The URL can be used to link to this page

Home My WebLink About020-1404-08-0003Wisconsin D%partmentof Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division 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: City Village X Township TI Magnuson Enter rises,Inc. Hudson Townshi :ST BM Elev: Insp. BM Elev: BM Description: t58.O Ofl • a UL. TANK INFORMATION 0 ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic 5 VV_ 2ao Dosing L �, � � 1 J Aeration Alt. BM 020 - 1404 -08 -000 Holding 29.29.19.2540 TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic L �, � � 1 J ! t� Alt. BM 020 - 1404 -08 -000 Dosing 29.29.19.2540 Bldg. Sewer Aeration Q . SZ: I SUHt Inlet P/L S v 1 3 . � j Holding .......... . LAKE /STREAM -4- Manufayiu r: PUMP /SIPHON INFORMATION Manufacturer Demand �Q-S GPM Model Number 5 H Lift Frictio Loss System Head TDH Ft Forcemain Length ! Dia. Dist. to Well Z0V 1 Z SOIL ABSORPTION SYSTEM 0 0 County: St. Croix Sanitary Permit No: FS ELEV. 420553 0 State Plan ID No: 3 Parcel Tax No: DIMENSIONS Alt. BM 020 - 1404 -08 -000 Section/Town /Range/Map No: 29.29.19.2540 STATION BS HI FS ELEV. Benchmark ! 3 Liquid Depth DIMENSIONS Alt. BM (#2 6^- 3) Bldg. Sewer 13• Q . SZ: I SUHt Inlet P/L S v 1 3 . � j Q 7 , 9z ! St/Ht Outlet LAKE /STREAM LEACHING Manufayiu r: Dt Inlet Dt Bottom A) CHAMBER OR 9o,lo ! Header /Man., Type Of System: CRUAJ 1 )o$".IS Dist. Pipe --------- UNIT Bot. System !2•o go 0.(#0 0 • a I 10Z. Final Grade q,p •Ov •t 10.4 - 0 1 0 F.40 St Cover f~ 9�•9� i 85 S'. 90 X11 101 BED/TRENCH Width Length No. Of Trenches Vent to Air Intake PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 (#2 6^- 3) SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufayiu r: INFORMATION CHAMBER OR ,(� Type Of System: CRUAJ 1 (� --------- UNIT Model Number: to DISTRIBUTION SYSTEM ( 4 All".. f[L, I Header /Manifold a Distribution x Hole Size x Hole Spacing Vent to Air Intake kAS Pipe(s) Topsoil , j] Yes No 7 Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At - Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil , j] Yes No i _I Yes j No CO S: (inc��cogey4yscrf<p cie� persons present, etc.) Inspection #1 A /,_ (�_ �i3 Inspection #2: / I CO 425 Jack Pine Driive`��Hudson, _ W � I 54016 (NW 1/4 y §W 1/4 29 T29N R1 9W) Walden Woods Lot 8 Parcel No: 29.29.19.2540 1.) Alt BM Description = �,a� S �� •S'� 2.) Bldg sewer length= ! fir -amount of cover= 1 Zf+ "t 3)StpMn st�9+udt�nS 36 revis Plan Re quired? Yes side for additional information. No ZO Use other Insepctors Signature Cert. No. SBD -6710 (R.3/97) + Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 N visconsin Madison, Wl 53707 - 7162 Department of Commerce (608) 266 -3151 Sanitary Permit Application In accord with Conan 83.21, Wis. Adm. Code, persona' it f�, _Zµvide may be used for secondary proposes Privacy Law 15.Ow I. Application Information - Please Print All Information f . �itet: n Property Owner's Na me Property Owner's M ailing 15ZI ( City, State ti f /v �- S Zip Code W A4<C - - vim$ II. Type of Building (check all that apply) X1 or 2 Family Dwelling - Number of Bedrooms ❑ Public /Conttnercial - Describe Use ❑ State Owned - Describe Use Phone Number d S Z _` County - Cg-@ l K Sanitary mit Number (to be filled in by Co.) P 4ZV SS3 State Plan I.D. Number Project Address (if different than mailing address) 1 �Z,s 3 Po'F DRS Parcel # Lot # & Block M ® Z 6-!ca O/ _ Property Location c Y' N 1 /i / LV '/4 Section a ci of o T N; N; R E or� Subdivision Name CSM Number ❑City ❑Village`h4Township of sp✓(/ III. Type of Permit: (Check only one box on line A. Comolete line R if arnnlienhle) A ' New System y ❑ Replacement System ❑ Treatment /Holding T ank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal . Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued VI. Tank Info Before Expiration Total Plumber Owner C! ry ss_ - ✓r -- .