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Home My WebLink About020-1395-48-000Wiscrnsin Department of Commerce PRIVATE SEWAGE SYSTEM Sa~ Band Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Buechel, Mark Hudson Townshi CST BM Elev: DD Insp. BM Elev: a BM Desc ' do ~~'~ ~ ~~~ -~ / / v ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic / , ,`~ Z (0 b Dosing ~ f ~ ~D t ~~ Aeration Holding TANK SETBACK INFORMATION TANK TO /L~ WELL BLDG. Vent to Air Intake ROAD Septic > ~~ / ~ (D ~.- Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Numb TDH Lift Frictio s Head TDH Ft Forcemai Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ~ ~ ~~ (3~-~~~~~ ELEVATION DATA county: St. Croix Sanitary Permit No: 430372 0 State Plan ID No: Parcel Tax No: 020-1395-48-000 SectionlTown/Range/Map No: 25.29.19.2442 STATION BS HI FS ELEV. Benchmark ,~. 3 ~o8r t o . ~ Alt. BM ~S7` 6 /u7 • `~3 Bldg. Sewer SGK _ 3.2 ~a57 SUHt Inlet . ~ ioy~ 33 SUHt Outlet ~, ~ ~o J D3.93 Dt Inlet ~" ~ Dt Bottom ~ H 2dPr/AA ~~~~ / /- ° 7.9 3 Dist. Pipe~"7'~ a ms ~~ I /~ 9 ~{ / pJ~j, g Bot. Syste 'li I .D q y-93 Final Grade U fi't' --~ ~ ~ Z (Od.'13 s~ Z ,ns.~-s r ,~ ~o~~ y 9 S~ '13 ~ s-l~ ~eI I ~ ~ ` '~3 S awn. ~ I ~ ~~~ BED/TRENCH Width ~ Lengthy No. Of Trenc es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ Q D SETBACK INFORMATION SYSTEM TO P/L-C BLDG WELL LAKE/STREAM EACHING CHAMBER OR nur •, / L~~~~ / 70 Ty Of System: / V ~ L n ~ ~ ~~~ ~ ~ ~ UNIT odel Number: ~ ~~~ SOIL COVER ~ x Pressure Systems Only xx Mound Or At-Grade Systems Only ~~ c ~'~'~ ~ w`~ Depth Over ~/ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center /„p~ Bed/Trench Edges Topsoil /~ Yes No _,, Yes ,; No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ~ ~ /~ Location: 740 Regal Ridge Ci/rc~le Hudson, WI 1.) Alt BM Description = S'r~~ 2.) Bldg sewer length = 1 ~ f - amount of cover = ~ t Plan revision Required? ^ Yes ~o Use other side for additional information. SBD-6710 (R.3/97) 54016 (NE 1/4 SW 1/4 25 T29N R19W) Scenic Hills Lot 48~K Inspection #2: / / Parcel No: 25.29.19.2442 rta~~e~ s' ~! ~' 0 ~a~~ 2. 7/ Z G to r- a.bDv'e- Sy.S,l~m m-~~>7 ~~ -- ~~ _ % Yt T 0 Y~ ~ i ~_ _- f / ;; 0~3 __ -- --- _ _ _ L~G~i1/YI ~ ~ ~ --~---- Date Insepctor's Signa re Cert. No. ~ I ~ o ° ' ° ° ~o ~ m ~ ~ I N ~ c ti ~ a O ~ ~ Y ~ ~ °' N C I ~ O N ~ Y "' C O T ~ G V N N . O r - ~ ~ °c~ ~ `~ a a~ ' ~ E 3 I y~ O a i V ~ I ~ ~ y"- ~w uTi ~' t ~m E0'o I ' c i O c ~ I y , F OC~ ~ r ~ ~ ~ ~ y a I >c ~u~ca~ ayi ~ O EZ o~ ' J C o N ~ Z C ~ N y ~ p LL O ~ ~ O O z U~ N I _ L N N y L Q ~ a~.ca yv v 3 I ~ ~ ' z ~' ~ ~ ~~ ~ g €~ I z ~ ,nNw am I I N F- Z O ~ O 2 '~ C i+ ~ r d ~ ° Z ~ M F- ~ ~ c ~ Z o is ~ ~ ~ M I N `~ ~ C C y `~ N ~ N ~ ~ N I C a ~ o t '°- c c Y O z° in ~ z d c I N ~ N N ~ ~ I1 11I f0 G: .. l0 a ~ p ~ O ~ ' ~ o c ~ c ' c v~v ca ~ Z I o333 a z I a a a ~, I ~~ a 7 p f~/) = N c'7 M y I w~U ~_°o°o ~ I 0 U v o v ~N\ O N ~ O ate-- ~ = 'O , ~° ~ ` °1 rn ° ° Q ~ a :: i v d a 4 ~ ~ ' Q z is m I ° . . Q ~ ~~ ~ c~a c°'ia'ol r c c O r L ~ ~ ~ ~ ~ Ca ~ pj N a d M O y a+ y~ C t~ ~ O N= m~ 0 Z C a ~ !A O ~ r .