Loading...
HomeMy WebLinkAbout020-1439-25-025Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ' r INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacv Law, s.15.04 (1)(m)1• Permit Holder's Name: City Village X Township Landsted Homes Inc. Hudson, Town of CST BM Elev: f Insp. BM Elev: / ~ BM Descript//io`• n: 1 ~' C~ .d '~T` eln TANK INFORMATION TYPE ,> , ,,MANUFACTURER CAPACITY Septic IZ sS Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 7 t ~1 ) ~ ~ i ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Numb r TDH Lift Fri n Loss System Head TDH Ft Forcemain L gth Dia. Dist. t II Sell 46SORPTION SYSTEM / 14.1 Ll,... _ L,.... .U-„o~..e..L ELEVATION DATA county: St. Croix Sanitary Permit No: ~ 487902 15 State Plan ID No: Parcel Tax No: 020-1439-25-000 Section/Town/Range/Map No: 25.29.19.2751 STATION BS HI FS ELEV. Benchmark ~ ' a.:s g~ f 3~~d D3. o ~ GU.v Alt. BM Bldg. Sewer S- D J ~~~. SUHt Inlet .Zo i ~(G •~o St/Ht Outlet G O ~~P • 30 ~ Dt Inlet Dt Bottom Header/Man. l~•~ t2- O Dist. Pipe L ivy 11 • fZ.'~o ~jZ • Io r Bot. sys j 3• o o ~ o', Final Grade ,~ / °I6 •zo St Cover ~ ' - n RENC DIME S Width 2 / Length ` O~ ~/ D'f' No. Of Trenc s /Z 1. PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuf urer. INFORMATION CHAMBER OR Type Of System: • ! ~D ~ ~ ~~ UNIT Model Number ~ • O /1 rIICTRIRI ITICIN SYSTEM / I wL. L..~L-f// / 1 Header/Manifold tt Distribution x Hole Size x Hole Spacing Vent to Air Intake L-~ ~ Fipe(s) Di ~ ~~, \ Dia Length Length a CC111 Rl1VFR ., o.e ~~~.e c..~4cm~ n..r.. vv Mnnnrl nr Of.f;rade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ` <~ Yes i;?, No ~ Yes I =?, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~V'• 0 ~ Inspection #2: Location: 791 Highlander Circle Hudson, WI 54016 (NE 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 25 Parcel No: 25.29.19.2751 1.) Alt BM Description = //,~ 2.) Bldg sewer length = ~„~' -amount of cover = j$'I-f- sv2~ t~•er, 3) ~ . tne# cis-1,~.~cQ ~- c~.s~~_d~~- -------- -- ~~ I Use other s de for additional information. No !_"_~ Uh ~/1 `~`_~~ _J _ _-___ __` ~ L- ~/ ~ Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division County~~ ~~ ~; Box 7162 P O . . 201 W. Washington Ave., _ ~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.} I v~C~ffS/I f (60$) 2b6-3151 ~ 7 ~6 Department of Commerce State plan i.D. Number Sanitary Permit Applica ' n _, In accord with Comm 83.21, Wis. Adm. Code, personal i orm ou pr a Pro ect ~~~ (if different than mailing address) (1)(m J L a may be used for secondary purposes Privacy t Alt Informs ~ ~/ ~ ~ ~ I ci rt~G~ C~/~(~ P i r n L Application Information -Please Parcel # ~ Lot Block # Property Owner'sName Q C~ 9~ 7 Q Q 5 ~ at,.) C ~~ .. r~-C! h. 4. r1 ST. CROIX COUNTY ~'oP~S' Location Property Owner's Mailing Address C ~/~ ~~~~ ZONING OFFICE ~ G ~ /~j. _ 'mil /~ '/.,/~Y'/., Section City, S Zip Code Phone Number /~ (tire one) / ~ j~ ~ < W E i T N _ c J q r ~ _ lI. T e of Building (check all that apply) ~ /'~ ~ p ('; S ~ Subdivision ame CSM N ber e ~ - i '_ ~ ~ !