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020-1439-48-100
r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515037 0 GEN ERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: I ' Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Knuth, Steve & Jennifer Hudson, Town of 020 - 1439 -48 -100 CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range /Map No: -1�- d i 25.29.19.2774B TANK INFORMATION I ELEVA TION DATA TYPE MANUFACTURER I CAPACITY STATION BS HI FS ELEV. Septic �- , •� Benchmark Dosing Alt. BM �•l C . (j 3 ''7 .3 • a7 Aeration Bldg. Sewer Z'9 Holding SUHt Inlet St/Ht Outlet TANK SETBACK INFORMATIONS ,( j 5G • -� 1 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DtInlet Septic " Dt Bottom ._ Dosing Header /Man. q Aeration r s Dist. Pipe H0laing - 60t. System j. �S`pt' • ` l ! (, PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM *•,•. ,}'•C; 25 V •' Model Number r - TDH Lift Friction Loss System Head TDH Ft Forcem.M Length Dia. - ist. to Well 777 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia, liquid Depth DIMENSIONS } ^ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION 1 0 1 1 CHAMBER OR J - -+• Q — tT Type Of System: u UNIT Model Number: DISTRIBUTION SYSTEM , ; ,,;+ j �•:,_ Header /Manifold IDistribution y x Hole Size x Hole Spacing Vent to Iptake ipes) F�, . Length Dia Length L Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -G rade Sy stems Only ^- Depth Over Depth over xx Depth of ^ rTeededlSodded xx Mulched Bedrrrench Center Bed/Trench Edges Topsoil •� 'N Yes No �• Yes ��] No w. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / I Inspection #2: I 1 Location: 887 Highlander Trail Hudson, WI 54016 (NE 114 NW 114 25 T29N R19W) Indigo Ponds Lot 2 Parcel ` o: 25.29.19.2774B 1.) Alt BM Description 2.) Bldg sewer length = `a5 j .. , �..•1 ; ,, •_. t: - amount of cover = Plan revision Required? no Yes X r " Use other side for additional information. ' �- % -� LJ Date InsepctoriSignature, Cert. No. SBD -6710 (R.3/97) S PAID co Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 T. T i L� ^ o n s /„ Madison, W 1 53707 -7162 Sanitary Permit Number (to be filled in by Co.) Department of Cotntne 3 Sanitary Permit Application State TransacionNumber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental A- unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Add ess (if different than mailing address) submitted to the Department of Commerce. Personal information you Provide ma p urposes in accordance with the Privacy Law, s. 15.04 I m , Stats. 6�Y+t.2— 1. Application Information - Please Print All Information Property Owner's Name Parcel # FEB 0 3 2009 02o -1q31- Property Owner's Mai Iin Address Property Location ST. CROIX COUNTY Govt. Lot City, State Zip Code y., 'b, Section �� circle o 6" T N; R �� Eo W II. Type of Building (check all that apply) Lot L�s'� �!'�� 01 or 2 Family Dweiiftrg- Numberof Bedrooms Subdivision Name Block # C1 Public/Commercial - s rite Use Q7 /4 II w�� /� �r a ❑Ciry of State Owned - Describe Use —�� CSM Number Z s' ❑ Village of 9 07hW12 - Ar- Ce -rronx .G?uat,a,zw& JR Town of WZ1 D / e of Permit ox a (Check only one b A. Complete line B if applicable) A Ne List Prev Permit Number and Dace Iss Ne S stem ❑ ❑ y Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner ` 3? a-- /h'L ",y IV. Type of POWYS S stem /Com onent/Device: Check all that appl ® Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ M > 24 in. ofsu'table poil Mo p d < ;4 in of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) / �C re reatment Devicfa / uf)� Y /v r °� V. Dis ersaliTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Arek Proposed (s System Elevation v . A-9 ' 0 R9 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units zo U New Tanks Existing Tanks c A. U in H A i++ C7 Cs. Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P ature MP /MPRS Number Business Phone Number % 3 ,> lope — O Plumber' Address (Street, City, State, Zip Code) /� S a V1 1X County/Department Use Onl Approved C1 Disapproved $et Fee Date Is � [ ing Age Sign e El Owner Given Reason for Denial S ` IX. C " 90 oval/Reasons for Disapproval i Septic tank, effluent filter and iV dispersal cell must all be serviced / maintained AU C&&tQ_ /�; a d , as per management plan provided by plumber. 7 PQ 2. All setback requirements must be maintained as per a p Ica eaa© for the sy and su t e County only on �aper not le}S than 8 to x t t inches in size /� j Si�012L J� - i�D _ � y,\ J �/ /l id wtr f SBD -6398 (R. 01/07) Valid thru 01/09 � �'�� / (� v► (�� 301' ��liW/�1- Aped . .. . ••PL8 67 PLAT & c"m Sacrm PL Q4 =APPJA SAM EXCAVATNA W- e uw .. Pam= _ o vfR A00 Yo / lmv hW OXA7Y LYNE Aiv o 13?6N44N4f1Z 77WL t 3 /L�'wLY (1l6ATE0 h/�fJi /�ilo.4�/1TY L�vt vF Lo7 ° 02 SS 4,F r. oo.00' 8 • Y/o ✓G J'GV6t 3v QLOG lEwFA 7 J'coPE y/ At y T o' scoe 65 Yb69^ - <T- �94�70 Y "avc - 4 Acz4 ;r LtvE AccE.f1 c/eY J'7/1ljCT(d� ALT � f B Af • = /1/AtI.SN /S S L.9L3 o ri/vi40E cvOl c {'iQEE EGE = 93.00 \ � 7.t0 �.a�qL • G✓S�EJBR J'E, TANK - {.Q7N Zi9BF,� A /8t+o EFi�L//En?� i L2N /� NOTE = ExrsrzNG �F. tZDWC4 / [30L f s!,/6cL ANO /�owT.s A/!E oV6R /SD'Ews7 of / ACCES.S J'7/WCT4OV, AcArr P/toFEArY LINE I, f 0v62 0200' A o S- Lt / `JTi��v4.9/1O o�, a - o,Q1 tom aw. / -.oF $"Dow. Quzci< ----� r i,►r cow ucum: 041FA✓/97W V1k.C1Vr JrACK To 76Q AMV /A -W-We &WIF sr 4 Oft TEsTm sr: (OWECnVE LENSTM �/I E r Tito /►�2ro.✓ AL SIDE VWW 71McWCN o' ooh ,6"A y_Zo1v AeA tov VIEW S am TzrT MuttiPort End Cap ' liYF1LTi�L►TavQ ,.t"�'SrEi�; .� 34' Document Number Document Title St. Croix County Accessory Structure Affidavit Name — (Owner) Typed or printed being duly sworn , states, under oath, that: n 1. He /she is the owner /part owner of the following parcel of land / located in St. Croix County, Wisconsin, recorded in Volume N/A Page N/A Document Number _ 860540 _ St. Croix County Register of Deeds Office: Recordin Area A parcel of land located in the NW % of the NE % of Section 25 Name and Return Address T 29 N — R 19 W, Town of Hudson St. Croix County, Wisconsin, being duly described. as follows (include lot no. and subdivision/CSM or detailed legal description): Parcel Identification Number (PIN) Part of NW NE, Pt of SW NE, Pt of NE NE & PT of SE NE fka Indigo Ponds lots 47, 48 & 49 being CSM 22 -5456 lot 2 (5.63 AC) 020 - 1439 - 48 -100 ( #25.29.19.2774B) As owner of the above described property, I acknowledge that the private onsite wastewater treatment system (POWTS) serving an accessory building on this lot is sized equal to a one (1) bedroom home, or a design flow of 150 gpd. This building may not be used as a residence; there is an existing principal dwelling on this parcel. I also acknowledge that I will disclose this information and stipulation to any future parties interested in purchasing this property. Dated this day of * >ti AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St. Croix County. ) authenticated this day of Personally came before the this day of the above named to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) who executed the foregoing instrument and acknowledge the (If not, same. ,,- authg ed by § 706.06, Wis. Stats.) / l THIS IN RUMEI*T WAS DRAFTED BY �, , .�.Lt�d' ��� ��7R/Ln S J.I"� ° "a-1 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not, state expiration date: necessary.) Date: This information must be completed by submitter: document title. name & return address. and PIN (if required). Other information such as the granting clauses, legal description, etc. maybe placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2 00 to the recording. fee. Wisconsin Statutes, 59.517. • - -FU 67• P60T Sz CM68 SECTION PWr3 =/1PPA 6AOS. SmAYAw ai vc Y : PuN�IMO L"T PROJECT oVE!! APO r o Al wati I)WOOA Y aw" 4a La[N Aivo /i2GNLaN10fR T/LQIL AAGWAY DZ A&S7 /4WAL- YITY LINE VF LOT I X ' /�RVA,atEa /Oav✓D SS' tLEIG- /oo.00� �� 8' �� y'/� ✓GJ'GY6L So QL06.PE1vER Q /33 � ���� � Pr+vAarEV G✓ ELL n � SGgF • � ` / ooAE,o 7AAZG — Rl ® Y :WC EFr "Ll�FiVT LZvF o- ACGE.UORY .rr"C;rVIW ALr BA. _ /1/AIL jN IS a SLAL3 wv GRADE aAK r/lEE EL61i = 9.?. 00 7.f'p G.vc . l�✓ -r",A ` sE o7ZG TANK kovv ZA6Et ,4 /8Oo AXAC �/BNT ' f.W� .9wo �Sii+»ivitr AL.st� OVER BOO ` 70 .roa7/I N OTE = ExZS'7zNG /S/�J:ZOtY✓CE �o o[.