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020-1439-36-000
isconsin Departmes:t of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix ,Safety anl3uilding Division INSPECTION REPORT Sanitary Permit No: 14841 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 44-a 4 Permit Holder's Name: City Village X Township Parcel Tax No: Sorensen, Bryan & Suzanne Hudson, Town of 020-1439-36-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ' A, ~ % ~ , S~ 25.29.19.2762 TANK INFORMATION ELEVATI N DATA /0. 7 =J24,1-2-' TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark l (o (JU s /0 f loo Dosing Alt. BM T , 7 3.6 02.3 Aeration Bldg. Sewer f/.z 7,2- Holding St/Ht Inlet I' Sri` /D, O O . S TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic Dt Bottom Dosing /:JU f Header/Man. Aeration Dist. P' 7"- 10,0. 7 Holding Bot. System Final Grade PUMP/SI HON INFORMATIO ~~aXY2d ~i ! 3 Manufacturer _ Demand St Cover GPM ~f 7 Model Number TDH Lift / Friction Los Syst 'H ad T2 Ft W6eJACd 1 bVb Forcemain Len th Dia.Z y Dist.((~OWell f Olt,' & AZ& SOIL ABSORPTION SYSTEM (.vim BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Insid o. Liquid Depth 4o ~~4-4 DIMENSIONS Q / 2.(a 3 V Q I SETBACK SYSTEM TO P/L BLDG WE K TREA LEACHIN anufact~ur~ertl: INFORMATION OR Type t=m: zaf~ r IT Model Number: DISTRIBUTION SYSTEM Header/ anif I Distribution x Hole Size x Hole Spacing Vent to Air Intake IV Pipe(s) Length is Length_ Dia Spacing SOIL C ER x Pressure Systems Only xx Mppnq Or At- rade Systems Only Depth Over Depth Over Depth of ' xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil (0/ Yes No Yew0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 5 / OJ Inspection #2: //7/! -OWIV1W --y- OYr ~ Location: 760 Kilt Court Hudso 54016 (NE 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 36 -ty ~ Pao ll No: 25,29.19.2762 1. Alt BM Description = 2.) Bldg sewer length (~C?At - amount of cover = , (J J Plan revision Required? 0 Yes I No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Si nature Cert. No. TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERWG MODEL 152/153 W MODEL 152 153 tzi 50 Feel Meters Gal. Liters GoL Liters 153 5 1.5 69 261 77 291 12 40 10 3.1 61 231 70 265 152 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 8 30 9.1 23 87 33 125 ° 20 35 10.7 22 85 a is 40 12.2 1.1 42 4 Lock Valve: 36.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 o14M 0 20 60 80 100 GALLONS s t/4 0 80 160 240 320 - 3 27/32 4 5/8 FLOW PER MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ • Trmled dmalg pis aYaflle. ® 3 27/32 • EWdrk;d dwnakfs, for duo" systems. aft avaflabie and Supplied with all alarm. sitgle phase 1 • Variaable I ,vd 00111(01 MU m we available for M" mg system yafjaMe WM flod smtdles ate available Ibc vatidlle 1 I wm"and dwd cycle controls. 1 • Sealed Qwk-Box arcdable forot><door installations. See FM1420. • Over M-F. (WC.) special W01adw Swiss" 12 1/8 1 5 1/8 model YoYs Ph Mode AvW N762 115 1 Non ZkdWW_2or3 6N152 115 ~ eKSOS~ Non E752 230 1 BE152 1 Aub 43 N153 Hm 10.5 2er3 _2" 3 SELECTION GUIDE BN153 115 1 Aub 10.5 bdded E153 230 1 Noll 63 1 2o0 1. Single p variable level poet switch or double pWybadl vaebdla krvel float BE163 230 1 Aub 5 3 Mabded V*jkjL ReW Io FM0477. 2. See FM0712 for coned model d SOCk ced Abmdw E-Pak. Ay betdwAoa of cawbrok. peeleclba dadea aad rri doM be dose by a Vs~ 3. Vatfable Ievel canrol swddl t04= used as a coned acBve .*9* duplex (3) Yceosed A Adm. All docbkai ds O =ft AwN be %now" M Nsb Act (OS111y ar(4)0W qdwL east Nedaal ElecYk Code p0~.7 RESERVE POWERED DESIGN For unuwA conditions a reserve safety factor Is engineered into the design of every Zoeller pump. wuL m: P.a emc tsar Lorrlpft KY 402515-M 4fanufiduersd. . SAW m: 361CaseRmNoed p Lwimft KY 4121t-1101 % ;~irurr ✓~i,1 /3~9' xm PUMP !D_ ' AXW4 • 0 Copyright 2000 Zoeller Co. AM rights reserved. r 04/22/08 TUB 09:30 FAX 715 386 4686 X001 L I C9Ns11s110it7B.wi.pav Safety and Boildiaps Di Cwuuy 201 W. Wed itt(ow Ave., O. n Madisow, WI 53767 62 Sseipay w2whr(w is by 00.) Sanitary Permit Application 5 in accordance wilt a. Cows& 9321(2), Ws. Adm. Cods, sol miaioo of drat form to the appaepriame units ngritad ptior fa *bmkaod a =a** posit. Noce Applieaiee town wo.4m Addssa (if ddl'aeem tiro tteailiu~ address) a6ffitaed to the Depsunew of Commence. Personal iefbttsrioa you im socardamlro vuft da ftivew low s.15 ! anStan. p K~L~'- Cr 1. - -Please Prim AN Uhme4 o sNaene PJ;~o-IV39- JUN 2 6 200 3&.-&z) P ingAddns ST. CROIX CO SaperwLocation f LINTY Qoa. lr City. Soft t Zip Cade E /v!y section 1 TN; R H Type erBusding (check an tbt ep, Smbdivisiom 2FamrlyD"in-Nlaa rof LaY~ Se e_ J~vtJF Bkw;k. UU 0 Publie Cammortial -DeecTibe use D city of 0 stain OvmW - Deaaibe Use CSM Nwnba 0 V• or ~ awn or 1Ii. type J%nuit (Check estly sate box eaa Ice A. C q*ft rtbe B if s ) A. syaln. D Bepincewa t Sywm D Ti atmendHoklin8 Ttsdt Doty ❑ otlax ModiHaSise 14 Etris<irlp syslen (explain) Z O 8. i Pernik Ravisicw ❑ cbrlde of lklm6er OPownitTmufwtoNew List Previous ~ 1h Number w knod 1V.T stfPOVYTS dmt OF Z7) 0 Nom-F and k4mmmd ❑ Finasurixed be-Gwand 0 M*vgd> 24 in.d's sQ ❑ Mood <24 in. ofaaiable soil ❑ Holding Teak DOtlrarDisitasatcaatpataR( ❑PtaseaueeraDwice(esplvia) V. trselfl'se*tswvwt Area Itdaneatiew Da:ipt flow (ppd) DesizaSoil " i OKUdst) Dispsasl Asa Re9ebed (af) Area Propoaad (st) S sx a -1'00 . /J VL TuA lefo capacity in Tate! tl of Wneladlma GBlww copses URNS k g y~ a+ew rtMks Fx""Taft ~ ~ a $ it i N i+: t3 a. Sapt4e a lti lank a0Z finial C1na~Der VII. L tie tar iww~ do of Me POWT$ obava e a tie s ttaeied P1 s Nerae ( 'trt) MPA4M Number >itsittesx Pbare lipabw P1rmaWs Adarrw (SIVL cats, saw 51 tlse V ft D Disapproved P«ta Fee Dale n9 ❑ owaext3ivm ltcesoe far Dew! s 0Qit ,5 6 a' p DL CoetiWwi - of AppravaU[temsons for Dhapprevsl / y~ /~4 Pal t/T $ SYSTEM OWNER; 0~ Q