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Home My WebLink About020-1404-03-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: MANUFACTURER City Village X Township Renton Homes - I Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: / 001 0 1 / 0, ?- ) -6 1 8— / A14-00 A-,., ' TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic - /�aD Dosing A --0 System Head Aeration M i /rM Length Holding ell /02 TANK SETBACK INFORMATION M M. a "My M M - 0 1 . - TDH ®A riction Loss System Head T Ft M i /rM Length mm_ ell /02 Bldg. Sewer SETBACK SYSTEM TO ®- 92. - - LAKE /STREAM � � / wm== St/Ht Outlet Type Of System: 9z o PUMP /SIPHON INFORMATION Manufacturer St. Croix Demand GPM Model Numb r State Plan ID No: TDH Lif riction Loss System Head T Ft Forcemain Length ✓ ell County: St. Croix Sanitary Permit No: 2] 8 y'a State Plan ID No: Benchmark Parcel Tax No: 020 -1404 - 000 i F_ ELEVATION DATA ' STATION BS HI FS ELEV. Benchmark Inside Dia. Liquid Depth DIMENSIONS /D Alt. BM b Len th L-✓ Dia Spacing ✓ /02 Bldg. Sewer SETBACK SYSTEM TO D � ' 92. SUHt Inlet LAKE /STREAM LEA HING / 7 St/Ht Outlet Type Of System: 9z o Dt Inlet Model Number: t 11ottom J Header /Man. Dist. Pipe »� ,1 S qo- 9� Bot. System �z� Lc�eG wt s ►3� t ��•q� Final Grade s- a ( St C ver SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trench x Hole Spacing PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS O 2 ! �+ Len th L-✓ Dia Spacing ✓ �i SETBACK SYSTEM TO P/L BLDG( WELL LAKE /STREAM LEA HING anufa er: �j'� YQ �✓ INFORMATION CHAMBER OR UNIT Type Of System: y� Model Number: DISTRIBUTON SYSTEM X` &� 4- 2,0, Header /Manifold ] 11 Distribution Pipe(s) Lr/,S 7 x Hole Size x Hole Spacing Vent to Air Int ke ! Bed/Trench Center h 1--- �'` O 2 ! Length Dia Len th L-✓ Dia Spacing �i SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over / 7 �/ Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 1;t0 Yes [a] No [] Yes ! 1 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: ( '5; / 02 Inspection #2: / / Location: (Jack Pine Drive Hudson, WI 54016 (NE 114 SW 1/4 29 T29N R19W) Walden W Lot �4 3 Parcel No: 29.29.19.2536 p �'c� �dn p6 .�-ed �ruVl . F /�t,�, 14, k.ce�/ lot# a c,� A�„ 10 1. Alt BM Descri = 2.) Bldg sewer length = 09 � - amount of cover = \ U l - - -- -- - I in __ _ i!/Y L ?� S - Plan revision Required? , Yes � No Use other side for additiona formation. L � ✓ I �.�! - __ _____ - ` J SBD -6710 (R.3/97) Date Cert. No. Insepctor's ignature ' r 99b I IN W Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 City C 0 �aeonsin Madison, WI 53707 - 7162 Site Address Department of Commerce Z — ( C)Pt w e Ofz Sanitary Permit Application Sanitary Pe Number In accord with Comm 83.21. Wis. Adm. Code, personal information you provide $-eheck if may be used for secondary Privacy Law, s15. 1 m I. Application Information - Please Print All Information State Plan I.D. Number Prope Owner's Name Parcel Number /�G v /�J li(V� r_j / lY�(i7� CG?� 1�!