~ C ~ rI ~ ~ l0 m a ~" at °' ~ `a ~` • `1~1 ~ ++ a m . ~ ~ c as c :: ~ A iao ~a i ~ c ic o~ ,SAS ( ~2 ~~ ~/ S Safety and Buildings Division County C ~Q ~ 201 W. Washington Ave., P.O. Box 7082 ~ S~Ons',~ Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 261-6546 ~ ~] .7 Sanitary Permit Application State Plan I.D. N e r In accord with Comm 83.21, Wis. Adm. Code, personal information you provide / ~ '" maybe used for secondary purposes Privacy Law, s15.1k1(1 xm) Project Address (if different than mailing address) I. ApplicatioaInformation-PleasePrintAllInformat n EL`E~VE® ~~ ~id~ot~ C( Property Owner's Name 1 ~ Parcel # Lot # Q 8 Block # 7 C~ SEP 5 2003 ~ av z Property Own 's Mailing Address Property Location ~ ~~, ~~ ST ~R~~X ~o~NT~ ZONI I, ll,~ / z . Zy /t/ ~ yy 1'V y S ti ~ City, fate ~'/ R~yLo~ ~ ~ Zip Ctod~e j ~ 1," ~ f I 7 ~ 2 bZ z~ ., ec on _~ T~N. R~Eo~ IL Type of Building (check all that apply) ~~ bdi i S i or 2 Famil Dwellin - N b f B d u v s on Name iutttber y g um er o e rooms ^ Public/Commercial - Descnbe Use ~~ ~ C ~ " / ^ State Owned -Describe Use ~ ~ ~ 5~' C ~~.~ W 13 .~jy~.. w ~ ^City ^Village ~I.I'ownship of b ~ O / v III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) - A. ~Idew S tem ys ^ Replacement System ^ 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 IV. T e of POWTS S stem: Check all that a 1 Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter thing ('hamper QDrip Line ~ Gravel- s ^ Other (explain) /~ V. Dis ersallTreatment Area Inf rmation: /7-F~j' ~-~-~.~j rS" Design Flow (gpd) Design Soil Application Rat Dispersal urea nequire ispersal Area Propos (sf) System Elevation / VI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufac ter ~ `~~~~ " r / ` ' Prefab Concrete Sit Constructed Steel fiber Glass Plastic N E i i / ~ J 0 ew Tanks x st ng Tanks ~` Q Septic or Holding Tank ~ j Z ~7., l .~ V ` ' 1 ~~ ~ Vv y. /\ Aerobic Trcatmeat Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume res onsibility for installation of the POWTS shown on the attached pleas. Plu bet's Name (Print) ~~~y Plum 's Signatu MPMtPilgNumber ~ Business Phone Number ~ ~ 6 6~ z ~ ~ ~ ~3 PI tuber's Address (Street, City, State, Zip Cod VII oun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) ~ i at Issu ~ Z y suing A t Signatu o tamps) ~~~~ I % ^ Owner Given Reason for Denial ~~. O ` t~`{ ~~Q~ ~Ii ops of ApprovaUReasons for Disapproval 3 U-yL eptic tank, effluent filter and C~I'1/1rt ~3. S'7~ d~ -~ ~ ~-~ ed /maintained l ll st all be servi ' ~ c spersa ce mu ~~ ~ S' lumber er mana ement lan rovided b ~~ ~ . p 2 p g p y p II setback requirements must be m intained l ~ ~~~GG~2~FP~n`~' ,~Q~- er applicable codelordinances ~ ~3 C . , p F3f rn. v ~„ ~ Z ~ eompkte pleas (to the Coeaty only) t the syst oa paper aot kss Bran 1/2 : I1 inches in siC~'_'-'Y % ~~ ~ ~ ' ~~ ~ ~~~ a~~y~ ~i~is wl~~~ ~ -~ ~ ~= S 98 (R. 08/02) Gl%u2- s~ B2 ~~ ]~P~6it.J SyS~' _~2c% ~ ~.D ~/S a~, SIC., ~_otc~P.ti.