h0u~7,eG~ G' ~cc~ Q- 1 eptic tank, effluent filter and .740 101"1 a;0'_ ispersal cell must all be serviged / maintained seM MI r(,elrgw~rMprMrMlMSiaetUtilltaAesYaiac 14U 2. Alf setback requirements must be maintainednAy ~ZeQ,vyt 12,E r as per applicable code/ordinances. (4-n CG~ibo SBD-6398 (R. 01107) Valid Mm 01/09 l~Yt`S~ d l~Y~f~(-t1 ~ /p h 11 t s 6)'t RAQ s r ' PLOT PLAN PROJECT Brvan Sorenson ADDRESS 760 Kilt Ct. Hudson Wi 54016 NE , 1/4 NE 1/4S 25 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 99.0 BEDROOM 5 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1600 LIFT TANK SIZE DOSE TANK SIZE 1400 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1250 # of chambers none BENCHMARK V.R.P. Top of Wildlife Sign ASSUME ELEVATION 100' Filter. BEST„ Q-$_ ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark To kilt Ct. Scale = 1/4" = 101 2 Acre Parcel Well is to meet all setbacks found in Comm. 83 Huffcutt Combo tank ~ Tank is to be properly bedded and Property Line provided with lockdown covers with approved warnin labe 97' 98' B-1 12% Slope Pro s Bedroom Grading is to be House Area 15' below done to divert system is to remain run-off away undisturbed B-3 from system i ~ cam/ 355' Property Line B rMl B-1 99' 100' i f , fix, r busE I 1-0 T 3 7 187.04. ~.LE/ r i am'-a" ! ~ r r j ~ / ~i~NPlsTNF.Q V PON 930.g!°I O.NdJ,M• ~ It ~ ~ i , 1 ' / COlB _ ~~.~'fl ~ fl?GIL 'fj": F 1 :.a 00 3 3 ~P~g „ 1 j k/~T IJ 3 33✓W 3 3'+40~ ,,ltd see' _ M S 5q. 13j3 If m~ ~m V~ Q 2 ~ Safety and Buildings 3824 N CREEKSIDE LA commerce.wi.gov HOLMEN WI 54636 TDD (608) 264-8777 isconsin www.commerce.wi.gov/sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary May 29, 2008 CUST ID No. 226900 ATTN.- POWTSInspector r- SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/29/2010 Identification Numbers Transaction ID No. 1541912 SITE: Site ID No. 735386 Bryan Sorenson Please refer to both identification numbers, 760 Kilt Court above, in all correspondence with the agency. Town of Hudson St Croix County NE1/4, NE1/4, S25, T29N, R19W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1184579 Revision; Maintenance required; 750 GPD Flow rate; System: At-grade Component Manual, Version 2.0, SBD-10854 (N.03/07), Pressure Distribution Component Manual- Version 2.0, SBD-10706-P (N.01101) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to doso by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component arm. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. C'ondi • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c APVI, DE EM' VJ" • A Sanitary Permit must be obtained from the county where this project is located in accordance with the M requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COR Rl • Inspection of the POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat - SHAUN R BIRD Page 2 5/29/2008 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be orrsite during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 75.00 Fee Received $ 75.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. RECEIVED MAY 2 7 2008 SAFETY & BUILDINGS Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 5/20/08 Owner: Bryan Sorenson Location:NE1/4 NE1/4 S 25 T29 N,R19W 760 Kilt Ct. Hudson System type: At-Grade Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test Shaun Bird ,Jftl y Signature 1 D License number 226900 COMMERce fwn Q►Ncs a ENC I i ' PLOT PLAN PROJECT Brvan Sorenson ADDRESS 760 Kilt Ct. Hudson Wi 54016 NE , 1/4 NE 1/4S 25 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 99.0 5 BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1600 LIFT TANK SIZE DOSE TANK SIZE 1400 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1250 # of chambers none BENCHMARK V.R.P. Top of Wildlife Sign ASSUME ELEVATION 100' Filter BEST GF10-8 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark To kilt Ct. Scale = 1/4" = 10' 2 Acre Parcel Well is to meet all setbacks found in Comm. 83 Huffcutt Combo tank Tank is to be properly bedded and Property Line provided with lockdown covers with approved warning labels Sic ~ ,r p I(,, " 97' 98' 1~ o 12% Slope l~ Pro 5 Bedroom Grading is to bed House Area 15' below done to divert system is to remain run-off away undisturbed from system B-3 M ~Y I 355' Property Line B M * B - 2 N 99,100, s'e -0 v qL • L 5t } g a„ > 5 ~ PYC PattC.~.MAj N > 5' 2 ~Tiuikw- UPS" t- DtSTIRt 1Tto~t 1.ATtRAL J EA srwgtL, tD *a6mYAT{►N WELL > 5' 1/6 B 1/6B 1/2B A = Ft. S= R. L = R. CELL. of kz"- AGGRErmarE P,1?rR.bvr. b SYMTOEML Fabr'so { Distribution Lateral sTAI 11r..b Observation------,., ~2„ . Soil Cover Well 10% FLj,WEb LAVIA >J' A 02t • 5' SLOPE plan View and Crosse Section of Wisconsin At-grade Unit with a Single Absorption Area on a Sloping Site Si Li ,WA7u SCE : CEnlSE : Page Of Distribution Pipe Detail For Two Lateral Network ACCESS 6oY. TuRN -uP" (CL. PwOUT) Holes Located On Bottom. Are Equally Spaced 4PVC Force Main * PVC Distribution Pipe Y X k P P~ ! X * Last Hole Should Be.Next To TURN-UP Olt, i A ce P Ft. Hole Diameter 5~ Inch D a F1 X 2~ Inches Lateral Diameter Inch(es) Y (W Inches Force Main Diameter Z, Inches # Of Holes/Pipe, p~ PL 3 / Invert Elevation Of Laterals Ft. Signed: License Number: Date: } r- SPBCII TIONS r CROSS 5 EC'F 0, AND SEPTIC 'TANK F Ott? CtF,t'iBrR ~I yt£A~ F AppROV ED 1V ER liSN- .BOYS GRADE jUNCTIO14 $t3X voff PZP£ 2 IN C€3 IT ~$DDE CY. 6 C1 VI NDOW OR 'WITH ill FADL 5 1g • PROK- DOOR T I3iG LkBEE to ~FRES~z AIR iMKE~D ifZli- .w a i I GAS17 ` y MiA?£R TIGHT SEAX.S SEAL -JOINTS PIPE PI 13 . 