Loading...
HomeMy WebLinkAbout030-1096-10-400 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 592240 State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No Bryan Citrowske TOWN OF SAINT JOSEPH 030-1096-10-400 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 8m 05 32.30.19.350E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. I / Septic CJ Benchmark % Alt. BM r~~' 11.x, a ~ 3 • 3 Aeration Bldg. Sewer ~O• 0 ✓ p + ~p Holding St/Ht Inlet 7z cr7,yr TANK SETBACK INFORMATION St/Ht Outlet -7.3 of 7, TANK TO AP/; WELL BLDG. (!:nt,11 Air Intake ROAD Dt Inlet Septic Dt Bottom O \ Dosing Header/Man. Aeration 0 •q+ q- T5 - Z 71 Qist. Pipe Holding 4 Bot. System 10 . Z iQ r , PUMP/SIPHON INFORMATION Final Grade 5.6 Manufacturer Demand St Cover GPM Fes; ~~r 3 05.3 Model Num TDH Li Friction Loss System He TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTIO SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia` Liquid Depth DIMENSIONS ,3 z -77 2.01. ckkkl SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION III , Type Of System: CHA UBER OR 66 ow a~•~ MoN,mb~r: , / h DISTRIBUTION SYSTEM 5oJ f-l/e u b Header/Manrfol/ / Distribution x Hole Si x Hole Spa n~L p Vent tq Air Intake t/ Pipe(s) ` iWl Length 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 xx Mulched Bed Trench Center Bed/Trench Edges Topsoils Yes E' No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection `#1: Inspection #2: Location: 1213 TROUT BROOK RD N a 1.) Alt BM Description= F-44-4--_ rN, 2.) Bldg sewer length = 7 h - amount of cover = GU Plan revision Required? Yes 5 / Use other side for additional information. L~j L4 5 SBD-6710 (R.3/97) Date Insepctor's Sig ure Cert. No. County r 1 Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Sanitary etmit Number '(to be filled in by Co.) Madison, Wl 53707-7162 t t. Sanitary Permit Applic Stale Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fc is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted ifl Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ores in accordance with the Privae Law, s. 15.04(1) m), Stats, , I. Application Information -Please Print All Information Cc . Property Owner's Name Parcel # Property Owner's Mal Addrms Property Location V E ~ t z t'/ i r l ' /v Yt Govt t 23 City, State bet Lip Code Phone t/y1/,, Section ~[itty ) !l (.r / l ' 1 r.~ / ~f { one II. Type of Bailding heck all that apply) Lot # T30 N; R or 1 or 2 Family Dwelling -Number of Bedroo Subdivision Name Bloc ❑ Public/Commercial -Describe Use N (J~`K - ~ OJSt~ 4 -sue ❑ City of ❑ State Owned - Describe Use CSM Number p ❑ 'Village of C "0 own of III. Type of Permit: (Check only o box on line A. Complete tine app tcable) A- system D Replacement System D Treatment/Holding Tank Replacement Only D Other Modification to Existing System (explain) B- ❑ Permit Renewal ❑ Permit Revision Q Change of Plumber D Permit Transfer to New List Previous Pernik Number and Date issued Before Expiration Owner IV. ofPOWTS S stem/Com onent/Device: Check all that a I a Pressurized In-Ground D Pressurized In-Ground Q At-Grade Q Mound 24 in. of suitable soil ❑ Mound < 24 in- of suitable soil ❑ Holding Tank D Other Dispersal Component (explain) ❑ Pretreatment Device (explain)V. Dis rsaUTrea ent Area Information: _ Design Flow (gpd) Design Soil Application Rate dsf) Dispersal Area Required (st) Dispersal Pro sed (sf) Syst errl n Y l stmC' G," r a. El o VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks ExLmng Tanl~ j J v B o .2 E ''aa' a m c`a'v Septic or Holding Tank /V U v Dosing Chamber j I VII. Responsibility Staten - F the undersigned, ass a esponsibility for installation of the POWTS shown on the attached plans Plumber's Name (Print)i Plumb Si azure MP/MPRS Number Burners Phone N °p Plumber's Address (Street, Ci State, Zi 4 VIII. untv/De artment Use Only Approved Permit Fee Date sued Issuing. ent Signature tven Reason for Denial S f a ) 7 a. Conditi asons ffor Dis pproval ep rk, elflum. iitte < n f oispert<*.,i cell must dll be s,~icas ' r i- Inta'..:ec as per inaragement plan pto iiaeri by pluinbei. p 2. lAlllC%"'FEL?Wpemems