� In/6ct.� Alva /OowrS A/!E ov6A /SO`EAST Of 1 Amrs-'oRY - mluecrwq� --AJ7 P/loPERTY LzNE Zc ovE/t aoo' /W XMIC L/.rcx / S7A AR0 L.�W/r1 R - O�QSE/21/Ig77A�1 /. E G4A -- *le* {�ivr Vim 3 3 Od.LFAYArlon/lkEnlr.JTACKTo T6QI/%q73F At ',wove 6 /7,vxz,-y vol 96 come �' `Pvc J•NEL fo , Soo 5�! - 4 V TEBT" By: (EFFECTIVE LIMn) r Tiri/D�rQco�/_ ZYVERT - 1. e o0 SIDE VIEW T/lENCN AZooR Tov VIEW Sari 7Z MultiPoort End Cap;t,,; ' _ . . . Lz;� 1/Vfs[Ti"70 2153 SOIL EVALUATION REP OR t i Wisconsin Department of Commerce Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County 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. � 020- 1439 -48 -100 Please print all information. iewe Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 3 Property Owner RECE P operty Location Steve & Jennnifer Knuth C M. Lot NW 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Address L t B O 2009 # Block # Subd. Name or CSM# 887 Highlander Trail 2 CSM Vol. 22, Pg. 5456 City State Z1 Cod 9 T• C phi 9 �I��,O N rTber UNTY _j City J Village e Town Nearest Road Hudson WI ZONING OFFICE Hudson I Highlander Trail 61 New Construction Use: 0 Residential / Number of bedrooms a der' sign flow rate 150 GPD J Replacement J Public or commercial - Descri :Private Accessory building Parent material Glacial Outwash - - Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for conventional POWTS using 0.7 gpd /sq. ft. loading rate. Recommend system installation at 60" below existing grade. Q2�� Boring # J Boring f Pit Ground Surface elev. 94.04 ft. Depth to limiting factor >109" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -6 1Oyr3/2 none sit 2fsbk ds cs 2fm,1c 0.6 0.8 2 6 -17 1Oyr4/4 none gr sl 2fsbk ds cs 2fm,lc 0.6 1.0 3 17 -25 7.5yr4/6 none gris Osg dl cw 3vf,2f 0.5 1.0 4 25 -31 7.5yr4/6 none Is Osg dl cw 2vf,f 0.7 1.2 5 ` r 1-109 1Oyr5/4 none s Osg dl - - 0.7 1.2 2 H #3 displays Gay coatings individual sand grains. LoadinTTite adjust #d to reflect re used permiability of horizon associated with high clay content. M e Boring # -i Boring Pit Ground Surface elev. 93.21 ft. Depth to limiting factor '104 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -5 1Oyr3/2 none sit 2fsbk mvfr cs 2f,1m 0.6 0.8 2 5 -25 1 Oyr4 /4 none sicl 1 msbk mfr cs 2fm,1 c 0.2 0.3 3 25 -36 7.5yr4/6 none sl 2fsbk mvfr cw 2fm,1 c 0,6 1.0 4 36 -44 7.5yr4/6 none Is Osg ml cw 1fm 0.7 1.2 5 44 -104 1Oyr5/4 none s Osg dl - - 0.7 1.2 g'.0 S - 2 * Effluent #1 = BOD > 30 < 220 m /L and TSS >3 50 m /L * Effluent #2 = BOD < 30 m /L and TSS < 30 m /L _ 9 _ 9 9 mg /L 5— — CST Name (Please Print) Sig atur _ CST Number James K. Thompson ,f' 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 1/29/2009 715 - 248 -7767 • Property Owner Steve & Jennnifer Knuth Parcel ID # 020 - 1439 -48 -100 Page 2 of 3 3] Boring # Boring i/ Pit Ground Surface elev. 97.40 ft. Depth to limiting factor >127" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2 1 0 -5 10yr3/2 none sil 2fsbk mvfr cs 2f,1m 0.6 0.8 2 5 -26 10yr4/4 none sicl 1 msbk mfr CS 2fm,1 c 0.2 0.3 3 26 -45 7.5yr4/6 none sl 2fsbk mvfr cw 2fm,1 c 0.6 1.0 4 45 -59 7.5yr4/6 none Is Osg ml cw 1fm 0.7 1.2 5 59 -127 10yr5/4 none s Osg dl - - 0.7 1.2 F-1 Boring # Boring _f 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 F-1 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 GPDW 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 = BOD -s-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. SBD -8330 (R.07 /00) A.C.E. Soil & Site EValuabons r � .}(�U o1 � � So :/ ada•P / o , � Cvrr,�o /uSeu/�+- t�>,re / �91i �ar a�w °Fs�cbd'vi's�bn a�oa�er�it/ e %n!- ° 1oc&4 S64*e ScQlc: /= 5� /s3 u �1 S�eG�cd ti?e�1�li,� 1�hutL�pl�,o. 0 dot z, es„ p J.P z? �. sxs<o Iavv E 25 �oc1 e a?1i - 14539- 4-1ce 6e,V s. (, 3 60 — A sjane� 4e I&A w w L� L W � � e , / s "oQK trcc. /�. 3 or3 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S�� J e ' leni k O (A Mailing Address ti 1 !4 C q ` Property Address - clef e (Verification required from Planning & Zoning Department for new construction.) City /State Hg Parcel Identification Number 02-0 - I l LEGAL DESCRIPTION NW NC Sw, Property Location - -S F- : 1 /a , N E 1/ , Sec. 2 , T 2 - `1 N R W, Town of tl S d Subdivision V1 c + , Lot # a'6c 11 Certified Survey Map # 5 S 61 *2 , Volume � o`� , Page # Warranty Deed # "I �� ` �� ,Volume ,Page # � Spec house yes Lot lines identifiable 0> no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bed goom.s q C < eSSo y�j S'Jr %xej" V e. l J 6 I SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page —/— of FILE INFORMATION SYSTEM SPECIFICATIONS Owner -Septic Tank Capacity a l ❑ NA Awo Permit # '1 Z Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS ) 7 Effluent Filter Manufacturer ❑ NA Number of Bedrooms I@ NA Effluent Filter Model A_ ❑ NA Number of Public Facility Units ® NA Pump Tank Capacity gal ® NA Estimated flow (average) al /da Pump Tank Manufacturer 111 NA 9 Y Design flow (peak), (Estimated x 1.5) Sp _ gal/day Pump Manufacturer 18 NA Soil Application Rate gal/day/ft 2 Pump Model IN NA Standard InfluentlEffluent Quality Monthly average* Pretreatment Unit ®NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 15220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L 0 In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At - Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ®NA Other. ❑ NA Other: ® NA * Values typical for domestic wastewater and septic tank effluent. Other: IM NA MAINTENANCE SCHEDULE Service Event Service Frequency ❑ month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: ! ® ears) Pump out contents of tank(s) When combined sludge and scum -third of tank volume ❑ NA q ❑ month(s) (Maximum 3 years) [3 NA Inspect dispersal cell(s) At least once every: v9, ® year(s) ❑ month(s1 ❑ NA Clean effluent filter At least once every: l ® years) ❑ month(s) IN NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(sF ® NA Flush laterals and pressure test At least once every: ❑ year(s) ❑ monthls) 10 NA Other: At least once every: ❑ year(s) Other: 10 NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for, any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. ' When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of :512 months, shall be performed'by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4 /01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ® A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANWOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Z levA ' Name _ Phone — Phone — SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone 3- ��d _ C) Phone — This document was drafted in compliance with chapter Comm 83.22(2)(b)l1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. i li Parcel #: 020 - 1439 -48 -100 02/03/2009 03:19 PM PAGE 1 OF 1 Alt. Parcel #: 25.29.192774B 020 - TOWN OF HUDSON Current [X] ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/14/2007 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner 0 - KNUTH, STEVEN R & JENNIFER P STEVEN R & JENNIFER P KNUTH 887 HIGHLANDER TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 887 HIGHLANDER TRL SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 5.630 Plat: 5456 -CSM 22 -5456 020 -07 SEC 25 T29N R19W PT NW NE, PT SW NE,PT Block/Condo Bldg: LOT 02 NE NE & PT SE NE FKA INDIGO PONDS LOTS 47,48 & PT LOT 49 BEING CSM 22 -5456 LOT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 2 (5.63 AC) 25- 29N -19W NW NE 25- 29N -19W SE NE 25- 29N -19W SW NE 25- 29N -19W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 09/14/2007 860541 22/5456 CSM 09/14/2007 860540 QC 0911412007 860539 QC 07/02/2007 854795 WD more... 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 258900 805,900 Valuations: Last Changed: 05/07/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.630 180,700 567,700 748,400 NO 05 Totals for 2008: General Property 5.630 180,700 567,700 748,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 111111 IIIII ;" "'!III IIIII IIIII f(il 111111 IIII IIII * 8 6 0 5 4 1 2 860541 KATHLEEN H. WALSH REGISTER OF DEEDS n ° RECEIVED FOR RECORD t = 09/14/2007 01:30PM A CERTIFIED SURVEY MAP o VOL: 22 PAGE: 5456 IAA S00 °24'08"- 5278.71' NO RTH -SOU 1 LI NE REC FEE: 13,0 -- lu F 1779 .70' PAGES: 2 3499.01' m z ,,,,aatudmrrnrpr� /ci 0 m: o o n a 3 = r n BEARINGS ARE REFERENCED TO M n n y �� D fll C7 a THE NORTH -SOUTH 114 LINE OF m ' r m ; :0 z ti+ o � }} •'. SECTION 25, WHICH BEARS E 5 ,2 1 _ _ �„ S00 °208 °E (ST. CROIX COUNTY ` Z D � •� m f a COORDINATE SYSTEM) Nl�0 N QQ w �• m 1�Zt, .A m 4 �°, N N I�t1 1 r 00= C) P C ;m Wp =O . {�v z�mm i0 ICI m Ozcl)0 I P o �_° _____ z t O T , aa I�oao� I� t --I = I� I (,9b'9093MZ£,0� °90S) V C p . 