000 ;f,.ID. POW OiT AIL UNDER C03~Ci M PAD AppRpY E3~ 8} DING ' SP~~'CZFZCATZ4t~5 r DAY = DpSF,S. PER Nu 5 SEPT;G } DOSE -AMER: (,C ~%l~"'' voxttsE ic1z ~,~7 c TAN FAC ® F ~ p4(, = 6 J -PTIC CAL. • o GAL. '~A1tK SIZES = . • THCRES E.s ~ a 61 DosE ~~.tCJ CAPAC%TZ 2II4CIiES MAD "00a. C sin wlxZ~aG Al MM- F KODEL £ IV Gm pump ~ At~K per/. - FEET gEQts21LED ARGE "TEE ~ ~DEI,rZOti PIPE p/ / .g.Iscg FEET F AND DZ FACTON _ FEET FFER~ SE SUP or TOT v ER I"tCA Si3PFLY pR , s m/10 g'.FT ' AL DYE% t MI)A FEAT ~pRC ~ X i newts TANK :3't3 - I,IWID j%T£i ML. D1t4V5;ONS Of P'iJHP SIGNED: - r/88 1 710 DOLL VOL/ ; MMY-a-wo A-uw ms , °y" • , Sent By: HP Laserfet 3100; 9J EH SERIES SUMP/EFFLUENT PUMP 9 11.65 0 Spee~ficstions em Now NLtal MR ca mss aa>ra Rai. rw ow *Bit* Nt IL OLk) OWNR Y N _ 1AB 2Q 2t t11:StBtxlM saw, SUM .01M vfe 115 39 1$Q 1wao 70 W 55 41 32 ~ gsIw SWO WG L 4M No 3" ES m00 70 P 55 41 A N N 1tt Z0 21f , N N t11 tit : :11MA" tilS4% 4 *"am sown am 4qG 115 39 13A 1000 70 W a 1 20 We 21 27 ttl 0Mv- a ~r0 an 3w ss moo 7e W mum sm r.~.~ooo~a+~-~.c~ara~aosa.peso.~w~a~rasmr~.~~aae.~rnrr~ FLOW- LITERS/WaR M ~ f~ pxy Cpated Csct Iron o tow 2000 3000 Poly C`wbonato Impeller Material Closod Vane.-. . 30 Volute ABS - 73 Power Card SJTW A 2a = Mec]uanicul Shaft Seal Tiitrik with carbon and ceramic faces 5 1 a Fsstene~rs Sesinku swet r . 10 Shaft - - Sninles~s Soil 2z Bearings Upper Stem and Laver PAR BearinV 0 0 0 20 40 60 so FLCIW- CAL-&41E PUMP PERFORMANCE CURVE Litft GiMt Pr =p C A16 ltSV iOtR row" imoo ll" I rCNAOK13157 rbmc as 1 7.353! -1e: 4W=kW &s~ www. r~~ecxfautPuwP-com 0 Pam 995456-07)03 ,5 imUAL & MANAG~ POWTS OWNER SYSTEM SPEGIM- fl i•1A se nlc 0 NA sepwTom` p rU► o~ Pgter N~ . 13 NA j1dW 13 NA Of 0 pump'y arlk NA N..Wof GwUner,*- j Unb Pump Tat* MA. u MA Pump II ~tk> ~K pump Model tiOW • ~~•r- ems Pest~n'ttr'er't U f6eF 0Peat Qua" Sib MWL 0 0 Fs Gc (FOG) _-a20 c/- ❑ Dis~n° -<I- 111~) IL 11AMMUtghm: Bb TOW jujimied DMW* i g6~ fltspe~ s Q lrnwund 7 MU mound P Quay . ~ mom- t3 in~grade 13 0016C . BlocheTo an Scuds tom) ~ Mg/L iloClmt Q e fordoelwamt"'O°` OW Food Cow rne~ K ir,ilikster • 1XL*0ff waste lie Ste % VPUW tern 'e.° Maxknum servta. F.-°ency mum 3 Yom-) 9~r-VUt•E 1111 Event At least once every rronths scum (10 of ram volume ~ Service © °n . tnspe~t oondNon of tank(s) men m'mDined sludge and r(s) (Majclrnar:' 3 Yss-) © m pump out p°ntero wKs) At least once every D s) tnsped dwesw oe0t5) At tesst onoe evegy ' (7 s) NA S Clean amuentAw At least onus everY s) 0 MA wapea PUMP, puree conuals; e< $teRn At Est once everY Qn mom C Yes) 0 NA got AL least once every Q nxx*w g his) Q Na Flush MWeb and q!'°c At Most once 41wwY loorks" or on,.c CTIONS made by an ~5 SNAW Sewer P0VV T3 lrisp tr11 Q or broken _ i.Wd leveft 1 must lndude a VhPx t In bind sludge 8~ so 00 effiLquit up SaMoft Opss- Tank Rwcdot the Oi tnea~ volume of oossb kapeated to m in be ot slit on y AM cracks or teaks. The disDe1" oeti(e) sriah sur'~- 1216 ' on the g of elflueat en"91 of the low mgLANWY or p)p~s and to cl~adc far any n pon' end l Ix nix" s me trnme ° nom' ofttte ~ VOWM the to chlw~~ ground w4t9 x nosy s e snd scum in any tank equ81S a of In scwrd*(N* d'' HR When the eam> removed by a septa $8c`rie~r'g OPe~W er+ts. 3m sly enft Code. mk*WM 113, ~ Ad 5 o. prssurized POwliS WMPM p~~rtned by s cWftd POWTS Of L'Mu " SMS. 12 months Of less sbg be Of 21 dw ~ >7egui .W v aut~Y min 10 d* of mplBdOn A tell sham tine loci to oft ptndudsr o"er START UP AND OPERATION otgo Pam aleck ~mertf WK(s) ix o~s2. if Iml damage tine d' i muse` W&or For 0W cac • P wfiqe to rase ffl ~ ~ of me ta~Es~ ~`°1ed by 8 sePtage servtang . . •corgl,fiom are frozen at the int0114ft Surfa0e- Sysbaaz stal up st>a not IM above norrnaS higthwa oW_ ) an dd teMW real in it-e ovedloagra PLUM ? oeX tit in one IsMee doze. ft* Me Power outages teaioved by a vA be Ta avoid this s z tare the P «POWTS Malluainato dWchSfg& bacRUP 40r°f Pcmer to the emuent PUMP ct c"dacC ~k. S"We 5ervkkzj'i CVOMI IP6 f. we tlOrmBi W'.1s wltfurt me purm In sl as Y ' am twks mid fi~spe+rsa~ COIL Do not ddve Or PER OW- orate DO riot tiriylB or fiwt down SbQe of =w ftj~~ Of 3t-$~g St>iI jP~ M& mid PMbV ft ~i' 13 aria m Pie go pe*rawm R wig may ills the from tle edd or ~ Of The WORM ~ o; coW swabs; dab' i ' Still V~eg P df oxxidigIn d~ (~A Pump) Vr" fail to ksstrrs drat ttee we foIIMing wtva sw to ASANDONUENT v powra wks"Wb is - com VAM C Ch. C, th.,nm 83.33. vYrsoorhsdrh Adri* Codes is pr peo ' and the abandoned pipe sealed. Eor OP~ Sw%**19 f by a oper SM~ system AN pVg to onks and Pits shaII 4DO d _ so and pmts' disposed o rt+e contac+~ o~ alt tsmxhc and Ptt whall be rierzzoed arsa d rK i~ 'ea'°""dae+d 010 -W spaei Mbar pcmzi • att tanks kW pft shai[ bee ~vateC filled hVrA wt orris &,art so5d rrhat 181- CDNitt►4Gfl+iCY PLM irhg measures gave been. or nhust be fa OM m p~e a code If the poWrS falls and aaru>ot be repa'ed go f0ff0vt replacerrmt We ohtreps bow evaluaied and may be ut5¢ed for tits kw of 2 snd shaa~td ~t and CPSCOM t3 A h~ it smg should be protected from dtsfurbar absorpfan systwL The rem from existing artd proposed.sttuc0uM jot Vnes and was- FAMMO to be infringed upon ~ in the need for a n &w soil and site ~r at 9 a pnoDect Sze rep Will t systems must comply with the rules in offiaci Sur 9 advaricw In pQWTS area. _ice In not available'dus m setback and/or soil repblownent U.Madom 0 AsLAM We ~tanjc may be as a just resort to replace the fazed ~1NTS• .arid _ upon tam of dw POWTSas tedlcgy a twl&ng kwtilled area. to identify a suitable raplacer.nt _ t= not bom awaksaWd must OedXr"Od to ~'ft a s'~ie repla~eat area- If no reP ° is ava~able a site ~ reso to site be butalled as a 190t ~ repjaoe the tailed POVVTS- holdl(V tank at2tiy a6:ocp~ sy~hs may be reoonstmG in w1th' the nibs in el~ectatfiat&r-ML .po0n$V&jcdons of such sysrerns Must Comply c4-,itAf7lti[(Nta>> R WStJFFtCfEN'COXYGOL SEPTIC. POMP AND OTHER I RFA MENT TANKS MAY GONTTAMK W uL N ~ ~q~ DEATH WAY pp Nor EWER A 80frC„ PUSAP :R O'T'HER TgTMO ENT A. TANK MAY BE DV*=ULT OR HwPOsgm& RESULT RESCUEOF A POP-BOX ~ THE ttV7~R! ADDITIONAL. t -MTS P0VYfS jNST1~3.ER rttarne POVYTS M7d7i phone LATORY ~O A{ moRffy LOCAL RECst1 