~~ ~~~l~i.rr%S rtv~G~,u~ 3 6 h ~.o.~,n.~ ~~ vn ~On ~~~ ~~Y Q~o~ ~~~~ ~~,_~~~ T a~ . ~~' ~~' ~~` ~~ ~ Y ~'(~ Ce ~ S-~e.~P~ ~ dew ~r B ~, - ac~1- l D I . b' ~ use I oc~~ ~~ d ~cbov ~-~-s~ c~'p'~.~1G 5y s-~ ~lGv . -~ u~~.e r cell. 1 Q ~~ P~'X~~° ~ ~~ ~%~° ~ ~ ~~~ ~~ Sys~-~ r~; Q ~ ~~ ~ ~+ /1/f 2 z,~ ~q~ M~~~~ ~~~~~~~ ~r,_~0, T a~ Ge\ ~~ ~~ x~R ~~ P~'x~~~ ~ ~~ ~` ~~ ~~ ~ Q .~ ~~ ~ ~ ~~' V v I~o~ K~ s s-~-~ y E~~, ~,~. ~b~l ~el~ r~- ~~/. ~ ~ r-~~ ~ B~ - ~ lD(. b'~ u~-~ ~~'uh- -~ s-t~y ~, Iocc~-y~~ sad ~ u~~.~r ~~..~Q ~+ `~ ~~ Z ~ ~~~ MW W Q Z ~s G_ ~ ~ c- ~~~~ ~, ~= • N ..._~I .L D ~'-'1t13~N1--^I ~ 0 V 0 O C c c c a r C `' Wisconsin Department ~ Commerce Division of Safety and Buildings in ac Attach r~rtt~lete site plan on Wooer not less than RECEIVED SOIL EVVALUATION mce wmrA 8~, ~~drr~ 11 inch insize_..Planmust 1723 Page 1 of 3 A.C.E. Soil & Site Evaluations St rrniY include, but not limited to: vertical and tarfzontal cafe poi percent slope, scale or dimemsions, north arrow, and 'ahY1~ ~ 6~ri:st road. Parcel I.D. D~O ~ / S ~ _ ~~ / Please print all information. Date eviewed B Personal iniamation you provide may be used for secondary P~P~ (~~1' Lard. s. 15.04 (1) (m)). GC~.- Z ~} Property Owner Property Location Mark Buechel Govt. Lot NE 1/4 SW 1!4 S 25 T 29 N R 19 W Property Ownet's Mailing Address Lot # Block # Subd. Name a CSM# 404 Orange St. 48 Plat Of Senic Hills City State Zip Code Phorte Number _,~ City _;j Village Town Nearest Road Prescott ~ WI 54021 715-262-3271 Hudson 740 Regal Ridge Circle 1 ~S h~~ V'' f '1 " (~ ~ ~. v! 3 ~/ New Construction Ilse: Residerttiat ! Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement Public or commercial -Describe: Parent material Glacial outwash Flood plain ek~vation, if applicable na General comments and recommendatiorts: install three trenches at 93.00', 94.00' & 95.00' using 39 leach chambers. ~, ~ f w Q:~K1- i sha a '~" 3~- , h ti . ~~ # ~ Bonng >112" i /~ Pit Ground Surface elev. 97.87 ft. n. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Descr~tion Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr3/2 none sl 2fcr mvfr cs 2f,1mc 0.5 0.9 2 4-16 10yt3/4 none Is 2fsbk ds as 2fm,1c 0.7 1.2 3 10yr5/3 none Ifs 1 msbk dsh cvv 2f,1 m 0.4 0.6 ~4 31.-5 10yr5/3 c1 7.5 r5/8 sicl 2fsbk dh ai 1f 0.4 0.6 5 /! 