909 30601 905 N N cn 0 0 (A, to 0 = o t0 ^ i, IT( E x t �q tea � n 0 O _� � � C C1 j� rDXCD� �'a �,�� - iC)m 0 cT` 0 ) t� OOnm b w- S`. 1 -nC_1 _pm ul a YS ® zO 1J lr ms \y\ � � m u, v � q.a� °cos � \ 0 � -� O o� X6 '3. 6411-W ,£q 6£4 24 0 00 c D co o ,9L'�Zti i m ,09 �Zti Z Z Z Z Z D V ld Lp k A co �Qo �C4 m / \ \g6 \ ,� u m Q o COW � i� 4 > i co my mi m Sys F° M o o� �� _ rat 9 M PS q O B • L5 q2Z ��� c�2`� o a'b� m °m 0 0 m0 M v fTl N < rn i z z �z Z a 0 �0 o v 00 \ Z �o�pr a- >mNnz F,� c m� zD o� - v?<c7oo State of Wisconsin LRECEIVE J Gen i andscape Pond Department of Natural Resources al Permi t Packet R1 -06 WWW.dnr.wi.gov Form 3500 -10 page 4 of 8 Notice: This application form is required under Section 30.206, Wis. Stats. and ch. Iubmit a complete application to the Department at least 35 days prior to the date of proposed cons our application, forfeitures or other enforcement. Personally identifiable information included on this form will be used to contact you and is not intended to be used for other purposes. It may be made available to requesters under Wisconsin's Open Records law ( ss.1931- 19.39, Wis. Stats.]. Section I: Landowner Information Name Contact Person i' k= Mailing Address Email Address 9 )tr r� s- 514 u '� D a ba 'a� wsc4. e,o *i City State Zip Phone Fax A (7 /S' - 7 -7 04Z� Section II: Activity Check the box next to the type ofgeneral permit youare requesting with this application ; ❑ Biological Shore Erosion Control ❑ Dry Fire Hydrant ❑ Integrated BankTreatment ❑ Riprap Repair/ RQlgacemerit "' ❑ Boat Ramp ❑ Fish Habitat Structure ❑ Pilings ❑ Seawall Replacerr ed t • Clear Span Bridge ❑ Ford Pond -Landscape ❑ Seawall- Replace wO. Riprap___ • Culvert ❑ Grading ess Than One Acre ❑ Pond - Stormwater ❑ Temp in -Str am Crossing 9- P Y g ❑ Dredging - Drainage District ❑ Grading - One Acre or More ❑ Pond - wildlife ❑ Wildlife Habitat SiRture ❑ Dredging - Utility Crossings ❑ Intake /OutfallStructure ❑ Riprap ❑ Other: ry Section 111: Agent Information Check one 0 Consultant C3 Co ntractor Contact Person KNC� *Authorized Representative ❑ Not Applicable 1 &V A r4A 4e4 It 1 27- 01 4 Mailing Address E -mail Address :5w is - Z loi tc6 �e-ct . Go �-n City M 1 5 - 40 1 b Zip Phone Fax ( &5_1 z-V 7 / 5 - 42 - zo 2. Section IV: Site Information Project Address Waterway Name RO - 7 1.4ofar.. brio j h nakn /a �/4 Section Township Range E/W Check one Cou w Sul N / Z 7 29 N Fs� k1 L3 City Town ❑Village of ►111 _. S T ' °'o� Project Start Date Approximate Project End Date ( Month/Day/Year) E b. (� ( Month /Day/Year) J u / Z 0 0 Will this project effect wetlands? ❑ Yes No 11 Unsure �/ ( How did you arrive at this conclusion? h g i�t ld- wt�ft✓ ' &Y 11 t` ✓� �'tny tht v r h e- a G+/t•�rtc2 It-IV � .rr :E��s ,'.,�► J1 A P IA h .4 .6 -'' Y I`C-Ie5 $ tV4 YA+I' -1 61 -f k e pr se-d, .i d - e - 1 of ��-is - h`-�� po-•�d State of Wisconsin Landscape Pond Department of Natural Resources General Permit Packet RI-06. www.dncwi.gov page 3 of 8 Standards Summary This sheet generally describes the standards & conditions that you must follow when you have received eligibility for a general permit. All of our general permits have specific standards for construction and location contained in law. By acting on this permit you certify that your plans comply and that you will follow the standards and laws pertaining to the general permit program. No portion of the berm or pond maybe any closer than 35 feet from the ordinary high -water mark or within 100 feet of the location of any public rights feature as described in NR 1.06 '® The pond or artificial water body is not constructed, dredged or enlarged in a wetland. Fish will not be reared in the landscape pond unless prior department approval has been granted in writing .� The permit does not authorize any work other than what is specifically described in the application and plans dated as listed above and as limited by the conditions of the permit. A permittee shall obtain prior written approval of modifications from the department before modifying a project or amending permit conditions. R-The pond may not be associated with non - metallic mining activities. The excavated material may not be temporarily or permanently stored in a wetland, floodplain, or below the ordinary high - water mark of any navigable body of water. j� To be eligible you must devise an erosion control plan that prevents erosion and meets the technical standards found at: http:/ /dnrwi.gov/ water /wm /nps /Stormwater /techstds.htm. The pond or artificial waterbody is not constructed, dredged, or enlarged in the regulated floodplain Er The permittee shall notify the department at telephone number listed above before starting construction and again not more than 5 days after the project is complete. The permittee shall post a copy of this permit at a conspicuous location on the project site visible from the waterway, beginning at least . 5 days prior to construction and remaining at least 5 days after construction. The permittee shall also have a copy of the permit and approved plan available at the project site at all times until the project is complete. Upon reasonable notice, the permittee shall allow access to the project site during reasonable hours to any department employee who is investigating the project's construction, operation, maintenance or permit compliance. The permittee shall complete the project on or before the expiration date listed. If the project is not completed by the expiration date, the permittee shall submit to the department a written request for an extension prior to the expiration date of the permit.The request shall identify the requested extension date and the reason for the extension.The department may grant a permit extension for good cause shown.The permittee may not begin or continue construction after the original / permit expiration date unless the department grants a new permit or permit extension in writing. E The permittee shall submit a series of photographs to the department within one week of completion of work on the site. The photographs shall be taken from different vantage points and depict all work authorized by the permit. The permittee shall maintain the project in good condition and in compliance with the terms and conditions of the permit, this chapter and ss. 30.206, Stats. The department may modify or revoke the permit if the project is not completed according to the terms of the permit or if the department subsequently determines the activity is detrimental to the public interest. 'MAcceptance of a general permit and efforts to begin work on the activity authorized by the general permit signifies that the permittee has read, understood, and agreed to follow all conditions of the general permit. If the department determines that a proposal submitted under this section has the potential to impact an endangered or threatened species in accordance with s. 29.604, Stats., the application is incomplete. The department may not issue a general permit until the applicant submits information to demonstrate one of the following: a. that the project either avoids impacts to the threatened or endangered species or b. that the project has received an incidental take authorization under 29.602, Stats. c. if the project is modified, the applicant must submit the revised plan before the application can consider the application complete or issue a general permit. State of Wisconsin Landscape Pond Department of Natural Resources General Permit Packet R1 -06 www.dnrwi.gov Form 3500 -108 page 5,6f 8 Section V: Permit Conditions FOR DNR USE 1. The permit does not authorize any work other than what is specifically described in the application and plans dated as listed above and as limited by the conditions Date of.Pr j t Plan of the permit. A permittee shall obtain prior written approval of modifications from the department before modifying a project or amending permit conditions. Phone 2. The permittee shall notify the department at telephone number listed above I ' before starting construction and again not more than 5 days after the project is t complete. 