& ✓ DZ(�-- - fe� -0 j -DOb �Z�T Property Owner's Mailing Address Property Location S Z ^^�� C -A T G N.R City, State Zip Code ne Lo Number Block Number �V J j"Vr 200 2 Su ion Name CAW - Number 0G A3 /� S II. Type of Building (check all that apply) D or 2 Family Dwelling - Number of Bedrooms ZO N i G C r F _ >uage ❑ Public/Commercial - Describe Use hip ❑ State Owned / N III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A 1 * 1 2 ❑ Replacement System 3 I ❑ Replacement of I 6 ❑ Addition to For Co tmh use Sy stem Tank Only Existing System B. ,Check if Sanitary Permit Previously Issued Permit Number Date Issued zo IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) K �S P 44'.Non - Pressurized In -Groin 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 44 ❑ Recirculating 30 ❑ Other V. tment Area IWnfo 'on: Design Flow (gpd) Dispersal DisperstArea q Soil Application Percolation Rate System Elevation Final Grade Required cq/ �� Propose Rate(Gals./Days/Sq.Ft.) (Min./Inch) Ele b��D zg s 8 /N rf� q► VI. Tank Info Ca mty in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks q 1 Concrete Constructed Glass New Existing Tanks Tanks Septic or Hoklit Tank Dosing Chamber t C& VII. Responsibility Statement - I, the undersigned, assume responsibnity for installation of the POWTS shown on the attached plans. Phut is Naar (Print) Plumber' Signature MP/MNumber Business Phone Number vw I U ,7 ?c5�Y- C/41, Plumber's Address (Street, City, State, Zip CoCW VIII. Corn me artment Use Onl Approved ❑ Disapproved S anitary Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) ❑ Owner Given Initial Adverse S Fee vp-� Determination QrA _ 2 IX. Conditions of AP roval/Reasooiks for Disapproval /�� "�� _ ,�p� j/�,� 1 � —t �� t) 119 t -� O't�t l " " NQ ta) S A 1 t 1 ""„'�"' Q�G� 1�' t t Lt r f j`"'"�`� A n 1 s Y -4— o,...,Q. �- s-�t� , Attach complete plans (to the County ao17) for the system on paper not leas than SM x 11 teaches In air SBD -6398 (R. 05101) LL iY �. f pj E v fzt [rt✓ P�bA- pI.RN LL N �rr�lE Y/leltat✓ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ) of 3 Division of Safety and Brjildings • in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and C M C I D percent slope, scale or dimensions, north arrow, and location and di j jjq �fD07� Please print all information Revie ed by Date Personal information you provide may be used for secondary purposes (Privy y Law, gf4 (fi)). Property Owner roperty Lo gb'ft; � k .'� /4 N S Z� T Zq N R E (o W Property Owner's Mailing Address u ame or CSM# City State Zip Code Phone Number ❑ City ❑ Village (Town Nearest Road ssQ-5 ( 6S)) X02- 6S'f S i6 1z New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate q Ski GPD ❑ Replacement ❑ Public or commercial - Describe: Consistence Boundary Parent material _ C> \—Py Flood Plain elevation if applicable 'Eff#2 General comments and recommendations: S U 6 G �r � �3 f_`I'�t•r 3 �x 3 � , S ' W 6 Lu N G l� n.r tT' S OF - �i6s L L'b(s,JLAi ��Z Lt C!`f -2i3� �ZS P�2 CE_ LL , ` w �3 o'T�jr -� n 1-=- �ct� C �t.IS `iU '�� L_��V • 9 0 , p � Boring # ❑ Boring 6 ® pit Ground surface elev. q S- 8 _ ft. Depth to limiting factor �) in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD /ft 'Eff#1 'Eff#2 1 0 - ) 6 \0K R-- 3 l - L z s� Yq y-fv ` w - - s — Z ) b -3g tp �,�. 3 1 y - s; l csb lz m v c s - • � • � 3 32 -SO 't V2 31(, Sl it S \e '�N w — •q . 0 -11r3 os9 c�l - ,� �•z Oto•a b I - to / as � Boring # [j Boring H [SI pit Ground -surface elev. S S ft. Depth to limiting factor — 7 l in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots r GPD /ft 'Eff#1 - Eff#2 1 0 -1S lu- 1Q-3)L — Z. 1S - 3Z ��IZZIZ — sL1 .S 'Ir?