5 0 10yr516 none gr Is 0 sg dl cw 1f 0.7 1.2 ~ 60- 2 10yr6/4 none trot s&g 0 sg dl - - 0.5 0.9 concetrations described in H# 4 discounted as per Comm. 85(3)(a)2. H#6 contains 118" - 1 1 /2" bands of 7.5yr4R Ifs at 6" -18" intervals. Load ing rate adjusted to reflect permeability restriction assocaiated with banding. " a~~# ~~ns ~j' Pit Ground Surface elev. 98.00 ft. pepth to limiting factor > 6 in. Solt Application Rate Horizon Depth Daninant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr32 none sl 2fcr mvfr a 2f,1mc 0.5 0.9 2 5-1 10yr3/4 none Is 2fsbk ds as 2fm,1c 0.7 1.2 3 16-48 1 none Ifs 1 msbk dsh cw 2f,1 m 0.4 0.6 4 48-55 7.5yr4/6 none gr Is 0 sg dl cw 1f 0.7 1.2 5 55-116 10yr6/4 none strat s 0 sg dl - - 0.7 1.2 H#6 contains 1/8" -1" cols of 7.Syr4ll Ifs at - 20" intervals. Permeability of horizon should not be affected by banding. ~~~ * EfftueM #1 = BOD y> 30 <_ 220 mg/L TSS >30 < 150 * Effl - BOD < 30 mglL and TSS < 30 mglL CST Name (Please Print) 'nature: CST Number James K. Thompson ~~ 3602 Addn~s A.C.E. Soil & Sfte Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. 154020 9/132003 715-248-7767 .~~ ! ~~~r~yG ~r property Owner Mark Buechel Parcel ID # Page 2 of 3 ;~ Boring Boring # j¢t~ Pit Ground Surface elev. 101.59 ft. Depth to limiting factor > 125" in. Sal Application Rate Horizon Depth Dominant Color Redox Descr~tion Texture Structure Consistence Boundary Roots in. Munsell (Zu. Sz. Cart. Cobr Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-5 10yr32 none sl 2fcr mvfr cs 2f,1mc 0.5 0.9 2 5-30 10yr3/4 none Ls 2fsbk ds as 2fm,1c 0.7 1.2 3 10yr5l3 none tfs 1 msbk dsh cw 2f,1 m 0.4 0.6 ~l 4 48-60 10yr4~ none gr Is 0 sg dl cw 1f 0.7 1.2 tt 60-125 10yr6/4 none strat s 0 sg dl - - 0.5 0.9 O ~,r r FI#6 contains 1!8" -1" bands of 7.5yr4l7 Ifs at 10" - 20" intervals. L ing rate adjusted to reflect permial~ility restriction associated with banding. Sil inclusion T' thick x 14" kx~g x 10" wide observed at 72" - 79" with m1 d 7.5yr5/8 redox. concerttra ~~ # ~ Borng ~f Pit Ground Surface elev. ft. De~h to limiting factor in. Soil Application Rate Haizon DepU~ in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Cobr Texture Structure Gr. Sz_ Sh. Consistence Boundary Roots `Eff#1 `Eff#2 ^ Borng # --1 ~~ J Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Fbrizon Depth in. Dominant Color Munsell Redox Description C,u. Sz. Coni. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 `Eff#2 ` Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mglL and TSS < 30 mgll The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ~ ~± ~O; ~. • Elc~~on Sca/C.'/ ~ ~O~ \ ,Qc~ ~ r7z 3 /of ~8 s~~~; ~ N• ~ls, T • O Kcr$Gr~ ~' C~ k ~'m• cJ6 aehc.h n'lar,~= o of % ~/~/, @. ~ri~• Ss cc m c.:~l e. l Et/: /Gtr. G~. ~ i ~, ~. I i `~ ~•3°F-> January 21, 2003 Adam Schumaker, CST #253309 2113 80"' Street Somerset, WI 54025 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4684 Re: Soil Evaluation Report for+~~cenic Hills, Hudson Twp. Dear Mr. Schumaker: Subsequent to my review of the submitted soil report(s) for the above referenced parcel/lot, the information provided is insufficient and additional data is required before the report(s) will be accepted by our department. The following items must be addressed: 1. The southerly lot line has hash