3. The permittee shall post a copy of this permit at a conspicuous location on the project site visible from the waterway, beginning at least 5 days prior to construction and remaining at least 5 days after construction. The permittee shall also have a copy of the permit and approved plan available at the project site at all times until the project is complete. 4. Upon reasonable notice, the permittee shall allow access to the project site during reasonable hours to any department employee who is investigating the project's construction, operation, maintenance or permit compliance. 5. The permittee shall complete the project on or before the expiration date listed Project pirati n Date above. If the project is not completed by the expiration date, the permittee shall submit to the department a written request for an extension prior to the expiration date of the permit.The request shall identify the requested extension date and the reason for the extension.The department may grant a permit extension for good cause shown. The permittee may not begin or continue construction after the original permit expiration date unless the department grants a new permit or permit extension in writing. 6. The permittee shall submit a series of photographs to the department within one week of completion of work on the site.The photographs shall be taken from different vantage points and depict all work authorized by the permit. 7. The permittee shall maintain the project in good condition and in compliance with the terms and conditions of the permit, this chapter and s. 30.206, Stats. 8. The department may modify or revoke the permit if the project is not completed according to the terms of the permit or if the department subsequently determines the activity is detrimental to the public interest. 9. Acceptance of a general permit and efforts to begin work on the activity authorized by the general permit signifies that the permittee has read, understood, and agreed to follow all conditions of the general permit. 10. This project shall comply with all conditions identified in the following Wisconsin WI Adm. Code Administrative Code, and identified in the Instructions for the General Permit NR 343 application. Section VI: Findings of Fact 1. The department has determined that the project site and project plans meet the WI Adm. Code standards in s. 30.206, Stats. and the following Wisconsin Administrative Code, to NR 343 qualify for this General Permit. 2. The proposed project will not injure public rights or interests, cause environmental pollution as defined in s. 299.01(4), Wis. Stats., or result in material injury to the rights of any riparian owner, if constructed in accordance with this permit. 3. The department and the applicant have completed all procedural requirements, and the project as permitted will comply with all applicable requirements of Section 30.206, Wis. Stats., and Chapters NR 102,103, 150, 299, 310 and the following Wisconsin Administrative Code. WI Adm. Code NR 343 Section VII: Conclusions of Law 1. The department has authority under ch. 30, Wis. Stats., and applicable Wisconsin Administrative Codes, to issue a permit for the construction and maintenance of this project. 2. The department has complied with s. 1.11, Wis. Stats. State of Wisconsin Landscape Pond D of Natural R esources General Permit Packet R1 -06 www.dnr.wi.gov Form 3500 -108 page 6 of 8 n VIII: Sectio .Certification and Permission I am the owner of the riparian property or am the duly authorized representative and may sign this application on behalf of the owner(s) of said property. I hereby certify that the information contained herein is true and accurate. I have read and understand all of the conditions listed in this permit and in the instructions. I have designed the project to comply with the conditions, and I will construct the above - mentioned project in compliance with all such conditions. I hereby give the Department permission to enter and inspect the site at reasonable times, to evaluate this application and to monitor compliance with any resulting permit. I understand that failure to comply with any or all of the provisions of the permit renders the authorization contained herein null and void and may result in a fine and /or imprisonment or forfeiture under the provisions of ch. 30, Wis. Stats. Landowner or Agent Name (please print) S 6r✓ W &6 + Landowner or Agent Signature Date Signed h zz.o�t Mail this signed, completed form, along with all the information shown on our check lists, including three copies and the appropriate fee to the Department of Natural Resources office in the region where the project is located. See the instructions for regional office addresses. This permit application is approved when it is signed and dated below by an authorized Department of Natural Resources employee. Section IX: Permit Approval DNR USE ONLY Dat Applic tion Received DocJke�t� #� Date Ap licati n Completed Fee Received lao V9 NH Check ? Historic Checked? ASNRI? PRF? PNW? L3 El 1c, Yes & Yes Yes 1UNo Yes &o ❑ Yes b-No State of Wisconsin Department of Natural Resources Title r ' for the Secretary 0 _ � a, Mai W_� Date Signed Issued by a] W �ee Copies of this permit sent to: Conservation Warden U.S. Army Corps of Engineers Zoning Administrator .� Tmm0ei ka,'RYk_ P Other 1 llllil 11111 l�lll 11141 Ili ill ililll 4iil till Document Number Document Title 888490 BETH PABST St. Croix County REGISTER OF DEEDS ST. CROIX CO., WI Accessory Structure Affidavit RECEIVED FOR RECORD 02/11/2009 10:45AM AFFIDAVIT kq . --F•-6 EXEMPT N Name — (Owner) Typed or printed REC FEE: 11.00 being duly sworn, states, under oath, that: PAGES: 1 1. He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume N/A Page N/A Document Number _ _860540_ St. Croix County Register of Deeds Office: Recor ding Area A parcel of land located in the NW '/ ofthe NE t / of Section 25 Name and Return c ress 11r S'i,t(� T 29 N — R 19 W, Town of Hudson St. Croix County, Wisconsin,, being duly described as follows (include lot no. and subdivision/CS M 1 wx (C or detailed legal description): Parcel Identification Number (PIN) Part of NW NE, Pt of SW NE, Pt of NE NE & PT of SE NE flea Indigo Ponds lots 47, 48 & 49 being CSM 22 -5456 lot 2 (5.63 AC) 020 - 1439 -48 -100 ( #25.29.19.2774B) As owner of the above described property, I acknowledge that the private onsite wastewater treatment system (POWTS) serving an accessory building on this lot is sized equal to a one (1) bedroom home, or a design flow of 150 gpd. This building may not be used as a residence; there is an existing principal dwelling on this parcel. I also acknowledge that I will disclose this information and stipulation to any future parties interested in purchasing this property. Dated this day of lT� G / �_ . ZJ * i _V_ r► t�_ IrAr u * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. S t, Croix County. authenticated this day of Pers Wally came befor 7- e me this day of - Ot? the a e named 9r - to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person(s) who executed the foregoing instrument and acknowledge the (if not, _ same. authorized by § 706.06, Wis. Stats.) _ T141S tt� WAS D�RAFI'£D BY Note �blic, Sta�o (Signatures may be authenticated or acknowledged. Both are not My C ss �i i� 10 Aate exp6tion date: necessary.) D This information must be completed by submitter: document title name & return address. and Pl1V (ifrequire2111,.73ther i>;forin?ritbn such as the granting clauses, legal description, etc, may be placed on this first page ofthe document or maybe placed on additional pdges ofthe document. Note: Use ofzhis corer page adds one page to your document and to the recording fee. Wisconsin Statutes, 59.517. 1 of 1 Q z, �° °'° 0 p ° v3 p ° 6F). N c c cc O o rnm m 3� v o �v CL qz, �V cam �? w a> 3 0 mQ t r 0 � V ma 2 o o-0 o Q 1 o o Qc v Z`mCa� 1 °ts°3u' O v m rn� o °ov y °3 N � l w�oao I m a am c y (Dn ° a � ao ai � �= = .4 1 > rn Z O 'y O N Z N m m C U y a O C y (D LL C pajm NN lL C y.