must. "-1naintcir F.1 as per PXHcrble GYl& / ,..rd: nallCa.1R. Attach to complete plans for the system and submit to the County only on paper not less than 8 v2 x 11 inches in sue SBD-6348 (R- 11/11) System PLOT PLAN PROJECT Brvan Citrowski ADDRESS 6705 Crackle Berrv Lane Woodburv Mn 55129 NW 1/ 4 NW i / 4 S *,,k 3 T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 96.1/96.0 3.5' below grade DATE 3/7/17 BEDROOM 3 CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of nail in pine tree ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *I1.R.P. same as benchmark Scale=1/4"=10' Trout Brook Road Vent >6=, Quick4 Standard Pro 3 Leaching Chamber _ Bedroom of Cover with 20.0 ft2 of Area House 12„ 5.6ft^2/pair of end caps 4' Long ALI 34" Grade at System Elevation 30' 2-3' 66' ecells with >3' spacing ;-0 i6 20' v o B- B-1 ALI ~ 3~ 47' t 52' B-3 0% Slope B-5 -4 2' B. 2, All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 92' 154' j property line 40' 40' Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/7/17 Owner:Bryan Citrowski Location: NW1/4 NW1/4 S5 T30 N,R19W 1213 Trout Brook Road St. Joseph Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Sep ' n 4-6. Maintanance an C tingency Pla 7.Filter Cross Secti Signature _ License nu er #226900 System PLOT PLAN PROJEC'T~ Brvan Citrowski ADDRESS 6705 Crackle Berrv Lane Woodburv Mn 55129 NW 1/ 4 NW 1 /4 S ,--1,3 T 30 N/R 19 W TOWN St. Joseph COUN'T'Y ST. CROIX SYSTEM ELEVATION 96.1/96.0 3.5' below grade DATE 3/7/17 BEDROOM 3 CONVF,N'T'IONAL XXX CONVENTIONAL LIFT HOLDING TANK 1000 gallons LIFT TANK SIZE DOSE 'L'ANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of nail in pine tree ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL -II.R.P. same as benchmark Scale = 1/4" = 10' Trout Brook Road Vent >6„ Quick4 Standard Pro 3 of Cover Leaching Chamber _ Bedroom with 20.0 ft2 of Area House 12„ 5.6f A2/pair of end caps 4' Long Grade at System Elevation 34" 30 S 2-3' X 66' cells with >3' spacing 20 B-2 B-1 47' Vents 52' B-3 0% Slope B-5 112' B-4 B. 2' All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 92' 154' property line aia 40' aia 40' Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ftA2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 996° ,jVen t Vent Grade 4" 3' ~~30/34 Septic T:nk 5' L ong 1 Grade at System Elevation 3 6 " Grade at System Elevation Spacing- 5' 2-3' X 66' Cells Same on other end Observation tube/Vent At end of cell A B 16 chambers per cell System elevations: A-96. 1' B-96.0' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of 9LE INFORMATION SYSTEM SPECIFICATIONS j Owner ✓ E:r Septic Tank Capacity Permit # al ❑ NA Septic Tank Manufacturer ❑ NA :)=SIGN PARAMETERS Effluent Filter Manufacturer !'l ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units NA Pump Tank Capacity i al NA Estimated flaw {average} ~ ZIV gal/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) aUda Pump Manufacturer NA !Soil Application Rate al/da /ff Pump Model NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit Fats, Oil & Grease (FOG) 530 m A 9/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 420 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg/L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal CeII(s) Biochemical Oxygen Demand (BODs) 530 mg/L -Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L *P A ❑ A% trade ❑ Mound Fecal Colifonn (geometric mean) 6104 cful100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size 3k in dia. ❑ NA other. (other: 1:1 NA q Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent" Other. ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency (Inspect condition of tank(s) At least once every: F. ❑ month(s) ' ar s (Maximum 3 years) ❑ NA !Pump out contents of tank (s) When combined sludge and scum equals one-third {'fa} of tank volume ❑ NA Inspect dispersal cell(s) At least once every: El month(s) . S ear(s) (Maximum 3 years) ❑ NA (dean effluent filter At least once every: ~P2 ear(s)s) ❑ NA inspect pump, pump controls & alarm At least once every: ❑ mon (s) ' ❑ year(s) NA 1=lush laterals and pressure test At least once every: ❑ month(s) ether. ❑ year(s) NA At least once every: ❑ month(s) tither: ❑ year(s} NA 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 cell(s) 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 I-egulatory authority. I,Nhen the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of !:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 1411 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <12 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. page of START UP AND OPERATION other chemicals tt>g1t For new construction, prior to use of the POWTS check heatment~l{s} for ~ ~ ~b painting r dete~dedacts or have the contents of the may impede the treatment process and/or damage the dispersal (s)• 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. will brr During power outages pump tanks may fill above nommai highwater levels. When power m is the restored backup the s excess wastewater will e ll bl. urface discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result ang Operator prior to restoring pouter to the To avoid this situation have the contents of the pump tank removed by a Septage the pump controls to restore normal levels effluent pump or contact a Plumber' or POWTS Maintainer to assist in manually operating the area within ~within the pump tank. disturb or compact, Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise 15 feet down slope of any mound or at-grade soil absorption area. of the POWT:: Reduction or elimination of the following from the wastewater stream may improve the floss; diapers; di and s~ prong rolong t fat; foundation drain antibiotics; baby wipes; cigarette butts; -condoms, cotton swabs; degreasers; medications; oil; Painting fonrai products; (sump Pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; pesticides; senhaary napkins; tampons; and water softener brine. ABANDONMENT shall be taken to insure that th e system is When the POWTS fails and/or is permanentiy _ o~°~~'twis~rsin Adminisfi'ative Code and safely abandoned in compliance with chapter propetiy • 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 code If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a compliont rreplacVnent system: replacement soil absorption system. A suitable replacement area has been evaluated and may be utilized for the location of a rep he replacement area should be Protected from disturbance and compaction and should not be infringed upon by requiried setbacks from existing and proposed s"cture, lot lines and wells. Failure to protect the replacement area will result in the insect for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rote:{ in effect at that time. in POWTS tectmnologK a 13 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances 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 sal 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. removal of the biomat at the infiftrakive E3 Mound and at-grade soil absorption systems may be reconstructed rules in effect at that time. surface. Reconstructions of such systems must comply with the <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO O RCUM TANCES DEATH MAY RESULT. RESCUE O~ A ENTER A SEPTIC, PUMP OR OTHER TREATMENT E TDIFF1 ANK NDER ANY T O IMPOSSIBLE. R CI PERSON FROM THE INTERIOR OF A TANK M ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER j Name ~ 4 Ct-~ / Name, Phone - 7 j 'm J Phone j SEPTAGE SERVICING OPERATOR P ER LOCAL REGULATORY AUTHORITY _ L Name Name Phone 7 Phone This dovJnedwurs drafted in compliance with chapter SpS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. T U A' WIN_ v4 l/ I, ~zl ~ ii+I ~ 1 I r~ i f I I I 1 a I i Il ~ ~ iJ ~ Pl ~ j ms O 'VI/ C._? W i d" ~ ;tea m ~ ql'i ~I =lL In fi HLVS NIISVtY ST. CROIX COUNYY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer C'-4 a j t Mailing Address C 6 7 o Property Address { 1 ~ ~ Z / /ro /1- 9 /V, . (Verification required from Planning & Zoning Department for new construction.) 