-.3 I Sl it S \e '�N w — •q . - tmuen[ *i = bVU > su < ZZU mg/L and 155 >30 _< 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature — �� 3 CST Number Arthu>:'• L. Wegerer d 220254 Address W e g e r e r Soil T e s t i n g & Design Service Date Evaluation Conducted Telephone Number 421 N. 14ain St. River Falls, WI 54022 G - ZcSP -OZ '.715 -425 -0165 Property Owner C-1 Z 1 f Y CVt- S Parcel ID # N3 ZC) — ) O $ ® Boring # Boring t❑ l f lSl Pit Ground surface elev. `I ft. Depth to limiting factor 7 0 S in. Horizon Depth In. Dominant Color Munsell Re'dox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots ovu mppncanon Ka[e GPD /ft • Eff#1 I •Eff#2 0 1 k)I Q - L l Z - L Z +3 b VC r'1 \J - Cw - Z t'1 -30 1 Oy tiZ- 3 l -� s e Sbk Tn of l CS R S16 - S o s9 C I Boring # ❑ Boring u ❑ Pit Ground surface eiev. ft. Depth to limiting factor _ In. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots sou Appocauon Rate GPD /ft 'Eff#1 'Eff#2 Boring # U Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in, Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots aou Appncauon rate GPD /1`1 •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 < 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. AF Page Z of 3 SBD -8330 (R.6100) / PLOT PLAN ' ✓ Scale 1' _ ' 3 t�DR.Y� 4 Y I \ � � �Y1'L. � � \'Z ) N t`} - tr C.t�2,.LS � 3p' �s 9� L-7- T - P! ti L DrZ. Page 3 of i I I i I /j N J �i M L N1 IUIJLST CUwsr- D t�3v, OF ' tvDS0►.J, CI- 715 - 425 -0165 220254 CST Signature Date Telephone Igo. CST No.' Job PTO. r 1468 Wisconsin Deparbtieht of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of-Safety and Buildings , in accordance with Comm 85, Wis. Adm. Code AC.E. Sal & Site Evaluatons Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County 02 include, but not limited to: vertical and horizontal reference point (BM), direction and P percent slope, scale or dimensions, north arrow, and location and distance to nearest road. - - 3QW0, I .19.334C Please jodnt all lnfonnatfon. By VED ate Personal infonnabon you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). Prey Owner NZ I p� C�i Property Locforl _ ` W. (� Midwest Const. & Developm f Hudson„ INC. Govt. Lot 1/4 SW tt (j ?9. IN R 19 W Property Owners Mailing Address Lot # J Block # �• P.O. Box 932 3 Id ds City State Zip Code Phone Number City Village ,Tam Nearest- o�C7, Hudson i WI i 54016 715- 760 -1149 Hudson �.l_ j nna Drive 9 New Construction Use: Residential / Nurnber of bedrooms 4 Code derived design flow rate 600 GPD MI Replacernerd Public or commercial - Describe. Stnxture Consistence Boundary Parent material Glacial outwash GPDKe `Eff#1 Flood plain elevation, if applicable na General rorriffa to and recommendations: Install trenches using high capacity infiltrator chambers. System elev. = 92. 