-. C ca C I O m N O V1 � a) Lo N O O 7 Q �9ind m Q N.0 I I a) N $� Z Z O Z !_' G !_' C a) 4) am am LO 04 N I- Z N C C7 O Z c 0) U a' a- O N O (V V! d Z a C C rn m c° E c v � m N N C � N Y 7 U N 7 � • O N O a) y O a) a m a m 0 I O Z Z O Z Z N ° m V) L q o R �? C� _ N N f_p N v o N al N c a) N 0 O F y Fy a s m o {y am 0 Fy a Q a N a N Co • aaaaaa � a �i 'v oN �o °� o boo a a� 0 0 t1) J U t N O Z L N N p} 'O O O �) R) Mo Z rn o a r Z� m O O = N U = V, LO 2:! 0 N N f- O .-. O a B O O - C) W - C O C I 0 n .- C a a0 p NII LM 9 H a) w 'C Q n (n w 'C d Q n (n N m m d C d 0 O 0 N C '�7 N C m r.+ O o O 'B 06 O E 00 O 00 � 3 a> � a) a M c'a c a c8 0 0 1 c E d C m 2 m N 00 co O y � c ` : a. N - U U 7 s- N N C ai r s o ai (D w m d a`) c c c w rn oo Fes) O ' N a 7� +..+ t` 7 M N LO 7 1 C O N (a O C O O N N N m U 1 • mil ' O N= Y it> 0 Z A a Z Y v 0 Z � Y W y C a a � �a� I Lam tt`Iw��j w a c 'c c 2 c O �1 A uCL 00) 2 OU) Wisconsin Department of Commerce County: PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463372 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Knuth, Steve & Jennifer I Hudson, Town of 020 - 1439 -47 -000 CST BM E1ev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 0 a0.0 r y _UI&v 25.29.19.2773 TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. w Z A--(ft _ Septic Benchmark 12 S Dosing Alt. BM _ Aeration Bldg. Sewer Holding St/Ht Inlet I St/Ht Outlet TANK SETBACK INFORMATION 5 9. 6-5 - TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > S0 , 2 q 1 _ Dt Bottom Dosing I Header /Man. Aeration 13tst Pr¢e 1 3 ' _ 0 Holding / Bot. Sy 0m 11.0 /O !O i el A14, , i Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover Model Nu er TDH Lift ction Loss System Head TDH Ft Force mai Length Dist. to Well l— SO SORPTION SYSTEM 8 R NC Width i Length I No. Of Trenches IT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIM T 1 �� ( 2— SETBACK SYSTEM TO P/L \ BLDG WELL LAKE /STREAM LEACHING Manufagturqr r ` INFORMATION Type Of System, A CHAMBER OR .� (Af �v — h� O I l 1 L �— UNIT Model Number/ /I DISTRIBUTION SYSTEM 5 t�Qt Distribution x Hole Size x Hole Spacing Vent to Air Intake k Pipe(s) > 0r Lengt Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes 'j No Yes i� No j] COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 4 Zeu S7 / Location: 887 Highlander Trail Hudson, WI 54016 (NE 1/4 NW 1/4 25 T29N R19W) Indigo Ponds Lot 47 � Parcel N 29.19 277 1.) Alt BM Description = vt* 2.) Bldg sewer length = 3`� 4� l 3 ) tw v -41 9- P'f'sz' "'' 3 e Plan revision Required? Yes Y'X No 1 Use other side for additional information. ' Insepctor's Cert. No. SBD -6710 (R.3/97) r r - Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 S - C �� _ i,�eoinsin . � 8`� 53707 - 716 1 � Sani Permit Number (to be fitted in by Co.) Dep ment of Commerce CE V ( 4 Stagy tan I.D. Nu mber mbs' Sanitary Permit Appli t o R o o 20 In accord with Comm 83.21, Wis. Adm. Code, personal info 'off o MY be used for secondary purposes Privacy Law. s15. ) ROiX �pU - `I;roject as (if different than mailing address) E A wn- I. Application Information - Please Print All Information Parcel Lot X jl10 /6 Block Property Owner's Na me ar rY �0-rls Address Property Location " 'A. �[_ Sf.Secaon _ City, State Zip Code Phone Number (circle one) y •� I T C P_9 N; R_ZLE 06) II. Type of BW g (cheek all that apply) S "`` S Subdivision Name CSM Number ® 1 or 2 Family Dwelling - Number of Bedrootr>s ❑ Public /Commercial - Describe Use r ❑City ❑Vinage XTownship of�� ❑ State Owned - Describe Use — III. Type of permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System S B. Q Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued o Before Expiration Plumber Owner IV. T of POWTS System: Check al that appl 19 Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Fitter 'S ❑ Recirculating Synthetic Media Filter XLeachin Chamber ❑ Drip Line ❑ Gravel -less Pipe 11 Other (explain) S V. Dispersal/Treatment Area Information: - .F - ) i`' Design Flow (gpd) Design Soil Application Rzm(gpdsf) I Dispersal Area Required (sf) Dispersal Area Proposed (sf) yytem 2ilevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site y Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing 1 Tanks I Tanks Septic or Holding Tank _ r Aerobic Treatment Unit Dosing Chamber VII. Responsibility St atement- I, the undersigned, ass ume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature MP /MPRS Number Business Phone Number Plumbe Addre ss (Street. City. State, Zip VIII. C ount /De ent Use Onl Approved Cl Disa Sanitary Permit Fee (includes Groundwater Date Issued ng t Signature (No Stamps) Surcharge Fee) ❑ Owner n n for Denial — o n A ` IX. Conditions pprov 3 , Q WsLd. apt tyu a.� cR C-Dk� SYSTEM OWNER: 9 1 Septic tank, effluent filter and dispersal cell must all be serviced f maintained F �_ as per management plan provided by plumber. o t MCUL 2 - S 2. All setback requirements must be maintained ) as per applicable code /ordinances t - XA JQ�1 1 nx Attach oossiplete plain (to the County only) for the system on paper not less than 81f2 x 11 inches is size &J jrLL a P`` PLOT & CV,4ng SECTM PIAi �a ZWA §V.40L §=AV� u RCS ` g8'i LAAJ ew49 �or �r tX Locw Lj"'<'cttkbwp SINE �E,1/eN >z� o��L . w,ESEe O EP7lC T"ve AO .Z4 &4 Alroo `/ ` A/c f; ur L A l E P� AINE o Ct�� 0 1 JJ�c1t �e11$ 4a1pK4 /lo iG c�i�S�Q+�I,kT�owl otZ SIGNED: VENT e,14p ucENaE: FN�s,�E OATE: r1AA JJ"d%Nt IW i4'6evc #•qrL i9tK PAr .so1l.tES sr. The Stan In Iti s tor Chamber 1' Overlap at Lau**V _. T�kN $o"fr�w+ ��PSac� 12 .. o z r rG ° lE� = A S,oe View 75• 677 PLOT & CNOei SECTION PIA ZAPPA MM. EXCAVAUA N P0u►ARINa ulrt /�lEw CQQ v r ��lctf S O 'S�fPflt 7"�nr� c��7¢f .Z�B�C� �/8'471D I " Alc FXWk Jr 1,+A1 E 44 r� r P� � o 4 of , ` 0464.' d RCA 3 Q® e# ,6;teYfAjb s itVA Mum VEN T 40V ucum: au /�NfL DATE: The Standad In lit for Chamber V Overlap at Lalching 0 Sloe V iBw 75• Effective Lengm l y 1898 Wisconsin Department of Commerce SOIL EVALUATION REPO Page 1 of 4 Division of Safety and Buildings in accordance with Comm 85, WW A e A.C.E. Soil & Site Evaluations Attach complete a inch County t� site plan on paper not less than 8Y2 x 11 � Q St. Crob( - include, but not limited to: vertical and horizontal reference poin BM), percent slope, scale or dimemsions, north arrow, and location a distance to nearest road.JZ6 arcel I.D. 020 - 1439 -47 -000 Please print all information. Q 4 ppR R vie ed By Date Personal information you provide may be used for secwday purposes Low, s. 15.04 (1) (m)L 00 41Y O S Property Owner C: Scott & Jennifer Knuth NE 1/4 NW 1/4 S 25 T 29 N R 19 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 47 Indigo Ponds City State Zip Code Phone Number City _j Village J Town Nearest Road Hudson 1 887 Highlander Trail ✓_ f New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Install conventional POWTS using two trenches with combined E.I.S.A. = 857.15 sq. ft. at elevation of 103.00'& 100.0'. ❑ Boring # Boring ✓J Pit Ground Surface elev. 110.15 ft. Depth to limiting factor >147" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -5 10yr32 none I 2fsbk mvfr as 2fm,1c 0.6 0.8 2 5-21 10yr4/4 none sl 2fsbk mvfr gs 2f,1 me 0.6 1.0 3 21 -30 10yr5/4 none sl 2msbk dsh cw 1fm 0.6 1.0 4 30-62 10yr5/4 none Ifs 0 sg dl cw lfm 0.5 1.0 5 62 -147 10yr5/6 none s 0 sg dl - - 0,7 /,b Boring # I Boring Pit Ground Surface elev. 99.97 ft. >1 in. Soil Depth to limiting factor Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 - 10yr3/2 none I 2fsbk mvfr as 2fm,1c 0.6 0.8 2 5-17 10yr4/4 none sl 2fsbk mvfr gs 2fm,1c 0.6 1.0 3 17 -32 10yr5/4 none gr Is 2msbk dsh cw 1fm 0.7 4 32-45 10yr5/4 none gr s 0 sg dl cW 1fm 067 4 (p 5 45 -115 10yr5/6 none gr s 0 sg dl - - 0 7, Ma Horizon #3 contains gravel & cobbles, H#4 contains approx. 15% gravel, & H#5 contains approx. 10% gravel. Effluent #1 = BOD ? 