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020-1329-70-000
`.ment of Commerce PRIVATE SEWAGE SYSTEM ng Division INSPECTION REPORT _r r~L INFORMATION (ATTACH TO PERMIT) ,gal infdrmation you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. .emit Holder's Name: City Village X Township Thelen, Jon & Jennifer Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: ~ dC> ~ M. ! ~.~ T TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic r ti Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic Dosing ~ c5 ~ ~- Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand pv` GPM Model Number ~~ TDH Lift Friction Loss System He d TDH Ft Forcemain Lengthy Dia. Z Dist. to Wetl SOIL ABSORPTION SYSTEM BED/TRENCH Width ~ Length 1 No. Of Trenched ~`~~ DIMENSIONS7/Z~1/ ~1~r~ddd/ "l7J SETBACK SYSTEM TO P/L BLDG WELL INFORMATION Type Of System: Gon,~e~+ anc~Q.. yZ ~'S~ DISTRIBUTION SYSTEM r L. ~ ELEVATION DATA County: St. Croix Sanitary Permit No: 515167 0 State Plan ID No: Parcel Tax No: 020-1329-70-000 SectionlTownlRange/Map No: 24.29.19.1720 STATION BS HI F5 ELEV. Benchmark 7+ ~L 7 ~b7` /~ Alt. BM~ ~ J u • ~ ~ ZZ f ~ l ~ Z Bldg. Sewer St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe 9. D 7 g~ ~~ ! Bot. System ~ ~a l Final Grade ~j ~ ~"~ /~Z • ~~ St over CJ t,~. u (r ~o • ~ ~ Z 3 Y „ /~ r~ 47~ TL /D.a 3 /D. .~ DIMENSIONS No. Of Pits ~_ '~_ CHAMBER OR UNIT .~ ~ nside Dia. Liquid Depth ~_ ~lanufacturer_.._~ Jlodel Number: Header/Manifold ( Distribution x Hole Size x Hole Spacing Vent to Air ntak :3 r~ I~rd Lengthy~Q_ Dia Pipe(s) ` Length ~ Dia Spacing ~ ~ \ ~~ G v...~Q SOIL COVER x Pressure Systems Onlv xz Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded BedlTrench Center Bed/Trench Edges ~~ Topsoil 'es ~ No °° Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /, Location: 875 Wyldwood Lane Hudson, WI 54016 (NE 1/4 SE 1/4 24 T29N R19W) Wyldwood Lot 7 1.) Alt BM Description = L ~'~~ ,~,~~ Z.) Bldg sewer length = ~ t~r~.~ -amount of cover = J!~ ~,~,~ V~~ ~~ ~ r ~ ~ ~ Plan revision Required? ~ Yes ~No ~~ Z a ~ C Use other side for additional information. (( SBD-6710 (R.3/97) Date Insepcto igna Inspection #2: / / ParcC`el g ~4e~.1720 ~In'h /t~Z'~~/ , a~>I~- too Q Z w iJfJ ~1/•G.nn xx Mulched ~~~~- Cert. No. Safety and Buildings Division County 5"'r" G Rd ~ X ` ~ ~ ' 201 W. Washington Ave., P.O. Box 7162 ,sCOn~ ''~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)266-3151 5/~/ Sanitary Permit Application ,` Plan I.D. Number N ~( 7~- In accord with Comm 83.21, Wis. Adm. Code, personal informatio ~ may be used for secondary purposes Privacy Law, s15. m ...~°° Project Address (if ditl'erent than maili address) I. Application Information -Please Print All Information ~ $'75 ~+ ~~ Property Owner's Name spa 3 Sl~,viur~~/2 T~~"/~ Parcel # Lot # Block # D~ ~ • /329. 70 • o00 Pro rty Owner's Mailing Address 7S ' Pro perry Location '/ '/ ti S City, State/~ //, Zip Code 0`7 Cv ., ,, ec on Q (~ T 2 N R E W II. Type of Building (check all that apply) 'VS 3 ~~/ ~ ~ ; r Q~I or 2 Family Dwelling-Number of Bedroo s / Su i tsion Name CSM tuber }~^ ^ Public/Commercial -Describe Use ,~ ~ ~~ FOOD L Q ^~ `f/ r / ^ State Owned -Describe Use ~ ^City ^Viila a Township of v so A, III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) '4' ^ New S stem y ~ R lacement S stem ep y ^ Treatment/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 'lam ~ /~ Z ~ /1 / '-l 0 rJ 1..~ (J (I~ 04 IV. T e of POWTS S stem: Check all that a 1 Non -Pressurized In-Ground ^ Mound > 4 in" of suitable soil ^ Mound <24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-G and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ T ~i Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) J~~~~~~'7re4'Ca'Z, V. Dis ersal/I'reatmentRrea Information: ~,` Design Flow (gpd) C~y~ Design Soil Applicatio ate(gpdsf) ~ 7 Dispersal Area Req d (sf) 9~~ ~ Dispersal Area posed (s qyo ~3. System Elevation 9~~ ~a ./ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass T ~ g ffvf~F~v rr w t a, dca . ; Septic or Holding Tank Z O (.~ e O / •.7 ~C~~ t/ /~ Aerobic Treatment Uni[ Dosing Chamber -~ D ~ ~/ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number t,J cirr~_r~' N~ct~v.~~~-~ t~ ;z~-~~/v ~~s - ~K 4 - 3 3 ~ ~ Plumber's Address (Street, City, State, Zip Code) L`o ~ C~ b ~ ~ ~'~"-4 ~ , ~ ~ D r2 '~ VIII. oun /De artment Use Onl pproved tnve Sanitary Permit Fee (includes Groundwater Date I sued Issuing Ag ignature o ps) ~ Surcharge Fee) ~ L/ ~~ ~ p 0 ~7 f0 /'s Q J t7gmer n eason for Dem IX. Conditions of ApprovaUReasons for Disapproval 3~ ^~, t• 1 _ ~ ~ ~ z C~~ ~+ y~p,t~, SYSTEM OWNER: ~~ ^~' r ,(-~,.~o •jyf~~' 1 Septic tank, effluent filter and ~,"~ ~ ~J U 4 dispersal cell must all be serviced /m • ~+ i t i k~ « d Z i a n ne a oth ~ as per mana em t l ~ w g en p an provided by plumber. ~ `_ ~ 2 f Ail Q~~t~,,~ o~ SG~,; a...t p . setback requirements must be maintained wax.. per a licable code/ordinances. ryI, ` .,,,; ~, 3 t Attach eompleh plam (to the County only) for the system on paper not leas than 8 x 11 inches in si ~~ w+.t~- ~ ~-~1 ~o f ~ tie.. ~. G ~~r~ ~, (~s .~.~. I~ ~ 1 - (R. 01/03) Sek-b~ac.~c.., ~ow. ~tx>t ~b ~ra,:.~Fi"~~i/ i ~ l~J r+e~', 7LlJ v ~- ~. ~' ~,~. `~ "°~ ~- ~. ~ ~` w ~ ~ ~ ~ - ~ ~ ~ a ~ lL. o ~ ~ ~ V ~ ~ ~ v ~ '_I I of 'o ~ _ I I --~, ~°v~ j ~ I I ~ I 1 I o ~ 9 I I V (`~ Ioi ~~ I °~ 9 I'~I Z ~ I~ I'-' i"I - i I I `~ III I~ ~~ Ij it ~ ~ I 11 II (i I I I I I ~ , I ~Ii 11 II I! 'Y I~ I I ~; i t I k I l i I~ I . l i I , I ~ I I i, l i I~ ~aI lol ~q It~l ~ I I 1 ~ I~~ ~° ~ I ~ o~ v D ~~ v'~ ~ ~~~ ~~~ ~ ~~~ h ~ '~ r ~~ p. J ~~ i ~l._ I ~ ~ ~~ l ~`i Q -1 v .~ ~f~4' I ~; „ ~ i~ o ~ ~~ ,_ tl~ 4 ~ ~ ~ _ 'J v I~ ~~~~ ~ I ~~ ~ ~ II ~ p ~I ~ ~ ~ a I ~ ~ w . I w ~~ ~ O ~_ ~~ 3~ II ~~~ ~I i~ ='! ~~~ ~p;~ ~ c ~ 2 ~ ~ ~ ~. 