0 City/State Parcel Identification Niunber 3 0 LEGAL DESCRIPTION Property Location P',,) Y. 6-U/ V4 Sec. T D N R W Town of 3 s ~G^-- Subdivision , Lot # Certified Survey Map # Volume Page # Warranty Deed # Volume , Page # - Spec house yes Lot lines identifiable! no SYSTEM MADffENANCE 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 wasLv 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 a year expiration date. I/we certify that all statements this form are true to the best of my/our k:uowledge. I/we am/are the owner(s) of the property described above, by virtue of warranty deed recorded in Register of Deeds Office. Number of bedrooms ;7 31U.NATURE 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. 08105) Z06£ 06Ed hL -10A Z p o CD d ° c w w o -C) C14 ~a cn 0 [D U U 2 G m W Z C7 Q = Jm~ II On N s - m z z o' o 3 X r--f 3 a Z L.~ z m e O O J W ~~Z O /a.E c ~mm o z Y w~ Y. i F- N a C w Q w Vw7 U D cJ Q z Z a 0 Q rn m y t o ° w Q O z w r w~= wz w a m z a cn z~ _ v 8 z o 13 W w z O o w a 3 ° cD L w U 9- w C Z a o ° z O N N V) M, -It W Z ZO C-4 m 21 O m z LLJ Q N N (n riw w O Z Ir X f!J O J J I = CO o~ J Q a ~ Q f - v V? p I < o e v c- Q el- 0. ICD Z' Q U N- w~ • O w q l W Q1 w _3 w . L.U o I WI r14 E4 V) I C3I m 1i O ` I i o Q p 0.i v r,. 7a o Z W w 0 I u w¢ P4 3 co* to m m(/.) u~ ::D w 1:3' > w QI QI ~O Fyi S °o f J w i Wli v r^i CI Z N -,r oo~ z131 mN~ LLJ CO. w 6 3' co M I I C j i S01 °02ATE 404.93' w 'r ° w q 371.93O 33.00' z M I I I ~ J I r C~+~Y ~i i O 41z- -4 3 C~I `--l c-3 ~ C.~ fem. N N ' Z L'' I~ U 04 V w w N N oW ~I I T co I l..l N 60 Ln rn CD ~I Tl- 00 m di 01) cu Zo V 1 { M o co ~co C/D 4~ I I 'r~~' I \ I I I WEST LINE OF THE SW 1/4 00v,~ I \ \ V ~i EXISTING CENTERLINE o J o 01 DC \ ` co N00°53'56"W 222.06' cO N00'04'47"W ~ - Z 2389.89' co IRL./ NO0°04'47"W 257.73' co N U M„CL,9b.69S 6V38 01 a3WnSSV 'Z£' ` NO1103S 30 b/LMS 3Hl 3O 3N1-1 H1nos U_ NPLATTED _LANDS C4 3Hl 01 033N3a333a 3HV SONiaV36 ❑WNED_ BY _ OTHERS 1 IM "00)qolo is L 00 'ON 80f• OO0Z/6L/L 3NV)i 'a WV1-13IM l8 O31AVH0 1N3Wna1SNI SIH1 HSlVM H N333HiVM ti~ . a~I F- inr ~ S~89Z9 Parcel 030-1096-10-400 03/10/2017 09:00 AM PAGE 1 OF 1 Alt. Parcel 32.30.19.350E 030 - TOWN OF SAINT JOSEPH Current I X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner MINH PHAM O - PHAM, MINH BRYAN H CITROWSKE C - CITROWSKE, BRYAN H 8316 CHICAGO AVE S BLOOMINGTON MN 55420 Property Address(es): Primary Districts: SC = School SP = Special Type Dist # Description SC 2611 SCH DIST OF HUDSON SP 1700 WITC Notes: Legal Description: Acres: 3.528 SEC 32 T30N R19W SW SW BEING LOT 4 CSM 14/3902 Parcel History: Date Doc # Vol/Page Type 12/08/2016 1040027 WD 10/24/2013 988026 EZ-U 03/13/2000 619592 1495/327 WD 07/23/1997 1230/193 QC Plat: Primary Tract: (S-T-R 40 160v< GL) Block/Condo Bldg: * 3902-CSM 14-3902 030-2000 32-30N-19W SW SW LOT 4 2017 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/20/2014 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.528 65,100 0 65,100 NO Totals for 2017: General Property 3.528 65,100 0 65,100 Woodland 0.000 0 0 Totals for 2016: General Property 3.528 65,100 0 65,100 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 Wisconsin Department of Industry, l <bor aad Human Relations SOIL AND SITE EVALUATION REPORT Page 1 of 3 `Division of,Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code /61;' ~ 3 BUT 34eDIC ✓ 4 COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # L/~, dimensioned, north arrow, and location and distance to nearest road. 030-1096-10-98 APPLICANT INFORMATION-PLEASE PRINT ALL 1NFOA,MATION R IE k D TE two r PROPERTY OWNER, - PROPERTY LOCATION Janet Dilts (12V g GO LOT SW 1/4 SW 1/4,S 32T 32 N,R 19 X (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SU . 0 CSM # 1218 Trout Brook Rd. N. 4 na csm CITY, STATE ZIP CODE PHONE NUMBER C ❑VILLAGE NEAREST ROAD Hudson, WI. 54016 .