+J All UL 11VPljl Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 of suitable soil ❑ At -Grade ❑Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground L1 Holding Tank ❑Peat Filter Aerobic Treatment Unit Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe- ❑ Other (explaii V. Dispersal/Treatment Area Information: i — D ' est n Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area (SO Dispersal Area Propos d (sf) System El ation /O CID [ Required VI. Tank Info Capacity in Total Nmnber Manufacturer Prefab Site Steel Ib 2 Fiber Gallons Gallons of Units Concrete Con tr sucted Glass astic New Existing `ra Tat ks Septic or holding Tank Aerobic Treatment Unit Dosing Chamber n j� � _ VII. Responsibility Statement- I, the undersigned, assume •esponsibility for blstallatimt of the POWTS sttowu on the attached plans. Plum s Na me (Print) Plumber's Si gna MP/ Number Business Phone Number 0(2 d4\- _ z z� 0 z r�� Plumber's A%ddrre s (Street, City, St Zip C VIII. County /De at tment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ssui b Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial LX. Conditions of Approval /Reasons for Disapproval n �} r 0 P-Q..► t`sto . Attach complete plans (to the County only) For the system on paper not Icss than 81/2 x 11 inches in size SBD -6398 (R. 01/03) ( 0-1 Po c LV eVwA N T &fi�- mP z 6rg1 r� hae w F 4,-'� 3 1q << P ,)( �,. �;�2ti64`t1 Wisconsin Department of Commerce SOIL EVALUAT ON REPORT Pa a of 5 Division of Safety and Buildings P� g in accordance with Comm 85, Wi t! e 1'11 County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Ivan must X uiuuue, out not emitea to: vertical and horizontal reference point (BM), direc$Sl►o✓ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. OZ� Please print all information. Redox Description Qu. Sz. Cont. Color R iewed by Date Personal information you provide may be used for Secondary purposes (Privacy Law`;` - - tp.04 (1) (m)). f O Property Owner Pr perty Location �� ` G 1VU S l7N C�e►vt -t�et- tip^-) 1/4 SW 1/4 S L cl T Z N R E (o W Propert Owner's Mailing Addres } \\ Lett # Block # Sub Name or CS f1 � City State Zip Code Phone Number., � Cit ❑ Village ® Town Nearest Road ® New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate 1300 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ G L 'l l i�L Q) l-1 T R S N Flood Plain elevation if applicable N ft. General comments and recommendations: 3 COLS � r �� SC �Z_� / L- j"j C, �/ t U r ✓tv 17' S O� s 0 Sq Boring # ❑ Boring R Pit Ground surface elev. C -q ! ft �J ^ r)ant to n hr}nr 7 / Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots gun rppncauon rare GPD /ft 'Eff#1 'Eff#2 10`12 ZJI L g b H m, ��'} C� • � 4 s 0 Sq 3 zq -8l !Oy R S l !� — S S ►yt — 1r Z _7 L I J Boring # U Boring ® pit Ground surface elev. u ft. Depth to limiting factor '2 E U in. 0..:1 Anr .::.....:.... CM.. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots vvn r+yNnw- na.c GPD/ft •Eff #1 `Eff#2 \ es bvt - 7 W 0-- s 0 Sq !uvz S1 _ S S ►yt — 1r Z _7 �Muc"I. n - ow - -')U t tcv rngrL ano r ab --au < you mgrs. - tmuent w2 = BvD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S(gna re r" CST Number Arthur L. Wegerer �_ O 3 -1 Z8 220254 Address W e g e r e r Soil Testing & Design Se Date Evaluation Conducted Telephone Number 421 N. Hain St. R iver Fa WI 54022 --) - ZS -03 715 -425 -0165 Property Owner K A N G Parcel ID # o ` — l q U T" —0 8 -00c) Paae A. a Boring # ❑ Boring cc�� G — ® Pit Ground surface elev. C� it. Depth io limiting factor 7 U O 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 ,. Depth In. - o Z� \) V- z[ — L 1 0 Boundary Roots GPD /ft •Eff#1 'Eff#2 `Z Z yBo mz s4 - S bg 1-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor In. Horizon: ,. Depth In. - Dominant Color Munsell Redox Description Qu. Si. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD /ft •Eff#1 'Eff#2 r r F-1 Boring # E] 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 . yq...vv oav GPD /ft •Eff#1 •Eff#2 r r 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. SBD -8330 (R.6/00) .. PLOT PLAi1 Scale 1' = -)O ' Page 3 of J C r� tJ ✓ CJ ; i CST Signature 7- ZS - 0 715- 425 -0165 2 20254 03 -1 2 Q Date Telephone No. CST No. Job "i0. Wisconsin. Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL WFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: TI Magnuson Enter rises,lnc. City Village X Township I Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Inside Dia. 7 uid Depth SETBACK INFORMATION SYSTEM TO Type Of System: P/L Dosing IWELL LAKE /STREAM LEACHING CHAMBER OR UNIT Manufacturer: Model Number: Aeration Holding PUMP /SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 420553 0 State Plan ID No: Parcel Tax No: 020 - 1404 -08 -000 STATION V BS I HI I FS I ELEV. St/Ht Inlet SVHt Outlet Dt Inlet Dt Bottom Header /Man. Dist. Pipe Final Grade St Cover BEDITRENCH DIMENSIONS Width Length No. Of Trenches Vent to Air Intake PIT DIMENSIONS No. Of Pits Inside Dia. 7 uid Depth SETBACK INFORMATION SYSTEM TO Type Of System: P/L BLDG IWELL LAKE /STREAM LEACHING CHAMBER OR UNIT Manufacturer: Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Bed/Trench Center Pipe(s) Topsoil Yes # No [ Yes ffiJ No Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes # No [ Yes ffiJ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ! / Inspection #2: / Location: 425 Jack Pine Drive Hudson, WI 54016 (NW 1/4 SW 1/4 29 T29N R19W) Walden Woods Lot 8 Parcel No: 29.29.19.2540 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Al Yes 0 No � Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Pia&onsin Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 na O Madison, WI 53707 - 7162 Six Address Department of Commerce 1 1 ;4 - . 3 (10 b, �Sf�C K PI- D2 Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ` - ❑ Check if Revision may be used for swandary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Information State Plan I.D. Number Propert y Owner's Name C ,. R Parcel Number M+6 AJU 50 AJ &^' I �1 L d - z o - /Yo cle - Property Owner's Mailing Address L Property Location s 44.' t- A.) AU ik Z i•' Y `L/'k ; S T , R City, State Zip Code PhofloT �1G t Number Block ber ZONIN . S -ft ` L wA -fL7im 5 (C. Su Name CSM Number H. Type of Building (check all that apply) y ❑City 1 or 2 Family Dwelling -Number of Bedrooms ❑VUtage ❑ Public /Commercial - Describe Use _ wnshi n S <Ir ❑ Stat Owned Nearest d �( M. Type of it: (Check only one box on line A (numbering scheme for internal use). Compjf line B if applicable) A. 1 A'New f N, � Rep3PE I lacement System Replacement of 6 El Addition to- For Co use. S stem Existing System B • ❑ Check if Sanitary Pe viou a Pe Number Date Issued IV. Type of Permit: a Ning ' g scheme is for internal use) 44 Non - Pressurized n 47 El S2 Filter 22 11 In -Gro a an k 48 El Single Pas rhd rip e El 4 45 El At -Grade ` reatment Unit 49 El g Other V. Dis ersal/Treatme A a Inf tion: Design Flow (gpd) Di Dispersal a L Soil Application Percol Rate ystem Elevation Final Grade Required Proposed ate(Gals.lDa q.Ft.) (M' ch) ag /� Eledoon /e �✓ nlP�+- t q /o VI. Tank Info Capacity in Total Number ufacturer Prefab rte Steel Fiber Plastic Gallons Gallons of Tanks l� Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank C �p _� —7 Dosing Chamber Q ®� VII. Responsibility Sta tement- I, the undersigned, esp onsibility for installation of the P show on the attached plans. PI ber's Name (Print) / Plumber's Signatur MP/?APM Number " Business Phone Number �6Gt'J� dN 7 Z 7 35, Plumber's Address (Street, City, State, Zip Cod Ci L G w� --F-R (.cJ ( �0 VIII. Counnty !De artment Use Onl Approved ❑ Disapproved SanitaY