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HomeMy WebLinkAbout040-1310-00-006 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 592227 GENERAL INFORMATION State Plan ID No: ~ q Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)I Permit Holder's Name: City Village Township Parcel Tax No: Michael & Susan Dobkins TOWN OF TROY - - CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: Jbt I R C r 1 .28.19 - TANK INFORMATION 4V % \j , ELEVATidt4 DATA W13 TYPE MANUFACTURE I ACITY STATION BS HI FS ELEV. Septic I2 Solo/ Benchmark YV U r% R2`t s ~12s. s DQrrg r r L j L ' No o 2,S-- Alt. BM fJ •3 y~ S / • 2,81 2- A trotieR Bldg. Sewer Z. HaWfRg SU I Inlet TANK SETBACK INFORMATION OVA Outlet TANK TO WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , not Dt Bottom Dosing G Header/Man WX' J~ 3. S Aer tion Dist. Pipe A 2 3. 8 Holding Bot. System `122.0 PUMP/SIPHON INFORMATION al Grade Manufacturer Demand St Cover J --N 1-kr 2.3gf 93y-Z5- Modell tuber TD Lift Friction Loss Sys ea TDH Ft Force Length la. Dist. to Well i*D~l SOIL ABSORPTION SYSTEM 75- -v 7.5 f 7 S- 7, 5--/186 BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -7~ q / 1--~ SETBACK SYSTEM TO P/L DG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR TC,0WVQ"l4NRL 11Z / 7U / UNIT Model Number: DIVRIBUTION ,SYSTEM (Aye/ Header/Ma 'rfo ID istribution x Hole Size Ix Hole Spacing Vent to Air I take Pipe(s) /n](C-n Length Length Dia Spacing l J r SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded Im Mulched Bed/Trench Center 1 Bed/Trench Edges 2, / I Topsoil / Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 7a3i~:: f°~~ ~ ~ y al.I~.✓ t~ ~ I r ~ ~ ~ C I , ~ . 1.) Alt BM Description = k; r quk t ~.ic WTI 1 00+ in sin l lfA 2.) Bldg sewer length= 3o t i n s p e c u on - amount of cover = ~ Lj J` it C0-4k/f- ORO~11. Plan revision Required? ❑ Yes VNo / ( r]_. Use other side for additional information. ` ! 7 SBD-6710 (R.3/97) Date Insepctor's Sign ure Cert. No. County Safety and Buildings Division S~ C ' ID~ 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) ` S 0: f-l t: ' Madison, WI 53707-7, 62 ILL- 59zZ Sanitary Permit Appli Transaction N In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to me appropnaio guv".......... is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information rovide may be used for secondary u oses in accordance with the Privacy Law, s. 15.04(1 m , "tats. 1. Application Information - lease Print All Information Property Owner's Name e 90- &J:~ Parcel # 1'I, y L/ a -oo -006 Property Owner's Mailing Address Property Location I 'l , Ic 1 .3 Govt. Lot _17 City, State 7;-")de Phon(:Number Section 17 i (circle one T A7- N; R _Z~_ E or V& 11. Type of Building (check all that apply) Lot # Subdivision Name 0'4 or 2 Family Dwelling - Number of Bedrooms ff~ A Block # //f~pd /CAA G ~~d ❑ Public/Commercial - Describe Use ❑ City of J El State Owned -Describe Use CSM Number El Village of W,Town of Y .5 C-6 11 . type of Permit: (Check only a box on line A. Complete line B if applicable) A. ;"ew System ❑ Replacement System El Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision El List Previous Permit Number and Date Issued Change of Plumber ❑ Permit Transfer to New Before Expiration Owner 9/10 1 IV. Type of POWTS S stem/Com onent/Device: Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Ra (gpdsf) Dispersal Area Required (sf) Dispersal Area Propo (sf) System Elevation d d i 50v /Soo ' VI. Tank Info Capacity in Total # of anufacturer Gallons Gallons Units New Tanks Existing Tanks o 2 a 'E U Septic or Holding Tank 1~ W le- ✓ Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signat MP/MPRS Number Business Phone Number irk y~~G~ 2 z Sys 7/S- zS~~-mil Plumber's Address (Street, City, State, Zip Code) VI oun /De artment I Ise Only Approved isapprov Permit~Fee Date ssue Issuing nt Signature Reason for Denial $ 4f V 6 / - IX. Condit~on ~ ealsoof fo nqisapproval u Sj er i dlpN Mu _1[ 1311 be is :~s ! . , irtta~r e( as per ya ement plan p o liaeh by pluinbe:. 