1 a`~~~~ ~ - ~ ,~ p ~w 0 N. ~= Q v ~ ~! ~~ _~ ..e ~~ ` ~ i ~ W a `~ ~ ~D ~1, ~ ~ ~' ~ ~ o J ~ ~~ ~- 1 ~ Cn V _Q ~n ill o ~+-- ~~ ~,,~~ ~ ~ ~ ~ ~~~ ~ ~ ~ ~~ ~ ~ 2 c~i~ ~ 2 v~ ~~ ..~ . Q I v\ '- { v ~ I ~ ~~ . ;~ ~ ~; .. `, ~ o ~ it . _ ~~ o ~ ~ S _ 'J v A i' ~~ ~ ~ ~ I ~I t-- N- ~ ~ ~ I C'~ II ~ I I 0 r~ - Q a / ~ ~ ~- ~ o ~_ ~ W ~~ 3 ~ '`' ~ ti O N ~`D ~~ ~ ~ ,-~ tV ~Il ~` ~~ ` ~ W ~ ~ ~ ~ ~0 Q. k I i I~ i ~~; I~ I~ l i II i II ~ (I I; i ri l i ~ 1 lol lol Iq Idl , I I I I'I I OI 0 I ~ lol 11_ i I lol 91 i V 1 `~ I°I ~I01 ~ I"~I ~I I ~ i I I i t l i ~~ I I I I I I i I ~ ~Ii ~~ I~ I, 'y (~ I I i i I I Q ~~ v'1 ~ ~~ ~~~ ~~~~ ~ W` ~~ ~- 2 I ~~ °_ J~ o ~~ ~._ 1 ~ ~ °~, 1 I`. ~-'"", ~- 1~ ~ ~ ~~-~ ~ ~~ ~~= ~ °` ~ ~ ~~ ~-- ~ 2 z ~~_ o .~ ~ ~ ~ o J ~ L , p ~ w ~ ~~ 0 1 ~~, ~ n 2812 10th Ave. • Spring Valley, WI 54767 ~r~g. L~e~igners of Engineerinc: S; srer,? 715-772-3442 P~,.,,-~«t; ~~rwaye c(1;,.$(lir';,t PROJECT INDEX Plan I.D. # Owner JOa ? ~FN,V/'~L~ -ThF/E•v Date d C~ ~ ~ .-2c~ © 9 - Phone sl ~~ p ----- - ,-L- - i-- - - ~_ Address O 7s ~/GO~~I~ li~t1- J'T ~f~s~9,t~ `U/ s Ya~~ Legal Description L,0 ~" 7#7 GU~yDwDav S~/3D. ~/.u vZ0•~I3Z9.7d•wz N~ s~, Sic. 2y. T 2~ w, e21 Q ~ , Town of _ f°f'UE2SD ~ .~ ~1~~` _.-----.._ County s T C '' O % ~ C.S.T. ~-Z1f~QIC(j,T` 2~~.37.~ Installer ~L~'I~Qy'~I,Gljr¢.L)`L,e - A~~-`/' /lTl/~'- Local Authority/ Supervision PROJECT DESCRIPTION '~ ~~1~•u 1'`' C'D~U ~1~~~~O~i¢ ~ ..~Nf~G`t-2 h11`v~. ~I2L ~~, ~aQ,~tc tE~c cvl ~ 3 ~y~~~~I~~ s ~/s7~.~-r 1~2 ~ crt~ ~`~ ~ '~~so ,u ~/®~v -~. C~ y~ ads ~, . v~y ~ y ~S7/~- ~(~{'fCV7-T- art ~3 ~ -s'~~° ~~'~ T~1F,ur~ ' c,c.~ ~' /~ E~ /~ - ~~~ ~ ~U ~u ,~~- ,ems ' ~~ S~ ~~~ ~~ ,,~n~"~~+eirmr •~`` . G p~ '~er~ ~ ~ ...... ! ~ ai j ~$ 14 ~',' I V ~:•i. ~l~{~ry~ ©~ Pg.l PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE DETAILS INSPECTION PIPES & FABRIC/TOP FILL DETAILS) Pg.3 PIPE LATERAL LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERI~L CLEAN OIITS) Pg.4 DOSING CHAMBER CROS5 SECTION ~ SPECS. Pg.S PUMP PERF~f3RMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) f c m A A .P 01 a m e. ~I I11 O O ~, ~~~ a~ ~~. ~- ~~~* ~~ ~ ~ `~. i~ ~ , ~ h t~ ~1 _~ "~, ,~ O .,~ .~ ~v 01 y ~1 .~ o ~ ~^ v)~ ` > ~'?~' ~~ c `~~ ~ N G~~ ~r ~b y 0 .~ W ~~1 ~° ~~~~ .~ ~~ 1 ~ ~~ ~ ~ "1\ ~ W ~ ~ ~' ~ ~~ ~~" H (1 `J n ~~ ~~ 1 1 ~jr?~,t`'DU~ C~.~Cl?` Si' ~.GL SSG T~~D.~.~ c~,os s• ~ s~• -~- ___ --_ -- _----_ TyP~'cA-L ~~2 fl-/ 0~ ~~ © TrP~"~vc~s CRo SS Sic Tio~ ~ ~ ,, ,,, ~~, ~ ~ ys ZlS/N G- lN~i'L 7~'~9- Toy's y,~,~, c~P~G, ry w,~, / ~. / sQ ~ . c~-~~cir~/ ~ s~~ ~ .e.~ 1~~ ~IiN . / 2 ' ~~.~~G .~ ~ 1/// ~9PP~°orr~~ v~,v T c~4/d a,~ it/SpE~ T/orv ~ /`e~2. ~.. ~„v~ s /QED ~D~ •~~ sc~ . ~0 9R~f~~ ~ g -~ ,, w A~~~ ~,v~~~X~To~E' 1~ c~. ..-~~~c T,P~ti c -i ~~ /4,13,CG ~ s y~T~~ ~i~v, ~'~ . ~D _,.,t----- ~-~ ation Pipe Details. tN~ ~. i ~~ , .~,~~ ~a• P SEPTIC TANK ~~~PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4` ~, 4" CI VENT PIPE 12" MIN. ABOVE GRADE ~ ai ? l0' FROM DOOR, WINDOW OR FRESH AIR INTAKE C~~ BM = 7e~ ~ " ion ~~ s' " ~ : l I ~ ~I vt IN 9~ ~~t I ~ SG,p.4n, . P~ P~ per, 3~~ SOLID SOIL ~~~ ~ip~z,~ Modt~ ~ ~=-1 D PUMP OFF ELEV . q3. FT. •~, 4WEATHER PROOF JUNCTION BOX -WITH CONDUIT --~.. ~ ~~ 1 ~q ,, ., , ~' ~~ . ~ ~ ~ ~ ALM ' ON ~I OFF ~! , GAS- T S TIGH A ~ SEAL ~_ ~ x'''15 C i D i `" ~ ' 3" APPROVED BEDDING UNDER TANK tio~ qa.~.5" ~aN~ ~-- ~~Isri~G- SPECIFICATIONS SEPTIC / DOSE f~vff~~r TANK MANUFACTURER : PREcgS'T_ TANK SIZES: SEPTIC ~2/r.D GAL. __._ DOSE ~ GA L . ALARM MANUFACTURER : (f~G f?7/~ .SyS ~i~/ MODEL NUMBER : -~ LI/ SWITCH TYPE: t~hh ]- " PUMP "MANUFACTURER : ' /IYD/QD~/,7~/G MODEL NUMBER: ~ .SWITCH TYPE: ~ ~ j~'- REQUIRED DISCHARGE RATE 2s GPM ~ CONCRETE PAD NUMBER DOSES PER DAY: /' /~e2 DOSE VOLUMME INCLUDING 5 .~.. F LOWB~~A//C K CAPACITIES: A = ~7•S ~~ / GAL . INCHES = y4Tl I B = 2 INCHES = 33 1 C = ID INCHES = ~~ 7 i D = ~~ S INCHES = ~( PUMP ~ ALARM WIRING AS PER I LHR 16.2 3 . s• 5 FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . + MINIMUM NETWORK SUPPLY PRESSURE . + _„~jQ_ FEET FORCEMAIN X /•3~ FT/100 • ]c FEET FT.•FRICTION FACTOR.. ~ FEET TOTAL DYNAMIC HEAD = " r,' FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH L,/• / , ~/ ~ WIDTH ~'7 ; LIQUID DEPTH yS N - UDC UOw.Y~ FOk . 30 DI~:METER,/ -~ SEPTIC TANK, per Comm. 83.44 (2) (c) shall be equipped Kith an /AJ GiNE ..ii/y /~C~ ~iPESS l>~%Ztzv ~~ y S~EC.S rum ~n ~ti8eter ~ AwetasNc tttedcls Fdl Food aracteristics set~otttl SitEF+OM2 _ ; sliG10A1 SNEF40AY 4 10 lY 6.5 a Poi. (a ~j R7~ 1550 Pf~e 18 Y • 115 430 Iltrts 60 140° F lRox. FioY ~ A ~sdelioa Ciosc A SJse I i Y NPT Sefds 3/4" 2d 16s. rowttr ford lti/3, stlllti so~ std. t30' eptioad! .materials of Construction s st oM ~ tNetar N Cast as Shat Nisdmskal Stadt sect Sad Fans: CarboA/terawic Ssd lodyz ~ N Raw tie! fletNca Plate S ~ ~ Performance Data 30 ~ 20 ~, l0 0 10 20 30 40 i0 60 70 GPM Toh+l Hoacl (that) 10 14 17 21 Z5 Z8 30 35 {m) 3.0 4.3 S.2 6.1 7.6 8.5 8.8 10.7 GPM (tJS GPM) 70 . 60 50 40 30 ~0 10 0 ( seKj 4.4 3.8 S.2 4.8 1.9 1.3 1. All dpnetistiots in iruhes. (Metric fo- iiibrnnliono) use}. 2. Component dimensions may vary t 1/S inch. 3. Not for construction purpose unless certified, 4. Dimensions aad weights are a~roximete. 5. We reserve the rght b nmke revisions b our product tmd spodficatioin Without aatite. Dimensional Data 1 ~ f~1' ®1998 Hydromafic` Pumps, Ashland, Ohio. All Rights Roserved. ~~+~ NYDROMATfC Fr -Your Authorized Locol DistrilwlM ' •i ~+ ~ ~ ~ ~ } 1840 8oney Road 4s~bnd, Olio 41883 rek 119.2893012 fact 419-281-4081 Web Ssa: www.pentairpump,com // !~~ ` ~« .: Rakr re 'Ptampt"r, rhorho yaow Pews o~D lRrfi A1VD f0rlMTRlES ~/ ~ ; f"~' tbw phorto Y /or 7vw 10ta! pjslry~fit ~ %!~(~/,yy/~(,jf/ ^ ~ ~+: ' , OZ 6d90 t 19@ 5M `` c , N ~~ >~ •~ ~ ~~ ~~ a~ U a ~, ~ O .--~ ~' ~ O N M "! r~ O~ ~ J 0~0 dj ti ~ "%4S ~ ~, r r! .,, , W `~. d d C ..3 ~ ~~ ~ s N ~ N O ~: J ~~ ~ r 8 0 ' v ~i $ $ ~ ~ ~ T' v __ ~ avi ~ .e° '_' .