0'. RECEIVE® 1Oyr3/2 Ong # Boring gr. fill G i_v 0 2 > 3 - im Pit Ground Surface elev. 97.27 ft Depth to limiting factor in. Sol Rate Horizon Depth Dominant Color Redox Description Texture Stiuchrte Consistence nd T(gPDlft' OP, N G C F 11 1 102 1 0 -16 1Oyr3/2 none fsl 2fsbk ds as 2fmc 0.5 0.9 2 16-32 1Oyr3/3 none Ifs 1msbk ds cs 2f,lmc 0.4 0.6 3 32-47 1Oyr4/4 none gr. Is 0 sg dl cs if 0.7 1.2 4 47-76 1Oyr5 14 none s Osg dl gs - 0.7 1.2 5 76 -93 1Oyr6/4 none s Osg dl - - 0.7 1.2 1.2 Horizon #3 contains approximately 30% gravel ,cobbles & stones. Horizon #3 contains WroDdMatey 30% gravel ,cobbles & stones. M Ild Boring # W Boring Pit Ground Surface elev. 97.11 ft. Death to limiting factor >94" in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Stnxture Consistence Boundary Roots GPDKe `Eff#1 *Eff#2 1 0 -9 1Oyr3/2 none gr. fill - - - 1 f - - 2 9-21 1Oyr3/2 none fsl 2msbk dsh aw 2fmc 0.5 0.9 3 21 -30 10yr4/2 none fsl 2msbk dsh cs 2fmc 0.5 0.9 4 30 -48 1Oyt3 /4 none fsl 2msbk ds aw 1f,vf 0.5 0.9 5 48-52 7.5yr4/4 none s Osg dl gs - 0.7 1.2 6 52 -94 1Oyr4/6 none s Osg I dl - - 0.7 1.2 Horizon #3 contains approximately 30% gravel ,cobbles & stones. Effluent #1 = BOD ? 30 < 220 mg1L and TSS >1 <150 mg/L #2 = BOD < 30 mg1L and TSS < X mg1L CST Name (Please Print) Sig CST Number James K. Thompson 3602 Address AC.E. Sal & Site Evaluations Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 9 /15/01 715- 248 -7767 Safety and Buildings Division MIN 201 W. Washington Ave., P.O. Box 7162 N visconsin Madison, WI 53707 - 7162 De artment of Commerce Y'�9 -D L O t Sanitary Permit Application In accord with Comm 83.21. Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, si5. 1 m I. Application Information - Please Print All Information Property O is Name ✓uh if ,65 /Owe; f cotes Property Owner's Mailing Address P 0 - 1? Y, 7�Z City, State Zip Code /lap / --1/ a II. Type of Building (check all that apply) X I or 2 Family Dwelling - Number of Bedrooms ❑ Public /Commercial - Describe Use /43 S ❑ State Owned Phone Number Count 57 C'O\V >C Site Address #- 3 (o _ ov_ - Pew t De Sanitary Permit Number Pe ❑ eheck 2O State Plan I.D. Number Parcel Number Property Location - p L- V 545OA; S Z9 T Z/ A N, R/< OAT Lot Number Block Number Subdivision Name %3NtfFmnber IV AC ✓ W&m ❑city ❑Village ' 17 Al Nearest Road f"E III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. I *ew 2 ❑ Replacement System 3 ❑ Replacement of 6 Addition to" For County use. System Tank Only TExPisting S stem B • ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal us) _X A- -too by 44X Non - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 El Constructed Wetland ito 22 Pressurized In- Ground 41 El Holding Tank 48 ❑Single Pass 51 El Line % v YS J, . 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: Design Flow (gpd) mom Dispersal /yea Propose4 c �� K-, Soil Application Rate(Gals. /Days /Sq.Ft.) Percolation Rate (Min./Inch) �'�_ Count 57 C'O\V >C Site Address #- 3 (o _ ov_ - Pew t De Sanitary Permit Number Pe ❑ eheck 2O State Plan I.D. Number Parcel Number Property Location - p L- V 545OA; S Z9 T Z/ A N, R/< OAT Lot Number Block Number Subdivision Name %3NtfFmnber IV AC ✓ W&m ❑city ❑Village ' 17 Al Nearest Road f"E III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. I *ew 2 ❑ Replacement System 3 ❑ Replacement of 6 Addition to" For County use. System Tank Only TExPisting S stem B • ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal us) _X A- -too by 44X Non - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 El Constructed Wetland ito 22 Pressurized In- Ground 41 El Holding Tank 48 ❑Single Pass 51 El Line % v YS J, . 