6fe.A 2 °'AM W".iaems must ue i,zitti Ir.E•1 118 per ippike W Cult: / . rd;rsrl/u a3, R%L, A)o it 4An Attach to complete plans for the system and submit to the County only on paper Tt less than 8 t/z x I t inches in size SBD-6398 (R. 11/11) BOREING 1 -----V Bench mark N1 RESERVED FOR REPLACMENT DRAIN Alt bench mark FIELD' Scale 1" =40' Lot 6 ~o d nw1/4se1/4S17T28R19W town of o OREING 2 troy . St Croix county 7 H LE DROP BOX - 4 bedroom system BOREING 3 OBSERVATION System elevation 2 ft. below sur- PIPES face. 3 34 PIPE VENT PPPIPES PIPES 1 ft. of cover . Est bench mark and Adjust for elevation. OLY LOCK 525 FILTER o o SCH 40 4" PIPE _y WIESER 1250 SEPTIC o d d PROPOSED HOUSE 0 PROPSED WELL y In~~ Q 3 w 0 i CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE/ Project Name: Owner's Name: L~~~Z.~ (iI/, ~Od ~fj~f Owner's Address: S~ ~•~l~i~ Gam../ .4 < < SS/y i Legal Description: sue' % S6G ~ 7 12,q Township: ~d County: Subdivision Name: Jcar,~ Lot Number: Parcel ID Number: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: 2"h License Number: Date: Phone Number S~ 1-2 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101). Pagel BOREING 1 Bench mark N1 RESERVED FOR REPLACMENT DRAIN Alt bench mark FIELD Scale 1" =40' Lot 6 o d a nw1/4se1/4S17T28R19W town of O BOREING 2 troy . St Croix county 7 H LE DROP BOX 4 bedroom system BOREING 3 OBSERVATION System elevation 2 ft. below sur- PIPES face.i 3 34 PIPE VENT PPPIPES PIPES 1 ft. of cover . Est bench mark and Adjust for elevation. OLY LOCK 525 FILTER 0 o~ SCH 40 4" PIPE WIESER 1250 SEPTIC PROPOSED HOUSE ; O PROPSED WELL 3 u, 0 SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Page_of_ Project Name: No. of Cells .S Per Cell Ln ft Cell Width 3c Total No of ft Cell Length 41t6- sq ft EISA Per Cell 3 7 ft Cell Spacing sq ft Total EISA Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: Gravelless Leaching Unit Model: Z 20 - Z /2oi ~D Typical Cross Section Finished Grade It Observation Pipe with approved cap or vent i ; y m -Soil Backfill in Geotextile Fabric a q;0 • ft Infiltrative Surface 12 in Q ft Limiting Factor in Slotted and Anchored Vent/ Observation Pipe with Cap wwe■■eweeawewee■■■■■■e~~.eeee■■www■e■■■■■c■w ■■e ws■. ■.■■■ww■■■ a■■e■s■■■■w Plumber/Designer Signature: License /~1f 2~ f//7J Dater Zk~ O/P V LLJ - - U CL O O a j - - - - _ U) Ea: :D NJ ~ i p = Q a- N a O U W Q Cn ~ V V ! cz~ W= M Z O O ~Gi i! N tf> ~t ®a da 63 O Q- QF o p~ Z- ZO~Z ~ o s Co o Q d ~ 0 ~U Ora LL. a - :D U - O Q _ E N M U O U V M O (D J Cl) M M _ W W E O U co U m U CO - CV M lq M N M C7 CO I N U O r` M N Lq Fes- _ ~ ~ r 07 N CD z W V' 0 U Q LZL Q U u) ~ 2 X z o W c C/) ~ CO O LLJ ~ J Q W Z Co Q C) C) W LU L.Li C) = Q O U) U J O Ur W m Z W ~ U O n- > cn O = N Cl- 0- WZ L? J I- - W N Cl- U ® J OLLQ F-NT Jzd Z~~ J O O = p Z LL. CO 0- U) LIJ Q > :2i LCD N E- W J m ~QQO~in ~~ME =Oco " TUFaTITEO 6wHole Distflbtfflon Tough Probk-:= s 3 i Y °Idt V~ 3s P 6 G~' TUF-TITE Solution A s'u rN. s,ab1,~ ; „r, lane:3„ ron-, rnJ~.ve` ui-Tili~ slr:Llution Box, v0;=i a "Ct I, rrII A 4y~ 4 /lsU t~ Lf '1. SR Injection raided p M Non-corrosive Simple to install 19 Easy to level s e€kk)'re t, oche" Snap-in pipe