~ ~ ` or 2 Family Dwelling -Number of Bedrooms ( Sul.~,,,s. ~_~t ^ Public/Commercial -Describe Use (~,, /1 ^City ^Villa ship of //~~ I~} t'~~ C a ~ , i ^ State Owned-DescribeUsel l) ~~~' ~P.L~S ~' ` "` III. Type of ermit: (Check only one box on line A. Complete line B if applicable) Q Z ~ ~ - 6~b • 2751 A. System ^ Replacement System ^ TreatmentlHolding Tank Replacement Only ^ Other Modification to Existing System ermit Number and Date Issued List Previot ~ B. ^ Permit Renewal rmit Revision ^ Change of ^ Permit Transfer to New $ 7c~ ~ Z Before Expiration Plumber Owner t IV. T e of POWTS S stem: (Check all that a 1 ) of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ nd < 24 in ^ M . ou -Pressurized In-Ground ^ Mound ? 24 in. of suitable soil ~- ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ ~ / ssurized I ound ^ Holding Tank ^ Peat Filter ^ P re Constructed Wetland ~ ^ Gravel-less Pie ^ Other (explain) c.~ ~l ~ Recirculating Synthetic Media Filt thing Chamber ^ Drip Line P V. Dis ersaUTreatment Area Information: Di ersal Area Pro sed S stem Elevatio Area Require/d (sf) sp Po ~/ ~ /~ ~ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal ~ ~~ / // ~ I ` /~7 `~ % V ~ c~ --- t l Number Manufacturer Prefab Site Steel Gb~ Plastic T t a o VI. Tank Info Capacity in Concrete Constructed Gallons Gallons of Units ~- New F.~asting („, Za (~-- f ~ t-, Tanks Tanks Septic or Holding Tank .',~~ Aerobic TresAnent Unit Dosing Chamber VII. Responsibility Statement- 1, the undersigned a responsibility for installation of the pOWTS shown on the attached plans. Business Phone Number Plumber's ure MP/MPRS Number Plumber's Name (Print) ~ ~~ , / /J~~~ ~~J `'z 6-! ~~ Plumber's Address (Street, City, State, ~p e) ~ ~ i . ~~ ~ ~ l~ / ~ ~ VIII, un /De artment Ilse Onl Sanitary Permit Fee (includes Groundwater Datets issuing t Signatlu (N ps Approved ^ D~ pprov Surcharge Fee) ao ~j5/3~ ~ ~ ~ b ^ O Gi on for e TX. Conditions of ApprovaUReasons for Disapproval ~ ~~ ~~ ~jtj , t ~E~~' a,C~ 3 ~ e,~,s tom. SYSTEM OWNER: 1 ~Sepfic tl~Mc, eflM~etlt flRer and dlepersal cell must an be sarvioas 1 miltflold ~ par manapert-ent plan provided by plumber. 2. AN seRlaek ~ ^~ be rtd ss per applcable code / oraktancee. .._ r~_.._......,r.,r r .-.tie. cvstem on saner not less than 11112:11 inches in size ALWGY Wua`ncw ~nr-"- ~w ..... ~...--.~ ~. SBD-6398 (R. Ol/03} ~ `~~ , `,~.. ~~~ f~~NWq M3TcV2 "--- ~.<:^t92 9d ifo !2:1T t;y; t:1.t~8~ 19tl~tuly ~j•; ; • ,t.: 71r~ r~F ,,.; '~ ~'irrt:~?~Gfttfn t;lR ES trsi;~s`,rnsrr ~,: +~c~ir atnsma'NUpst ~~+~a NA S 2y.i:!~~'t!