marks (/ /) in two places that indicate missing distances between lot corners due to its length compared to the scale used. However, no measurement is provided to confirm location of benchmarks 1 & 2. Comm 83.40(3)Sa requires a report to include "a permanent vertical and horizontal reference point or benchmark from which all distances and elevations are delineated on the site plan". BM2 can be located 25 ft. north of the lot line if the measured distance to a point along the lot line from one of the corners is provided. Distances between all three borings and BM 1 & 2 must be accurate for scale indicated on plan. Please amend the report to include the required distance measurements. 2. Boring #2 is shown in relation to "waters edge" without any confirmation that the system is a minimum of 50 ft. from OHWM. The subdivision plat map indicates the OHWM is approximately 100 ft. east of the SE lot corner, which means the system must be a minimum of 150 ft. west of the east property line. The hash marks (/ /) along the southerly lot line need to be defined with an actual distance to show that the plan meets horizontal setbacks required in Comm 83.43-i. 3. Contour lines are a requirement in both Comm 85.40 (3)(a)5d. The contour elevations for the soil tested area are not shown, apparently due to "no slope" on the site plan. This conflicts with the 2' contour map for the subdivision (see attached copy) at a point 150 ft. west of the lot corner where slopes are approx. 14%. The slope increases significantly above the 75' building setback shown on the map. The apparent conflict between data must be resolved before a system can be designed to follow actual contours in the tested area. 4. Comm 85.40 (3)(a)5e requires "current surface elevation of any adjacent navigable waters or reservoir', which would provide some comparison to proposed system elevations. If additional elevations are needed to provide documentation of site contours, please include a measurement at "waters edge". ~' ~ ~~ ~ + . Schumaker -Page 2 5. The distance between test locations B-1 and B-3, according to plan scale, is 45 ft and the width of the tested area is 30 ft. Given that a system can extend only 15 ft. beyond a test pit, the maximum length of any trench is 75 ft. A 3 BR system will need 22 chambers, a 4 BR wi(I require a minimum of 28 chambers, which may be restrictive for providing enough square footage for both primary and replacement areas. If you have any questions regarding the above requested changes and/or additions to the soil reports, please feel free to contact me at the Zoning office number. Sincere) Pamela Qumn Zoning Technician Encl. Scenic Hills Plat Map, Lot 48 Cc: John Arkell, property owner (on report) Leroy J sky, POWTS Wastewater Specialist file vlresaonsin Department of Commerce - SOIL EVALUATION REPORT .A" Division of Safety and Buildings Page ~ of m aoooroance vnm ~;ornm eso, wis. rwm. ~.voe 5+ , 81 t Pl s f • C r0 t Attach complete site plan on paper not less than an mus . indude, but not limited to: vertical and horizontal C 3 and Parcel 1.D. D~Z 0 - 3 9 S '~ peroent slope, scale or dimensions, north a and di~oe ~neare~ road. / ~, Please print rmw by ~ Date '. 