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: Design Flow (gpd) Dispersal Area < 1 1 Required Q/� _ 5 '� 3 ( til�`� , Dispersal /yea Propose4 c �� K-, Soil Application Rate(Gals. /Days /Sq.Ft.) Percolation Rate (Min./Inch) �'�_ stem Ele ion 2� / ' Final Grade Elevation , 8 VI. Tank Info Capacity in Gallons Total Gallons Number of Tanks Manufacturer Prefab Concrete Site Constructed Steel Fiber Glass I Plastic New I Existing Jepne or H01ding - I anK 2 /77� Fig _ V Dosing Chamber V D VII. Responsibility Statement- I, the undersigned, assume responsi ' 'ty for Installation of the POWTS shown on the attached plans. Plum Name (Print) " lumber's i cure MP/WA" Number Business Phone Number Pl ber's Address (Street, City, Stage/,, Zip Code) Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) ❑ Owner Given Initial Adverse . � A Determination G .Conditions of Appr_ oval/Reasotgs for % ppi oval k kle, G 11uen 1 t AA:v / /a4 a, , • ^ Date Issued Issuing Agent Signature (No Stamps) atJx j44er it / plete plant (to the County only) for the system on papa not lea than 8112 x SBD -6398 (R. 05101) RED Tu ZIA L\- 73 . C{2 -l- q fo4 RAN 4- 0- 7 3 .1 �a c� C t2.$. d D tok( Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County A2 include, but not limited to: vertical and horizontal reference point (BM), direction and Pa percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. -10 - 3t& Please print all Information. By E �) Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` Property Owner Property Location Q Midwest Const. & Development Of Hudson„ INC. Govt. Lot 1/4 SW 1 Property Owner's Mailing Address Lot # Block # Su)ad. N P.O. Box 932 3 City State Zip Code Phone Number City � j Village T6v�n Neare Hudson WI 1 54016 715- 760 -1149 Hudson Cl_ o/ 1468 Page 1 of 3 A.C.E. Sal & Site Evaluations C Ina .19.334C zwz 29. R 19 W Bid V ds enna Drive ig New Construction Use: j o Residential / Number of bedrooms 4 Code derived design flow rate Replacement j Public or commercial - Describe: -- - Parent material Glacial outwash Flood plain elevation, if applicable General comments and recommendations: Install 2 trenches using high capacity infiltrator chambers. System elev. = 92.70'. na ❑ Boring # A Boling tld Pit Ground Surface elev. 97.27 ft. Depth to limiting factor >9 3 11 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fN /ftZ *Eff#1 *Eff#2 1 0 -16 1Oyr3/2 none fsl 2fsbk ds as 2fmc 0.5 0.9 2 16 -32 1 Oyr3 /3 none Ifs 1 msbk ds cs 2f,1 me 0.4 0.6 3 32 10yr4/4 none gr. Is 0 sg dl cs if 0.7 1.2 4 47 -76 1Oyr5/4 none s Osg dl gs - 0.7 1.2 5 76 -93 10yr6/4 none s Osg dl - - 0.7 1.2 6 52 -94 IF R3 fie -- s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 30 gravel ,cobbles & stones. Fil Boring # Boring Pit Ground Surface elev. 97.11 ft. Depth to limiting factor _— >94" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ *Eff#1 *Eff#2 1 0 -9 1Oyr3/2 none gr. fill - - - 1 f - - 2 9 -21 1Oyr3/2 none fsl 2ms bk dsh aw 2fmc 0.5 0.9 3 21 -30 1Oyr4/2 none fsI 2msbk dsh cs 2fmc 0.5 0.9 4 30-48 1Oyr /4 none fsl 2 ms b k d s aw 1f,vf 0.5 0.9 5 48-52 7.5yr4/4 none s Osg dl gs - 0.7 1.2 6 52 -94 10yr4 /6 none