seals They're permanent t D e 1tef t P I ns rt yoo. Unlik cer ent . S d pif)e €tr r N _ C a, ut 1 : P° g ipp and p,i } :g~,th-, T_ Tire seah,j[I not crao; or 3 orrode 3e yf { f i1K ~ f f^. o f tsl,e,,`,, otf ~ ..tir < are rI i P Xia 7E7 bl_ t In Se C C .t.?' T f pliable 1 x = C< y =Ct;IY [.,C"' } [w ti t ;'c £ tt F rts.ai[atic c,,ouldn't and .'v tertight per anertlV. e t easier, a, s flfle`s or oan, TUFaTITE 6-HoleDistflbuflon Box 6HD2 ~ IV IYII p ~ non M 'oa ~ ,r w v a Y taj3 T 3k~ f r [3 x vC1M € i ~ W INSTALLATION IS JUST THIS SIMPLE z 1. Position the Distribution Box on level virgin soil Do not place box on a concrete slab.` ' -35 S 4Q 2. Install the inlet pipe and outlet pipes. Be sure the bottoms of all pipes rest on virgin soil. P-10 3. Level the Distribution Box and all pipes as needed. Choice of Fittings Choice of Lids Tuf-Tite Speed LevelersTM 4. Backfil) the pipes to within S-35 Pipe Seal, for: Regular Lid. Molded of rugged Control the flow of effluent from two feet of the Distribution ■ Sewer and Drain HDPE. the Distribution Box. Simply Box. Recheck the level of the 0 SDR 35 ■ ASTM 3034 Inspection Port Lid. For easy insert a Speed Leveler into each box, then backfill up to the E Thin Wall ! 1500 Li Crush access and inspection. Accepts outlet pipe. Rotate each Speed top lid ridge. 5. Install and adjust Tuf-Tite S-40 Pipe Seal, for: 4" riser pipes. Leveler so the flow is distributed Speed Levelers. ■ Schedule 40 as desired. Available for 3" or 4' 6. Place lid on the Distribution ■ 4" Corrugated PVC pipe. Box and finish backfilling. P-10 Plug, for unused holes 16 A S-40 JUFTITE Water-fight Lids and Risers by Tuf-Tite rporat;:: 1200 Flex Court Lake Zurich, Illinois 60047 ~2') v u` 1 teG r _ retlon din USA I ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer. 'tc~!. 1 kwa~_i S Mailing Address A16W If i Property Address kc ` ~I (Verification required from Planning & Zo g Dep ent for new constructi 16:~~ City/StateZty c 6-j- Parcel Identification Number ! LEGAL DESCRIPTION Property Location -!/4, % , Sec. T N R W, Town of ` Subdivision t t c - / Lot# Certified Survey Map # , Volume , Page # Warranty Deed # L , Volume , Page # Spec house yes (/,n-o Lot lines identifiable no 1--- 61 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 car 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 (I) the on-site wastewater disposal system is in proper operating condition andlor (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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this rrn are true to the best of my/our knowledge. Uwe amiare the owner(s) of the property described above, by virtue of a warra deed recorded in Register of Deeds Office. Numbe/ofdr6oi IGNA 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. 08/45) 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, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge. 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 s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems 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 (pumper). • 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 the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ 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 TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER Name C'0 f 1 . L Name Phone ^ 2 y~- L2aj Phone - 2 Y6- 2` SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name 1'c " Name e, 154• Goo Phone I Phone -7 1,'f 3 (0 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 40C0 104 1 / Tank Manufacturer: t/,'c El NA Permit # EWSeptic ❑ Dose ❑ Holding Volume: $ a (gal) DESIGN PARAMETERS Tank Manufacturer: KNA Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: GT NA Vertical Distance Tank Bottom(s) to Service Pad: (ft) Estimated (average) Flow : jf '0 (gal/day) Horizontal Distance Tank(s) to Service Pad: (ft) Specific servicing mechanics must be provided if vertical is >15 feet or Design (peak) Flow = (estimated x 1.5): "~D D (gal/day) if horizontal is >150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: / y (gal/day/ft2) Effluent Filter Manufacturer: 1104/y 101 ❑ NA Standard (Domestic) Influent/Effluent verage Effluent Filter Model: ~2s Fats, Oil & Grease (FOG) (:536 mg/L Pump Manufacturer: Biochemical Oxygen Demand (BODS) :220 mg/L ❑ NA 6W NA Total Suspended Solids (TSS) :5150 mg/L Pump Model: High Strength Influent/Effluent y average Pretreatment Unit (FOG) >30 mg/L Manufacturer: (GODS) >220 mg/L C'NA q<-NA (TSS) >150 mg/L ❑ Mechanical Aeration ❑ Peat Filter ❑ Disinfection ❑ Wetland Pretreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other: (BODO <_30 mg/L Soil Absorption System (TSS) <30 mg/L %Z~NA Fecal Coliform (geometric mean) < a QaAn-Ground (gravity) ❑ In-Ground (pressure) ❑ NA ❑ Maximum Effluent Particle Size &d ' ❑ NA At-Grade ❑ Mound ❑ Drip-Line ❑ Other: Other: ❑ NA Other: tJ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) &-When combined sludge and scum equals one-third (l) of tank volume ❑ When the high water alarm is activated Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 RL year(s) Clean effluent filter At least once every: / ❑ month(s) ❑ NA l 123 year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) 66~ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) P NA ❑ year(s) Other: At least once every: ❑ month(s) '&NA ❑ year(s) Other: t2R_NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). 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 a check for any back up or ponding of effluent on the ground surface. The soil absorption system 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 treatment tank equals one-third (3~) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper) 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 30 days of completion of any service event. GMW-005 (02/05) 583°35'~9e€ I41.38' ` b SETBACKS: ' -FRONT BUILDING LINE SETBACK FROM R.O.W. 7 -SIDE BUILDING LINE SETBACK = 25' wr -REAR BUILDING LINE SETBACK = 25'-- -SEPTIC SYSTEM FROM LOTLINE = 5' APPROX. SEPTIC ARE I, Ty R. Dodge, Wisconsin Professional Land Surveyor, hereby certify that this stake-out plan / L :..J. was prepared by me or under my direct supervision and is correct to the best of my knowledge and belief. PRELIMINARY 1/31/17.__ _ L-_ Date F, / N LOT -6` N I 1.13 ACRES PROPERTY ADDRESS 040-1310-0o-006 466 MEADOW RIDGE TRAIL = I HUDSON WI 54016 L 'B0=940 25. \ • ti_ w _ -HOUSE - ` r I 2' F _ j .rte : " i NORTH -NW22'20"E 116.77' -L"=47.03, R=633.00 j LEGEND ` X =WIRE FLAG SET - =WOOD HUB ORIO'OFFSET OR ON BUILDING EXTENSION MEADOW RIDGE TRAIL FOUND IRON MONUMENT PER PLAT - SETBACKLINE 12 DRAINAGE AND UTILITY EASEMENT ELEVATIONS SHOWN ARE NAVD 1988 DATUM. DRIVEWAY ENTRANCE LOCATION PER PLAT DERRICK CONSTRUCTION LOT 6, MEADOW RIDGE OF TROY (DOPKINS) ro" ar,taor ...a-..._ W~..r_ STAKEOUT PLAN Auth•Conwlfin lawdeAs SW lend &TTe 6 r + Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in aaor'a Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less 81/2 x 11 inches in size. Plan must include, but not limned to: vertical and cGnta{ reference Wnt (BJM%%h.di;e ion-apd Pa rcel LD. :'lease prim an iryrormavon. v v v~ r Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.11 (1) (m)). Z g S Property Owner Property Location • DCCI Land Planners Inc Gov(, NW 1/4 SE 1/S 17 T 28 N R 19 ©r)❑W Property Owner's Mailing Address tat.