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Home My WebLink About020-1395-31-000 (3)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Div'sion INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.95.04 (1)(m)]. Permit Holder's Name: City Village X Township Tro ood Com anies, LLC Hudson Townshi CST BM Elev: Insp. BM Elev: BM D,esq~iptio~ : +~ / 0 b , 0 / 0 ~ .v l v C~v~. / l~ l~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (~ ~fi lJ Dosing /\ ' ~ f Aeration Holding ~ TANK SETBACK INFORMATION TANK TO P/L WELL BLDG, Vent t 'r Intake ROAD Septic ~ ~ ~ >~ + I ~6 ~ I h /~ t V (,~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Man facturer and GPM Model Number TDH Lift Friction Loss ystem TDH Ft Forcemain L Dia. Dist. to well F_I F_VATION DATA County: St. CroiX Sanitary Permit No: 430664 0 State Plan ID No: Parcel Tax No: 020-1395-31-000 Section/Town/Range/Map No: 25.29.19.2425 STATION BS HI FS ELEV. Benchmark ,nn ~~ I,'l ~ , /Ur ` 7. /~r Alt. BM Bldg. Se r .}.q . (o ~ 1.8c,f . S3 / Z , 9 ~ St/ net ~+ 3.~ gf r,~ d~ lvf. t SUHt Outlet S z~ ~ ~ ~~a Dt Inlet SC ~/ ~ / ~ ,i _, Dt Bottom i / eade an. 1 0~(' / D- ~iI W'Z I Dist. Pipe ~ ! ~ . "~ ~ 3. 16 Z•O System Bot 3 •v~ . I.II•~ Final Grade ~~ S 3 1~~, St Cover 2 /~' q3• ~ -~ Sr' I~ ~ 14~~~ 1'~f•ZI IZ7,17`~~I ~v ~o.) f03.0-1 24. SOIL ABSORPTION SYSTEM .~ll' („ e.t ~Tis , ~e // //.-, ~ ~ '7 -~ %~i lC.~ L, ~1''~ LI•~3 (~~ • / 'S BED/TRENCH Width ~ Length No. Of Trenc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ t `i SETBACK SYS M TO P/L BLDG WELL LAKE/STREAM LEACHI G Manufer: ~ INFORMATION CHAMBERO (~ {/ Type f System: ~ ~5,~, ` ~ ~1 ~ Zao' UNIT , Model Number:t '/~ DISTRIBUTION SYSTEM '~ /~ ~ ~__ t~ ~ ~ / /,.a //0 Header/Manifold Distribution I x Hole Size x Hole Spacing Vent to Air Intake Length [ Dia / I ~ ~ ~ Pi e s , r (~ ) ~ Length L~~] Dia H ~ ~p c ng ~ '' a„vl SOIL COVER Y Praesura Svcfemc llnly YY Mnund nr At-Grade Systems Only K.~N/~.~ ~ ~ Gi~ r Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ ~ , Bed/Treri dges ~ Topsoil ~ Yes No Yes No ~• COMMENTS: (Include code discrepe cles, persons presen ,etc.) Inspectlon #1:~/ / Inspection #2: / / Location: 771 Kinney Road Hudson, WI 54016 (SW 1/4 NW 1/4 25 T29N~•R-•19W Scenic H_ill-s L/ot 31 m~,Q Parc~el~Nfo:"25.29.19.2425 1.) Alt BM Description = rJT~~~~~' 2'~ ~ ~ _ ~~ t ~ 7 / ~~~~G'~C~ -~v~c/~ ~~7/(/tf.~.. 2.) Bldg sewer length = ~ ~ /~ , 5( `, /_„ OQ/ L ~, . ~~ -amount of cover = > ~ ~ ~~ t~,S'~~~ ~ ~ GV G~LC~JC,- ~F-O '~L~ sl~~~te~v~' !u~" f-l ~ti~ 0 Plan revision Required? Yes ~ o ' ! ~ ~ .~Q~j~' Use other side for additional information. __-- ~ 1- __ , _, _-Gu!YV~ ___ Date Insepctor's Si~at`ure ,, / ,- //- / +C~ert. No. SBD-6710 (R.3/97) C~~ / i _ ~~G~J W l~-\ ~j~2.~~(,Q ~ u~l /YI.f7~~[~]'(I I'~. J ~l~ I .. 2~g` Qw p ~ ~ ~\ ~N ~,~!xa J •' ,• c9 e plain [b the Cut.ty ody) sy oa wd Wn sin i ti~m~sh~e n~ G~YL j ~ G~ h~,ua~ ~.e. 5~~°v"'~ CC~X~C rao 9~. o Ct t~cc.,n,-~w(.c,l„~. ~~ S '.{,r'~l,,~t ~,-t~eY ~ ~ ~ `~Q"'' , Q ~ ~ J ~. s~ c~~,c~.,•_. d ~~ w ~ ~ ~~~ ~ ~~~/ ~~- ~~ ~°~ PsT. ~~~- ~~ ~ i--r~ --- _ - Safety And Buildings Division __ County 20l W. Washington ., E T. ROIX ' ~~CQ~~E~ Matiiunn, WI 537t?7 auu • Permit Number {to be filledut by Cu.