4 ~ 2 Personal kdormaUon you provide may be used dary Law. s: '15. (1) (m)).. G2~ ~ /~"' °'~- 2 Q Property Owner c . > ~ 0 ~ ~ ~ ~~ ~ Prope Location 5T t;A Govt. of ,~f E 1/4 s(,~J 114 S ZST L q' N R / ~( E (or) Property owners Maim Address - . ~ ` cou ~n .dot Bbdc # Subd. Name or CSMIf , ~ ~ I OFFICE ,, ! i City Stale Zp t :ode AID... _.. ~- ; :t . `, °~ Cityl ^ Ydla9e ~ T Nearest Road _ _, : _, ~. ~S7i: I L wa..}-~r YVt r\, . ~'S"o ~Z ( ~(~ ~ ' ` _. s k ~• ~ ~ Q G( ® New Construction Use: ® Residential I Number of bedrooms 3 _ ~f Code derived design flaw note ~~5~ ~~ O ~ GPD ^ Replacement ^ Public or oommerdal - Desdibe: Parent material OU fc~.ra-8 (r. Flood Plain etevatiorr if applicable Q~° `~. d R General c«nments s ~ S ~ ,.,.` e. l e i1 a f .b n - 9Z- So and recommendations: ~ U ~ e.1 ~,~ a- '~-: d r~ - qZ ~ S O ~~ ~m ! a ca~d~ s w{ 6 o~w~ ~j/ ~~ ~ ate. -~ 7 S ~ s~f'b ~ Z~ d2d~n~ f~~,c/rj-~ Sc~-P~ .vim ~~.~ vs. ~~~v,.,. s lrw~-.~ > ~ sl u~~t.~ s s~ wuu.Qd d~ Boring # r^~ ~9 t:pl Pit Ground surface elev. 5.0 0 ft Depth to limiting tailor g ~ in. Soft Rate Horizon Dep#h Dominant Color Redox Description Texture Stnrc~ure Consistence Boundary Roots GP D/ftt in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •Efflf1 'Eff#2 I ~ -r~ 10 ~ 312 5 " 1 2r,-.aek m-~r ~ 5 (~ ~ Z ~-l~ 1D ~-fl ~ LS lrrt m ~S _ :1 i, z ®Pit Ground surface elev. qs U d R Depth to limiting factor ~ in. ~ ~~ ~~ # ^ ~~ __ Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP WfP in. Mansell tau, Sz. Cont Cobr Gr. Sz. Sh. _ 'EfT#1 *Eff#2 ~, ~, _ * crn~ ~.,t irr = anrt > ~n c ran r.r,n ~nrl TR.R >~n < 1 5fi mo/1 ' Effluent #2 = BOD _ < 30 rrralL and TSS < 30 trglL CST Name (Please Print) - - Signature CST Nu~r ~G wt ~~ 1„.~ w~.a-~ e. r .~~t - -; ~~.- ~___-- z5' 3305 Address Date Evaluation Conducted Tele~one Number 2113 $dTM 5~ . Sbm ~e,r-se-~-~ t~\ S~i02S ~9 --1~ ~ / -115 -2~{ 7-~fob~ r Property Owner 14.r ~~- ~ Part~l ID # 3 Boring # ^ ~~ ^ Pit Ground surface elev. ~S U ~ ft. Depth to limiting factor ~Q.~? in• Soil fication Rate i th D ant Color D mi Redox Description Texture Structur>3 Consistiertce Boundary Roots GP D/fi? zon Hor ep in. o n Muttsell Qu. Sz. Cont Coiot Gr. Sz Sh: "EtT#1 *Eff#2 I o-~to l~ IZ SL ~ k rr~r c. I -~ . y • . ~ 2 ~_ lb 1 m ~ I - -~. l. 2 ~~ ~~ _. _ ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. ~~ ic~tion ~~ Horizon Depth Dominant Cobr Redox Description . Texture Strvcf<tre Consistence Boundary Roois GPD/ff in. Mansell Qu. Sz. Cont Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Pit Ground surface elev. ~_ft. Depth th limfirg factor in. Boring # ^ ~~ Soli ication Rate Horizon Depth Dominant Colo Redox Desatption Texture Struc~tre Consister-oe Boundary Roots GPD/fl? in. Mansell Qu. Sz. Corti Color Gr. Sz. Sh. 