['b ': yb(:~ Nid6Ji1(tQ6 %~y'?6 ' Test and System PLOT PLAN PROJECT Landsted LLC ADDRESS 431 2nd St. Hudson Wi 54016 NE i/4 NE 1/4S 25 /T 29 R W TOWN Hudson COUNTY ST.CROIX 10/24/05 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN-GROU P SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 ,BENCHMARK V.R.P. Top of Walkout Foundation ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 91.7/91.0 5' below grade Line _ 60' 40 Well is to meet all setbacks required by WDNR 2-3' X 88' Cells with >3' Spacing 80' 10' B,.2 Vents B-3 11% Slope Plans Designed Using Conventional Powts Manual Version 2.0 Pro 4 Bedroom 25 House ST B-1 2 -^ 0 ~ 25' B.M. 198' Property Line Vent >6" of Cover 6' Longll l " Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area at System Elevation Test and System PLOT PLAN PROJECT Landsted LLC ADDRESS 431 2nd St. Hudson Wi 54016 NE lia NE leas 25 iT 29 R W TOWN Hudson COUNTY ST.CROIX 10!24/05 4 MPRS Shaun Bi rd 226900 DATE BEDROOM CONVENTIONAL XXX IN-GROU P SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK IZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 ,BENCHMARK V T .R.P. op of Walkout Foundation ' ASSUME ELEVATION 100 Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 91.7/91.0 5' below grade Property Line _ 60' 40' Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts Manual Version 2.0 2-3' X 88' Cells with >3' Spacing Pro 4 Bedroom 25 House B.M. 10' B-2 Vents 80' ST B-1 25' 20' 25' B-3 11% Slope 198' Property Line Vent >6" of Cover i 6' Longh 1 " Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area at System Elevation Wisconsin Department of Commerce ,~~IL EVALUATION REPORT Division of Safely and Buildings ~ Page of m a c,e wnn ~, m oa, vvis. morn. t.vue ~ [x County ~' ~- Attach com er n than 8 11 inches in size Plan must lete site lan on a , ~ p p p p . indude, but not limited to: vertical and horizo ~ percent slope, scale or dimensions, no ow, a d loca~~~~~l~r Barest cad. Parcel I.D. Q~Q - f 3 9 ` zs " 625 a Please print all inf rmation. Review by Date Personal iMorrnation you provide may be used for sewn ary purs~Pri~c~a(~i~~~.04 (1) m)). /D 3 / d Property Owner ! ~~ ~~ ~'.~ ~T. CROIX CO Property ~oYrt. Lot cation ,1~ (,>/ % 1 /4~y 1 /4 S ~ T ~~ N R E ( W Property Owners Mailing dress Blod< # Su~Na or CSM# l ~ ` oCn _ ~f ,T 7 ~ ~~.L%p ..~~ .i City State Zip Code Phone Number ^ City ^ ~Ila wn Nearest Roa ew Construction Us Residential I Number of bedrooms Code derived design flow rate ^ Replacement ^ Public or meraal -Describe: __._____ Parent material 6l~C~7'S~ ~c:'~-J Flood Plain elevation if applicable _ Gerreral cormierrts ~ / ~ ~~ and recommendations: jyS~ P r!~ /or~^J !~ e ~ ~e~~~ ~ ~~ ~ ~ ~~ , l ao %~'~ 3 GPD ft. I I I Boring # 0 Bonng ~~ ~,~~`~ `~ r t t Jn~ Plt vrouna sunacx eiev.r ri , i n. vepur w nrrnwry iauur - - u ~. Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z -3 rs --- ~ ~- ~ c.v ~ I ~ 3 - z l G S Os Ni ~i~ ~ 1 ~~. go.ge (o a S.~Oo ~ ,~ J Bing # .