SMARE SERWWG OPMATOR c E Agency S74. Nam 7-49 Phone - Phone rn* dow0d mess rl>is dr ~x sty ofdw tipm Lam. mmoft aw Wxzi m cou* zap and ofjr>ti ear ~ . t>>t~ ~awrs. ' I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code n County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ` include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~J 7 3 9'QU Please print all information. Reviewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 6 Property Owner Property Location Ftl-LIar-1 S-0 n Govt. Lot A/,~-- 1/4 /~1/4 sZ s'T N R E (o W Property Owner's Maili ddress Lot Block # Sub7neor CSNX city SttateZip Code Phone Number ❑ City ❑ V lage own Neare4R Construction Use:gsidential / Number of bedrooms 2~- Code derived design flow rate Jam! GPD ❑ Replacement Pu lic o corn2-Describe: Parent material 0, Flood Plain elevation if applicable General comments and recommendations: System Type r System Elevation a 9i D Boring # Boring © Pit Ground surface elev.l-a.0ft. Depth to limiting factor Y in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 -lo /-1 - n Boring # Boring -,pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Of/ 3l i ~ l'- - ZJ Co" Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:5 150 mg/L • Effluent #2 = BOD < 30 rrKA and TSS < 30 mg/L CST )`came (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 -0 715-246-4516 I Property Owner _ Parcel ID # Page of Boring # ❑ Boring 3 ® W-Pit Ground surface elev. b ft. Depth to limiting factor J~ in. Soil -Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 f rl ~ly _S ✓k t'._ oZl~ O 2 6-~ y' e- • C7 F-I Boring # ❑ Boring ❑ pit Ground surface elev. It. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon 7epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I I I Effluent #1 = BODS > 30 1220 mg/L and TSS >30 1150 mg/_ ' Effluent #2 = BODS < 30 mglL 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. sBD-8330 (8.6/00) ~I i. ~j Soil Test Plot Plan Project Name Byran Sorenson Shaun Address 760 Kilt Ct. Hudson Wi 54016 CST #226900 Lot 36 Subdivision Indigo Ponds Date 5/2 /08 NE 1/4 NE 1/4S 25 T 29 N/R 19 W Township Hudson F-J Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Wildlife Sign Post at System Elevation 99.0' *HRpSame as Benchmark 149' Property Line To kilt Ct. Scale = 1/4" = 10' 2 Acre Parcel Scale is 1" = 40' unless otherwise noted 97' 98' B-1 r 12% Slope Pro 5 Bedroom House B-3 2 0"" 355' Property Line B M * B-2 99,100, P A i Y 1 • ~`,o~: 'ifs :I ~ I ~ } Ff k d a~ Z& 7. 98 Y (4 o N e. d s T ~ o W. oNG ; -AA A P ~~n 4dct~TT ti ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Sf Y G 4 ~SU Z G d N 2 S'D f P A LS e A/ Mailing Address Property Address 7 6 K 7! I C v U} ✓ V cj S A N 1/ v -L 6 (Verification required from Planning DIpartment for new construction.) City/State T U l S t) A/ , W 1 Parcel Identification Number D L D I f 3 9- 3 6- D O C LEGAL DESCRIPTION A.3 Property Location Sec. ZJ~ , T 21 N R--W, Town of kv ~t S.3 Subdivision V) A'16 POV\ , Lot # 36. Certified Survey Map # , Volume , Page # Warranty Deed # 9 G3 2 2- , Volume , Page #f Spec house ❑ yes ■ no Lot lines identifiable • yes O no 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 County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal 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. I/we, 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 yours tic system has been maintained must be completed and returned to the St. Croix County Zoning artment within 3 days of a three year expiration date. IZ l2el 67 SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I/we certify that all state ents on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described ab e, by vi of a warranty deed recorded in Register of Deeds Office. J21 d 7 SIGNATURE OF APPLICANT DATE Any information that is misrepresented 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 and a copy of the certified survey map if reference is made in the warranty deed. I I ` l I! II I I IiI I ` ` ' I III1I1 II11I VIII IIII~ ~I~II VIII fll~'lllll III IIII * 8 6 3 2 84 2 1 State Bar of Wisconsin Form 1-2003 863282 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI RECEIVED FOR RECORD 10/30/2007 11:00AM THIS DEED, made between Landsted, LLC, a Wisconsin Limited Liability WARRANTY DEED EXENPT r Company ("Grantor," whether one or more), REC FEE: 11.00 and Bryan Sorensen and Suzanne Sorensen husband and wife _ TRANS FEE: 656.70 PAGES: 1 ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): River valley abstract & Title, Inc. 1200 Hosford Street, Suite 201 Hudson, Wl 54016 Lot 36, Plat of Indigo Ponds in the Town of Hudson, St. Croix County, Wisconsin File # 2696399 020-1439-36-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of-way of record, if any. Dated October 2007 Landsted, LLC (SEAL) (SEAL) * * Mark M. Erickson, Managing Member (SEAL) (SEAL) AUTHEN~IFA'xsri~ ACKNOWLEDGMENT Signature(s) X, L' STATE OF WISCONSIN ) authenticated on ) ss. St. Croix COUNTY ) * Personally came before me on OctobeoA007 TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Mark M. Erickson (If not, to a known to be the person(s) who executed the foregoing authorised by Wis. Slat. § 706.06) i a 14ed tie sa,_. THIS INSTRUMENT DRAFTED BY: Attorney Doug Berg Notarylic, St to of Wiscons 1200 Hosford Street, Suite 201 Hudson, W[ 54016 My Commission (is permanent) (expires: (Signatures may be authenticated or acknowiedged. 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 NO. 1-2003 Type name below signatures. 1 of1 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ttt~~t~■ u... ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 November 25, 2003 James Rusch James R Hill, Inc 2500 W County Road 42, Suite 120 Burnsville, MN 55337 RE: Shoreland Zoning District / Indigo Ponds Subdivision Dear Mr. Rusch: Certain lots of Indigo Ponds may require a Count 5 ecial Excep i it for filling a ding du to their to ti i e Shoreland Zonin e lots includ . 