'Eft#'I 'Ef#i2 ' Effluent #1 =BODE > 30 < 720 mglL and 7SS >30 _< 150 mglL ' Effluent #2 = BODS < 30 mgll. and, TSS < ~ mg/l. The Departrnent of Commerce is an equal opportunity service provider and employer. If you need as§istance 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 (R07l00) PAGE ~ OF NAME 14. Y` K-e-~ ~ LOT# yS LEGAL DESCRIPTION,UE t/a~li/n,S Z,STZq,N,R Iq E (or)~ » v y 5~ CONTOUR EL AT n v S n P .~ SCALE: 1 = vev+~ ABM 1 ELEVATION l~G • U - d~'s~ce ~'~'''^ 5 BM 1 DESCRIPTION n« ~ i ~ -~ ( `~ o ~ IC ~r< ~ W wrl ~~~, BM 2 ELEVATION f (~ • d l o G~-f~~^- - ~~Q~c~ n ~ ` BM 2 DESCRIPTION 11 a ~ ~ t' n. 1 ~ ~}-5 h {-r{ ~ SYSTEM ELEVATION ~ Z • S U ALTERNATE ELEVATION Q Z ~ S ~ ~ EV ION ( ~- 1 ~~b~ J ~~ ti ~~ S-QA- C`'t~~~L/1~ S A~,O~.~La~I+~. 7 o~ ore ~~ / ~ r Q~ 6,3 ' ~ Clt~,~ b V ~' 6m ~ (~ I ,~V~~ ~~~ _ ` ~~~ V ; ~ (1" i ~~ ~~, ~ ylo ~ ~, ~b -Z s ~ SS, ~a~ ~~~ '~ 0 ~ ~,~ ," ~ 1 ~ ~Z ~,~ SIGNATURE ~- ~~-~ ~--- DATE G -~-~/ ~~ O Nf .r;~ ~F\ ),...-- ~ A X 63.5 966. .4 ~ y~4. ~ ~i 9 1 ~• ~~ ` ` .'Ji._ 2 \.__ ,; ~ r ~! , .~~ % .'~' x 99 ~'~ ~ %.%. .. . x~ l ~, ~; ~, ~ \!; 1\ \\ , „ . ~~ ~ ~ s~~E DINA i ~ pRpINAR OIrtW~ vVater ~~ r o _ ST CROIX COUNTY SEPTIC TANK MAINTEI?1ANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~ ~ /l, t,~ ~ C~-f~L- Mailing Address Property Address eta ~ (Verification required from C' r Department for new c nstruction) ~_ City/State Parcel Identification Number (~ZO -/39'$- ~~-~°o LEGAL DESCRIPTION ~ 2~ Property Location ~~ '/4, ~ '/4, Sec. ~ T~N-R~W, own of S ~Y~ Subdivision S'~~~C ~~LLS ,Lot # _l~• Certified Survey Map # ,Volume - ,Page # _~?~ Warranty Deed # J l T ~ 7 ~---~ ,Volume ~~, Page # _~~ Spec house ^ yes no Lot lines identifiable ~] yes ^ r1o SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by z master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal systen is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standard set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certificatior stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 3C days of a three year expiration date. SIG ATURE OF LICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to tltc best of my (our) knowledge. I (we) am (are) the owner(s) the property described/a~bove, by virtue of a warranty deed recorded in Register of Deeds Office. C/ 6Jl G~ t l~ 3 / ° .~ S ATURE OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed :~ c ~~ ~~~~ ~~~ ~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- T~h~n ~ • Cac+om nacinn SnPCificatlonS Sanitary Permit Number d 3 ~ ~ Number of Bedrooms Design Fiow -Peak (gpd) Estimated Flow -Average (gpd) Septic Tank Capacity (gal) 2 5U Soil Absorption Component Size (ft2) 3 Type of Wastewater Domestic T~hln 7• Cnil Ahcnrr,tinn C_mm~nnc~nt - t_imits of Reliable Operation . u......... .............