~ B°"ng 1~ i , ~ ,/ I - I Pit cirouna surrace eiev. ° v ~ i n. uepm [o ummng ractor i ~ ~ ~• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BOD > 30 < 220 rrxyL and TSS >30 < 150 `Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~--a ,~ ~-~ 715-246-4516 Property Owner _ ~rcel ID # ~ Page of a Boni # Boring ) ~ Pit Ground surface elev~ ~ ' ft. Depth to IimiGng factor `~ in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft i n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 n / )~l C /~ / a Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Cd Redox Description- Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 = BODE > 30 < 720 mglL and TSS >30 < 150 mglL ' Efl1ueM #2 = BODS < 30 rr)g/L 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. SBQSl30 (8.6/00) Property Owner _ Parcel ID # / Page of ®~~ # Boring J pit Ground surface elev~ ~ ' ft. Depth to limiting factor `~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Munse ll Du. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Etf#2 )~~ll ~ } _~. ij ~ rv~-.J~ ~ ~~ ~ ~------ S~ ~ N1~ l~ ~ 7 jY a ~~# °ring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soii ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP O/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soii ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/ff' in. Munsell Qu. Sz. Cont. Color - Gr. Sz. Sh. •Eff#1 'Eff#2 • Effluent #1 = BODb > 30 < 220 rttg/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. sao-e~w crt.~oo~ . Safety and Buildings Division County ~. , C ~~ i `~ 1 W. as ~ gton Ave., p.0. Box 7162 = Ma ' WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) lS'COl1Sl/t os 66-3151 ~' ~oZ Department ofi Commerce grate PlanLD.Number Sanitary Permit App ~~~~1~E ersonal inf ate you prove e ' Tn accord with Comm 83.21, Wis. Adm. Code, P Proj Address (if different than mailing address may be used for secondary PmP~~ privacy Law, s15. (1)(m) ,~~~ - . Application Information -Please Print All Information ~ ~ ~®®~ S7 Lot # Block # P eel # ZONING OFF C~T~ roperry Owner's Name /) I / ~CG riGt~ ~ !^ l^ perty rion ,ropy Owner' ailing Address ~ T Phone Number Zip Code I ~ ~ / circl one} :iry, State r. r- T ~N, u/ E r W l ~ ~ M Number e of Building (check a at apply) ~ $ ~'`'` Subdivision Name I~YP ~(~% or 2 Family Dwelling-Number o edrooms /i ^Ciry_I~V'' ~wnship f~ ^ PublidCommercial -Describe Use / ^ State Owned -Describe Use O~ p _ 9 - ZS Bt3C~ ' Z ~'.S~ III, Type of Permit: (Check only one box o erne A. Complete line B iTaanpcpl~i Pl~le~~t ~y ~ Other Modification to Existing Systan' A, gystein ^ geplacement System ^ Treatment/Holding List Previous petinrt Number and Date Issued hange of ^ Permit Transfer to New B. ^ PermitRenewal ^ PermitRevision Plu er Owner Before Expiation < 24 in. of suitable soil ^ At Grade ^ Single Pass Sand Filter IV. T e ofpOWTS S stem: Check all that a 1 ^ Non-Pressurized In-Ground ^ Mound? 24 in. of suitable soil Mo~Filier ^ Aerobic TreatinentUnit ^ Remrculating Sand Filter ^ Holding Tank ; r Cons Wetland ^ pressurized In-Gro Gravel-less Pipe ^ Other (explain) ' Chamber ^ Dhp lane Recirculating Synthetic Media Filter ; osed (sf) SYst~' Elevatio V. Dis ersal/Treattnent Ar formation: u d (sf) Dispersal Area Prof ~~ S Desist Soil Application Kate(gpdsf) Dispersal Area Keg _ ~ ~ r Design Flow (gpd) . ~ ~-~ /~ ~ / fob Site feel F'ber P ~C ~~~ f