#.-- Block # Subd. Name or CSM# 1505 14WY 65 I 6 I I Meadow Riclue OfTrnv City State Zip Code Phone Number ocity []Village E]Town Nearest Road New Richmond WI 54017 1 ) o city Cove Road New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD I(~ Replacement_ Public or commercial - Describe: Parent material Loess over elacial till Flnnrl Plain Plpvatinn if annlirnhlp ft I General comments * with and recommendations: ith seven continuous bands, ci, 10yT5 3, c2nd5yT~ 8, Om ~✓j Zee. N'o filer r ~1n ~ 36' b?5 a 3~ I ; I A Boring • pit Ground surface elev. 922.22 ft. Depth to limiting factor >30 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/2 sil 2msblk dsh as 2f .6 .8 I I 2 113-19 I 1r.-A1A I I sil I 2mcbk I dsh I cw I if 1 .6 1 .8 1 3 19-26 7.5,.4/4 s! lfgr dsh cw I - 4 6 4 26-54 7.5yr5/4 - is Osg dl cw - .7 1.6 5 54-72 7.5yr4/4 sl 111917 dsh cw - .4 .6 I 6 1 /2-90 /.5yr4/4 - I si Urn dh - - .2 ❑2 Boring # © Boring 925.05 >90 • Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox DescriDton Texture Structure Consistence TBoundarv _ Roots GPD/fP I I in I Wncell I 0.1 R7 rnnt 'rnlnr I I Gr S7 Rh I I I *Fff#1 I *Fff1Y> 1 0-15 10yr3/2 sit 2msbk dsh as 2f .6 .8 2 15-24 1 Oyr4/4 - sil 2msbk dsh cw 1 f .6 .8 3 24-31 7.5yr4/4 sl 1 fgr dsh cw _ 4 .6 31_51 11 7 14 4 7.Sy1Yi r s --r' ai i 5 53-90 7.5yr4/4 i sl Om dh - - .2 .6 i .8 kpu Effluent #1 = BOD_ > 30 < 220 ma/ L and TS >30 < 150 mo/L Effluent #2 = BOD_ < and TSS < 30 ma/L r_RT Namp fPlaace Prinh Rinnahirp -r'STN,snh r Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, W1 9/18/05 715-246-2454 Property Owner DCCI Land Planners Inc Parcel ID # Pending Page 2 of 3 Boring # Boring E3lin. 0 Pit Ground surface elev. 923.09 ft. Depth to limiting factor 72 Soil Application Rate I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD/fF in. I Munsell I Qu. Sz. Cont. Color I I Gr. Sz. Sh. I I I I *Eff#1 i *Eff#2 I 1 0-31 10yr3/2 I - sil 2msbk i dsh as 2f .6 .8 i 2 31-52 1 4/4 - sl if dsh cw if .4 .6 3 52-72 1Oyr4/4 - sl Om dh cw - .2 .6 min n A 77-40 '7 c.-A1A _,.~.._i_.. ..is A-* at .2,10 .0 N n tl"°l _ • 2 !i Boring # oul 1119 ~j Pit vivu,a sur2aca: e!-V. rt. vepm,o, mnnmg lw--" m. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I G ~ l I i a-. I I I I I I I I I F-1 Boring # Boring H Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate l Horizon Depth I Dominant Colorl Redox Description I Texture Structure I Consistence BoundaryI Roots GPD/fF in_ I Munsell I Qu. Sz. Cont. Color l I Gr. Sz. Sh. i I I I *Eff#1 I *Eff#2 I I FM Lant *1 = RCIr) > -in < 99n mnA nnri TRR >4n < 1.rin mnA * FM cant 99 = Ron < An mnA onel Tq.R < In mnA 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. sBO-8330rest (rL07/00) DCCI LAND PLANNERS, INC. ® SOIL BORING Lot # 6 -MEADOW RIDGE OF TROY NW 1/4 OF THE SE 1/4 OF SECTION 17, BENCHMARK ~Pra T28N, R19W, TOWN OF TROY, ST. -TOP OF CONDUIT r CROIX COUNTY, WISCONSIN. ALT BENCHMARK • •r • • • • -TOP OF CONDUIT 11~2 1-3 TOM NELSON CST - Lic. # 227387 N NOTE: THE CONTOURS IDENTIFIED ENVIRONMENTAL BY DESIGN ARE PRIOR TO CONSTRUCTION. LJ31 CONSTRUCTION GRADING WAS IN 1432 120TH ST. PROCESS DURING SOIL TESTING. • { • NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO i CONFIRM FINAL CONTOURS Ph. # 715-246-2454 DURING INSTALLATION. SCALE IN FEET 1• s 40' 100 0 100 • 7 B3 .28 Zr) 153• 7 N~ 87 EL 918.89 14~ 3 7' EL=922.22 B1 EL=919.60 ^ w 15' EL=925.61 .58 B3 EL=925.05 ®EL=923.09 2 s'EL=925.3 B1 1 0