° '~ °q ~ o° d b3 ab t o s-~ p„ ~ ~..a ~, m o ~"~~ H 3,5~ 'O c ~~.'~~ ~" N~:IiyQ~ °cv - ~w °'>,m ..r ~ cd v_.~~°~os°coQ,~~> -t~oE~"~~'>~°: =~ .5m~ ~•~3Q,~° ,`~. -^ J o.o ~• c`C ~e o ° ," _ ~'~ ~ .p ~Dy p w i° ~ = npp~sY `' ~ ~ :s ~'0 3?.0,~ f°nw E"" _~3g' ao c o a~~ ;.nom '".o ~._ d ;, v L], •^" - cxicEc~.'-Y~~C`~6g _~m.~5p~•p3~3 '" _.a'~°a.c~, '°Qf~ o ~`" ;.; ~ ~ `~ -_ y~;; ~ Q i7 ~°. ~ ~ t~ F" U G r: ~ ~. •^. R. c Y N C ~ 'r '- ~. ~ ~i ~ " " ~ 7 ~ y d O ~ •~;. ~ ~. ~ ^S ._b.°^.:~a°o..cdc~c°iasi~"' ~.c°3ycvw°'~$_° Vs•°~~.-• 1Y~~E~d :~- Q., c. mac. o c~ ~ra °.3 m .. _ a $•5 bA ~ cn~ ~ m cs E•° °, °' `o > b = ~~._a ~ ~ ~ ao?3 _ ~ c ~ d 1" _ $ o ~ c'~ O ~ ~ O ..'" o o ~ >+~ d p 5 c ~°'~-~d - o o ~ .._ ~ m - ow~.o~:., -x y~'~ ° ..O ~ ~ = :r ~~v « v a~ ~,~v vim, E ~ ~. ~w°~t ~.C cC c d ~ .r ~ fn 3~ 3 ~ ~~3 o ui 3 ...a r-' ~ J ~ _ O~ ~f~~ ~ r ~i , ~ .= ~ 3 ~ g u >_ ~~ ~ ~ ~~ - *~- ,, o ~ ... eM_ E"., ~ _ 40 ~ CG _. ~v 'cN~.~ N~a.v cue cn pp > C N y ~ o b ..-. ~~~kao•~o o~~o z ~~ ~.~ ~~ :~ ~e~~,~"vim=~~~ ~ ~ ~~ _ .~ v ~ i1 p., ~ ~ ~- e ~-. ..d ~ ~ U ~ C ° o ~ ~ a; ~ ~ i-. a. ~ ~ an O ~ ~ , 3 °" ~ ~ d ~ ~ O ~ • ~ ~ U , ~ ~ yy 0 ~ H ~ ~ 0 ^ r7 ~ . ~ Q ~ O ~ ) p ~ `~+ ~ .~ ~ C/1 N V2 ~ ~ W ~ ~ Q 3 :~° /~+ r f,, J ~i-'-~ .r.....-, =- `~ ~ P^ N .J ~ ~ ~ s ~ ~° °° ~= i "~ ` ~' .r~yi O c ~ z v ~ y ~ s_ e a • l '!. :. ~ y ~ ~ 'v 3 ~ a~ -~"' ~ .s .. ~ .tea 3 r OWNER's MAINTAINCE OF SEPTLC SYSTEM i POWTS (landowner) is reponsibi~ for proper operation and maintenance of this system. Regular periodic inspections and servicing is necessary far the safe healthy operation of;this system. The owner is required by code to submit all necessary maintenance/inspection reports to the controlling ,authorities. SPECIFIC CONTACT AGENTS * Governmental authority/ inspectors: * Licensed installer, responsible for maintenance "Users" manual: ~.~~~~ ~,~ ~~~~y ~~ sr~ cRo l ~ Zp~i' NG- ~Epr . providing an operation/ * Licensed servmce / inspection agent other than installer: ,~ U~I,o~ - ~o~ ,M~'y~S * Electrician, for pump, electric controls, wiring units: ~~~~ ~ ~~, LDS 's ~' lec ~ ~ C~~,~ IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1. Winter traffic (sledding, shove ring, etc.) acros,~ the area shall not be permitted, or frost can/will p~snetrate into the cell, freezing up the system. Discontinuos use in the . winter_(a vacaction trip, resulting in no water .use) can also lead to freeze ups, 2. Water conservation-needs to be exercised! Or system can be hydrolicaily overloaded and destroyed. This svs~em was designed for a maximum wastewater flow of !~/~ gals. daily. 3. POWTS are not designed to accomodate wastes from a garbage.. disposal unit, or any ether unnatural sources of waste. Any introduction of such waste materials will overload and destroy this system. 4. If a power oatage occurs, or a pump fails, it ma;rfresult in a temporary overload of effluent being pumped into the cell, which may adversely impact the cell (leak~'ge). It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct; amounts. Consult your installer immediately for advice. 5. Neglect of the vegetative cover (the cells insulation ~ erosive preventive) can lead to failure. Compaction or heavy traffic also can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETATION OVER A SYSTEM!! Effluent in the system beneath IS NOT sufficient alone t0 maintain a ,1 covsr. 6. Periodic inspections h~ +~~o „v~..w _~ L, _ _ _ ~ - RECE~VE[~ ~~ ~Q ~ ~ ~ SOIL EV,AI~.UATION REPORT ~~~ ~ 6 Z~~g ~~,~~ Atlach she Pin ~ PaP~ not less than 8112 x 11 irx~es N1>~e. ~ must indude, but not 10: vertical ana hoazent~ reference point (BM), drtea~orr and percent slope. scale or ~mensicrls, none, arrow ~d location aNd ~tanoe to nearest road. paro~ 1•D• O 2 O - >' 3 ~ 9 ' 70 • ~ P/aase prlst ~ lnformaetolr. Date PenonN ~famotion You provide ony be uW ~t+~Po~ taw, t 15.04 (~) (m)6 ~- .(/yL/'~ ~ rQ (~ Q ~~~UN t ~~~ ~i~`l~~~/~ 2 y ~ 9 ~9 t t L 0 'S£ ' . ~,1 o 1l4 1/4 S T N R E t Y1F ~peKY Oemers 9 - ~7S G(J /G p t<,o o v LN • ~ Block # Subd Name or CSMq w t yv cu ooD S v,I~D . State 2~ Code Phone Number > °_ _- ~f U12SU.v ~,ul. s~y , t t 0 ~ ^ V~age ~Tawn Nearest Road Uf~s'~,V - ~' s 7- Div%L~ ~ pop LN . ^ NeNCarasmx~ion tJse:~ Re~e~al / Nun~er of bedrooms design flow rake ~ ° GPD parent matel~• SS U UE' ~ .VU D rl ~Lf> ft lions: T ~C'~'1'~. ~ t-Ct.~jnc~~~ Z ,~'~ t i t ~ {l`~~~ 7 ~ ~_ v-1T0 pO ~,_ et:t tpr .. ~ ~ ~ ~~ ICI ~gr~l~nd tayekm (P.Q.W.T.S.j -~ ""'7LJ ,c,~ a. ^ ~g ~ 0 ~ } Pit taroutrd srrfaoe e R Depth to t~iferg tacoor ~~ iri. . Horiaon Darr~rrarrt R,edorr Texture ~Strucdxe Rate Cor~stence Boixrdary Roots in. Murfee~ ~. Sz ~. 't~1 'EIFe2 d.g >-oY~ y~~ s~ z~~~~ ~ ~ . ~ ~. d 2 ~- 3 ~ io Y ~ ~ ----- ~ ~ s ~ cs - • > ~• . Z p,,,~,,~ "`^. y ~ ~ d / 0 ~' ~'~ c f l > ~}f ~I~ ~ ror.i eur aoe e et-. n Depth tQ f8G10r in. ~' sa Rafe +~` Depth Redox Desaipeori Texture SUuc~ Consl~enoe 8ourda ry Roots C3PDItP to t]u. Sz Cart. Cabr (3r: 'Etfr~1 '~ ! o ~ ~ ~ io ~ . ~ -------- ~ ~ s 6 s Cs a f ~: o /o y~ ~~ .S n, ,~ + ~ ~ ~ G ~~ i • ~ eoD > 30 _< 22a mgA. and Tss > < 1 _ 5<1 aglL - Efthetnt i~ = eoD < ao melt. and ~ . csr Name tptaae+r slg„etur D I G I~ e ZZ 3 S Addres s =•~L ~ Date EvaN~on Corrdi,wied Telephone i ,.. ldlbricht & Associates ~ SEP7• ~N ` v~D 7/S •~77~`~ Pnvate ewage Consultants 2812 10th. Ave. ___ -- - -- - - ~y~~_ - ~~'r~2 Spring Valley, WI 54767 sa;~ ~; r ~3, - ~X~sr~,vG- ~sysr~•y ~~~~bx . q~. yD s , ~ ~ ra~~~~ 5 ~~E ~N c69~ co ~P/,~ti 7- 'so;/s , ~,u~ ~~y ~e'Re ~u~~- r ,ids,. ~- ~`~ ,k,; sq ~ T .. ~: `ipi ~,p MII "" o ~~ ~ Z -~ Paroel ID # ~ ~ 3 °2 ~ ~~~ ~~ ~ Page d 3 Pit Groundsurfaoeelev. a oeptntoGmf~tO6ory 9~ in. sw awe lioriton Depth Dominant .,. Redooc Dosaiplion ` ~ Cansisterxe :. lions GP OA! in. MunseO Du. 3L Cont. Color Gr. Sz Sh. 