36 7 38, 3#, 40, 41, 45 47, 49, 50, 51, 52 an 3 Lot 53 is cun-e n er review her su ividing. If the building site is located within 300' of the Ordinary High Water Mark (OHWM), has direct surface water drainage to the ponds and exceeds the grading limit that is allowed by ordinance in the Shoreland area, a Special Exception permit will be required prior to commencement of construction. Affected lots whose building site is beyond 300' from the OHWM of the ponds will not be required to obtain a Special Exception permit. Please note that on these lots an erosion control plan must be reviewed and approved by the Zoning Office before the issuance of a sanitary permit for the particular lot. It is preferred that the erosion control plan and the sanitary application be submitted to the Zoning Office at the same time to better coordinate our review. If you have questions or concerns, please feel free to contact this office. Si rely, Rod Eslinger Zoning Specialist RErh CC: Town of Hudson, Brian Wert file S-A 87174 S.F.~ _ (1.095 AC N.B.P.A.~' COL ' 39 i 87149 Pik c m (2.001 AC.) 4p - (1.643 AC N.B.P.A.) 98.97':. b8 87145 S.F. ' / t "87. 1' (2.601 ( ' a r a, ~ ®63 • j i AC.) 1 N i r / (1.776 AG N.B.P.A. ' ' ! r /f y =80 ^ 5( I 4 ,368 1 Q f ; 719 S.F.t` F m)) Q 3 o• ~1 2.002 AG ! I(}}-/t , . ~ 6;, ~O~ b ~ r •r . ` r (1.223 AC:/. N.B.P.A.) 00, 9951 .(1.607 AC j l,% / Jr fy. 87594 S.F. jf ti j j / ' (2.011 AC.) / % / f!r ! (1.157 AC. NAPA)/ I r ( t ~ co i l , 36 J 87389 S.P. f i 76, (2.006 AC.) N i\ (1.805 AC. N.B.P.A.)' f r t i t ~16 , j i, 244.36' ; Ot~P 118.35' 1' `1g 26 01 I ATTr-n 1 A n111^' 1 '41 J-\ "W+ -2606.35 ' ON ED q_ RCS -v L 1 1 L_ LJ _ L_!'\ I V V T o KILT ~;~3 FF 3 ~m T in m 2 0 D v • z `r 1 p O - INDIGO ~ i ~ • ~ PON D i 930.aM O.IIA+P7• '1 ~ - ICY - , (~l f • . i n' ~ ! z O ho I ~ f'1zoPo5~➢ IMf'!%izVIDLlS ~ z ;e< ' ± ~ /N LI ~(~156i.f'[~ I-~ONSE/(~.(Z/•f+E N' = n n - / ! - H 13059. K FRoP r FOI- H Fµ, u $ j 2 srs~4.Pf = Lt;oK6 PATIOS wA4 5j"WG PADS a lW m / ~ l I zos Sd, rT = U A = ~ n / i 4smsO.iY, T. YRB OPa'vg OUMP 3m'o P 30605p, Fs . aursi~ 3an'dF P.0 PeNG ~ PAC : ~ w i. I 37,'1FiSP.Pr9 'fPThL DIS`P7/KBFG' ARE+><.. 0 3 ~ - wrrHtN Soo' 3 3 Z,/'Ob fG _ O lO JJWEWNb E?T. OfP+lIU6/LLOM~E9 bELeJ PILY 9-1 y.A q~ r W C~~'J l/ C N R [II=: 07li n.~7rri;A Il-: It I commerce-W1-$0y Safety and Buildin Divis' 201 W Mad hson, 1 Sv3% J - co nsin it Number (to be filled in by Co.) s 4Y -K Y/ Sanitary Permit Applica Lidema MAN 2 2008 rTransaction Number in accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this fo governmen tal unit is required prior to obtaining a sanitary permit. Note: Application fo Tot~►x tie ojact Address (if different than mailing address) submitted to the Department of Commerce. Personal information you prQN44 (OFFi dary u ses in accordance with the Privacy Law, s. 15. ! m , Stars. 1. Application Information - Please Print All Information Property Owner's Name Parcel # Z")r . c o26 - 1x39 3 (p 6p Property Owner's Mailing Address / Property Location - Govt Lot t/• City, S Zip Code 1 l _ Phone N A y., Secti ! l~ T N; o W 11. Type o Buil tng (check all that appl f9kC Lot Subdivision N or 2 Family Dwelling- Number of Bedr ms block # ❑ Public/Commercial -Describe 0! G~ d ❑ city CSM Number 'Ila l) 0 State Owned - Describe Use ~y 111. Type of Permit: (Check only one box on line A. mpl line B if applicable System 0 Replacement System ❑ Trea t/Holding Tank Replacer t Only Other M cation to Existing System (explain) A. LKPrevio Permit Number and Dave Issued B. 0 Permit Renewal ❑ Permit Revision ❑ Cjange of Plu r 0 Permit Trans r to Ne Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: eck all that apply) 0 Non-Pressurized In-Ground 0 Pressurized In-Grountlf ❑ At-Grade 0 Mound > 24 t . itable soil and < 24 in of suitable soil 0 Holding Tank 0 Other Dispersal Component (expl ) 0 Pretreatment Device (explain) Ir~i V. Dis ersaLlTreatment Area Information: ' Flow (gpd) Design Soil Application f) Dispersal Area Required Dispersal Area Prop (s S m El vation VI. Tank Info Capacity i Total # of Manufacturer Gallons Gallons Units a 2 New Tanks laming Tanks y w C7 a+ p ke v ! Septic or Holding Tank x Dosing Charnher l/ VII. Responsibility Statement- 1, the undersigned, assume r Ility for Installation of the POWTS shown on the attached plans. PIurrn e (Print) Plumber's S' re MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) w tment Use Onl VIII. Coun e ar Permit Fee Date Issued Issuing ent SiPProved for Denial IX. Condittoin8weasons for Disapproval r~d~i ~f~ 1. Septic tank, effluent fitter and dispersal cell must all be servlces / maintained I& ~a't~e~ w1 e~ all per management plan provided by plumber. \J 2. All setback requirements must be maintained t4 Or, Attach to complete plans for the system and submit to the County only on paper not lea than S 12 x 11 inches is size (,vfr,Ftw~ ft 5 P.G t aK. ~k' Sf3D-6398 R. 01/07) Valid thnt 01/09 ✓ poc 4-L ( It 1 i ' . PLOT PLAN PROJECT Bvran Sorenson ADDRESS 760 tilt udson Wi 54016 NE 1/4 NE 1/4S 25 IT 29 N/R 19 W Tot udson , COUNTY ST. CROIX SYSTEM ELEVATION 97.2' 1.7' Sand Lift fr ~BEDROOM 5 CONVENTIONAL AT-GRADE CO NTIONAL LIFT HOLDING TANK MOUND )(Xx SEPTIC TANK SIZE 1651 LIF TANK SIZE DOSE TANK SIZE 1362 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 750 # of chambers none BENCHMARK V.R.P. Top of 12" pipe ASSUME ELEVATION 100' Filter BEST GF10-8 ❑ BOREHOLE 0 WELL *H.R.P. Same as Benchmark 253' Property Line Scale = 1/4" = 10' , 97.2' 98, 97' 96 / Property Line B - Alt.B.M. To Kilt Ct. B.M.