s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 30% gravel ,cobbles & stories. . ( L GPD 600 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >4 < 150 mg/L #2 = BOD K 30 mg/L and TSS <30 mg(L CST Name (Please Print) Sign e: CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 5410 0 9/15/01 715- 248 -7767 " property Owner Midwest Const. & Development Parcel ID # 020- 1083 -30 -000, ID# Page 2 of 3 F 3 ] Boring # 1] Boring - jog Pit Ground Surface env. 97.92 ft. Depth to limiting factor > <99" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDflt= *Eff#1 *Eff#2 1 0 -12 1Oyr2/1 none sl 2fsbk ds as 2fmc 0.5 0.9 2 12 -21 1Oyr3/3 none gr. Is 1msbk ds cs 2f,1mc 0.7 1.2 3 2140 1Oyr4/6 none s & gr. 0 sg dl cs If 0.7 1.2 4 40 -69 1 /4 none s Osg d l gs - 0.7 1.2 5 69 -99 1Oyr6/4 n one s Osg dl - - 0.7 1.2 1.2 Horizons #2 & 3 contain 10% gravel & cobbles, #4 contains 5% gravel. Horizons #2 & 3 contain approximately 25% gravel & cobbles, #4 contains 10% gravel. `f'F old • �F`f 4 �"', Boring' # 96.79 ft. Depth to limiti factor >90 in. jg Pit Ground Surface elev. � " Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 *Eff#1 *Eff#2 1 0 -12 1Oyr3 12 none sl 2fsbk ds cs 2fmc 0.5 0.9 2 12 -21 1Oyr3 /4 none Is & gr. 1msbk ds cs 2f,lmc 0.7 1.2 3 21-40 1Oyr3 /6 none s & gr. 0 sg dl cs if 0.7 1.2 4 40 -69 1Oyr5 /6 none gr. s Osg dl gs - 0.7 1.2 5 69 -90 1Oyr6 /6 none s Osg dl - - 0.7 1.2 Horizons #2 & 3 contain 10% gravel & cobbles, #4 contains 5% gravel. Horizons #2 & 3 contain approximately 25% gravel & cobbles, #4 contains 10% gravel. F $ Boring # jj Boring IM Pit Ground Surface elev. 96.17 ft. Depth to limiting factor >92" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -11 1Oyr3/2 none sl 2fsbk ds a 2fmc 0.5 0.9 2 11 - 38 1Oyr3 /4 none gr. Is Imsbk ds cs 2f,1mc 0.7 1.2 3 38 -58 1Oyr3/6 none gr. s 0 sg dl cs if 0.7 1.2 4 58 -73 1Oyr5 /4 none gr. s Osg dl gs - 0.7 1.2 5 73 - 92 1Oyr6/4 none s Osg dl - - 0.7 1.2 Horizons #2 & 3 contain 10% gravel & cobbles, #4 contains 5% gravel. * Effluent #1 = BOD 5> 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. a soil E ✓a &C 40t p la & cl C 64)c 5e c. ,Z9, �oj, �' I err? ,or" ✓e i va�y �ac A Jeri ✓e 01/13/1995 02:37 7152737753 . Lod 3 V Q 1W6 z d w NELSON PLUMBING PAGE 01 ju 4 � �L�� i h T s L i N 1 4 � ,U3ANI . 1 :. E v � � m U x 0 v �p X cl N •�- o c a C)` N C D m � O h 1 :. �j TV (j 7 Combination Se?t, POMP CHAMBER CRO55 SECTIO im L-E T ti ' C.I. vEfJT PIPE lio FROM 0001t, ,1jkJ1)OW OR. FRESH o.,IR imTAY, E Pi APPROVED JOI W/C. FIFFORK SEPTIC DOSE ILIJ �,( ALARM PUMP A Tank. construction shall comply with ILHR 12.15 and 83.20 �V7 e�� C--an C ) I T r PROVIDE AiF,Tl:,HT j PL )- K15[R. EXIT PEF,11117ED OQLy IFTAWK MAWLFACTURZ9. HAS 51^,', ? �'HRUVI•L SPCCIFICATICKIS MAW U FA CT U F, F. R_ TAM K :� IZ V. G AJ_L 0 kJ S MLIUFACTUFUR: _sL-iiM3 MODEL QUMESER,: IQL Nw IWITCH TtIFIZ: _* � slai?-Y t'%AMU FACT URZ K: E Ls MODEL CUMBEM. 5f:g!b .W17CH TYPE: 1JOT 7 : P11 1 - AMD 1 K C T i di tAIMIMUM D15CKARGE RATE GPM VEKTICt,L DIFFEKEMCE DETWEIIJ PUMP OFF AW0,015TRIbUTIOW + MIMIMUM WETWORK SUPPLY PRESSURE . .. .. . . . . . . . . F I + FEET OF FORCE MAIN Y, 47.,2�(Y, FACTO K_ .,&�2 FEET TOTAL () MAMIL HE FF_Z As per manufacturer , ga in. lJU!