s). ~In-Ground (gravity) ^ At-Grade ^ Drip-Line _ ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency tnspect condition of tank(s) At least once eve n`' ^ month(s) (Maximum 3 ears) >~ ear(s) y ^ NA ?ump out contents of tank(s) When combined sludge and scum equals one-third {y) of tank volume ^ NA inspect dispersal cell(s) At least once every: ^ month(s) (Maximum 3 ears) ~ year(s) y ^ NA Clean effluent filter At least once every: ^ month(s) ~®ar(s) ^ NA inspect pump, pump controls & alarm At least once every: ^ month(s) ^ year(s) ~l_VA -'.;s` aterals and pressure test At least once every: ^ month(s) ^ year(s) ANA V ~ - At least once every: ^ month(s) ^ 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) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the imm=drat= notification of the local regulatory authority. 4'Jhe~ «y ~embined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire ccnt~^-s o' the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, V,'is~_-s- -d:~-~-istrative Code. A c-- _~ sa-. ces. including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment .s __ _ a-• ~e~:icing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. - : e ~ ~ ~~ _ . sr,z;i be provided to the local regulatory authority within 10 days of completion of any service event. r Page~'of START UP ANb OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a Septage servicing operator prior to use. 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 effluent. 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 vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 7 5 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; trail and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative 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. CONTINGENCY 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 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. ^ 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. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFlC1ENT 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 / Phone r_ SEPTAGE SERVICING OPERATOR (PUMPER) Name -lone POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Name ~ ~ + Phone / _ - _ ~==_-=nt was d-~°,e= - ~_-c'~nce with chapter Comm 83.22(2i(bi(; 1(dl&ffl and 83.54(1), (21 & (31, Wisconsin Administrative Code. START UP AND OPERATION Paget of For new construction, prior to use of the POWTS check treatment tank{s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). !f high concentrations are detected have the contents of the tank{s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells} in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a 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 vehicles 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 and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative 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. CONTINGENCY 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 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. ^ 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. < < 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 RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~/ / Phone r SEPTAGE SERVICING OPERATOR (PUMPER) Name =~~ne POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Name s Phone / _ _-_- ~~" ~~'as c-a~-a_ - __-= e~ce with chapter Comm 83.22(Z)ib!i? '~&ff) and 83.54111, (2) & (3), Wisconsin Administrative Code. LOT 3 N ~T ~ T S~M ~ .. N Q~ ~~ _ ~_r ( j i`_®L. 11 - EAST-\IVEST 1 /4 ~.ItVE = ~~. CD ~'~. 2975 - - - - - X26.31' 230.3' LOT 1® ~~~ X02 ACRES ',210 SQ. F't'. ~`~ h • ~.®T 9 t.0~ = 91 Q.60 „~~ ~ry 2,004 ACRES ~~~ s7,2a4 so. Fr. L.B.O. = 910.60 • • • . `s? . .