30 < mg/L and TS >30 < 50 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <,0 mg/L CST Name (Please Print) Signature: - CST Number James K. Thompson 1 3602 Address A.C.E. Soil & Site Evalu s Date Evaluation Conducted Telephone Number 340 Paulson Lake La , Osceola, W154020 328/2005 715 - 248 -7767 Property Owner Scott & Jennifer Knuth Parcel ID # 020 - 1439 -47 -000 Page 2 of 4 3] Boring # Boring Ae Pit Ground Surface elev. 100.11 ft. Depth to limiting factor >119" 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 1 0 -5 10yr3/2 none I 2fsbk mvfr as 2fm,1c 0.6 0.8 2 5 -26 10yr4/4 none sl 2fsbk mvfr gs 2f,1mc 0.6 1.0 3 26 -38 10yr5/4 none sl 2msbk dsh cw 1fm 0.6 1.0 4 38-66 10yr5/4 none Ifs 0 sg dl ci 1fm 0.5 1.0 5 66 -119 10yr5/6 none s 0 sg dl - Horizon #5 contains approx. 20% gravel & cobbles. F—I Boring # v � 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 GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F—I Boring # -i 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 QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eti#1 *Eff#2 * Effluent #1 = BOD ? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 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. ♦ Ele ✓a.:6, z �etl°. �veilni�t�7Cnut"q, toe �? Pla e dlc �d,' o d a - o C.. ,z S r,,. c� .4,gArox. A 9nzd ' ' ��` 10 Ao p / 1dLL0 Co.t*-r 0 sue'" ,— " �'^ �„�, -' , � •' " " " " ,b� _ Gene h ►�la�lC: 7 oN of y�,`rt -bar. Assu�+cd a ;l ;n CP i r - '�:5prsa/ CQ// Crots Spe6on 5ca /e / 3.0 /oQo' I Vi i I ! I t i POINTS OWNER'S MANUAL & MANAGEMENT PLAN pop-/—of -9L FILE WIMRMATI IN 81fS7lNIl SPECIHCATlON3 -septic Tank Capacity 1250 g d O NA Parmk d 3 �Z Septic Tank Manufwum Wieser a DESIGN PARAMETERS Effluent R W Mwwfwkwr table O NA Number of Bedrooms 4 O NA Effluent Biter Model A -1600 O NA Number of Public f"ty Units ► PwV Tank Capacity gal D NA Estanated flow laverage) 400 Pump Tank Mamdwtum D NA Design flow (peek►, lEstrnated x 1.51 600 galiday Pump Mamdactim 10 NA Soil Application Rate .7 t Pump Model M NA Standard Influent/Effluarht Quality Montdy average• Pretreatment Unit D NA Fats. ON b Grease IFOG) 930 a*n O Sa m d/Gravel Filter O Pest Fikw siochemicai Oxygen Demand 1800 a" nV& O NA O Mechanical Aeration O Wetland Total Suspended Some (T8S) 51 s0 nvx O Disinfection O Other: Pretreated Effluent Quality Monthly average Dispersal COINS) O NA Biochemical Oxygen Demand (90061 $30 MOA O M- Ground (gravity) O kWiround (pressurized) Total Suspended Solids (TSB) s30 a*& O NA O At -Grade O Mound Fecal Coliform lgeomstric rr'M) s10 du/100m1 O Orip-Line O Other: Maxwourn Effluent Particle Size Y in dla. O NA Odrr: ® NA thlnr: 31 I 0dw- N NA • Valves typical for domesda wastawassr and segue tank etika,nt. ®NA MAINTENANCE SCHEDULE SerAcs Event Sefvioe Fmimpumicy inspect condWm of tankls) At least once every: 2 ® m mr ( s ) 3 yam) O NA Pump out contents of tenkle) When canbined sludge and scum equals one -thbd N of tank vokune O NA Inspect dispersal ceNW) At least once every: 2 mo s g y p NA Clean effluent filter At least once every. 1 moo�t:f O NA month(s) ® NA Inspect PUMP, pump controls & alarm At least once every: O s Flush laterals and Presque test At Nast once every: O am(s) ® HA El 000r. At Nast once every: O monthls) RNA Lf- — i RNA MAINTENANCE INSTRUCTIONS or certifications: Inspections of tanks and dispersal calls shah be made by an individual carrying one of tin OP�a• Tank Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector POWTS Maintainer, as r. leaks, inspections must include a visual inspection of the tankls) to identify any passing or broken hardware, idwaft my masque the volume of combined sludge and scum and to dwck foc any back up or pm" of effluent an the ground surface. check the effluwU levels The diapered oslNsl shall be viauaNy inspected to in the obmvadon pipes and to cheek for any PmWft of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a fang condition and requites tt►e immediate notification of the local regulatory authority Whan the combined wmnwlation of sludge and scum in any tank equals one -third IK) or more of the tank volume, the entire contents of the tank shah be removed by s Septep Servicing Operates and disposed of in accordance with chapter NR 113. Wammisin Administrative Code. AN other services, including but not baited to the mvking of effluent filters m anical POWTS Maintainer • pm t units, and any servicing at intervals of S12 months, pia A service report shah be provided to the local regulatory authority within 10 days of completion of ant► WW" fit• OW 14101) Page at of • START UP AND OPERATION ucts or other chemicals For new construction, Prior to use of the POWTS check treatment tan f high ea+Woadans are detected have the contents that may impede the treatment process and /or damage the dispersal gs, g of the tank(s) removed by a septa90 servicing Operator Prior to use. System start up shall not occur when soil conditions are frozen at the Infiltrative surface. During Power outages pump tanks may fill above normal highwater levels. When power is restored.the excess wastewater will be discharged to the dispersal Collis, in one large dose• overloading the cellts, and may result in the backup or surface discharge of effluent. To avoid this sRuation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintalner to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soli absorption area. Reduction or elimination of the follow from the wastewater stream may Improve the performance and prolong the rds of the POWTS: antibiotics; baby wipes; cigarette butts; condoms: cotton swabs; degreasers, dental floss; diapers; disinfectants; fat; foundation drain (sump Pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps: medications; oil; painting products; pesticides; sanitary napkins: tampons; and water softener brine. ABAND , taken out of service the following steps sha tie taken to Insure that the system is When the POWTS fails and /or is perm properly and safely abandoned In compliance with chapter Comm 133.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned Pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and Pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code comp ant replacement system: evil soil absorption A suitable replecemernt area has been evaluated and may be utilized for the location of a repiacem system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proPoSW structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. setback and/or soN E3 A suitable replacement area is In n t ahead, fast r t esort replace the failed s' Beating advances in POWTS a suitable won. Upon talk" dF the technology a holding tank may be a soll and site ❑ The site has not been value ed identify itable replacemen replacement no replacement sea is available a holding tank eva l ua tion must be pert locate m to re lace the failed POWTS. resort P � be installed as a last of the bio ace follow removal mat at the cted In lion systems may be reconstructed PI lade soil absorption that time. p Mound and at-g m with the rules In effect at infiltrative surface. Raeonstructions of such systems must comp < <WARNING> > ASSES SEPTIC. PUMP AND OTHER TREATMENT TANKS TANK CONTA ANY LETHAL 0 MAY RESULT' OXYGEN. SCUE OF A ENTER A SEPTIC. PUMP OR OTHER TREATMENT PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTAINER POWYS INSTALLER Name ) r ' Count Ben Mor an Name oth Phone 715- 386 -213 Phone 715- 386 -2 SEPTAGE SERWCWG OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Tri County (Ben Morgan) Name St. Croix County Zoning OffQ e Phone 715 -386 -2130. Phone 715- 386 -4680 This document was drafted in Compliance with chapter Comm 83.22(2)(b)111(d1 &(fl and 83.54(1). (2) & 13). Wisconsin Adrnir "ti" Code ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM �- Owner/Buyer ieyc Mailing Address � � tYer, �l (�'t,� aA/ , �/(/„� �y 0 Property Address 837 [ca m Je.4/ -- firo i'l I II (Verification required 46m Planning Department for new construction g P ) City /State L tl C 160 -� IN . - Parcel Identification Number 2 - 3 y - 4 0 LEGAL DESCRIPTION Property Location ,d,�E_ /,, /4, Sec. Zs , T A 5 N- R_Zj W, Town of t1 Al S ubdivision -� ov S � Lot # 17 . I Certified Survey Map # , Volume , Page # Warranty Deed # � R . Volume el ?..?c'f , Page # do Spec house ❑ yes ® no Lot lines identifiable P 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, journeyman plumber, restrictedplumber or a licensedpumper 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 113 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 