Manufa o Crete Constructed Glass Capacity in Total Nu~tber ~ ~ , n ~ ~l 'VI.TaakInfo Gallons Gallons offiJni W ~J~.jRJC II_ __ New £xistmg r ~ l't~ Tanks 'rte Septic or Holding Tank .,,~ Aanbic'ilreamtenY Unit Dosing Chamber own on the atmcRed plans. assume o bility for instanation of the POWYS Business Phone Number VYI. Responsibility Statement- T, rho uncle ed, MP/MPRS Number ~~ Jai ~ ~y Plumb. s Signa ~ ~~ L~ ~ 7 Plum s I~amc (Print) ( ) Plumber'/s`Address (Street, CitX State, Zip C . ' Jrt , ' g t Signattue o Stamps) Sanitary permit Fee (in odes Groundwater Date Issued VIII. Coon /De artrnent Use Onl Approved ^ Disa Surcharge Fee) ~ ~ ~- . '~j~ ~ Reason for ial I IX. Conditions ro SYSTEM OW NER: 1 Septic tank, effluent filter and dispersal cell must all be serviced 1 maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. a cr not less than 8111 x It inches in s'ns to the Coua only) for the system on p p Attach complate pl~•% ( ry SBD-6398 (R. Ol/Q3) PROJECT , LandsXed LLC NE I/a NE I/4S 25 MPRS Shaun Bird 226900 CONVENTIONAL )OCX IN-1 /T LOT PLAN ADDRESS 431 2nd St. Hudson Wi 54016 N/R 19 W TOWN Hudson COUNTY ST. CROIX 9/24/05 BEDROOM 4 DATE PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING ANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 BENCHMA V.R.P. TOp Of 1/2" pipe ASSUME ELEVATION 100' Filter ZabelA-100 ^ BOREHOLE n WELL * H R P Same as Benchmark 94' SYSTEM ELEVATION 9:0/91.5/90.0 5' below grade ~_ ~~5'~. 41' , , 35' 210' 86' 38' Plans Designed Using Conventional Powts B~ Manual Version 2.0 Wel I is to meet all '~ setbacks required by WDNR B-1 .~ 10' ST 20' Pro 4 Bedroom House Please note: CST's uggested depth below grade does of work, he did not dig B-2 deep enough, also, 5.5' below grade would still be in a .6 loading rate soil ! A additional boring will be done if system is lowered! _ 31ope %? 91' _ _ 76' Vents 3-3' X 83' cells with B ? >3' Spacing A1t.B.M. is top of 1/2" pipe C? 99.7' 16 B.M.* 198' Property Line Vent >6„ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 11" 6 Long _ G Elevation 'PROJECT . Landsted LLC NE 1/4 NE 1/4S 25 /T MPRS Shaun Bird 226900 , CONVENTIONAL XXX IN-G PRESSURE 9/24/05 BEDROOM 4 DATE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE Vents HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 ,, BENCHMARK V.R.P. TOp Of 1/2" pipe ASSUME ELEVATION 100' Filter ZabelA-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark 94' 15' Plans Designe sing Conventional Po Manual Version 2.0 Well is to meet all setbacks required by WDNR 86'~ 38 B-1 10' ST 20' ,. ~~ SYSTEM ELEVATION 93.0/91.5/90.0 5' below grade 41' _ _ 35' _ _ 210' B~. Pro 4 Bedroom House Please note: CST's suggested depth below grade does not work, he did not dig B-2 deep enough, also, 5.5' below grade would still be in a .6 loading rate soil ! A additional boring DOSE TANK SIZE 3-3' X 83' cells with y- ~^ >3' Spacing A1t.B.M. is top of 1/2" pipe @ 99.7' ~. B.M.