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D11 \ (a~ ~ ~ \ ~ 3~ \ ~--//\ ~. ~0 O ~ `~'p,~ ~~~ 2d\ ~ ~~ ~~ _~Ns P~~ 1;~\~N ~~ Z~ ~d\~~ ~ ,\ \ Pd\\ ~ ~ ~ ,~ 6 ~ 0 CU ~ ~ O ^ I~ Uj W d' W ~ ~ a lf) ~ W ~ l!~ o a W ~ 0 (1.1 ~ o f~ ~ 0~ ~0 '-' ~ ~ (/~ v ~ ~ ~I Z (UI ~ " I i ~ I I ~ Q J I ~ t!') I QI wl ~-- o~ )~ I ¢I zI -~ ~ I ZI UI ~~ QI ~i \./ W Ha H~ w~ dw H~ H z ~a C7 ~~ U r~l x o `~ z U~ w Ha U~ Az ~w a H W N ct' ~C .--~ M V' ~z 'III a~pr s~~id auk o~ paaua ~uu~aq `M6t2I `N ~s~g pa~uaumuot POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of P3lEINFORMATION Owner Permit DESIGN PARAMETERS Number of Bedrooms ~ f 3~ ^ NA Number of Public Facility Units ®NA Estimated flow (average) ~ ~ gal/da Design flow (peak-, (Estimated x 1.51 (o ~j $ al/day Soil Application Rate -7 s / gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD5) <_220 mg/L ^ NA Total Suspended Solids (TSS- 5150 mg/! Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD5) 530 mg/L Total Suspended Solids (TSS) _<30 mg/L ®, NA Fecal Coliform (geometric mean) <_104 cfu/100m1 Maximum Effluent Particle Size Ya in dia. ^ NA Other: ®NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity /a ~d al ^ NA Septic Tank Manufacturer µ ^ NA Effluent Filter Manufacturer S e~,,...Ta.c,.~, ^ NA Effluent Filter Model S T (G _ / o o ~ ~, ^ NA Pump Tank Capacity -Z ~~ al ^ NA Pump Tank Manufacturer~~ ^ NA Pump Manufacturer ~ ^ NA Pump Model 5 J/ E' F - ya ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: ~. NA Dispersal Cellls) ^ NA ~ In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other: Other: ~ NA Other: ®NA Other: fa NA MAINTENANCE SCHEDULE Service Event Se a Frequency Inspect condition of tank(s) At least once every: /~ ,. ^monthls) (Maximum 3 years) ~/ 6d ear(s1 ^ NA Pump out contents of tankls) When combined sludge an scum equals one-third IY,1 of tank volume ^ NA Ins ect dispersal ceII1s) P At least once every: ^monthls- (Maximum 3 years) M yearls) ^ NA Clean effluent filter At least once every: ^monthls) ~ ! ®yearls- ^ NA Inspect pump, pump controls & alarm At least once every: t D month(s) ~ ! ~ yearls) ^ NA Flush laterals and pressure test At least once every: ^ monthls) ^ year(s) ANA Other: At least once every: ~ yea~~s~(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 tankls) 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 cellls) 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 immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY31 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 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. GMW (4/01) ' Peggy of START UP AND 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(s1. If high concentrations are detected have the content 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 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 •?cS- Z4q-' 33-2 SEPTAGE SERVICING OPERATOR (PUMPER) Name R cr~-0 S..q~nti, J .A.w-~co Phone 'j t S - ~ ~/ a[ ~ ~ 1 5 ?J POWTS MAINTAINER Name ~ o~.~ti, R, ` Phone Z~~- ZyQ- 3aj d2iZ. LOCAL REGUIJ!•TORY AUTHORITY Name 5 ~. C,p Phone ^~ L S ~ ~ !o - `I ~o $ ° This document was drafted in compliance with chapter Comm 83.221211b11111d1&If1 and 83.54111, (21 & 131, Wisconsin Administrative Code. " Page of START UP AND OPERATION For new ,construction, prior to use of the POWTS check treatment. tankls- for the presence of painting products or other chemicals that"Inay 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 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 lie 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 (~ ~'l/ Phone •-~GS- '~4q- ~v3~-2 SEPTAGE SERVICING OPERATOR IPUMPER- Name ~ ~,,~~ 5-~~-..~._ S .~n~r~-~,O Phone "1tS- ~`l°~- ~lSJ POWTS MAINTAINER Name ~ ~~' ' Phone ~ ~,~ _ z y Q - 33 ~ ~ LOCAL REGULATORY AUTHORITY Name ~ ~_ ~ ," Phone ~ L S ~ ~ (c1 _ y fo $ c This document was drafted in compliance with chapter Comm 83.2212)(bllt-(d-&If- and 83.54111, (21 & (3), Wisconsin Administrative Code. r ST Sizing Septic Tank Sizing Domestic Wastewater Based Residential Septic Tank Sizing Number of bedrooms Service frequency (yrs) Service frequency (months) Minimum septic tank size (gal) Commercial Septic Tank Sizing Design wastewater flow (gpd) Service frequency (yrs) Service frequency (months) Minimum Septic tank size (gal) Residential Service Frequency Based on Tank Size Tank volume (gal) Number of bedrooms Service Frequency (yrs) Service Frequency (months) Commercial Service Frequency Based on Tank Size 1250 Tank volume (gal) 648 Design wastewater flow (gpd) 1.97 Service frequency (yrs) ice #equency (months"" Version 6.0 vot. i5(l1PAGf 21J1 ~208;t30 ' STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED g GICROIX CODEEDWI This Deed, made between Roger H. Gehrke and Sandra M. __ RfCfIVED FOR RECORD Gehrke, husband and wife, _ __ 04-07-2000 11:45 AM kTY DEED YARRAF EXEMPT i Grantor, and Jon T. Thelen and Jennifer Thelen, husband and wife, CERT COPY FEE: COPY FEE: TRAIISFER FEE: 179.70 - REC~tDIN6 FEE: 10.00 - PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Plat of Wyldwood, St. Croix County, Wisconsin. Lot 7 Name and Return Address , Fi~^st Atonal Bank of/New~~t~¢Yt~top~ phew RX~chmorfd 'WI ~IO~ ' ,,t ~7b' 7/6/ Y ~ 37 -ino , S a7 .. ... ~., i 020-1329-70-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~__ day of Aprit 2000 s • AUTHENTICATION Signature(s) _._ authenticated this day, REBECCA J.PHANEUF @T>tkft~Pti9 w STATE OF WISCONSIN TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Hudson, WI 54016 __ (Signatures may be authenticated or acknowledged. Soth arc not necessary.) Q€) (is not) r/ R er H. Gehrke • Sandra M. Gehrke ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ~~">f'. Cry 1 ~ _ County ) Personally came before me this ~ day of April 2000 the above named Roger H. Gehrke and Sandra M. Gehrke, hushsnd and wife, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Notary Public, State of isconsin My Commission ist. (If not, state exp'tr.,a~n date: _~O ,~•) /d persons signing in any capacity must be typed or printed below their signature. ~rMOrmatwn Protessiona~a company. Fond a~ t.o. Vw noosss-cost STATE BAR OF WISCONSIN WARRANTY DEED FORM No.2- 1999 Wisconsin De artment of Commerce ~^ r ciavnai uuun nauun yvu Niuvwc inay uc uacu ivi accviiuaiy F1w F1V,C' ~r'flVdGy LaW,~S. ID.V4 (1)(m)] p PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) f1...