your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da of the three year expiration date. acjll�, 3 �Q5 SiGiRFUM 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. S A � d � 1 / - ]F ' 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 V` U, 2738F 084 -785'303 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 - 2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 81/27/2805 09:450 WARRANTY DEED EXEMPT # THIS DEED, made between Landsted, LLC REC FEE: 11.00 TRANS FEE: 497.70 ( "Grantor," whether one or more), COPY FEE: and Steven R Knuth and Jennifer P. Knuth husband and wife CC FEE: PAGES: i ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): � ✓ Q H Lot 47 Plat of Indigo Pon ds in the Town of Hudson, St. Croix County, Wisconnin. r/ t7 020 - 1439 -47 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, ifany. Dated al Z G 0s (SEAL) �.._s� (SEAL) * * Landsted, LLC (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF y tSC9 ^ S I'` ) ) ss. r J• f cr4" )c COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on at2 61 (If not, the above -named Landsted, LLC — &Wol CL,I S o authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: ins d knowledged the same. Attorney Kristina Ogland Hudson, WI 54016 &- ve IF No Publi ,State of V, CO- 1..+ My Commission (is permanent) (expires: 4 O (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 C 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO -PROTM Legal Forms 800 -655 -2021 ~.infoproforms.com JAY P. PENFIELD Notary Public State of W1st onsln TOP STMT PWE 'fix r " '`.•� f f 46 a t 91 . (2.R. Ac., , AW NO OVAUl OC , .�� omax �. 01-16 L RkJ y�,, 1265 Wisconsin Department of Commerce SOIL EVALUATION REPORT �� w( " f of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service County son 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. Please print information. Revi B Date Peral ictormation you provide may be for � -, s. t .04 (1) (m)). Property Owner I Iroperty Location ROSAMJI, L.L.0 t vt. Lot na NE 1/4 NE 1/4 S 25 T 29 NR 19 W Property Owner's Mailing Address 10 Block # Subd. Name or CSM# 2141 Cty Rd. C ST. CROIX C0(JN I Y 47 na Indigo Ponds City State Z p Code4%n *l frlii WE City _J Village 01 Town Nearest Road New Richmond WI 1 54017 1 715 - 248 -7071 Hudson Highlander Trail fM New Construction Use: 001 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD _I Replacement _I Public or commercial - Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments and recommendations: system elevation 94.85 ft, trenches spaced and depth to code 3.75 ft below grade Boring # Boring Pit Ground Surface elev. 98.60 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD& in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 I *Eff#2 1 0 -8 1Oyr2/1 none sil 2msbk mfr cs 1c .5 .8 2 8 -26 1Oyr4/4 none sicl 2msbk mfr gw 1c .4 .6 3 26-33 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 33 -120 7.5yr4/6 none cos osg mvfr na na .7 1.6 COS <35% coarse fragments = 36" & >35% - <60% = 60" below system Boring # I Boring 1I Pit Ground Surface elev. 98.60 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sit 2msbk mfr cs 1 c .5 .8 2 9 -24 10yr4/4 none sicl 2msbk mfr gw 1c .4 .6 3 24 -33 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 33 -120 7.5yr4/6 none cos osg mvfr na na .7 1.6 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature; CST Number David J. Steel j 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/26/2003 715 - 246 -5085 l Property Owner ROSAMM, L.L.0 Parcel ID # pending Page 2 of 3 3 ] F Boring # I Boring Pit Ground Surface elev. 94.40 ft. Depth to limiting factor 120 in. co' Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/2 none sil 2msbk mfr cs 2c .5 .8 2 8 -24 10yr4/4 none sic[ 2msbk mfr gw 1 c .4 .6 3 24 -32 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 32 -120 7.5yr4/6 none cos osg mvfr na na .7 1.6 F-1 Boring # I 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 P 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 Shucture 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 = BOD <30 mg/L and TSS S_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. J Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST- POWTSM ROSAMR, L.L.C. New Richmond,WI 54017 Lic. #248956 NE1/4,NE1/4,S25,T29N,R19W Bus .(715) 246 -6200 Town of Hudson, St. Croix Co. Fax.(715) 246 -9372 Indigo Ponds Lot 47 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 Eie. I OO.00Ft Top of 1/2" pvc pipe • = Alt Benchmark Ele. 99.94Ft Top of 1/2" pvc pipe ❑ = Borings Boring Elevations B 1 = 98.6017t B2 = 98.6017t B3 = 94.40Ft B4 = OO.00Ft r 9o, gz. � 770 s / 0- 2- r4- �,` R ' � `(1.581 AC. N.B P.A.) ' 0,398 ' /' /`� (2.075 AC.) } , (1.000 AC. N.B.P.A.) 897 S.F. ', • � ..?. -� 9�..� --_ ..-- --- 8718t . S.F.' _ . _.(2.004 AC.) ' •x,(1.581 AC. NAP.A.) 91875 9' `"� ` - (2.109 At) -._... ' '� v► '•( AC. N.B.P.A.) i ' $1 N. 9187S S.F. _ .'" 875 * S.F. cr (2.109 Ac.),% ' / 1 {2.109 AG.) "o. 0.725 ac. N.BrP.A.) _ .044 AC. N.s.P.A.)_ P Y , 1 75 S.F. " __ .. -- :.<:%'�. " "•.. . � . ( 2-109 A C. .147 AC. N.B.P. I r _ • - t w ST. CROIX COUNTY WISCONSIN ZONING OFFICE 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 County Special Exception Permit for filling and grading due to their location 61ihe Shorelnd Zoning District. The lots include: 36, 37, 38, 39, 40, 41, 45, 46, 9, 50, 51, 52 and 53. Lot 53 is currently under review for further subdividing. 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 Exce t' ease note that on these o s an ero con ro pan must be reviewed and approved by the Zoning Office articular lot. It is preferred that the erosion con a 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, 0 Rod Eslinger Zoning Specialist RErh CC: Town of Hudson, Brian Wert file r 1272 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach comp site plan on r not less than 8% x 11 inches in size. Plan must County PI papa St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, rest road. Parcel I.D. Z Q (� ) UC 1.. 6 Please ri t all ik"W E D / P Reyfewed B _ Date Personal informalion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner MAY t 3 2003 Property Location ROSAMJI, L.L.0 Govt. Lot na NW 1/4 NE 1/4 S 25 T 29 NR 19 W Property Owner's Mailing Address ZON NG OFF(C Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C 48 1 na Indigo Ponds City State Zip Code Phone Number _f City J Village fM Town Nearest Road New Richmond WI 1 54017 1 715 - 248 - 7071 Hudson I Highlander Trail ✓J New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement J Public or commercial - Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments / and recommendations: system elevation 95.30 ft, trenches spaced and depth to code 5.00 below grade ✓ Boring # I Boring f/ Pit Ground Surface elev. 100.30 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/2 none sil 2msbk mfr cs 1 c .5 .8 2 6 -32 10yr414 none sicl 2msbk mfr gw 1c .4 .6 3 32 -43 7.5yr4/4 none scl 2msbk mfr cs na .4 .6 4 43 -120 7.5yr4/6 none co osg ml na na .7 1.6 COS <35% coarse fragments = 36" & >35% - <60% = 60" below system Boring # I Boring 1/ Pit Ground Surface elev. 100.30 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr3/2 none sil 2msbk mfr cs 1 c .5 .8 2 6-21 10yr4/4 none sicl 2msbk mfr gw 1c .4 .6 3 21 -29 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 29 -1 0 7.5yr4/6 none cos osg ml na na 7 1.6 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg/L CST Name (Please Print) Signal ? CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/26/2003 715 - 246 -5085 Property Owner ROSAM3I L.L.0 pendin Page 2 of 3 p rty , Parcel ID # Pe 9 F ]Boring # Boring N Pit Ground Surface elev. 96.80 ft. Depth to limiting factor 110 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 1 0 -10 10yr3/2 none sil 2msbk mfr cs 7c .5 .8 2 10 -30 10yr4/4 none sicl 2msbk mfr gw 1 c .4 .6 3 3040 7.5yr4/4 none scl 2msbk mfr gw 1c .4 .6 4 40-48 j 7.5yr4/4 none sl 2msbk mfr cw na .5 .9 5 48 -110 7.5yr4/4 none cos osg osg na na .7 1.2 b F-1 Boring # I Boring j Pit Ground Surface elev, ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I 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 s 30 _ 220 mglL and TSS >30 < _150 mg /L *Effluent #2 = BOD S30 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST- POWTSM ROSAMJI, L.L.C. New Richmond,Wl 54017 Lic. #248956 NW1/4,NE1 /4,S25,T29N Bus.