~..' ~~ • ~ .: ~ ~s ~~~ ~ , ~~ • . \° $~'~ ~s \ • • . ~~ may' • •~ \ `\ DRAINAGE - ' EASEMENT ~ T 8i • • \ ~ • ^^Y r \' ~ HWL = 908.60 Z ~ ~`s~~ c7' ~': iNAGE DRA I' '^~. B~~ EASEMENT ~ W L~~ h \ s W f ~ F, . ~ ~' k' DT 16 >o s®. t= rr. ~ ~ ~ N ,2~ 6. o a. = si a6o ~ ~'. ... - ~, ~~ ~ ~ ,y.~9 ~ HWL = 908.60 M 101.50' ~N,r,~'1~L°~ •~~a .836 B•~T B3B ~~ N89 30'4f ._._ ,~ 20, o m • •~ 2.101 ACRES ~ ' ~ a• . --1 `°`r. 818 91,E 10 S®. FT. :v 1 ~~g mss-" ~, ~.®.¢~. _ ~~ 1.~0 ~ i ~~ O DRAINAGE , ~h' cis EASEMENT. ~ ~ $1~0 ,,s' "B" ~ ~ ~ s 2 6 •~~. _ •~j ~1~• 909.40 .- HWL ..~1 \'b kQ c~y $~ e~ ~ 05 ~ 2 m ~ s~~ a~ 5`~,~'?2.26 ~ ~ LET 1 ~ .'S ~~ 2,Q06 ACRES 1 J N LOT 9 N J ca x. a 0 .t N t 0 ~ v t ~ N I ~ LUT lfl .... I / ~~ ~°I ~ ~ l ° o y w j ~ ._ ROBERTS _- - ~ ~ LANE ~ i~ m~ ly j I. la I~ L~T~j I i I~ ---- IQ 1~ U 2y87P 11 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number wf~Rf~TY DEED This Deed, made between Willis D. Savadge. Grantor, and Grand Properties, LP Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County,-State of Wisconsin (if more space is needed, please attach addendum): See Attached Exhibit "A". , 7~~937 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 01 /07120ib4 11:15Att MARRAHTY DEED EXIT REC FEE: 13.00 TRANS FEE : 3240.00 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Return Address R~Mro3 i 020-1058-80-000 020-1059-00-000.020-1059-10-000. 020-1058-90-000, Parcel Ide ~~a~ Number (PIN) • This U'~~ homestead property (is) (is not) Exceptions to wazranties:"Easements, restrictions and rights-of--way of record, if any. Dated this Vt day of ~ /~ ~ ~~~~. . ----~ * _ -- -_ * Willis D. Savadg AUTHENTICATION CKNOWLEDGMENT Signature(s) STATE OF `~/~ ) ~__ ) ss. --- - ~(~~// County ) authenticated this _ day of _ Personally came before me this day of __ _ _ ~ ~ the above named ,,~`utn-t,1,f~ Willis D. Savadge, - - ` TITLE: MEMBER STATE BAR OF WISCONSIN ~~~`}~' ~ ~ ' ~~~/~' - ___ (If not, ~~rn . ~ • ~ ~j td• ~ ~~cnown to be the person(s) who executed the foregoing authorized by § 706.06, Wis, Stats.) _ ~ ; ~ .r ~~nstt~ent and acknowledged a same. L-t THIS INSTRUMENT WAS DRAFTED B~ ~. `~t'j~ ,_ _ Attorney Kristine Ogland %~,f'' • ' Hudson, WI 54015 '~i,, • Slr1 ~ ~~~ tary Public, State of SC jIIJ n nt~ - My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not neccssary.)~}ar~ ~ ~ 9 ~~~~` .) c3 * Names of persons signing in ally capacity must be typed or printed below their signature. information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 800.655-2021 WARRANTY DEED FORM No. 2 - 1999 MAR, 5. 2fi0,i~~.ir;.~l~~r'~11; ~9.,EDINA REALTY HUDSON a~~~•.~~~y~ r. r~•~~~~.t3~:~d +, sr- c~o» catm>T~r SBI~C ~`ANg MA'INTf3NAN1rG'B A~ ANA ~~' CSRTxFICA1'I(~NFORIVI NO. 9808 P. Z ~oa3 ~~~~,~~ ~. Ideari$ca~ion~dumber , cf •oe~4 P",'rLacnuon.,Li~I/s,Su,3 y,Sx.a~. ,T~~N~-LR,_9V,Tewaaf_.~,a.~.l~~? 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' ~e t late isadtho tibaus m~eauam ~a ages is msie~4ab-dre prirata: g;~w,s,! sfstem,oi& ~a S~7C.'Y1:sea £art6, 3, a satTyy ~ Depat;ha~ of Columosve ~d t6aAepatmear of3dattua3 F~swxccs, State of Wiseooshl. Cerci~i~ atrae~ smsaa that yon aepee alma Baca taostitr ec~pfaod saa nera{aod to the St. GSame coapty l~uniio~tk zoQ~q;tk-~r~ ahhfn;yo al~ysaf~e ea~o year ea~an aa~oe. ii4++~e ~~ ibsc.n snaueosm oa ~¢al6~am hoc sorbs Ueet ofmy./gyt {~1o.rEodpp. Tlafa aaYaro Mme alrnet(s) aftlp pxo~r ~,y ~k~~e'lxs+l above, lry •rittne o~'a wauamy deed ieooidodia Regisl~r of 37e+adR ~ffica 1'titttr~rs~~+~~t' ~rxdtnouts 04 1' ~~-'I:Wfrs ~ ~iG.~ '~J~E'Q~.ArM.IC ) I)ATf3 ,.«~y in;~~oetaa ibft is atiarepaseaeod amp m~1e ssnuaFP~litbeao~ revoked by the PLm~ 8c ~aS~ +"* lcata~s ~"~*~t (Itiu ~pplieation a reoosdeet Y ~vm~ Rs~soer erPl~eads OlHce ar-d s caggaf9ie e+eet~md wawey mq, if ,rsu:~: u rm~ ifi the warsxaty~~i ~/''' ~1 / ~( ~~// ~