* 198' Property Line Vent >6„ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11 " w111 be done if system is lowered! 34„ Grade at Syste levation LOT PLAN ADDRESS 431 2nd St. Hudson Wi 54016 N/R 19 W TOWN Hudson COUNTY ST. CROIX Slope %? 41 ' _. ,. 76 Wisconsin'Department of Commerce Division of Safetv and Buildings SOIL EVALUATION REPORT in arrnrdanrp with Comm 85. WIS. Adm. Code 1289 Page t of 3 Steel Soil Service - --- ---- -- County Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must St. Croix indude, but not limited to: vertical and horizontal reference point (BM), direction and D Parcel I percent slope, scale or dimemsions, north arrow, and location and distance to nearest mad. . . pending Pleas ~ ~ R iewed By Date Personal information you provid may be (~idSlrrt;9~r~~JYP~rPO~ (Privac Law, s. 15.04 (1) (m)). ~ . 2 Property Owner Property Location ROSAMJI, L.L.C MAY 1 Govt. Lot na NE 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Addre Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C ST. CROiX COUt~lTY 25 na Indigo Ponds City r _( City ~ Village ~/ Town Nearest Road New Richmond ~ WI 54017 715-248-7071 Hudson Highlander Trail i/ New Construction Use: ~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ~ Public or commercial -Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments and recommendations: system elevations 92.55 tt, trenches spaced and depth to code 5.50 ft below grade Boring # J Boring /J Pit Ground Surface elev. 98.05 ft. Depth to limiting factor 120 in. Soil Application Rate i i T t Structure Consistence Boundary Roots P D~ Horizon Depth Dominant Color pt on Redox Descr ex ure *Etf#1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-10 10yr3/2 none sil 2msbk mfr cs 2c • ~~ .8 2 10-28 10yr4/4 none sicl 2msbk mfr cs 1 c .4 .6 3 28-48 7.5yr4/4 none cos osg mvfr cs na .7 1.6 4 48-54 7.5yr4/6 none ms osg ml cs na .7 1.2 5 54-120 7.5yr4/6 none cos osg ml na na .7 1.6 COS <35% coarse fragments = 36" & >35% - <60% = 60" below system ~~ Boring # ~ Boring /~ Pit Ground Surface elev. 98.05 ft. Depth to limiting factor 96 in. Sot Application Rate i ti D R d Texture Structure Consistence Boundary Roots GP DIft= Horizon Depth in Dominant Color Murrsell escr p on ox e Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 . 0-5 10yr3/2 none sil 2msbk mfr cs 2c '~~ .8 2 5-16 10yr3/3 none sl 2msbk mfr gw 2c •~ `5. .9 3 16-24 10yr4/4 none scl 2msbk mfr gw na .4 .6 4 24-36 7.5yr4/6 none Is osg mvfr cs na .7 1.2 5 36-96 7.5yr4/6 none ms osg ml na na .7 1.2 i ,o (,o•~ * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and r 55 < su mgn_ CST Name (Please Print) ~ nature: CST Number David J. Steel ~ ~ -~, 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG New Richmond WI 54017 5/2/2003 715-246-5085 Property Owner ROSAMJI, L.L.C Parcel ID # pending Page 2 of 3 Boring # J Boring Pit Ground Surface elev. 93.55 ft. Depth to limiting factor 130 in. Soil Application Rate t re St Consistence Boundary Roots P Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture u ruc Gr. Sz. Sh. 