(715) 246 -6200 Town of Hudson, St. Croix Co. Fax.(715) 246 -9372 Indigo Ponds Lot 48 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. IMOOR Top of 1/2" pvc pipe * = Alt Benchmark Ele. 99.80Ft Top of 1/2" pvc pipe ❑ = Borings Boring Elevations BI = 100.30Ft B2 = 100.30Ft B3 = 96.80Ft B4 = OO.00Ft 7' I D � I vp3 fob '�' -���� � � : �h '� 1 � i O �. : d -� •/ s' '+ •r,��! � ;: 9 sk O � ' +.�:�� ' �t,�4 OVA, MA MA OVA L MA I L rlAi- !ma Ol�t ��G�►� !I,1.�`� • !`4 ��''sf4�`W►l�e+ SIR Qf Lp M, rfA MA F IX. MAP IPA M gr A R Ot MI R NOW MEN 0 1 1 Vr MIA iMll Parcel #: 020 - 1439 -48 -100 02/26/2008 04:45 PM PAGE 1 OF 1 Alt. Parcel #: 25.29.19.2774B 020 - TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/14/2007 00 0 Tax Address: Owner() s : O = Current Owner, C = Current Co -Owner O - KNUTH, STEVEN R & JENNIFER P STEVEN R & JENNIFER P KNUTH 887 HIGHLANDER TRL HUDSON WI 54016 ,_ Districts: SC - School SP = Special Property Address ( es): - Primary Type Dist # Description ' 887 HIGHLANDER TRL SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 5.630 Plat: 5456 -CSM 22 -5456 020 -07 9 p SEC 25 T29N R19W PT NW NE, PT SW NE,PT Block/Condo Bldg: LOT 02 NE NE & PT SE NE FKA INDIGO PONDS LOTS 47,48 & PT LOT 49 BEING CSM 22 -5456 LOT Tract(s): (Sec- Twn -Rng 40 114 160 1/4) 2 (5.63 AC) 25- 29N -19W NW NE 25- 29N -19W SE NE 25- 29N -19W SW NE 25 29N - 19W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 09/14/2007 860541 22/5456 CSM 09/14/2007 860540 QC 09/14/2007 860539 QC 07/02/2007 854795 WD more 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 09/18/2007 Description Class Acres Land Improve Total State Reason Totals for 2008: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 II� REcEIvEO i 11111111111 s' 01111111111111 Ill1 11111111111111 ?_ SEP 2 6 2007 $00541 KATHLEEN H. WALSH REGISTER OF DEEDS y N ST. CROIX COUNTY ST. CROIX Co., WI SURVEYOR'S RECORD RECEIVED FOR RECORD = 09114/2007 01:30PM CERTIFIED SURVEY MAP a VOL: 22 PAGE: 5456 �A,1 so0°24 os "E 5278.71' NORTH -SOU 1 LI NE A o REC FEE: 13.00 3499.01' 1779.70• `� PAGES: 2 m p = - i , `�auutstuwrrriup�iiq� n 7�D o °_a' 3 A s Q 'Z , >" . •° n BEARINGS ARE REFERENCED TO 3 a 3 a$ L3 n O THE NORTH -SOUTH 1/4 LINE OF �g s p c SECTION 25, WHICH BEARS S ' = = S00 °24'08 "E (ST. CROIX COUNTY I y 'fit Z '.��y COORDINATE SYSTEM) m f m ywtn na c� y� d cwr� � c•�''.� -� m p '• m tt1 1 A O 2 f- cn 1 z m m (gt'9093.ZE.OV.90S)' ' cn C O Vic' • y'r'409 3.6 - to v, CD O ` ;I to O - m tr m ' g ig) I . - m -I , m m t ,o 1 t0 -00 OC � 1 X '� w O \',� O cs y cn _wk y 1S rpm \ t Z �! o N \ 6£L C)) N > A9'Z/ \O Z O Z Z EL 59t / t�► �� /p V) v 0 O B • Y ° •��I�SZ� r m o vm T O m0 R °c ( m O m Q v� Z v Z3 Z r ti o j N 7 O Z DAp "� • m 26 D 2 o �° ci ST E P m m. ►►**�� m m CS e^y zo zz F so E oz =y z = Z Z � p02 Z 40 Amy °�-mf g Q.�� ; mz n 0 ma 0 O1 r T O p z m y Z ' of z $ z _v' m SHEET 1 OP 2 n 7O Vol. 22 Page 5456 it iillllllll !I!l1lllliflll I !IlNI lilt l!!1 5 4 7 9 5 1 State Bar of Wisconsin Form 1 -2003 854195 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number Document Name ST. CROIX Co., WI RECEIVED FOR RECORD 07/02/2007 11:55AM THIS DEED, made between Rosamji LLC, a Wisconsin limited liability company WARRANTY DEED EXEMPT t ( "Grantor," whether one or more), REC FEE: 11.00 and Steven R. Knuth and Jennifer P. Knuth, husband and wife, as joint tenants as to TRANS FEE: 510.00 an undivided 100/170 interest and Michael R. Nelson and Sherri L. Nelson, husband PAGES: 1 and wife as joint tenants, as to an undivided 70/100 interest, "Grantee" . 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 1 St. Croix County, State of Wisconsin ( "Property ") (if more space is Name and Return Address needed, please attach addendum): River Valley Abstract & Title, Inc. Lot 49, Plat of Indigo Ponds in the Town of Hudson, St. Croix County Wisconsin. 1200 Hosford Street, Suite 201 Hudson, WI 54016 File #2694813 020- 143949 -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. i Dated Jul y�� , 2007 Rosam'i, LLC (SEAL) (SEAL) (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) C STATE OF WISCONSIN ) ) ss. '' authenticated on .y St. Croix COUNTY ll * fj % Personally came before me on Jul 2007 -ae TITLE: MEMBER STATE BAR OF WISCONSIN the above -named `1c, u��tr� YYt Cn r KA (If not, t e known t be th erson(s) who executed the foregoing authorized by Wis. Stat. § 706.06) i c d th THIS INSTRUMENT DRAFTED BY: Attorney Doug Berg Nota Public, a e of isconsin 7 1200 Hosford Street Suite 201 Hudson WI 54016 My ommission is permanent) (expires: Z�Z (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 NO. 1 -2003 * Type name below signatures. 1 of 1 ..� � &62 �1�f .� / � Y 1 ' Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service ' Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimenuions, north arrow, and location and dis tance to nearest road. Parcel I.D. pending Please p ri aR@E ® Reviewed By Date Personal information you provide me be used for secondary purposes (Privacy La r, s. 15.04 (1) (m)). Property Owner MAY j 3 2003 Property Location ROSAMJI, L.LL Govt. Lot na NW 1/4 NE 19 S 25 T 29 NR 19 W Property Owners Mailing Address -;1 CIR' i X: COUNTY Lot # Block �SubdName # or CSM# 2141 Cty Rd. C ZONING OFFICE 49 na Indigo Ponds City State Zip Code Phone Number J City I Village e Town Nearest Road New Richmond WI 1 54017 1 715 - 248 - 7071 Hudson I Highlander Trail 16 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 elevation 92.60 ft, trenches spaced and depth to code 6.00 ft below grade Boring # I Boring 0 Pit Ground Surface elev. 98.60 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none I 2msbk mfr cs 2c .5 .8 2 9 -14 10yr4/4 none scl 2msbk mfr 9w 2c .4 .6 3 14 -36 7.5yr4/4 none sl 2msbk mfr 9w 1C .5 .9 4 36-54 7.5yr4/4 none sl/Is 2msbk mfr gw na .5 .9 5 54 -120 7.5yr4/4 none cos osg mfr na na .7 1.6 2 'q eo�� COS <35% coarse fragments = 36" & >35% - <60% = 60" below system Boring # I Boring wi Pit Ground Surface elev. 98.60 ft. Depth to limiting factor 120 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tlz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 1 Oyr2 /1 none I 2msbk mfr cs 1 c .5 .8 2 9 -21 10yr4/4 none scl 2msbk mfr 9w 1f .4 .6 3 21 -34 7.5yr4/4 none cos osg mvfr cs na .7 1.6 4 34 -120 7.5yr4/6 none cos/ms osg ml na na .7 1.6 * Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS S mg/L CST Name (Please Print) Si atu CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/25/2003 715- 246 -5085 • Property Owner ROSAM3I, L.L.0 Parcel ID # pending Page 2 of 3 3] Boring # Boring 1/ Pit Ground Surface elev. 94.70 ft. Depth to limiting factor 135 in. SoN Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots QP D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr2/1 none I 2msbk mfr gw 2c .5 .8 2 6 -23 10yr4/4 none sil 2msbk mfr gw 1 c .4 .6 F5 23 -45 10yr6 /4 none sicl 2msbk mfr gw na .4 .6 4 45 -60 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 601 7.5yr4/6 none cos osg ml na na 7 1.6 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 ❑ Boring # I Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu, Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg/L and TSS <_30 mg1L 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 GG CST - POWTSM ROSAMJI, L.L.C. New Richmond,Wl 54017 Lic. #248956 NW1/4,NE1/4,S25,T29N,R19W Bus .(715) 246 -6200 Town of Hudson, St. Croix Co. Fax.(715) 246 -9372 Indigo Ponds Lot 49 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' N ♦ =Benchmark Ele. 100.00Ft Top of 1/2" pvc pipe • = Alt Benchmark Ele. 100.80Ft Top of 1/2" pvc pipe ❑ = Borings Boring Elevations B1 = 98.60Ft B2 = 98.60Ft B3 = 94.70Ft � B4 = OO.00Ft ','� y3 1 �o 0 � Ia '`31 R 5 5.66' w 7��24 ST. CROIX COUNTY WISCONSIN ZONING OFFICE 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 County Special Exception Permit for filling and grading due to their location in thp Shoreland Zoning District. The lots include: 36, 37, 38, 39, 40, 41, 45, 46, 47, 49, 50, 51, 52 and 53. Lot 53 is currently under review for further subdividing. 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 REfjh CC: Town of Hudson Brian Wert file