} , (f 08)2 1~i54F.i ~30 Department of Cammerce __ Sanitary Permit Applieatio JAN 2 2O PI I.D.Nutnbe~r J a Wis. ~n Code, prrsaral irnfixtrtatioet provide In acavd with Comas 83.21 !" / ' _ , mayt,eusr,3litrstypat{ioseslRivacylaw,sl5.U4(! y ST.CROIX000 j~ ~(~di~' etrithann~ailiutgad&'ese) __ ZONING OFFIC KINNEY RD. L Application Information-Please PrinE Alt Information HUDSON, WI 54016 Pn O-titx;r's Nana' / L >~> --r~~y~u~va c~~ ~ 3 P Lot # 31 Block # -ANTHONY NICKOLAUS _ OZU-~~ ~~Lc ~ 1'ropcxty pwrncs's Mailing Address ' / ~~ 2 t7 G ~77(i(,(N "" ` Zy2 L ~ ~ SW 11 NW ~;r. Seth«t 25 City. State 7.ip Code Phone Number - --- LAKE. ELMO,MN 55042 651-773-5055 ~tte~trcla orle) T 29 N; R19W~;~ } te of Baildia (check all that a pl II T g p y . y> CS ht:ittrttber N t ! ~~ 1 ar 2 Family Dwallmg - Nltrnher ot`l3edram 4 BDR S PER SUBMITTED HOUSE PLA . 'vlsnmt ame Su tr 't; i l C] il t: { ] bli SCENIC HILL 9e ___ omntcrc a - escr x . Pu c CELLS W/14 CHAMBERS EACH ~ 2 DIST L1 ir ib L~Village ~_~i3nmalsipof HUDSON ^C;ity _ ,k _ yc c~cr o ' Ill. Type oT Permit: (Check only lone boz on little A. Complete lies B if applicable) ~!1__ 8 A ~a~ . t~ New SYskem .--~-^- ~~ Rzplacealtent. System ^ Ttnalnrertlfllutdireg Tank Replacxrrtera! (kity ~ ~ Ot!!er Modification w Pxisting Systan 8. l~ Permit Renewal ~~ Permit Revision ^ Change of U Pcxrnit Tras~'er to New cast Previaos PcratiE Number a Daie lssnt I~elure Ecgriration Plumber Ownea' 1V. T of POWTS 5 ten: Check all that a i ~Nwn -Pressurized ln-Cirotnnd U Mlxtnd_ 24 is ofsuitable sail ^ Mound < 29 in ofsuitable sail ^ Ai-Grade U Single Pass Sand Pil4x ~~ CcxtSVUCtOd Werlanlt ~] 1't - u LI Peat Fitton I I Aeratric't'raurttrerw l)na ~ i8ac:irwlaRing Sacral Filler i~ I ~E ~~. 12ecieptiatirtg Synthetic Media F' i~l.eactnirtg Chamber ® line Gravel-leas Pipe ^ (lltset (explain) _ V. Dis rssl/TlnesimeetAtea shoe: Z 0 2 87.50 trench cells- cam era ea. = 28 chambers re uired __ _----- i7esi®u t7ow {gpd~ Fh~ign Soil Applicati ~) rhspena ea eqn a R1e'F" rea ~ ~ ~ .7 ~ 857.14 870._g _ / 95.0 UPPER 94.5 LOWER 600 VL Tonic Info C>wa~v ~ Dial Nur~ws I~lanufatxArtx Prefab Site '~ ~ siic ILTER Comae Constructed cilass B EL F (:atlnaa ofii„i~s w/ZA Gailttns _ New FxlSlt[I¢, ~ / ~I ,~ / ~ W ~C. Tanks Tsdcs '~`~`~~'°lei~r,u~ X 1253 1 WIESER X Armbic Tn~alctK+nl Zlni! _ ~- ...P i?nsi.vV l'hnnbcr -- h ~ VII. Rexponsibilily Ststenn~rit- ], tLe ~®.c rrsptaecite'iitp for ~ otter F()~t'7'S ahmra m We aNac6ed P~"• Plwnher's Nanre (Print} s S Ml'1M1'fLS Ntrtnbtx Htwnlcaa 19mne 1~ttm ~ TODD FEATHERSTONE 242514 ------- r 715-381-1704 Plumber's Address (31ree1, City, Stn ,Lip (,odcl J P.O BOX 467 HUDSON, WI 54016 DATE 01/14/2004 --... j V Cove /De artmeet Use 4n _ Aaurrn~Yi ~ ~ Sanitary Permit Fee (includes Groundwater Nate Issued sst»pg ~~o C Owner Given Reaycxe for Derlia! IX. Conditions of Appravs!/Reasons for Disapprnv I `Q'.l~2 __ Gl.~(~h ~ STEM OWNER: ih- ~~•~Z `~~tin~ effluent filter and ~ yt~ tic tank 1 e ~ y~~~ ,p ,t , p J ~ / ~ ~Q-1~-~ L~ . dis ersal cell must all be serviced /maintained P as per man anent Ian rovided b lumber. S s~ '~'/ VY~~- ~ ~ y~~A'~ ~~' ~ l I 2. setback requirements must be maintains ~ ,, -~~U~L~-~fP~- -r applicable code/ordinances. ~3~~/ ~~.tnn, vt1 Ce.eea ~ ~~' ~~ ~.s,~ I ~1~~ Z \ ~ I =tea ~ ' ____ ,, ~~ ~~.,~.~ ~ ~, ,~,ai.~^'o~ ~2..~L. /pO~ D ~-,b4K /N ~ ~ /D • ~14~ Ti~E B~ - 9a• 9~ ~ _ 9~. ~ ~ . i i I< \. ~,,,~, ' ~ S~ r ~r ~~~ p,~ ~" ~ ~y~ ia8' , ~~ d s^ 2-,~ I j ~~ ~, ii i ~~ ~~~ I. ~~~~ Z ~y 3, ~ ~ , ~ b ~-~-- ~ ~ I ~~ ,~ 1 N /-~L./0.25 ~//SYc /.si/~? OAK ~12.~~./pO•d Q oia.~ ~E ~ + 9~ ~a I ~ ~ ~ ~ . <~ +~ .~, ~,r~ v \. ~„~' 73ya~t~' , ~ ~~ ~S ^' ~ o o ~ c 148' ~, ~' PAGE ~ OF~_ NAME; ~ r K-e-_t !__ LoT# 3 1 LEGAL DES SCALE: 1 "= y U 1 • - ~ ~,~ BM 1 ELEVATION /Oa • O ~' I ~ ~ ~ k , 6~ ~~~' " BM I DESCRIPTION c„' 1 i'~ Z "o q -1•rs ~ i BM 2 ELEVATION iao ' ~~~ BM 2 DESCRIPTION n u . I ~' .~ ~ o " o a l~ +o ~ c SYSTEM ELEVATION _ c/% ~d _ (I„ ALTERNATE ELEVATION ~ `l• 2 y ,~" CONTOUR ELEVATION qZ•o~~ q3 00, pyop pS Uc3 1 f Sew. ~ .S ys..