'Eff#2 "Eff#1 1 0-6 10yr3/2 none sil 2msbk mfr cs 2c •~~ •8 2 6-36 10yr3/4 none sicl 2msbk mfr gw 1 c .4 .6 3 36-48 10yr4/4 none sic{ 2msbk mfr gw na .4 .6 4 48-68 7.5yr4/4 none sl 2msbk mfr cs na ~~ •9 5 68-130 7.5yr4/6 none cos osg ml na na .7 1.6 ^ Boring # _.:~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate T t Structure Consistence Boundary Roots P Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. *Eff#1 'Eff#2 ^ Boring # ~ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots P `Eff#1 'Eff#2 " Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GCi CST-POWTSM ROSAMJI, L.L.C. New Richmond,WI 54017 Lic. #248956 NEl/4,NEll4,S25,T29N,R19w Bus.(715) 246-6200 Town of Hudson, St. Croix Co. Fax.(715) 246-9372 Indigo Ponds Lot 25 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted_ Legend 1" = 40' Benchmark Ele. 100.00Ft ~qp of 1/2" pvc pipe -~ , ~ ~, •~ Alt Benchmark Ele. 99.70Ft op of 1/2" pvc pipe N ^ =Borings Boring Elevations B1 = 98.OSFt B2 = 98.OSFt B3 = 93.SSFt ~' ` ~ ~ B4 = OO.OOFt ' ~S ~s _ ~., ~~._, •,~~ ... halo .o~ ~ --__ ~ ~ q x.53-f~ ~~ ~ ~ ~ 5~`~ ~~ gss~~~ F',t ~ 9~r. os !~ ~ I ~ G' `7~ ~'~=s 2 ~~~3 (1.649 AC. N.B.P.A.) ~ ' • , , '; 231 l ` _ ~,~: ~" ; ` i ~ : v ~ ~ 2.000 AG) i ~ ! } ~ 1.115 AC. N.B.P.A ~A.~ ~ ~ \\ ~+• •. ~ •. . / ~ 194.62 ,', i •, ;• ~ i I { c 3 24 ~: t / ~, ,, ,~ ~ r ; 87226.. S.F., ~'1 ~ . '. i ~-' , / ~ .' j (2 002 AC.}~~ ~ ! 1 ~, ~ ~ J ~ ~ =_ _ . ~ ~ ~ ,' ~ ~ , ~ (1.508 AG N.B.P.A.~ ~ `, ~~ l/ f T i seg. , ~ , o' /'r~ l ~ ~` __ ' ,~ \, i ~ f0" ~ ~ ~ + ~~ i/ ~ ~ ~ . vj '' " •• i ~ 95.07 ~ , \ { / R=~~ ~ ~ ~ • $7129 S.F'. `. ~. / ,, f ~'" ~ r „~ ~ ~ ~ ~'! ~~ ``+~ `~ %(1.539 SAC. N B.P.A. f f• ~. ^' ' ~ , j .~ ~ .,~ ~ . ^ ` ~ ,: .-~---' -'~,,, ~ ~ ! ~ 503 02' '1C~-~ ~-' _ _'`43'• '""~ 102593 S.F. ;; ~ " ~ :; f , C _.•,p~..-'`' (2355 AC.) ~ , i Y ~ ~<.~ ~ ~ ,~ ~ 1.023 AC. N.B.P.A. ~ , •~'~''~; i< ,~ ~ %~ 4. r-^ ~ j'It. ? I r '' ~ - ~+ ~ i ,~ ~ ~i ~ , \ ~ ~ ~ .:, ~` x . 5 ,` . ~'__ • ~ ~ 42~ _~.. _--~ - :.-~ = -- •7180 S.F. ~___ AC. N.B.P.A.) ~ f ~- ,c vti- `-• ~. ~ y° ~ - i~ ~~~ ~•: • ~:~' o ~~ •,j- rp• Q7 r ~ _ i ~ / .~~ I~ S 06';' ' 75.10' ~' _ ;~:.r .~ ~ ~ • ~ - ' .. - -. -_ r , t ~ ••. '; ~ 2 / r 109074 .F. '~;; • i ~ (2.504 AC.~ ~ ., • Y ',(1.062 AC. N.B.P.A.) ' j ~ r " t '. 389.2 ' , `~. • _ . •~ ~ '~ ~ ~ O M Y~~' ' ~ W ~ w ~ ~r " ~' ~ Z N `" o ' ~ ~rn 0 0 \ ~Z ~ N , ~ . O! ... '•~ ~ W W o 4 f LL. ~ ~ ~. •~ Z cn ~ ' ~ ~ W o ~ ~ ;y d~~ ~ morn • ~ ~ ~~ ~ w Uu ~' Z ` , : Z -J ~n = ` a. N ~ r ~~~ ~ ' ~~ "J ,.,~ ! ~ 1 1 ~ i /' •` •i ~. ~. ~ • ~ --. t ~ C ~ ... 3 'M _ L ~ ~ ~ ~ ~ V ~i~~;~ 3~ °r T~~cC33 V 1 "'' . y~ enV Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 ~in~~ Plan Option #1.