* Grading is to be done B-3 to divert run-off Property Line away from system Well is to meet all setbacks found in Comm. 83 6% Slope B-2 Tank is to be properly Area 15' below bedded and provided with system is to remain lockdown covers with undisturbed approved warning labels 268' Property Line Huffcutt Combo Tank Pro 5 Bedroom House 0Py 355` Property Line d e7C'Rr) 7r) 71 Iinr' PLOT PLAN PROJECT Bvran Sorenson ADDRESS 760 Kilt udson Wi 54016 NE 114 NE 114S 25 1T 29 NIR 19 W TO" udson COUNTY ST. CROIX ,r SYSTEM ELEVATION 97.2'1. . 7'Sand Lift BEDROOM 5 CONVENTIONAL AT-GRADE CO NTIONAL LIFT HOLDING TANK MOUND M SEPTIC TANK SIZE 1651 LIF TANK SIZE DOSE TANK SIZE 1362 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 750 # of chambers none kk BENCHMARK V.R.P. Top of 1/2" pipe ASSUME ELEVATION 100' ]Filter BEST GF10-8 ❑ BOREHOLE O )N%LL *H.R.P. Same as Benchmark 253' Property Line Scale = 1/4" = 10' 98' 97.2' 96 95' 97' Property Line B - 1 To Kilt Ct. AIt.B.M. B.M.* Grading is to be done B-3 to divert run-off Property Line away from system Well is to meet all setbacks found in Comm. 83 606 Slope B-2 Tank is to be properly Area 15' below bedded and provided with system is to remain lockdown covers with undisturbed approved warning labels 268' Property Line Huffcutt Combo Tank Pro 5 Bedroom House 355' Property Line Zd 8Z560 ZO Z6 unf s Safety and Buildings commerce.wi. ov 3824 N CREEKSIDE LA g HOLMEN WI 54636 TDD (608) 264-8777 sco n s i n www.commerce.wi.gov/sb/ www.wisconsin.gov tiepartmeni of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary March 19, 2008 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/19/2010 Identification Numbers Transaction ID No. 1516436 SITE: Site ID No. 735386 Bryan Sorenson Please refer to both identification numbers, 760 Kilt Court above, in all correspondence with the agency. Town of Hudson St Croix County NE1A, NE 1/4, S25, T29N, RI 9W FOR: Description: Mound / Five Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1174659 Maintenance required; 750 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual- Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual- Version 2.0, SBD-10706-P (N.01/01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupan(y or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component arat. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment. and dispersal are prohibited. C011d+ • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption APPI area. chs. NR 811 & 812c OF • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COW • Inspection of the POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat y SHAUN R BIRD Page 2 3/19/2008 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephore number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. Y Cover Page ws~~ Shaun Bird gFFj3,~ A <2pp8 Bird Plumbing Inc. 1411008 192nd Ave ~S' New Richmond Wi 54017 715-246-4516 Date: 3/ 13/08 Owner: Bryan Sorenson Location:NE1 /4 NE1 /4 S 25 T29 N,R19 W 760 Kilt Ct. Hudson System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and o igency plan 9-12. Soil test Shaun Bird Signature ►ndly License nu r 226900 WED 'COMMERCE 7 1 " Designer No Date 4" Observation Pipe Perforated Non-woven Filter Fabric Below Filter Fabric Distribution pipe ASTR C-33 Sand Topsoil ` -_m- f D. 7. Slope Bed Of ;Y,- 2 %2 Force Main ,\_ptawed Drain Rack From Pump Layer Cross Section Of A Mound'S•Ystern Using F Z/ el' A Bed For The Absorption Area - F ` G A Ft. Z' 12 6 Ft- c7Ft. 044A- e ahc,~ J Ft. 6fq 7.1 Alternate Position' L I~ , S Ft. of Force Main W 2$. $ Ft. 33 L ' j 4:0bservotion Pipe a A - - - Force Main ~ t From Pump a 4 Distribution Bed Of '7P 2 %Z Pipe. Drain Rack 4 Observation Pipe Permanent Marker be. (/s* -6 Plan View Of Mound Using A Bed For The Absorption Area PAGE QP f' d 8Z9:60 ZO Z6 unr Page Of Perforated Pipe Detail 0 End View T (Perforated %~C~ y I PVC Pipe t ( oar %l e _ ~ot,5,ora _ Holes Located On Bottom, Are Equally Spaced 9 S PVC Force Main PVC y Manifold Pipe Alternate Position Of Dis.riputionFaroe Moin Pie ' ri Pipe Layout P Distributiol ~ Ft. i ~ 'r n, wp S R S k oZ Inches Yo2 Inches Hole Diameter - Inch Signed: Lateral ~//Zlnch(es) License Number: Manifold inches Date: Force Main Inches 7 of holes/pipe3 V7-1 6 Invert Elevation Df Laterals Ft. c-d a un i r ~ti OSS SECTI A gEPT C Tit" c~~$-R F DE: ci 'w/ itly0ow atsp- .01 it's 1410 - jam. ~rxs~rr a s - a PV 3s OM Solt pri33t~ "F PIK ISq~.ID E - ~7, FT. ' Palo OFF D SE l7~t~£ TOO ~ET£ Fad ops r~s DO • , : . .4 D10SE rum'- Doss Zj-!L- HAW 3iEA~a r ;14 ~ = 1 6e# . ate= cam. D PUMP F - r VTg Tafm VAS r..•.w- _ J , f ~-z'ZFiiP S ALAgIS '~3'R'~117~0 , g~T sv" P%79 FMT . gD~3l'sxi~lE3 FUJI? - - ;CTICM FAG'F CR 'l F'Y- vIIt EWOM X . , , FT/ ~ 3Ywx Lc -F 5.- ..S'A'M = r _LICENSE ~S33I = 5~~ltE~= . r ti . rto$ , g•d eM:60 ZO ZL unf TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 W w MODEL 152 153 50 Feet Meters Gal. Liters Gol. Liters 1 3 5 1.5 69 261 77 291 12 40 10 3.1 61 231 70 265 752 15. 4.6 53 201 61 231 _ 20 6.1 44 167 52 197 3~ 25 7.6 34 129 42 159 z 8 r 30 9.1 23 87 33 1 0 20 35 10.7 i 22 E5 ° 40 12.2 11 42 4 10 Lock Volve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4) wssos 0. 20 40 60 80 100 GALLONS LITERS 0 BD 160. 240 320 s 1/a y 3 27/32 a 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS ` 3 27/32 • Timed dosing panels available. - _ ® ^ • Electrical alternators, for duplex systems, are available and supplied with 3 27/32 an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level. float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. I I • Over 130°F. (WC.) special, quotation required. t 1521153 Series' 12 1/8 19J151 MODELS Control Selection 1 115 1 Non 8.5 1 2or3 5 1/d EE153 Volts-Ph Mode 'AMPS Sim lax Du lex t 15 1 Auto 8.5 Included 2 or 3 sxzoe~ 230 1 Non 4:3 1 2 or 3 230 1 Auto 4.3 Included 1 or 3 115 1 Non 10.5 1 2 or 3 115 1 Auto 10.5 Included 2 or 3 SELECTION GUIDE 230 1 Non 2or3 230 1 Auto 5.3 included 2 or 3 1. Single piggyback variable level float switch or double pg yback variable level fbat switch. Refer to FM0477. IA CAUTION 2. See FM0712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. AWL TO: R.O. sox 15341 j Louisvile, KY 40258-0347 Manulaclamof • . SNIP T0: 3649 Cane Run Road W ® Louisville. KY 40211.1961 Gf[/TYQLMP9 ONCE /.7Jc~r htlpJAvww.zoelier corn PUMP !O. /FAX 502) 778 928 PUMP (502) (502) 77744--3 3624 0 Copyright 2000 Zoeller Co. All rights reserved. UAL. & MANAGEMENT PLAN PpyYTS OY1lAtE~'$ gYg Sp~CATIOM- DNA acey septic, Tank cov itt~ .