~, ' 5~~ ~~~ ~ ~^ ~~ _ ~~-~' s o' ~ 6 , ,, O ~ g-I ~',~~ ~ nr~~~ ~ ~ aX' 1~ 6'" ~ a 3 , ~~~~ Z SIGNATURE /~/ ~~,/~ ~~ DATE ~ G - d/ ~~ ~ SYSTEM CROSS SECTION LIFESTYLE HOMES, INC. LOT 31 SCENIC HILLS -1~-{-: CU~~'s' ° ~" `~ INSPECT ON PIPE ~~~~~ MAN HOLE ~ B3 - v~r~.t~-a~ ~2 G l.~' ~rri~-~ l3g3 GRADE 96.0 Gt~-l- `s, d . ,,~P~t)~ U F ZABEL FILTER .~ 1253 GALS. ~~ 7 87.50 ~ ~ ~r ~ ~/N,~~~d ~ :~~ SYSTEM ELEV. 95.Q UPPER - 94.5 LOW_~R C~~ 1 14 B!O DEFUSER CHAMBERS O ~ O 87.50 0 ~~~.~d- ~~- coo ~s"~~ - ~'~~ d .,~,cCS ,Q-o C~2~~~~~~ .~2e~-Gf~~ a~~~ ~ SW '1+ NW 'ls.S 25 ~' 29 N,R 1~E ~~~~lOfti7 ~/s.7~I1'+ . ~ 31 ~~ $l,}Q SCENIC HILLS C 242414 `Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of SafatY and Buibings Page 1 of ' m acooraarwe wim c:omm nn, vvrs. warn. was qty ' Pl t 11 i h i ¢ 5 croi an mus es e. nc n s Attach oomple~ site plan on paper not less than 8112 x inducts, but not limited bo: vertical and horizontal reference BM), drection and Panes I.D.. ~ ' S- 3 ~ - DUv 3 ` percent slope, scale or dirr~nsiorrs, north arrow, a to neared road. C 20- 1 Please prir-t all 1 ~ n. ~ , / ~~ ~/ e~-ie7""ad Date . Parson@i iMormation you provide may be used tar . , pu Law;`s., (1) (m)). , (a (9 6 Property Owner `.~_ ~ . ; Go~tt.• of 5W 1 /4 NuI1l4 S 2 .~ T L q' N R /q E (or) Property Owners MaiGngAddress -•-~ '- ~, ~ L ~ Bbdc # Subd. Name or CSMIt ~.. Co ~ Z O S~ ~ I l wc~. ,~~ S , e City State Zrp Code 'PhCna NBC' ity ^ Vdlage (~ Town Nearest Road _ -~ $3 :- ' ~` ~'SD ~Z ( I )' y STi I l water VY~ ° v K ~ • n ~ ~ ; ,. . ., < -1. ® New Construction lJse: ® Residential / Number of ' `l~ Code derived design flow rate DSO ~(o O Q GPD ^ Replacement Q Public or oommeraal - De~safie: Parent material U ~ (.~ Flood in elevation if applicable /U ~' General comments s s~ yyl e.I GJ0.f.b ''s o C '~' ~~~~~ Ic- and recommendations: ~ ~ ~ ~ I ,~ J a, .`o ,,~ _ 8' ~-n add~~~-f-to,.,~ bo,-~ ivy ~z l {2~n ~c~r-~- 4,YS1~ f~ D~ ° -` W ^ BOring - v ~ w i ~ , ring ~ e! f ~ # rev Pit Ground surface elev. q/ ~ ft Depth to limiting factor ~ in. ~Ob Sod ic~t+on Rate Horizon Depth Dominant Cobr Redox Description Texture Stnidure Consistence Boundary Roots GPD/fi? in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. •Eff#1 •Eff#Z ~- y-2 ~ ~ = S s ml ~ - .-l I.2 3 Zy. I Si I ZrY-.SbK ~' - - . S . $ ~2~'~S~in t~ 0 ~ 3d `( (,~ L~ ~~ Z Boring # ^ ~~ ®Pit Ground surface elev. 93' ~0 ft. Depth to leniting factor ~ D in. Sod Rabe Horizon Deptir Dominant Cob Redox Descriptbn Texture Structure Consistence Boundary Roots GP DIip in. Mansell Qu. Sz. Cont Color Gr. Sz. Sh. - 'E~1 'E1~ ~ o - l0 r 31~+ ~ LS l rr rY,-fir- c I v ~ • -l I.2 2 -3a lpy~ ~Ily rY..,s U ,~-, c3 _ .1 1.2 3 3n 7a 10 ~ 3I~+ -- >_ S i rr ~ ,,Y,, ~r -~ ! . 2 1, .z8 ~g` ~ - f~ • EtAuent #1 . BOD_ > 30 < 220 ma/L and TSS >30 < 1 50 mall ' F~Nuent #2 = BOD . < 30 mc~l. and TSS _< 30 mgA. CST Name (Please Print) re CST Nurnber ~ca c ~ ~• I~ .~ wLac_(~ e. s^ 6s~ ,~-~~------ ~ 25 3 3p`'7 Address Date Evaluation Conducted Telephone Number 21-3 ~~-`' ~ ~ rte.+4 ~~~ ~`~oZS ~~- ~"~/ -115-Zy7~y~g' Property Owner f~ r' k~ ~ I Parcel ID # . ~• _ Page Z of ~_ Boring # ^ Boring ® Pit Ground surface elev: 9'S•U ~ ft. Depth to limiting fac6or ~, in. Soil lication Rate h D t Color i D Redox Descxption Texture Structure Consistence Boundary Roots GP D/ff? Horizon i ept in. nan om Munseil Qu. Sz. Cunt Cobr Gr. Sz Sh: "Eff#1 •E v-~ I I ~ Imo-, ~ _ I ~~ _~. ~.z 2 g-75 31 =-- m S U S I GS ~ I. 2 3 9 ~ r ~~ -- ~ s ( S 'm-~r - .1 l- Z s ,S_ _. _ ~Z"S ._ ~ ~ a _ ^ Ong # ^ Boring ^ Pit Ground surface elev. ft. Depth bo limiting factor in. Sofl ication Rate Hori on De th Dominant Cob Redox Description Texture Structure Consistence Boundary Roots GP D/ff; z p in. Munsell Qu. Sz Cont Color Gr. Sz Sh. 