~ stem fails, determine cause of failure, use alternate area and install new s "m in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 OwnerBuyer _ Mailing Address Property Address ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT (Verification required AND CERTIFICATION FORM Syai 6 City/State ~y ~~ w7 ff ~ VV ~ Parcel Identification. Number bZo - /`f39- Z ~ ~ ( Z~S/ LEGAL DESCRIPTICON Property Location~F %,, ~ %4, Sec. Z~ , T~N-R~W, Town of ~s~ . Subdivision ~~ Lot # ~~ Certified Survey Map # ~- Volume ,Page # Warranty Deed # ~ ~ Volume 2~9~~ ,Page # __~_. Spec house ~ yes ^ no Lot lines identifiable ~ yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 a masterplumber, j ourneyman plumber, restricted.plumber or alicensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days a three ar expiration date. SIG TURF 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 (are) the owner(s) of the p perty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIG 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 (1; X891 P 395 Document Number Document Name THIS DEED, made between ROSAMJI, LLC ("Grantor," whether one or more), and Landsted, LLC ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits; fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is ~C~please attach addendum): of 25 lat of Indigo Ponds in the Town of Hudson, St. Croix County, Wisconsin. ~~~a~~ KATHLEEN H, MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 09t20/2005 09:30A1i WARRANTY DEED EXERT # REC FEE: 11.@0 TRANS FEE: 366.60 COPY FEE: GG FEE: PAGES: 1 Recording Area Name and Return Address 020-1439-25-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions t~/o w anties: Easements, restrictions and rights-of--way of record, if any. Dated C * (SEAL) (SEAL) ROSAMJI, LLC S ~ ~ ~ -' * (SEAL) (SEAL) _* ~ Signature(s) _ authenticated on AUTHENTICATION TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Attornev Krishna Ogland Hudson, WI 54016 STA ACKNOWLEDGMENT O~ ~;~ Personally came before me on the above-named ROSAMJI, to me known to be the person(s) who executed the foregoing instrtt/ct~p>:a~d acknowlsd~ed the same. (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ©2003 STATE BAR OF WISCONSIN FORM N0.2-2003 * Type name below signatures. T6.c~~ INFO-PROTM' Legal Forms 800-655-2021 www.infoproforms.com ~! ~.. ~~.l~?l~f` Nof~r~ ~a~alrs/ v~'f~f~' O$ ~~t ~~`~'~~' State Bar of Wisconsin Form 2-2003 WARRANTY DEED l 'b ''N 6Z '1 'SZ '03S a312Jbf10---, ^ n ~ I v' ~ rl -"I I I ~- ~ ~ n I n g ~•'9 l9Z M~~O, 1Sd3H1210N 3Hl .~0 3NIl 1St/3 .~ V I V V I v _~ ii V I C~ I V i i ~ ,9£'BZi~ , tL'86l 08"OS ~8 ~av 99~ 3~ \3„t~ x`tc 1 3 \ N u 6~1` bH~b o F ~ it o '0 ~~ M bb,b~ 1~ ^ ; O ~O ~ ~-• O ti W 1i ^ O J Of M N Q M~1 YJ a W Na J(rmQ W NN N W O N~~ ~OU 1pp N O = O N NM7 ~WZj M NU -T ~v o- v ~ o`~ZWO~ ~ a N ~ ,°~ N M o ~ ~ c :- ~v W ~ °~° ~~ ~~ N M ~ ~ Z / .~'~ ~ M y ~~ T ~y N GOBI \ / ~~~~'~~~' / ~ ~ ~ ' p / / ~ ' ~ ~ ,ci' ~ ~ ~~ ~. ~ i I d'. '' / ~ ~~ ~ . ~ i , s ,~ X52%i / ~ ~ -- ~ . i , .~. ~S~ MEN • ~ I '' .d ,~'~' li U \ ~~ ~ 1 ~~ ~ y a v 7 ~ ~'~ .y6g6 n ~ ~ ~•F, r ~~ ~I_~ ' : ~ ,g N n N ~0~2 as v 66p'~ Y ~ ~ ~ 5p S2 M r ~ L ~ ~ r. pti ~ , ~ •~ `gy`p ~` v ~g0 ~ v ~ ~` ~ ao ~' o ,~ _a j go 3 ~~ ~ ~ 8 N^ c ~~/~/ '~ \ ~ \ N •~1 X19 ~. ~~~ o ~ ~ ~~ ~`