-~.-..1:.t--....-tip....-....-....:......-.... L... .......12..-....---J--. ._. ___rn_~____ Permit Holder's Name: ^ City ^ Ila a own 'helen, Jon & Jennifer ~uc~so~own°s~iip CST BM Elev.; Insp. BM Elev.: BM Description: , ~~ l o l . ao o l . Flo uX r ~ ~-s ~~ = CSTs , it TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~'"~ ~ Dosing ~ Aeration Holdin TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic ~ ~ r ~ '~ ` -- --- NA Dosing u ~c `~ -.- 3 r~- ` NA Aeration y NA Holding e~ PUMP /SIPHON INFORMATION ~(~ Manufacturer ~ L D ~~ Model Numberlj {-~F'- ~~fl, H Lift `~,.°~3 Lriction ~ ~~ Syetem~ TDH ~~ ~ FFif Forcemain Length D Dia. Z " Dist. To Well SOIL ABS RPTION SYSTE `2 Width , Lengtfj, ~ ~ No 01 DIMEN 1 N 3 T~ 02 SETBACK SYSTEM TO P/L BLDG INFORMATION TypeO i System: 'BLS >'~ DISTRIBUTION SYSTEM GPM Coun~~ Croix Sanitar~{~gr~.jt No.: StateJJPl77anLGID# ~VNo.: rl Parceb7~c-~c~.29-70-000 ELEVATION DATA STATION BS HI , FS ELEV. Benchmark ~. ~ p~, ~p t. 8•(ao lo3•~r~~ Bldg. Sewer 1~ Ao ~~ -}- 8. ba 4<f. 3a r St/Ht Inlet ~,Io~ q3•/o~ St/ Ht Outlet Dt Inlet Dt Bottom 23. t3 ~`~.o} Header /Man. --~ _~ Dist. Pipe~^ q.~, 1 oz -So t. System ' ~' Je ' 2 ° 1~ 1 . 2 0 ; final Grade s ~ -'' t cove f z' ~ ~:~ l"z`2 yt. t,(r~?i 1, -- h, ~'-~ru. -u C^. ~' ,. _ . ~ 7 renches I I PIT I No. Of Pits WELL LAKE /STREAM tEACHtNG \ CHAMBER --- OR UNIT - K 8. ss = L Inside Dia. Liquid Depth r: Header /Manifold ~ Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia ~ Spacing ?~ j C3D ~ `~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~ (~, ~ ~ f- 3L'`) = `N Depth Over ~g ~ 3 ~ u Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMIkIENT de c e dis nue e r r uis~cccivu rrl.v~/I T~ W 111JFllilil1V111T4. - , --r- Locat>ton: 8'7~ Wy~c~wooc~,ane, upc~s 1 ~~~ ~/~ a~ 1/4 24 T29N R19W) - 24.29.19.1720 Wyldwood -Lot 7 1.) Alt BM Description = 1 ''~ ~• 2.) Bldg sewer length = 2~. o' 4 -amount of covers ~ $ 4 ~ ~, ~~ ~~ ~ n ~~ Plan revision required? a No Use other side for additio o r a to D Z. O ~ ~ ( Z., SBD-6710 (R.3/97) P ate ~~'` rt ~ I ; sp t 's~ natur ~ Cert. No ~1 Qo~res os-r. w~v+XC. PLOT PLAN PRgJECT Jon Thelen ~ ADDRESS 7901 171th St. Lane NW Ramsev Mn 55303 NE 1/4 SE 1/4S 24 /T 29 ~~ /R 19 w TOwN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 ~ DATEB/15/00 BEDROOM 4 CONVENTIONAL IN-G U D PRESSURE CONVENTIONAL LIFT X)OC HOLDING TANK MOUND SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 763 # of chambers 24 ,BENCHMARK V.R.P. Top Of 1 1/4" Pipe ASSUME ELEVATION 100' ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION •2 ~ ~ ~~/ -Y ~VI w Wvld Wood Lane Revision to existing plans 21' 72 B-5 `~'~ ~ ~ ~~4 l ., _ 77 5' Combo Tank Vent > 12" of Cover 6' Long J,16 " Pro 4 Bedroom House 2-3' X 77" .~ 70' Sidewinder High Capacity Leaching Chamber with 31.8 ft^2 per chamber Grade at System Elevation Rep A 5' Alt. 3 B.M., B_A ~`~~ 43' _ 12~' " Vents 6' B.M. 5' -1 77 B-2 12% ~ lope `/ ~~ l +c" CT VENT PYPE ).2" MIN. ABOVE GRADE 5 ~ 25' FROM DOOM, WINDOW OR FRESi~ AIR INTAKE FINISHED GRADE 4" CI RISER fi " MIN . ---•**~ A80VE G ADE 19" IN . 6" MAX . i -~ I WATER TIGHT SEALS GAFF L£ ~.J !" ;APPRQV~D >IPR 3' pNm ~QLTO 50IL PUMP OFF ELEV , ~ FT . WEATHER PROOF JUNCTION SOX WITH CONDUIT ~; ~ +~ 1~ {` GAS- i ,' TIGHTi ~~ A SEAL ~ B ~ t _F'- i ~ C ~ io 3" APPROVEI? BEDDING UNDER TANK APPROVED MANHOLE COVER WJ PADLOCK 5 WARNINQ LABEL ~.+..u" KiN. ~* APPROVED ALM JOINTS WJ ~H #ppRpy=D PIPS 3' dN~'0 #O~tD 30IL OFF *~ RISER EXIT PERMITTED Oi~Ly I F 'SANK MAI~RIFACTURER HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC /DOSE ~ TANK MANUFACTURER : ~~t „~•+„_(,~,c.~~~, DAY: NUhtDER DOSES PLR __,,,_~,._.,^.,, 'TANK SIZES : S£PTTC „•,(~~ 6 GAL • DOSE VOLUME INC LUDINt3 F LOi~iBAC K S. GAL • DOSE ~,,, s~.,,,_, GAL • ~ CAPACITIES : A r 02~ ~AL• INCHES • +~ ALARM MANUFACTURER: ` MODEL NUMBER : ~-/ g ~ 2 ~ ~L I NCk1ES a SWITCH TYPE : ` n L _ - C ~ INCHE3 a ~ GAL. PUMP MANUFACTURER : ~~ R 1 ~ GAL : .,.4..._ MODEL NUMBE D = , TNCHE3 = ,~'_,~„= SWITCH TYPE: ~ ~ w l ,._._~ REQUIRED DISCHARGE RATE ~ GPM RUMP ~, ALARM WI]~ING AS PER ILHR 18.23 WAC VERTICAL DxFFERENCE BE'L'WEEN PUMP UFF AHD DISTRIBUTION PIPE D FEET ••-~pEE,P + ?~ t~M NETWORK SUPPLY PRESSURE ~ FEET FORCEMP.IN X,_ U~F } ~~ ., Tf 140 FT. FRiCTIt~N Tr'ACT4R TOTAL JYNAMZC HEAD ~~_L~ FEET • Y ~ FEET ~ ~ ' S~ DIAMETER W I D TIC ~ i ------' INTERNAL DIMENSIONS OF PUMP TANK: LENGTfi „~_._.~ ~~-- / S --- LIQUID LEATN • . ~ r ~ i ~- • ,- ~ 4J~1 Performance Data rum L hgrgCterlstics /Meter uah Soba>ersible __._ Modu.t Mods SNEF4aM1 SNEF4aM2 Autolaatic Mails SHEF40A1 SNEF40A2 Non 4 10 Fu! load f 2 6.5 Motor T Shaded Pole (4 Pole) R.P.M. 1350 Pte. t~ v e ifs a3o Item 60 are 120° F Max. Flaid t1EMA A bedaHon (bse A • ~ ! 1 Z" NPT Saida Nadi $ 4" 28 ihs. Pawor Card 18/3, SJ11N, 20' std {3n' optioaol) Materials of Construction Stables Steel as of loot N t:ost Cast ka Steth S Methaeliad fah Seal Sad Fates: Carbon/Cerardc seal Body: A.o~i:at st~l :Stainless Steel ws: iu N 5kaw Saar 8 Row Ia8 B Bohan Pbte P e Coated S Fast lees Steal legs EagYuered iherwoplasik ~u 30 r ~ 20 10 0 i o 20 ~a ao so sa ~ o GPM Total Head {treat} T O 1 d 17 31 Z5 28 30 35 {m} 3.0 4.3 3.2 6.1 7.6 8.5 8.8 10.7 GPM (t15 GPM) 70 b0 50 40 30 30 10 0 ( I/ErY sec} 4.d 3.8 3.2 Z.3 1.9 1.3 .ti3 vemenslvna! uafa 3.7/8" 1a8.