'Eff#1 '"'Eff#2 a Boring # ^ Boring ^ Pit Ground surface elev. _,,,_ft. Depth m limiting factor in. Sal lication Rate Horizon Depth Dominant Cob Redox Desaiptbn Texture Structure Consistence Boundary Roots GPD/f~ in. Munsell Qu. Sz. CoM. Cobr Gr. Sz. Sh. 'Eff#'I *Eff#2 "Effluent #1 =BODE > 30 _< 220 mglL and TSS >30 <_ 150 mglL ' Effluent #2 =BOOS < 30 mglL and. TSS <_ ~ mgll. The Deparlment of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.07/00) t .. NAME y~ -e. LOT# 3 ! L~(iAL ll~SC;KLY 11V %aM SCALE: I"= yU •-n ~~ ~ S 1, BM I ELE NATION /OCR • d J J y ~ ~ ~ ,~ , 6~ BM I DESCRIl'TION a,1 I i'~ Z ''o Q ~.r; ~ i BM 2 ELEVATION ioo ' I ~~6 BM 2 DESCRIPTION n 4 ; I . ,~ ~ o'' a 0.k ~YS c b 0~ ~i SYSTEM ELEVATIONrj/• S d _ ~p ` ALTERNATE ELEVATION S 4. 2 y /" CONTOUR ELEVATION QZ• o ~~ Q3 00 ~ QY•oo. 9~: ~ ~ PAGE ~ OF~_ Tea ,N,R Iq E (or) ~ t ~. -{- _' I Sec. z 5 ` ~~ ~1 ° ~ ~~ ~ 3~~ ~ ~ ~~ I $% Sa c ~ ~t~ &0 ~.Z B-I ySy' J~ ~ ~GG~d ~ ~'~~ d. ~ ~ ~ r~-- S ~ ~~~h `~~ I 2 3 Y~ Y i fix' ~~ br 1~' 6°.~ g-3 2 ~ ~~ ~~ SIGNATURE .~o- ~-~ ~ DATE~o ~ - d ~ ~'~ . '~, M ~ -_.., \, ~` i ~ _, ~f1 ,j ~. ~~,'° }~; ~~5 i %~ ~ ~' X i ~__ _ ` i _ _ ~-~ 1 `/_~~ ~` '~~ _ ~ -. / j -_' ~`~ j /~,. ~ ~ ~~~~~ ~,`~ }% __ , , r / --~ ; ~ ,/ ~ f j / ~ i %~ -/~ i ~/ , ~.~ 1~ ;~ i ~ ~'~'~ i ~ ~~~ i / ; ~j /,'J~ / ,` ~, ,---. ~ X 9 p~~ ~~ ~I ~~ ~,, ~,, __ _ ~~ __ _ ~ /~ -~~, ;r ~ . ~,r ~~~~~ /~ ;, ~~ , ~,-~~~, ___---~,,' L /-~~ 1/ ~ ,~ ~ __ _, ! ,~ ~ ~ ~ __ ~ ~' - i ~ . J ~,~ '~;` X 948. ,,~ 1 ~ ,~ ~ `~:, .~~- I/ '~~'_~; . ~ ~~ 1-, / ;. 995.3\ •/' X } ' ' fi ~, / ~, ~, ~ ~I i ,~ ~ ) /_ 1~4 ~, ~ ~~ .!\ ~ ~~~ ~; 1 ~~1 '--- \ `~ \`~ \~ , 1 ~~ 9~ a t n.. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION Owner TROYWOOD COMPANIES L.L.C. Permit ~ y ~ ~ . DESIdN PARAMETERS Number of Bedrooms ^ NA Number of public Facility Units O NA Estimated flow leverage( lr7d j?„ 6 alldav Design flow tpeakl. (Estimate x 1.51 elide Soil Application Rate 7 al/day/ft~ $t Influent/Effluent Quality Monthly average• Fats, Oil b Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD,I 5220 mglL ^ NA Total Suspended Solids (TSSI 5150 mg/L Rretreated EFfluent Quality Monthly average Biochemical Oxygen Demand (BODsI 530 mg/L Total Suspended Solids (TS51 530 mg/L DNA Fecal Coliform (geometric meant <_10' cfu/t00m1 Maximum Effluent Particle Size Y. in dia. O NA Other: J~A 'Yekxts rypkal for domestic westewaear end septic fade ettlwrrt. fCVl;TFM SPECIFICATIONS Septic Tank Capacity 1253 a( DNA Septic Tank Manufacturer WIESER O NA Effluent Filter Manufactur O NA Effluent Filter Model ^ NA Pump Tank Capacity al O NA Pump Tank Manufacturer DNA Pump Manufacturer ^ NA Pump Model DNA Pretreatment Unit ^ Sand/Gravel Fixer p Mechanical Aeration ~ Disinfection D Peat Filter ^ Wetland D Other: ~~A Dispersal CeI11s1 O In-Ground (gravity) O At-Grade ^ Drip-Line DNA ^ In-Ground (pressurized) ^ Mound ^ Other: Orhsr~ ANA Other: ~ NA Other: ~NA tNAlltteR711AP14C aGnCWLc Senriee Event Service Froquency Inspect condition of tank(s1 At least once every: ^ month(s) 3 ~ ear(sl ^ NA Pump out contents of tanks} When. combined stodge and scum equals one-third SY,I of tank volume Q NA 3 ~ ~ month(s) ^ NA Inspect dispersal cell(s) At least once ev ~Y- year(s) ts) D -(s O NA Clean effluent fiker At least once every: 1 _ 2 L l 9~r~ D monthlsi ^ NA Inspect pump, pump controls ~ alarm At least once every: D year(si ' ^ monthtsl ^ N,q Flush lateral: and pressure test At toast once every: ~ yeaflsl Other: ^ monthlsl A At least once every: ^ earls) Other: ~L.NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall bs made by an individual carrying one of the following lieanses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tanktsl 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 calt(s1 shall be visually inspected to check the effluent levels in the observation pipes and to cheek for any ponding at 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 (Y,1 or more of the tank volume, the entire contents of the tank shall be removed by a Septeye 5ervicinq Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to rite servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shag be performed by a certified POWTS Maintainer. A service report shall be provided to tfie local regulatory authority within 10 days of completion of any service event. GMW 14/011 Page 2 of 2 START UP ANO OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell{sl. If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shat{ not occur when soli 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 wilt be discharged to the dispersal celllsl 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; tat; 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 lace the failed POWTS. ~jThe to h s of been a aluated to ide i a suitable r place ant area. po failure the POWTS a soil and site 'v / ~ evalu do mus be rfor ed to loca a su able rep cement ea. 1 o replac t area is available a holding tank may 'stalled a last re ort to r ace the fled WTS. ^ Mound and at-grade soil abso ption 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 6~ Phone ~ ~- 7d (~/ POWTS MAINTAINER Name FEATHERST Phone 715-381-1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX COUNTY Phone 651-436-5788 Phone 715-386-4860 This document was drafted in compliance with chapter Comm 83.22(211b1(111d1&If) and 83.54111, 12) & 131, Wisconsin Administrative Code. From: ........... To: PAM QUINN ............................................ Date: 1/21/2004 Time: 3:25:58 PM .................................................................. Page 1 of 3 .......................................................... FROM :LIFESTYLE HDMES FAX N0. :6517733822 Jan. 21 2004 03:19PM P1 S'I' GltUl'( ~~UI.1!'+'I"ti' SSP"1'lC TANK MAIN7ENAIJCB AGREEtiSEN7' A2+t"D OWNERSNfP CERTII:ICA7lC~N FdRM Ow~ncr/E3uyer '°X'D~i~ac~ao C'r1~'iPi9/uL~F-.5 ~ ./ . ~ . hiailin~ Addre..s 1/vZC~O S~iG4;l~[,---- ~ ~3'7~ . /1~0__~ - Property Address ~. ~,~ Imo, m/V ~:.~o~~ (Vrtritication required from Plar~in~ Departracnt for crew eorstrttction},~ .~ City/SS~t•~ WxsGOYlSiri Part:Cl Idcpti~cadOtt Nt2lri4JCC ;~ - OZD `~ 39~~3i"O-()d ~r~~,Ta_nIE'S_C11~rT'YpN -see Attar r1 r,e~r~~n Deed t~.a~-f~-Co-~ded ~.o~-~~- Property Location .SW /, NGtI t/ ~ ZZ~~,, - .~_ , ,, Soc. ,.3?-5 .. T.~N-iZ~W, ~Q~n of _,.~uos~l $ubdiVtSiotl Scenic 13ills~ _ _-- .Lot # ~~,_,.. Cutii`cd Sdrvcy lViap # Y ~~ ... _ ~'o1t>:tnt;., . Page-.#- ~ty ldt~ 7y 3 voltamtr Z yya _ _ ~,,~~ ~ z3 Z ~ %/03 Spar ha+~.se C] yos ~ ua I.ot lines idcutxfiablc r6~ yes G~ >no S'Y51'~M M.!