•,tiER al D05Z VOUJAE IA1CI_uD1Al.: 5AC1Cf1.I: �,�: _.._I��.�. GAL!.Ol. �i 0�17 _ V.14i6LI - 4 01 .W17CH TYPE: 1JOT 7 : P11 1 - AMD 1 K C T i di tAIMIMUM D15CKARGE RATE GPM VEKTICt,L DIFFEKEMCE DETWEIIJ PUMP OFF AW0,015TRIbUTIOW + MIMIMUM WETWORK SUPPLY PRESSURE . .. .. . . . . . . . . F I + FEET OF FORCE MAIN Y, 47.,2�(Y, FACTO K_ .,&�2 FEET TOTAL () MAMIL HE FF_Z As per manufacturer , ga in. 1��AJ ME40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve 40 MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 12 35 30 Z 25 20 15 0 K01 M a 1 0 20 30 40 50 60 70 Go go loo CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805-1923 419/289-1144 FAX 419/289-8658 Telex 98-7443 10 V) 5 lti z 13 4 0 2 3 Prtntad w, USIA, ge 4_ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 3 Number of Bedrooms Design Flow - Peak (gpd) Design Flow - Peak (gpd) U Estimated Flow - Average (gpd) c70 Septic Tank Capacity (gal) Maximum BOD (mg /L) Soil Absorption Component Size (ft 220 Type of Wastewater omestic 150 Table 2: Soil Absorption Component - Limits of Reliable Operation Table Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) I tw U Maximum Influent Particle Size (in) Inspect once every 3 years 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). NOK. The operating condition of the se ti k and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter hall be cleaned as necessary to ensure proper operation. The filter cartridge shou not be removed unless provisions are made to retain so i s in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 I Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. _ got ?2S gK,54 -?U 3 ST CROIX COUNTY SEPTIC TANK MAMIMNANCE AGREEMENT AND Ovmrpte II' ^10 CATION FORM ownermuyer /1? 5' D v Mailing Address Property Address (V lion required from Flaming Department for new construotioa) (J� Parcel Identification Number t�ty/State N r � . �Y, 33Yc LEGAL DESCRIPILON property Locati on ,&Er/., �� r /., Sec. ��, T� 1�LLw� Town of IyU�S''D77 . Subdivision 2 — S Lot # Certified Survey Map # Volume . , Page # S warranty Deed # (al-q . volume . Page # S t�.._• Spec house 0 ye94 no Lot lines identillable'K y es O no 020 -1 `F 03 -tsZ ( .2535 gX = MAINT ANCE lmpropCt use and radntmaneeof your septic system could result in its pMaiamm failure to handle wastes. I'r*W MWUO ranee 000sists of pumping out the septic tuck every throe years or sooner, if needed by a licensed pumper. What you put into the system as afeot the liar wdon 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 oestificatioa form, signed by the owner and by as masterplum1m, joutaaymaoplumber, restricted plumber or a liceaaed pumper verif/mg that (1) the °n sft wastewaterdisposai syst is in proper operating condition and/or ( after inspection and pumping. (if nooessary), the septic tank is Leas than 1/3 full of sludge. I/we, the undersigned have read the above requircmeaa and agree to maintain the private sewage disposal cyst= with the standardo act forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Cetdfktdou stating d4t vow septic system has bees maintained must be completed and returned to the St. Croix County Zoning Office within 30 vearexo date. OF ICANC I L E ! D OWNER CERTIFICATION I (we) certify that all statements on this forms are true to the best of my (our) knowledge. I (We) am (are) 60 ownet(s) of the property descnUd above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT 1. / _ DATE 0 . 