(715) 549-6476 St. Jospeh Trout Brook Rd. N. ] New Construction Use [x] Residential/ Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate ._bed, gpd/0.8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 .8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.60 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ERS ❑U ®S ❑U CRS ❑U 0S ❑U 1E] S ❑U ❑S ®U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon Texture Consistence Boundary Roots - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-13 10yr3/3 none sil 2msbk mfr cs 2m .6 ° 2 13-33 10yr4/4 none scil 2msbk mfr yw lm .4 .5 Ground 3 33-96 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 99.9 ft. Depth to 1~ O limiting factor Remarks: Boring # 1 -6 10yr4/3 none sil 2msbk mfr 9w 2c to .6 - 2 2 -30 10yr4/4 none sicl 2msbk mfr 9W if .4 .5 3 0-90 7.5yr4/4 none is Osg mvfr na na .7 .8 Ground elev. r I 99.8 ft. ~ Depth to limiting 00 factor +90 Remarks: CST Name:--Please Print Gar L. Steel Phone: 715-246-6200 Address: 1554 200th. e. New Richmond WI 54017 Signature: Date: 4-25-2000 CST Number: m02298 Janet Dilts SOIL DESCRIPTION REPORT Page 2 pf 3 PROPERTY OWNER PARCEL I.D. # 030-1096-10-000 Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. B d ~Trer 1 0-9 10yr3/3 none sil 2msbk mfr cs 2m . ( .6 ...3. 2 9-28 10yr4/4 none sicl 2msbk mfr gw lm .4 .5 i Ground 3 28-9 7.5yr4/4 none co s Osg ml na na .7 j .8 elev. 100.0 ft. Depth to limiting factor +90" Remarks: Boring # 5 .6 3 0-8 10yr3/3 none sil 2msbk mfr gw 2m . 4 8-36 10yr4/4 none sicl 2msbk mfi gw lm .4 i .5 r2- 36-9 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 99.6 ft. Depth to limiting _ factor +90'1 Remarks: - - Boring # 1 0-10 10yr3/3 none sil 2msbk mfr yw 2m .5 .6 5.> 2 10-3 10yr4/4 none sicl 2msbk mfr gw lm .4 .5 3 32-8 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 99.9 ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting J factor i i Remarks: SRn-R330(R 05/92) PROPERTY OWNER Janet Dilts SOIL DESCRIPTION REPORT Page 2 •gf 3 , PARCEL J.D. 030-1095-10-000 Boring # Horizon Depth '-Dominant Color Modes Structure GPD/ft Texture s Consistences Barry Roots in. ~ Munsel( Qu. Sz. Cont. Color Gr. Sz. Sh. Bed 'Trerttt 1 0-9 10yr3/3 none sil 1 2msbk t mfr cs 2m 3 - t 2 9-28 10yr4/4 { none sicl ; 2msbk mfr gw im .4 Ground -3---t28-9 ( 7.5yr4/4 none co s Osg ml na na .7 ~.i - elev. - --t - --t 1~ 100.0't Depth to limitin^y factor Remarks: Boring # 1 0-8 10yr3/3 none sil 2msbk mfr gw 2m g 4 2 (8-35 10yr4J4 none sicl 2msbk mfi yw lm .4t 3 T3~6-9 7.5yr4/6 ! none co s Osy ml na Ground elev. ~ , 1 99.5 ft. - s , Depth to - - i limiting - - f ~ factor i +9011 1 Remarks! Baring # 1 0-10 i 10 r3/3--- y Wane sil 2msbk 1 mfr yw 2m 1.6 5., 2 r 10-3~ 10yr4/4 none sicl b mfr gw lm .4 3 32-8 7.5yr4/6 none co s Osg ml Ground - - r--- na na .7 99.9 ft. I~ Depth to limiting factor Remarks: Boring # Ground _ elev E j ft, Depth to --f- _1--- - -r limiting factor - ' Remarks: 5BD-8330(R.05r92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Janet Dilts New Richmond, WI 54017 MPRSW-3254 Sw4Sw4 S32-T32N-R19W (715) 246-6200 town of St. Joseph lot #4-csm N 1"=40' BM.= top of nail in Norway pine C e1.,10D-.-00' Alt. BM.= nail in Norway pine C el. 99.90, V 1. I Gary L. Steel 4-25-2000 SCHMITT & SONS Q CAVAT.lNG,.,~. 586 Valley View Trail Somerset, WI 54025 (715)549-6651 9-21-2016 Soil & Site Evaluation Verification Report for: Lot 4 Parcel ID: 030-1096-10-400 Lot Address: 1213 Trout Brook North. I,Tom Schmitt CST 227429, on 9-21-2016 went and checked the condition of the system area originally evaluated by Gary Steel on 4-25-2000. 1 did not re-evaluate the soils as per conversation with Sarah Droher of St. Croix County Community Development, Sarah said it was not required. I was checking to see that the area had not been disturbed since the original evaluation was conducted. The system area has not been disturbed. Using the measurements provided by Gary Steel's report, I flagged the 5 bore holes and placed ribbon on the trees that the bench mark nails are in and placed ribbon on the nails, Thomas J. Schmitt CST 227429 e STEEL'S SOIL SERVICE Go n! L. Steel 1554 200th Ave. CSTM2298 Janet Dilts New Richmond, WI 54017 MPRSW-3254 Sw4sw4 s32-T32N-R29W (715) 246-6200 town of St. Joseph lot #4,-csm r N 111=401 aM.= top of nail in Norway pine ~ el.,100.00' Alt. BM.= nail in Norway pine el. 99.90' G 2 ltd' Gary L. Steel raulvb 4-25-2~odAvo 1,117 'rkea B NG ~ A,.^ ~ S f."o cE nl Q M al r k e 4 .