~iIrt`~ly-ANCE Impr~opa'tt3c tend aiaiaecnaaec a f y~aar scptre system caaId ~nlt is iL* pmmat~laitmti to 5asuile wsssea. Proper arra~ance eansirpt of p~aittg oat the re~rtxe tm1c every t}mee yracs et saaxr, tf aeedad by tr tisxased Per. what you put iota the >:ysicaa as afl'cct the fi~liptr of tha tstlrtic tStnL- as t tzr~tmw=at asge fa the wssbt: dispasai system. . T6c ptopaGty air agT,ecs to cubtait to $t; moat 7~ntmg Depa~te~t's oattticaliea form, sued by the oq>ucx twd by a tsrastrrpltlomibea, jousaoteymaa ptom~ec, >~ietedpttsrstbrti[ or R licensed pc~„xz vrsifyin~ tlsat (1) the on~te wastewalcsdispvul rystrm is is proper operiatir~ caadition and/or (~) rf to (nspaction dad ptn~+ir~ (ilaeccssnty), tt~e tcptYC tank is 1ess.tbutt 113 hall of tiudf;c. 1Jrve, the kutre read true above regtri~sraetsts aetid apex M ~isttsip the privxGt sewrxge disposal system with tiro staadactits set forth, herein, as aGt by tl:a ~ of Coa:nd the tlepttrtme~ltt of Natural Reaotmes, Stara at'Wisaansi~t. t'~:rlif cetiou ttatiaL that yore optic eysoer~ Itas beat ts~aiatxutedmidt be eoM1apir,;tcd and tetumad to the St. (~aix Cotmry Zonm~ tJilice witbm 30 days d , t~~ec Ymr e~~a~oa crate. . .: ~ 1 i ~l~ ATVRIr OF .4PI'f.T DATE OV~-rNER C>EttTIT'XCA 4N I (rove) certify that all t:txtemcAts au d~.is form arc true to the ben of ts:y (attC) laiowlyd6c. l (we} em (rr} the owncc(s} of the property dtxctY above, tsy v$rt~ua of a vatrt-nty decd rxordcd in ~Leg;sttr c+f 13ecds OfTice. ~~ , SI 'fLlRB OF f.>'pCiCAI~'T / ! aZ /I DATE •...•. Atxy iaformapion that is xnis-reps.-stntalr..ay result in tat sx,~titxy pcrtui! bCiu~ r>rvoked 6y t5c 7s~nigg Dcpartrnerit. ••••• • " Include wlth this aa}~tiextion: a ttartpcd K~a;rnnty decd fr~ra tht: Ftcgister of Detds ofrce w Copy of Ltc otrtifed stiwey ~tfsp if rafttence is t•.sndk in the warrtsnty decd Sel'~y fmd Brilclines Division carRy i 20] W. Washington Avc., I'.U.13ox 7052 i ST. CROIX _ __ ~~~~~I~ De aftment U) ~orTtlirerce p Mtrtli;,otf, WI 537f}7 7(1$2 IfrOif)2bl-(1546 I ~ tiat~itary Permit Number (to he filled in by Oo.] - ~---- ............... Sani#ary Permit Applieation ~ ~'~` rl~rl.D.'vutnbtx wts. Adot Code, prrtmoat! irttixm.tinn .gar (aoaide ]n gonad wilh Cnnen 133.21 , nuiy tb rarnrf Zia saeuodary prepnocx Pris9cy lrrr, s 15.01(1 xm) Projntt Address (if diBerar lhvt rnailierY adQress) 771 KINNEY RD. L Appli~ttoe Intornatitte-Pkftre Poet All lettrrmrltiop _ HUDSON, WI 54016 I _._~_ pryt[r~ty r)wner's rVmar Pm:~l b' t.c+t ti 31 FAacJr: ~ PENDING TROYWOOD COMPANIES, L.L.C. _ _,._._ _.__..__... . . 1'reparty t)wtr~i's Mailing Adam Peopexly I.rx~uian 11200 STILLWATER BLVD. STE 100 NW !%. SW ~. stcti.at 25 City, 8Wr 7.ip Code P6ata Nutrt}ra . _ . -'- LAKE. ELMO~MN _____ _ _ 55042 651-773-5055 ~{{~~rde tote) T 29 N; rr 19W~t~ lL '!~'pe of Builditr},+ [check all thst aPpb') --- ---- ' 4 BDRM AS PER SUBMITTED HOUSE PLA (~Ior2FnmilylhWellitg~-Nnrdrertil'13ebanrr_.___-_......._........__..._...._._-- -._............___~.-- ~4tNindw I'~7°""°"N'O1 l Lf l'UhlicCamroercial r)ouibe[.'ae _ SCENIC HILLS ~ I I scare o»,~ert rk..a;~ [.ixr 2 DIST. CELLS W/14 CHAMBERS EACH (]Cav [village C~I'.wm+clrp nr HUDSON ' -- -_.Y.~.w._._-___ I[L T~•pe oti'ermfl: (Check only vne bus oe 8ix ti Ct)mpktc bee H If rpplicrbk) -~-- _. .. --~--..~.------- ---..... .. ...-'-'---'--.-.'-._..._.....__.. A' ~ Ntvr System ~ ~ Iteplsoarrer sy;aam ~~ TtsurrsNHuldirry; Tads Rrylaaeraad l).rlr I I l..l Otly MoA{ifxatiora w TxiMing 9aslem 1 i 8, f i r~ar,nit Ranevar f_l rennt, xetigrun ^ e7wnar nr r LI ra,nn rr~rn~er u, Hsu rid rte,~+oor ra.nir rrumbar ane Date Issucrr I;e(tire F.zlwatan i'IurArQ lhnftx V ---- lV. '!' . of POW'fS S; Chetk rlt ttlrt a Iv --------- __~ 1 U Nun -1'k~santi~d 1a-(3rouod L] 1-lmnd ~ 2.1 on. of writalde soil ^ Mamd ~ 2~ in ofsuilablc soil ^ Ai~ir+dc ~.