0 . 0 • Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department - . «0440 40 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 , STATE it , o OF WISi't3N r NS� - 1998 Document Number I WARRANTYM '� This Deed, made between JoAnn E Neuharth and Betty M. Evien Grantor, and Midwest Construction and Development of Hudson Inc a Wisconsin Corporation, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property "): Is547474 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CRGIX CO., WI RECEIVED FOR RECORD 08 -24 -2001 12:30 PM WARRANTY DEED EXEMPT M CERT COPY FEE: COPY FEE: TRANSFER FEE: 1800.00 RECORDING FEE: 10.00 PAGES: 1 Recording Area NE 1/4 of SW 1/4 and the North 66 feet of South 495 feet of the NW 1/4 of SW 1/4, ALL in Section 29, Township 29 North, Range 19 West, St. Croix County, Wisconsin, EXCEPT the South 429 feet of West 203 feet of said NE 1/4 of SW 1/4 and EXCEPT part described in Vol. 461, Page 421, Doc. No. 300625 and EXCEPT part described In Vol. 477, Page 588, Doc. No. 307501. N sod Return Address Construction and Development of Inc. 17 Industrial Blvd �'�0 020.1083- 10-000 and 020. 1083 -50 000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) SUBJECT TO the rights of Ingress and egress for an access roadway as described in Vol. 461, Page 421, Doc. No. 300625 and in Vol. 477, Page 588, Doc. No. 307501 Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easement and restrictions of record. Dated this 23r day of August 2001. • AUTHENTICATION Signatures) MPVM A, authenticated this _ day of st ,ti TITLE: MEMBER STATE BAR OF %V'0 h r.,t Of not, authorized by $706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY William J. Radosevich, Attorney at Law 502 Second Street, Hudson, WI 54016 (Sigma ores may be authenticated or acknowledged. Both am not necessary.) persons signing in any capacity must be typed or WARRANTY DEED i .M r STATE OF WISCONSIN ) ) as. St. Croix County ) Personally came before me this 23 day of Au" , 2001 the above named JoAnn Neuharth and Betty M. Evlen to me )mown to be the person(s) who executed the foregoing instrume d )edged the same. Notary Public, State o Wisconsin My p ly/ ion is perlttanent, (If not, state date: 7 � ) STATE BAR OF WIscot FORM No. 1.19" Fond du Lae. WI 600.655-2021 I c S►opi .f� g • •'� LOT_4 LOT 2 . • •'�` '2.279 AS 2.026 ACRES f99,283 SO. FT.) 0 (88,240 SO. FT.) / • • . .'Yd.R.O. • MO N 1 LOT 13 2.520 ACRES 589°1 V52 348.59 ?0.89' 33' 33' j "�° I Z rn *: �^ LOT 2.416 ACRES ; �n (105,250 SO. FT.) -4 Q � S1DER LINE. S89°32'09"W 2t ._._._._._.- ._._._._._._._._.J rn' S89°1 6'62E 410.85' -! JACK PINE DRIVE W N89°1 &52'VV 410.41' ........................... . � I HOSE & I LOT 12 GARAGE I ° D I 2.633 ACRES 33' 33' (114,713 SQ. FT.) 1 WELL Q:j R S LOT 11 ( S EPTIC �C SO. FT.) 3.003 ACRES ''"VENTS • • / (130,791 SQ. FT.) ^ / 810 N C4 cul 1 l ail ' O1 743.14' 331.94' 86 302•x' NeNI ED NORTH LINE Ng "ZOWE 11 8 w BENCH MARK: TOP OF ESDEMIAL ESTATES (N89*2 *3M I I 1 - /4 IRON REROD, I w I ELEVATION 850.16 d05P 90 I d04 I I d04 9