~1 1. AO dimensions in inches. (Metric for international use}. 7. tomponerN dimensions may vary t 1/8 inch. 3. Not for canstruttion purpose DESCHAtipE -,12" roPr unless cerlifled. FLQAT SWITCH 4 Dimensions and wet his • g ore approximote. '~ S. We reserve the rigght to make revisions to our product and: t6eif spedfitatia~ without notice. I 'Y 1,-318" t 0-3tt 6° (aes.e2} (25b.78) _.~ 3.878" ~) f~\ O 199$ hlydromotic" Pump,, Ashland, Ohio. All Righh Reserved. '~'~ HYD ROMATIC ~~ -Your Authorized local Distrilwtor -- • . . . . ~ 1840 Bnney Road Ashknd, Ohio 4481!5 Tef:419.289.3042 fax; 4i 9-281.4087 Web Site: www.pentaErpump,com /~ tYfYb~, sAlES csFSlcES IM Atl AIAJQIr CITIES AND COtfMTIP16S u ~,+~ ~C~~ ;!J!`.~ ~ Refer to 'Pumps ' in Hie Ydlew Parma el yi°ur phm,e dliedor ~~ ~ 9+ ? trY Y ~Or year kcal Oistrr~utar ~ -' , Ifom#r ~-02.6dB0 r r98 5M ~~ ~~ / ~I G `y ..~._,kG_. ~ ~" d ~~~ ~- - SANITARY PERMIT ION ~~~cons~n , I ~ _~ , De~iattment of Commerce In accord with Comm 8 5. i~Ad~-+: Code • Attach complete plans (to the county copy only) forth than 81/z x 11 inches in size. • See reverse side for instructions for completing this a T Personal information you provide may be used for secondary purposes:4, ' [Privacy Law, s. 15.04 (1) (m)): ' ~,, ~tlpii~ttot IesS ~'~. rJ ~`S.L ~~,~~ =~~ .-r~nG -~ Safety and Buildings Division 201 W. Washington Avenue P O Box 7162 Madison, WI 53707-7162 unty s . ~~o;~ ate Sanitary Permit Number 37a 7~ Check if revision to previous application ici I. APPLICATI N INFORMATION -PLEASE PRINT A L INF ION ~~ Pro ert Owner Name ~* p y o~ ~~ ' P o ~ Lo on D/ i(~ va, S T ~ , N, 7 E (o Property Owner's Mailing Address 9'D l ~ ,t~i~J Lo m er ~ ~ Block Number Cit ,State Zip Code Phone Number Subdivision Name or CS Number ~ '3 ( ) II. TYP F B ILDING: (check one) ^ State Owned ^ !t~ ~ Vil ag ea/r-estlRoad I ~~ ' ~`~ Public r 2 Famil Dwellin - No. of bedrooms OF Y/ ~~ "" III. BUILDI G USE: (If building type is public, check all that apply) Parcel Tax Number(s) ac~ ~q. ~7ZD - 'I 1 ^ Apartment /Condo L 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 obile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ e /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Check only one box line A. Check box online B, if applicable) A) -~[-~€w 2. ^ Replacement 3• Replacement of kO l S S /" 4. ^ Reconne S. ^ Re air of an p . i n stem 1 E t S S ~ ystem ________ ystem______________ n n y_____ -_____ , ~ x i y c~ e s __ ____ B) ^ A Sanitary Permit was previously issued. Perms umber r 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 eepage Trench 22 ^ In-Ground Pressure a .~ ~ ~ 42 ^ Pit Privy 13 ^ Seepage Pit ~ .~ - ~ 43 ^ Vault rivy 14 ^ System-In-Fill " 3 x VI. ABSORPTION SYSTEM INFORMATION: ' v 1. Gallon er Day 2. Absorp. Area 3. Absorp. Area 4. Loadin 7. Final Grade g Rate 5. Pert. Rate .System Ele ~~ /, Re uired (sq. ft.) Pro os (sq. ft.) (Gals/da U ~ ~ sq. ft.) (Min./inch) ~ 2 EI v ti~}n i G . r Feet ICJ Feet VII. TANK INFORMATION Capaut in also s g Total # of Manufacturer s Name Prefab. Site Con- l St Fiber- Plastic Exper. N E i i Gallons Tanks Concrete . ee glass App ew x n st strutted Tanks Tanks Septic Tank ank ~ ^ ^ ^ ^ ^ lift Pump Tank/Siphon Chamber ~6 ^ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATE ENT I, the undersigned, assume re ponsibility for installation of the onsite se ge ystem shown on the attached plans. Plumber's Na : (Print) Plumber's i e: (No Stamps) MP/~/RJSW N /' Business Phone Numb r•~_ Plumber's Address (Str et, City, St e, Zip C~1~) ~ L /, ~~ ~1 ~/_ IX. COUNTY /DEPARTMENT USE ONLY ^ Disapproved Sanitary Permit Fee f"~i~desGroundwater ate slue Iss A nt Signature (No Stamps) A roved pp ^ Owner Given Initial Surcharge Fee) ~S ~ ~ ~ Adverse Determination ~6 X.: CONDII IONS Uf APPKC~VAL / REASONS FOR DISAPPKUVAL: ~,,.~~idh, Z^'i SBD-639H (R.12/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, INSTRUCTIONS :~ 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. ._ To be complete'arid accurate this sanitary permit application must include: L. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. 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 t,~rf replacement, reconnection, or repair. V. Type of system. ck appropriate box depending on system typey~yr`'r _ l VI. Absorption system i r vide a in rmation reques~imd for numbers 1 through 7. ~" VII. Tank information. Fill in th p i ew/or exi,,44tit~g tank, list the total gallons, number of tanks and manufacturer's name, indicate pre to nstructedand tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check expenm tal approval only if tanks received experimental product approval from DILHR. ~_ y VIII. Responsibility statement. Installing pl4er is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumt~r-tiiust sign application form. IX. County/ Department Use Only. _ X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inchesmust 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 byte co`br~'ty;-E) soil test data an a 115 form; and I/) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number afi~regulated practiceswhich can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. P , T PLAN PROJT9CT 'Jon Thelen DDRESS ~~~ f` ~ ~~ ~ _ ~ ~) ~ ~~trt~1`v ~ ~ ~S3 I NE 1/4 SE i/4S 24 /T 29 N/ 19 TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6/16/00 BEDROOM 4 CONVENTIONAL )00C IN-GR U PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .8 ABSORPTION AREA 763 # of chambers 24 ,BENCHMARK V.R.P. Top of 1 1/4" Pipe ASSUME ELEVATION 100' ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 96.2 Wvld Wood Lane 10' 72 I 1 ~ti ~~ y, B-5 ~~" 2-3' X 77' Trenches W ~- 6's ~ 0 4 10' edroom House Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber with 31.8 16" ft^2 per chamber 6' Long „ , „ Grade at System Elevation 6' 21' 77' _ ~B-4 Rep A 5' Alt. B-3 B.M. . _ 43' _ 1 ' ~ / Vents ~~ ~~ B-2 12°Io lope a ~z.