-~ 8mgk Pau 5aed Filter ~_~ e•.xotnwxee wetland ^ I'reasatized I ~ H~ radt U Put Pilrer I I .uric 7\„rrwara t.hr:t CI Rmi.ulMatg Smrncl I'rlrer I I I EFUS t-' R ecirorlating Sydlrlir ~;, ra-er ~ Clemlxt ~ 1?trilt Iirte I,J Ciravela~ Yip: ^ e>»ner (CKytaur) ~ ~V. UlspenrllTrerlftreel Ayer lefittmrtion_ a - 1 -~$ .50 trench cells-14 chambers ea. = 28 chambers rewired ~i~e}lwlnPa) f]..y,tro Swl Apprication Rwrygr6'F) tl:,lrr+d nxa RM^'rnA('~ r]rapsaw) Ora t~grrwer(nF) 3yrsarr Elevation 600 .7 857.14 870,g' 95.0 UPPER 94.5 LOWER Vt Tres[ Intlu (:apcisy ~ rad Kturi+or Matrtfrser~ Prefab site slcxl Fiber I Ylustic I t.•.Yorts [ollners nftierita W2ABEL FILTER Camera L'ud,urtal I [i!m ' ' j Yew• Eaisfa~,.. t ~ f ~ T.n4a T~adrs ~ ' I S.-pt~cn f tolAag Tmflc .._._......_..... _._ X 1253 1 WIESER X _ ------- --- ---I -- .._. ~.~ rR.o,..a~ trey -. --_. ___ _ ._ ______ ... ------- - - - ~ t , ( _ ~'Ti. Responsibility Ststetnserrt- !, t-e . +....r rwpdtrity fir `atadlo. of the I+dWIS drover w ~ aRhebe~ rkrra. -d - --- I Flunmcr'z Ntstr(Print) x ti - MIwM1'rl.Y hr>arrbtz Finnra~ Wrrwre Nrunher i TODD FEATHERSTONE 242514 ___ _~_ 715-381-1704__ _-~ rlumlrer•a e-ddre>9 Isweet• City, srN , tip e.~tte> 54016 DATE 01/14/20D4 1 P.O. BOX 467 HUDSON, WI : _ VIIL Crtra rtmert Use 0~ _____-_-_-----_, ~' U.~lDerm'~ ~...~ 1)isaptter+ve+d >taar"eery Pern+if Fm (in.:lydea G-aundrwter Daft Irirted (string AgGA Sq7~ (No S1>mPs) 3urJw~ 1'm) ^ t:l,-~asrGivar RaoGSnr for [?earl ~ I ( ~Coettitioee otApptvrrVltcrrons for Dlsrppfravel ' - - `- -....--- I ~~ V W` vi\~ /~W ` (J I I ~ ~~~~ ~~ i -V ~ I J ~naA ~ pl~r M the Cwl7 arb) tk qs grisra ea PPR rra 1os Ilr~ rit3 z< 1 r iwcis ~ arts From: To: PAM QUINN Date: 1!21/2004 Time: 3:25:58 PM Page 2 of 3 FROM :LIFESTYLE HOMES FAX NO. :6517733822 Stata Bar of Wisconsin Form 2 - ] 982 WARRANTY i)EEID 020-1395-31-000 Pors:el Idontiticatiar Nuinbsr (PIN) Carriage Homes ~CX'[, Inc., a Minnesota corporation conveys and warrants to Troywood Companies. LL.C, a Minnesota Limited Liablliry Company the following described rest estate in St. Croix Counry, State of Wisconsin: 3EE ATTACHED EXHIHYT A This is no horneatead property. Exception to warranties: any easements or restrictions of record, if any. Dated this 3 Ist day of July, 2003 Carriage Homes XXI, Inc. ., (SEAL) * Kallei St Mttrtin, 'Vice 1?resident AU'TIi~ENTICATiON (SE.AL) Sigtlaturc(fi) authenticated this 31st day pfJuly, 2003 T[TLE:.MEMBER STATE BAR OF WISCONSIN (lf not, .~, authorized by § 706.06, Wig, Stars.) THIS INS'T'RUMENT WAS DRAFT>;i7 BY Crregory A,. Booth, Atty, 1900 Silvan Lk ltd #200, Ncw Bri ton , IVI1V 55112 __ (Signatures tray be authenticated or acknowledged. Both are not necessary.) Jan. 21 2004 03:19PM P2 ~~ ~~~ 3~~ D ~ 23v ~~ ~Z~~I THIS SPACE RFSP.RVSD FUtt I~COR1aING DATA Nemc end Rctum AddreB,~: Lend Title, Inc. 1400 3tlver [.ake Rd p200 New [3righMn, )b[N 55112 (SEA ,_.,.~...~ -- (SSA: r ACKNO'1rV1,EDGMEIV7' STATE OP MINNESOTA } SS. WASHINGTON COUNTY. Personally came before the this 31st day of July, 2003, tl above named Kelloi St Martin, Vice I'residont of Carnal Womes XXI, Inc., a Minnesota corporation to the known to I the person(s) who executed the foregoing instrumcsnt at acknowledge the same. Notary Public, Washington County, Minnesota My Commission Expiros: *Nnntes of persons signing in eny enpncity should be typed or princcd 6olow their signntwes. ~ K NANCY J. L~NTZ NOTAflY Pl1BI.ICrMINNE50TA My Camm• E~plrot dan• 37.2005 r LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HUDSON -~~~ COMPUTER NUMBER 020-1395-31-0 arcel Number 25.29.19.2425 OWNER NAME: First Last TROYWOOD COMPANIES LLC PROPERTY ADDRESS: Hse # 1/2 P N -- 771 KINNEY RD SECTION 25 TOWN 29N RANGE 19W'/+160 NW'/.40 SW Line Description Line Description TOTAL ACREAGE 5.350 PLAT SCENIC HILLS LTS 1/72 020/01 LOT031 BLK 01 SEC 25 T29N R19W PT SW NW 15 02 SCENIC HILLS LOT 31 16 03 5.350AC 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 ~- F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit ~ ~~l~~ds /Zd. ~` ~' ~ ~ 0 ~~ . ~ ,.