~N . GO Tank ktarw fl ws t~ CI HU► ~erm~ Ef8 lOft 6 o - DNA Efl IIIIIIIIIIIIIIIIIIIIIIII 7 l 3 D NA *=W of 8e Pump'tank t~ MwWofa Ui>s } o ~ ~+FT~ CNN (Exemated Demon Aaw x 1.5) v • Puurnp Model N DNA Una tom ' y r ci Fiber D peat tnd Wfluanysuawd Qus~s' S3t3 rng/L fl Mew Aex~ LI VIleBand SZZfl D DOtser. M-9/L pwdbown Demand goat Rte) Mods' averages' Ubpersw caatKs) II t NA nti tavlt}~ fit*bund OxyWn t're Oars end MOLT .30 mg& Q At -OrSdO 0 Odw-__ Obetw7fical S SOWS CrSM ~ cfam QOMI Q e Mea~ewiaor and Fecal poti[on~n y inch tttarrseter VANOt Mwd pargde Sine = tr=W ~s ~NANC : 9CH9VULE service Frequency Servfte !fit D Mon s} (Masdmuas 3 ym•3 At feast once every of tank volume trispect oondction cf isnlQs) and scum equals Oise yVt:en combined sludge r(a) {Maximum 3 ym) Purnp out contents Of tanKa) Ai least once every ©tr! S) €nspea dbmzw cob(s) I JOEL t once every ` t3 m Clear Oftentfaer D morn s} O NA At ieasi once every D rrx>r~'a' s} 0 HA tnsped pump, pump Contw" az alarm At least once every plush bterats and preSsWO fast D rssotstils fl y9ar(s) D NA At test once every 13 rssond'~ ~ year'{s) DNA At Least once eVe7 5e hgAiiCiENANCE iNSTRVCnONS oe>~ stiaii be merle by art ictd'tVidttaF Ca"M One of t" Inspecown oftanM and dispersal Restricted Sewer. FVWM hVPOC;t*r- PbVTS _ Masor s muPkuT*W st In dude a Vbuat 1nsPecilon Of the WOO) g10 = ~ any dse fur any ~k uP aer.I&V ~w ur+e the vOiume Of combined study and to dwa dw e8iuerd Levels t om. kisn y am eYSdcs or looks. dispersal Celt{s} atsatt be ,►budK kwPOOW TAO of a on the any ,4 fmg of efAuwrt an M9 ground sut~ the Will r, y auttsoatY. or Pond'aig at egkISM the ground *m pes p> and to and requires the irnmediain rso °ts ,the to ~ser++a ground s:Waoe Y trafe s o< moce of When Ow ~ ate' of sludge a Sqe Sergi w. °f to ~ NN r+errto+red strati be ewe Contem of to t~ merits; and any 113, ~ mk Ad or g~su~ POY~'S camP~~• I p~tTS Mairsta~ Tie 9 of of.92 tnotiths of le" shah be, event cha to k=W ~Wbry WOW whin 10 days of COMOWOn START UP AND OPERATION Of pah'" Products or other i=4r crew t~ to use of the pOV~'{S edc treatment rartk(s} for i P 90 if high wricW"B" t PAS and/or damage the d cAemic~ls that ttsay Frrspede the removed by a septage servicing operatsX prior to use: dd£tf~ fWM the contents of ale tank(a removed System start shalt not ocau when iii"condifions are frozen at the infiltrative surface. p~adages pump tanks may above nottttial ti~gtrmratet !totals. When power is res )fed the e=ess DLKM vraswwaterwril be discharged to the dispel cell{s} in one large dose, overtoadutg the MRS) and may rMit in the backW or surface die of To avoid this situation have the contents of the primp tank removed by a So~ SeviciV pdor~t P~ to the effluent pump or contact a Plumber or POWT~' Matretatiter to 119 Openew angst in n7ww* oft de PUMP ConbWS to restore normal fevers within the pump tank Do not drive or park vrbtdes 0M- tanfrs and dtspersW tarts. Do not drive or park ow, DC oietwise dlsUb orcompact, the area vsri6tb 15 feet down slope of any mound or at grade sal absorgtlon arm Reduction or-eanination of the Mowing from tike wastewater stream may improve file peiomsance and prolong the ffe Of the powTS: aritib : {8Wyy4xw, cfgarette butts; condoms; cotton swabs; degreasers; dental floss; dikywr. dam: fat: ftgidid6n drain (MV PUMP) gate!; atilt and vegetable peefings= gases; giame; herbades; meat saws; rileftatiORS: ok OWn&q products. pesticides. sanitary napkins. tampons; -and tll aW sourer brine. ABANDOPOMENT Mm the POWrS talcs and/or is permanently.iaken out of service the forlo%4ng steps shaft he taken to Insure that the system is praperiy and sm-* abandoned in compriance with ch. Comm 83.33, Wisconsin Adrrlfifsirative Coder • Ail pWg to tanks and pits shall be disconnected and the abandoned pipe openings sealed- The oonterds of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumPlng, all tanks teed pfCs shah be excavated and removed or their covers removed.end the void space filled wide 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 reptaoerneni system: ❑ A suitable replacement-area has been evaluated and may be utgized 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 e;dsting and proposed structure. lot lines and wells. Faflure 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- 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWIS technology a holding tank may be Installed as a last resort to replace the fabled POINTS. The site has not been evaluated to identify a suitable replacement area Upon failure of the POWTS a soil.and site evaluation must be performed to locale a suitable replacement area If no replacement area is available a oldueg tank may be installed as a last resort to replace the faired POW'rS. i dound and at-grade soil absorption systems may be reconstructed in place fiaflo+nrinS removal of the biomat at the infiltradve surtatoe. Res of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICiEN ' 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 POWTS MAINTAINER / Name Name ¢ cc ~~4 u t _ Phone 7j----02~ r Phone l J SEPTAGE SEMCING OPERATOR 1Kp LOCAL REGULATORY AUTHORITY EN=2me A9~~' 00 a C Prone P zzij TMI eoaaaaiL+.mss diauf6ed by ore ttaM of V* Green tare. &Umuette and Waushara County Zoning and SxAatim This docr>mant MW use ftlk&n an re rents of &L Comm a3.22fZ)(b)(iXd)&M mod 83.Ss(S), (2) & (3), Wisconsin Ada.