~. r-._. . -----r-- --- -- Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BODE (mg/L) Maximum TSS (mg/L) 150 Tab le 3: Maintenance Scneduie Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Cpmponent Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the ' Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Trafi•ic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. L ~ ~ ~. ~ ~~ s a ,~ P~- ~ ~ ~~s~- 2 ~ 3 ~~~~ ~ ~ ~,J~ ~.- 1~~~'~- co~c2~~E 71.5 b~7 23 ~/ ~ ~ c~ ~s~~ ~b'bY ~6lJ~ ~., ~ _ S-f- c~Zo r ~ Zo ~~~'~ ~ .. z~3 - ~ 747 ~'(~ 3 IJ 2186P 366 STATE BAR OF WISCONSIN FORM 1 - 2000 WARRANTY DEED Document Number ~ _ This Deed, made between Carriage Homes XXI, Inc, a Minnesota corporation Grantor, and Mazk Buechel and Kathy Buechel, husband and wife, as survivorship marital property Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Lot 48, Scenic Hills ~ 1 4972 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 03/28/2003 09:30A1! iiARRAHTY DEED EXElPT t REC FEE: 11.00 TRANS FEE: 429.00 COPY FEE: CC FEE: PAGES: 1 Area Name and Retum Address F N 8 ~~ ~ ~- ~t-t( s p o fox -~~ ~~ ~ ~ ~.l Js ~J t Together with all appurtenant rights, title and interests. 020 1395 48 000 Parcel Identification Number (PIN) This is not homestead property. s4 o a ~- Grantor wamdtlts that the title to the Property is good, indefeasible in fee simple and free and cleaz of encumbrances except any easments, restrictions and covenants of record, if any. Dated this 21st day of Mazch, 2003. AUTHENTICATION Signature(s) _ authenticated this 19th day of March , 2003. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Gregory A. Booth, Attu, 1900 Silver Lake Rd, #200 ANNETTE D. THEIS I NOTARY PUBLIC -MINNESOTA My Comm. Expires Jan. 37, 2005 are not necessary.) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. WashingtonCounty ) Personally came before me this 19th day of March , 2003, the above named Kellei St Martin,Vice President of Carriage Homes XXI, Inc. a Minnesota corporation to me lalown to be the person who executed the foregoing instrument and acknowledged the same. O ~/~`^~ Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. l -2000 / ~ \ /~~ ' , ~ H.W.L. =964.0 ~ ~ ~. ,, ~ r v yam` ~~` ~' v . ~` ~` • ',cam `~~~ `~~~~/ "qY° ~ ~ ~ ~ ~~f ~ ` \ ~ t I H,W.L =964.0 ~ ~9' ~ ~ ~6 GI I , `i ~ ; ~ ~/ L~1 L~1~----~--- i~i O - O m 210,268 SQ FT z 4.827 ACRES ~, o' ~~ 5ET f • IRON PIPE WEIGHING 1.13 LBS-. PER LINEAR FOOT 191.05' 1 I ~I i ~' ~~ ~ Water 75' SETBACK FROM ORDINARY HIGH WATER LINE 371 sw1/a ~~~~ - 06/07/2001 REVISED: x/31/2001 ~~ \\ I r 1 1 I 1 0 a /~ WATER ELEVATION ON 08/30/2001 = 926.5 ~ ~ ORDINARY HIGH WATER MARK ELEVATION 929.8 ~ ~ ~-T ~- -, o ~~ C,, I I /`' ~ ~~ Lu `', I n~ ~XU GQ 5~ ~ u~ L I ~ ~I ~~ ~ . ~ ~, ~- ~`~ ~~.~ ~ ~ ~ n ,: -,r ~~~~ c~ I ~~ S1/4 CORNER SECTION 25 CI-IF~T ~ nr