~e ~ Q ~- - ~ wc,, i.ti.7C~~sX ~~ Cws. +O~.3 ~t.T ~Z s ioo.y a qT3'~ ~thZ "~b~-,.~yEyi,~ c~t~,c, 101.33 ~~ ~v0.Z, Wisconsin Department of Industry, SOIL AND SITE E V A L U AT T 4;~bor and Human Relations /,~ L^_ y~ ~~ Page 1 of 3 _ _._. ~ 111 QIRiVIV YYllll ILnll VJ.V ~~~.r7:~un~. vvaiv 1 ~ ~ ~ , ; ~ ~ U NTY l Plan,must incii~i4f 11 i h i 8 1/2 i l h St. Croix nc es n s ze x ess t an Attach complete site plan on paper not po ( ) p~;~sc~le or not limited to vertical and horizontal reference int BM ,direction and °rb~of slo ''' pAR EL I.D. # - 020-1329-70-000 ~ j ,`, ~ dimensioned, north arrow, and location and distance to nearest road _ I ~~® 5T EV DB D TE G,y~yy APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATI~,N -', ' ~UN1 ' ~ R (~ ~ 1 t- r PROPERTY OWNER: `, PROPERTY L ~ ~ ,~ McDonald Construction dpttT;'~p~NE _ ~~ 1/4,S 24 T 29 ,N,R 19 ~E (or) W ~, PROPERTY OWNER':S MAILING ADDRESS LOT #,~ ~ D. NAME OR CSM # 7601 145th. St. 7 na W ldwood CITY, STATE ZIP CODE PHONE NUMBER ^CITY OVILLAGE [MOWN NEAREST ROAD Apple Valley, MN. 55124 (6121 701-5519 Huds ~] New Construction Use [ ~ Residential / Number of bedrooms 4 [ ]Addition to existing building j ]Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 96.20 ft (as referred to site plan benchmark) higher Additional design /site considerations trenches 4 00' below grade, area 9f B 3-4-5- o be cut to 102.53 ~ or Parent material outwash Flood plain elevation, if applicable n~= ft S =Suitable for system CONVENTIONAL CAS ^ U MOUND CAS ^ U IN-GROUND PRESSURE CAS ^ U AT-GRADE ~r7 S ^ U SYSTEM IN FIL ^ S ®U HOLDING TAN ^ S ~1 U =Unsuitable for s stem SOIL DESCRIPTION REPORT Boring # 1' Ground elev. 100.2 ft. Depth to limiting factor +88" Boring # 2 ~> Ground elev. 100.2 ft. Depth Dominant Color Mottles T t Structure n istence C Bounda Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. o s ry Bed Trends 1 0-9 10yr3/3 none sl 2mgr mvfr gw lc .5 .6 2 9-2Q 7.5yr4/4 none sl 2msbk mvfr caw lm .5 .6 3 20-8,8 7.5yr4/6 none c~ Osg ml na na .7 .8 Remarks: 1 0-10 10yr2/2 none 1 2msbk mfr gw 2c .5 .6 2 10-21 10yr4/4 none sil 2msbk mfr gw lm .5 .6 3 2.1-~2 7.5yr4/4 none sl 2msbk mvfr gw lm .5 .6 4 32-8~8 7.5yr4/4 none co_s Osg ml na na .7 ~ .8 Depth to limiting factor +8811 Remarks: PROPERTY OWNER 1KcDonald Const. SOIL DESCRIPTION REPORT PARCEL I.D. ~ 020-1329-70-000 Boring # 3 ~`> Ground elev. 104.7 ft. Depth to limiting factor ~~ Boring # 4 Ground elev. 105.1 ft. Depth to limiting factor +120" Boring # .... 5 ... Ground elev. 106.0 ft. Depth to limiting factor + ~~ Boring # :?::: ... Ground elev. ft. Depth to limiting factor • Page 2 of. ~ 3 .,. • ,. H i Depth Dominant Color Mottles Texture Structure Consistience Boundary Roots GPD/ft or zon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 0-6 10 r2/2 none sl 2m r mvfr 2c .5 .6 2 6-20 7.5yr4/4 none sl 2msbk mfr gw 1m .5 .6 3 20-12 7.5yr4/6 none cos Osy ml na na .7 .8 t' ~ o r. 20 ~z~~ Remarks: 1 -6 10yr2/2 none sl 2mgr mvfr gw 2c .5 .6 2 -15 7.5yr4/4 none is Osy mvfr gw if .7 .8 3 15-120 7.5yr4/6 none cos Osy ml na na .7 .8 Remarks: 1 -13 10yr2/2 none sl 2myr mfr cs 2c .5 .6 2 13-32 7.5yr4/4 none sil 2msbk mfr yw lm .5 .6 3 2-42 7.5yr4/4 none sl 2msbk mfr gw if .5 .6 4 2-144 7.5yr4/4 none cos Osg ml Na na .7 ~.8 Remarks: Remarks: SBD-8330(8.05/92) ~ ~..: . . STEEL'S SOIL SERVICE Gary L. Steel McDonald Construction CSTM2298 NE 4SE 4 S24-T29N-R19W MPRSW-3254 town of xudson lot #7-Wyldwood N 1"=40' BM. = top of 14" pvc pipe ~ el. 100.00' Alt. BM.= nail in Aspen tree C el. 101.90' 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 c ~~ ~~''~ ~° Gary L. Steel 5-4-2000 ST CROIX COUNTY SEPTIC TA1~1K 1~Ii4~NTENANCB AGREEMENT . ~ . ANA, GWNE$SHIP CERTIFICATION FORM OwnerBuyer ~I> ~ Mailing Address ~ Q /~-s,P~ ~'o'LaJ ss 3(j '3 . _ -- -~ Property Address (Verification required from Planning Department for new CitylState ~ Parcel Identification Number ~ O -- 13 ~ 9 -~ ~ a- ~~ ELF. GAL DESQ~ Property Location ~ %., ~ '/,, Sec.o2~ . ~~N-R~W, Town of Subdivision Lot ____ Certified Survey Map # _ _ Volume .Page # r~--- Warranty Deed # _ _ ~~~~~~ ~, Volume ~Q~Page # ~ . Spec house ~ yes~~no Lot lines identilia~~p~ges O no SYSTEM MAIlV'I'E ty[~: improper use and maiatcaancxof yoar septic system could result in Sts grernature failure to beadle wastes. Proper maintenance consists of pumping out the septiic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic teak as a treatment stage in the waste disposal system. The property owner agrees to sabmit to St. Croix Zoning Department a ccrtif cation fora, signed by the owner and by a masterp[umber, jourt~,eyman plumber, restrictedplucaberor a licensedpumper verifying that (1) the on-site wastewaterdisposal system rs in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than I13 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the staadards~ set forth. herein, as set by the Department of Commerce and the D~partmcat of Natural Resources, State of Wisconsin. Certification stating that your septic system has been mainmised must be completed and returned to the St. Ceoix County Zoning Office within 30 days f the throe y e tion date. C ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owner(s) of th ropan~~iy a . by virtue of a warranty deed recorded in Register of Deeds Office. TT GNATURB OF APPLICANT DATE «««~«« Any infottn$tion that is rots-represented may result in the sanitary permit being revoked by the Zoning Department. ««•««« «« Include wlth ,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 decd vot.15~1P1i~E 201 * ` STATE BAR OF WISCONSIN FORM 2 - 1999 ' WARRANTY DEED Document Number - This Deed, made between Roger H. Gehrke and Sandra M. - Gehrke, husband and wife, Grantor, and Jon T. Thelen and Jennifer Thelen, husband aad wife, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 7, Plat of Wyldwood, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. 