~P i -~~ -~ a o ,: ~ ~ ~~ ~~ ~~a~~~ o~ ~ ~ ~~ ~~~ ~z~ ~ ~ .~ ~~ 3~~~ y0y 9 F ~x ~~f9 ~~~ .fir; ~i i LOT 31 OFFSET STAKES ARE 10' x DENOTES WOOD LATH SET ~ DENOTES w000 HU8 SET 1'38.35 DENOTES EXISTfNG ELEVATION ON OFFSET MUB I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that this Stake-out Plan was prepared under my direct supervision and is correct to the best of my knowledge and belief. W Q = cn J W _J ~ _ ~U ~- WW ~ WU ~ !~~, ~ J ~ O goo swat wa 1 Z Q J d H l~ a; Y' Q~ 1-- -,~'~ ~.~,~-, ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 Phone: (715)386-4680 Fax (715)386-4686 Memo To: Todd Featherstone, MP From: Pam Quinn, POTWS Inspector GGy,'i- CC: Property Owners, Lots 31 and 5 of Scenic Hills Date: 7/21/2004 Re: Frost sleeves required on building sewer cleanouts As a follow-up to my POWTS inspections, the following items need to be corrected so that the systems comply with code requirements for building sewers that are greater than 100 feet long. During the 5/14/04 POWTS inspection for Lot 59 we discussed the merits of code requirements for frost sleeves on building sewer cleanouts. Regardless of our opinions on the purpose frost sleeves serve or their effectiveness, Comm 82.35(5)(a) states: "Underground piping. cleanouts installed in underground drain piping shall be extended vertically to or above the finish grade" and " 2. A cleanout located outside of a building shall be provided with a frost sleeve." The section then continues with specifications for acceptable pipe materials, where the frost sleeve must terminate above the top of the drain piping, and that it must have a removable watertight top. The appendix for Comm 82.35(5)(a) shows across-section drawing of how the cleanout and frost sleeve must be installed. The cleanouts on both Lots 31 and 59 consist of only the SCH 40 4-inch pipe extending above grade. Both building sewers had been installed and backfilled prior to the date of inspection for the POWTS. The pipe on Lot 59 extends less than 12 inches above grade and has a vent cap instead of a watertight cap. This is apparently due to my requesting you make sure the s s~ tem was vented, but putting a vent cap on the cleanout doesn't comply with Comm 82. The requirements for vents on observation pipes are contained in the In-Ground Soil Absorption Component Manual, Table 3 (page 8 of 33). These two sites need code compliant cleanouts with frost sleeves and Lot S9 needs to have the vent cap placed on one of the observation pipes that extends a minimum of 12 inches above grade. ..~ - ~:.. ~.~``"` ~ t71 O O O ~ ~ N C, O 7 7 cn z (~ aDW Q N N ~~ ~G ~~ N ~ O 7 W f~D O'~ O y N w C GT N f~D C7 O. O. CD a 0 n m O .G. ~ F~ S C'~ Q W D a ~v,~ai~a~ a ~ m ?mcn 5 ~• o m 3 w d my - ~ o, z 3 p a °o_m ~_ O O r' (~D O d y N O ~ ~' ~ p ~ N 'O Q. 70c" _ fD a ~ 7c~ 7 a ~ O fA x O M ~ N ' n ~ f0..9 SwZmv m .CflO ~ oa o c x v N G .N. N -. d N W ~ ~ 7 N fD 00 ~ N O O ~ N .; N (~D ~. j N ~ j N 7 O. ~- 7 O N Efl O O ~ c ~ f ~ ~ ~ ~ 'v '~° 3 O (~~ O 3 ~ ~ ~' 5+ ~ - a y a ~ ~o J \N ~ ~ ~ ~ ~ ~ ~i O O O a ~~~_ y y y a ~ v v ~ !D w N ~ d_ ~ ~ 1 .. N O1 ~ " O_ K O 7 O O d O ? ~ O f~D f0 y n N S G fD 6 O. (~ 7 O C d W ~ a ~ O 3 ~! z m A F C a 3 ~ o ~ ~ 3 ~ v d ~ m ~ UNi N N IV O O 7 w CO (D ~ N ~ ~ W J y ~ O ~ °o v' N O C 3 ''• d ;-• ~~ ~~~~ N A Z n ~ ~ N; A ~ ~ ~ ~ ~ ~ ~ A d "- "~ ~. ~1 0 • O 0 ~• A wT~ 5 A fi ~^ ti N O A A ti GQ ~v A '`„ p '..