*its&21ff v. Cads Use of a& doeummt doo not guararsiee ft performance of the powrS. gl6tW (Z/Di1 Property Owner ROSAMJI, L.L.C Parcel ID # pending Page 2 of 3 1 3 1 Boring # J Boring II - 11 ✓ Pit Ground Surface elev. 95.30 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .9 2 5-18 10yr3/4 none sl lcsbk mfr gw 1f .4 .6 3 18-33 10yr5/4 fif.7.5yr4/6 Si 1 csbk mvfr 9w na .4 .6 4 33-72 7.5yr6/4 c2d7.5yr5/6 SUN om mfr na na .0 .0 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 4 'Eff#1 'Eff#2 ❑ Boring # J Boring _j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ' Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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. r L- 1269 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings Steel Soil Service y in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsioru, north arrow, and location and distance to nearest road. Parcel I.D. pending Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I Property Owner Property Location ROSAMJI, L.L.C Govt. Lot na SE 1/4 NE 19 S 25 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C 36 na Indigo Ponds City State Zip Code Phone Number I City J Village Town Nearest Road New Richmond ( WI 54017 715-248-7071 Hudson Highlander Trail New Construction Use: V1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD _j Replacement ._j Public or commercial - Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments A and recommendations: mound design, system elevation 99.30 ft, based on contour lines elevation 970 ft Boring # __j Boring Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .8 2 5-17 10yr3/4 none sl 2msbk mfr gw 1 c .5 .9 3 17-26 10yr5/4 fif.7.5yr4/6 sl/scl 2msbk mfr gw na .4 .6 4 26-56 7.5yr4/4 c2d7.5yr5/6 sl/scl 2msbk mfr gw na .4 .6 5 56-72 7.5yr6/4 c2d7.5yr5/6 sicl/ms om mfr na na 0 0 Boring # I Boring Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 16 in. Soil Application Rate Boundary Roots GPD/ftz Horizon Depth Dominant Color Redox Description Texture Structure Consistence in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 w 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .8 2 5-16 10yr3/4 none sl 2msbk mfr gw 1 f .5 .9 3 16-24 10yr514 fif.7.5yr4/6 sl 2msbk mfr gw na .5 .9 4 24-72 7.5yr4/6 c2d7.5yr5/6 sicl/scl om mfr na na .0 .0 i i I ' Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 1S.30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel Z 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/3012003 715-246-5085 Page 3of3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM ROSAMJI, L.L.C. New Richmond,WI 54017 Lic. #248956 SEI/4,NE1/4,S25,T29N,Rl9W Bus.(715) 246-6200 Town of Hudson, St Croix Co. Fax.(715) 246-9372 Indigo Ponds Lot 36 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 I"=40' N ♦ =Benchmark Ele. I 00.OOFt Top of 1/2" pvc pipe • = Alt Benchmark Ele. 99.1 OR Top of 1/2" pvc pipe ❑ = Borings Boring Elevations BI = 98. l OFt B2 = 98.108 B3 = 95.30Ft B4 = OO.OOFt h• h ~ Sri`' 6u v, OLOil SY- s~ 10 g (j to z ~~rS t/\ C h~f 7~ ~Y y_ 3 ~o3 40 87174 S.F. `(2.001 AC.}•~'... .(1.095 AC.\N.B•P.A.)- i _~i - - ' ~ \ ~ \ V' stn ~ r ' ,03 . L f ~ i t~ 435•?3' ~ , \ ~ 980 / ' _ _ 9 - 87149 S.F. (2.001 AC.) (1.643 AC. N.B.P.A.)_ P~ 355.90' ' W s'Io r 8714 F ~®63 2.005 AC. ' ) N r % (1.776 AC. N.B.P.A.) ' 1'8~• mar= n • 331.6 . ' i 87192 S /(2.002 AC.) ! } _ • f (1.223 AC. N.B.P.A.~ rQ~ ,~~0~0~/0 oll ~ ` I ; ~ J / / % 166• ,~9• ,r/ 99 ,(1.607 A 00, i ; I' X187.04' ?'-87594 S.F. .n r rl. s ( i (2011 .AC.) 36 "(1.157 AC. N.B.P.A.); / f 76 " / Go f j < 1$7389 S P. % ' ~650 (2.006 AC.) i /I (1.805 AC. N.B.P.A7~ r! l 244.36 118.35' ~•y " `1 355.41 i KIL~I nT-rr-n I A NIn t ( ' !N X606.35 ZONED AG-RES yw ► N , LJ-N I I L_ V _L_/ V L y 1269 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code raj Steel Soil rvice County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Q Z p -3 P~ Revie d By Date Personal information you vide maREe= 1Fr ( vary Law, s.15.04 (1) (m)). OY Property Owner Property Location ROSAMJI, L.L.C Y 1 3 2003~ Govt. Lot na SE 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Add ss Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C ST. CiWIX COUfJ 36 na Indigo Ponds City State _j City _f Village v' Town Nearest Road New Richmond WI 54017 715-248-7071 Hudson Highlander Trail 001 New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement J Public or commercial - Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments a and recommendations: mound design, system elevation 99.30 ft, based on contour lines elevation 97.60 ft 2 6 Muir. • 5`/ / Boring # I Boring 16 Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .8 2 5-17 10yr3/4 none sl 2msbk mfr gw 1c .5 .9 3 17-26 10yr5/4 fif.7.5yr4/6 sl/scl 2msbk mfr 9w na .4 .6 4 26-56 7.5yr4/4 c2d7.5yr5/6 sl/scl 2msbk mfr gw na .4 .6 5 56-72 7.5yr6/4 c2d7.5yr5/6 sicl/ms om mfr na na .0 .0 J Boring ❑ Boring # 01 Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 1 0-5 10yr2/1 none 1 2msbk mfr cs 2c .5 .8 2 5-16 10yr3/4 none sl 2msbk mfr gw 1f .5 .9 3 16-24 10yr5/4 fif.7.5yr4/6 sl 2msbk mfr gw na .5 .9 4 24-72 7.5yr4/6 c2d7.5yr5/6 sicl/scl om mfr na na .0 .0 Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS S.30 mg/L CST Name (Please Print) Signature CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/30/2003 715-246-5085 Property Owner ROSAMJI, L.L.C Parcel ID # pending Page 2 of 3 3 1 Boring # J Boring Soil Application Rate Pit Ground Surface elev. 95.30 ft. Depth to limiting factor 33 in. F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr2/1 none I 2msbk mfr cs 2c .5 .9 2 5-18 10yr3/4 none sl 1csbk mfr gw 1f .4 .6 F 4 3 18-33 10yr5/4 ff.7.5yr4/6 sl 1 csbk mvfr gw na .4 .6 33-72 7.5yr6/4 c2d7.5yr5/6 sicl/sl om mfr na na .0 .0 F-1 Boring # J I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. 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