020-1329-70-000 Parcel Identification Number (PIN) This is not homestead proPenY• pd) (is not) Dated this ~__ day of April 2000 s AUTHENTiCAT10N Signature(s) _~ Rewrding Area t620S80 KATHLEEN H. WRLSH REGISTER OF DEED5 ST. CROIX CO., WT RECEIVED FOR RECORD 84-07-@404 11:45 AM EXEMPTTi DEED CERT CORY FEE: COPT FEE: TRANGFER FEE: 179.70 RECORDING fEE: 10.04 PA6E5: 1 Name and Rewrn Address 'iXst At' sal Wank of~New~~Rifthyto}~ )air Richtn~/,~ WI~O~' ~7Y7/~/ er H. Gehrke + Sandra M. Cehrke ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ~, ~ j y( County ) authenticated this day, ' personally came before me this ~_ day of REBECCA J. PHANEUF Aprii , 2000 the above named ~ftY-PdBLi Roger H. Gehrke and Sandra M. Gehrke, husband and wife, ~ STATE OFWISCONSIN - TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, _~ instrument and acknowledged the same. authorized by § 706.06, Wis. Stets.) -~ THIS INSTRUMENT WAS DRAFTED BY •~° ~ ~ ~~^~'~ Attorney Kristine Ogland Notary Public, State of isconsin Hudson, I Ol My Commission is p manent. (Ef not, state exp~rr~a~~n date: (Signawres may be authenticated or acknowledged. Both are not necessary.) .~.-_. ~O~ ~ -~--') • Names orpersons signing in any capacity must be typed or printed below their signature. trfomuii°n Pr°m"°"°a c°mpary Fme °" tac,1M 60a85r+-2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-1999 /d __1 T F ~ -- - - c ~ 1 N A ~ i (11 ~ v \ 1\ ~ ~ 1 ~ \ ~ \ N J ~~ ~ ~ ~ _ ~ S o Q~ ~~ ~ \ ~4' rev N ~ ~ \ ~~ N N 0 A ~ +QO~ c v ~ o ------ ~ ~ f6. \ ~ r*~ Cv .p f'l ~ ~ ~~ gyp, ~ \ . °'~'~~ Z N "' _ ~ \ ~~ 0 40- ~ ~ ~ 3 ~ ~ N ~f~ ~ ~ a i \ \ ~ 4O"j. ~ ~ fj \ ~ D Z 7C ~ > ~ cn ~ r~ -- r ~ O \ D\ ~ ~ Q~6~ ~ \ D ~ N I O ~ o ~C ~D \ ~Qy 9.r \ \ rNi °-w °v o i ~ 3 ,.r I -1 N 1 j. Z ~ ~ ~ .-~\ - '~ ' 85.0( j I~ N 0'11'21' E 16"pp• ~ V ~` \0-.- I ~ 70.00 \pp~ f N 0'11'21' E \ bV b~ ~ o• ' I D D d ~ 175.00' ~ `. ~~ \ ' ~ \ 1 ~ I Z r t~ii ~~ ~ b~ ~'~ \ 0b ~ ~ D i~ ~Z Op`~~~p- _N 0'1121' E ~~ti ~~ 1 wo ~Z o~ 1 Z ~ ~ ~ `,~ j 238.72 ,Lb ~ ~ ~ ~ I ~ N ~ o ° .o b ° '•' N J ~ ~ ~C7 ~ ~O~ ~~ I "' ~ ~ ~ W /q w ~0 , oD / Z f Z I ~ N ~' A w ~ ~ \ ~(. I ~ ~ 00 ~ f .r 4` 00 ~. ~ n \FpS ~ ~ ' ~ ~ o° a ~ ~5~~\~S. ~--~I Q I ~ ~ I l ~ s -i t*i v~- ~` ,~ Q IU v W fTl Z n \ ~ ('ll ~ ` ~ ~~ v ~ ~ 0 1~J ~ ~ ~ ~N 0'48'39' W ~ f'l ~ :o H ) ti I ~ N I 95.00' ,~~ '~ 9c~. o ~ c °• I w 7- ~, I ( r I ~ ~` ~~GCjF90,,~ \-cam `1, F( ~ o n .lZ.ll.o s ~ / •N N~ - - - - - - _ - b 2 S4.Op- ,~~ o \ ~=° ~ _ ~ ~ ~ 10 °00,24 .4.73.0 N~ d tiN 933, E ~' ~~\` o ~55i ~ ~ ~ 99.6 ~~ 2 ogti N~ I ~~ ~ ( I f ~ ~~ ~ C r < n I -WiSconsinDeparlm4intoflndustry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations I16. ...,4 Co.fnly A Ruililinnc w J.- /".~J.. Page 1 of 3 .. 111 QliliVlU Wllll ILflll VJ.VJ, ..1J. /'~411~. vvvv ~'S COUNTY s i 1~ 1 Pl 11 i i i 8 1/2 h l h St. Croix a nc n s ze. x es an ess t Attach complete site plan on paper not ~ , not limited to vertical and horizontal reference point (BM), direction and % of.Sl ,'scaor RCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. x `-~ ` endin ~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATI~N._,"' ~. ~"-~'~}~ ~ ' ~;r? ~, WE Y DATE ; ~, PROPERTY OWNER: 1 PROPI'~~l Al IOy Greenwood Enterprises, INc. Y _~GUVT. OT ~1 ~'~44 g i+~, 24 . 29 ,N,R 19 ~ (or) W PROPERTY OWNER':S MAILING ADDRESS ~"CQT;# BL6 Kli,- ~'3fJBDr OR CSM # 1416 3rd. st. `~ n~` -. W • wood CITY, STATE ZIP CODE PHONE NUMBER TY ^VILLAGE []TOWN NEAREST ROAD Hudson WI. 54016 (715) 386-3674 Ht3dson BAdlands Rd. [x] New Construction Use [ x] Residential I Number of bedrooms 3 ( ]Addition to existing building j ]Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 643 bed, ft2 563 trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 93.84 ft (as referred to site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL C~ S ^ U MOUND C~ S ^ U IN-GROUND PRESSURE C~ S ^ U AT-GRADE CAS ^ U SYSTEM IN FILL f7 S ^ U HOLDING TANK ^ S ~1 U U =Unsuitable for s stem SOIL DESCRIPTION REPORT Boring # . 1 Ground 9~1e5 ft. Depth to limiting factor +98" Boring # 2 Ground elev. 98.4 ft. Depth to limiting 1 t+94 Depth Dominant Color Mottles T t Structure Consistence Ba rxiar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. . y Bed Trench 1 0-17 1 2 17-50 10yr4/4 none sil lcsbk mfi gw 2f .2 .3 3 50-98 7.5yr4/6 none cos osg ml na na .7 .8 Remarks: _ 1 0-19 10 r2 2 none 1 2msbk mfr gw 2m .5 .6 2 19-55 10 r4/4 none sil lcsbk mfi gw if .2 .3 3 55-94 7.5 r4/6 none is osg mvfr na na .7 .8 Remarks: CST Name:--Please Print G L. Steel Phone: 715-246-6200 Address: 1554 200th. e. New 'chm nd WI 54017 Signature: Date: CST Number: m02298 . 10-16-96 PROPERTY OWNER Greenwood Ent. PARCEL I.D. ~pendina SOIL DESCRIPTION REPORT Lot #7 - ~ Page ? ~~i . 3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bax~dary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 1 0-6 10 r2 2 none 1 2msbk mfr 2m .5 .6 2 6-27 10yr4/4 none sil 2msbk mvfr lm .5 .6 3 27-88 7.5 r4 6 none cos os ml na na .7 .8 Remarks: 1 0-8 10 r2 2 none 1 2msbk mfr lm .5 .6 2 8-30 10yr4/4 none sil lcsbk mfi gw lm .2 .3 3 30-80 7.5 r4 6 none cos os ml na na .7 .8 Remarks: 1 0-10 10 r2 none 2m k mfr 2m .5 .6 2 10-30 10 r4/4 none sil 2msbk mfi 2f .5' .6 3 30-80 7.5yr4/6 none cos osg ml na na .7 .8 Remarks: Remarks: SBD-8330(8.05/92) « J J f f STEEL'S SOIL SERVICE Gary L. Steel CSTM2298 Greenwood Enterprises, Inc. MPRSW 3254 NE4SE4 S24-T29N-R19W town of Hudson f lot #7-Wyldwood IN 1"=40' BM.= top of 12' pvc pipe ~ el. 100' ~+j` t ~ ,1, ~~~ ~~ 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 ~ ~ 2i~ zo ~~ I '~~ ~~ ~i •3 ~ ~~~, ~ n t~ ~r Gary L. Steel 10-16-96