Permit Fee (includes Groundwater Date Issued Ls ' g Agent Signature (No Stamps) • Surcharge Fee) ❑ Owner Given Initial Ad Determination lj / IX. Con ons of q►pp ;o D' ppr val �- ik b.r� ' �, V /I�tlach co lete �°°� tha,Fu� 7> for the psp . not si/2 :1 in a P3 rr) w� 4 -� MA-6Al sow C— N 4- CAC � f8 stria. / N Fig +, 97 15 r +I ° N ,.g f,°',f' ^' G o f 4 ».m � � :�4 � � � \� � y � ' .. . � � �/ � ®�\ ,� ± ƒ� . �# i< ¥ � \\ . . , % » ^! ■ � ^ ! , . / �# i< ¥ � \\ . . , % AJ kc ,6 ZAA 1, XWO r 1 0, t r! Wisconsin Department of Commerce SOIL EVALUATION REPORT Dii0on of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach' complete. site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include but not limited to v rti I d h ' tal f S e ca an onion re erence point (BM), direction and parcel l I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest rod. O ZO— �� o – O —000 J Z Please print all information 0 ,�� ID X R viewed by Date ry p rposes Personal information you provide may be used for seconds u C" ~ (Privacy Law, s. 15.04 (1) (m)). r f VDj e CCO"i r '�`k;' r. ti N>AJ 1/4 5 w1/4 S zq T Z9 N R l9 E (o W Property Owner's Mailing Address �ot # Block # I Subd. Name or CSM# S`M iaL 8 - ln/ � J' w City State Zip Code Ph4e er City ❑ Village ® Town Nearest Road New Construction Use: ® Residential / edrooms L Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable _ IJ General comments �� oS' �D C_�LS and recommendations: L E_N 3 I x- I go , LLB'✓ 6 Uyj\ - OF- G �PmY�CI�f s Z D�7-Wtwp LL�PceN a - �2 cAEtlS - M SE ❑ Boring # ❑ Boring ® pit Ground surface elev. 1 0 ft. Depth to limiting factor 1 in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots r- GPD/ft 'Ef f#1 'Eff#2 1 o zo ion iZ z�l - L z 9 ►- �► v�r c �� , s .� Z - ?-b SS ) o , � rZ Y! L — L ti L3 b vz- m Vtr C-W — - L4 t -Z- 3 -i-) C ZD`l 2 _s/ 1 S O S - ,� t. Z Z J Boring # ❑ Boring ® pit Ground surface eiev. b- ft. Depth to limiting factor D O in. c.,a 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 o -Z'0' i oK %Z-Z - z r rn v � w 1 . s .� ">. 2$ -t{3 1i3-1 VL Y 16 — L ti L3 b vz- m Vtr C-W — - L4 • b 3 �!3_!Do )b�m Ylb - tmuent in = 6UD > 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) Signature CST Number Arthur• L. liegerer OZ -Z4 3 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. 1-lain St. River Falls, WI 54022 t4 —D 715 -425 -0165 Page \ of 3 Property Owner < 7 fJ 1 V Parcel ID# 0Z0- fCrby -03 -00 N Boring # ❑ Boring ® Pit Ground surface elev. 6 ft. Depth to limiting factor in. Page 3 of 3 Horizon Depth in. DorrdfWnt Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD /ft 'Eff#1 'Eff#2 0 3 n ! a-1 2 2! Z -, L z`F9 M U TY- is LAj l . S • ° u Z 30 -l� 3 tio�-t R UI b — L `cs 1�1i »1 U�'►- e IAJ — • q Sc. OV�i U O 'IU N10't't 1 w G NO`S S L LLZO)J � IT w r-1 1, ❑ goring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. Soil A lication Rat Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots pp e GPD/ft 'Eff#1 •Eff#2 ❑ goring # 11 Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' 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 < 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.6100) ' 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. SBD -8330 (R.6100) PLOT PLAN Page 3 of 3 Scale 1 =SO ' � =Liry wL— N) 1 -SPrC- 1 I.I.- 0 ._: �� + :E Lf� r c-OI Gam: ot-o G CST Signature 1ti_Z�_C)1715 -425 -0165 2 j�Z_Zy3 Date Telephone No. CST No: Job NO. Rvy -� Zl "lo I y y -46 A J 17 � F • Q a� -,�,, �0lv 1 \ l 1 I.I.- 0 ._: �� + :E Lf� r c-OI Gam: ot-o G CST Signature 1ti_Z�_C)1715 -425 -0165 2 j�Z_Zy3 Date Telephone No. CST No: Job NO. '('Z Mft6N(A,S0N ( fAjfi (A/ C, 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 Septic Tank Component Number of Bedrooms Design Flow - Peak (gpd) Design Flow - Peak (gpd) 5'Z Estimated Flow - Average (gpd) o� Septic Tank Capacity (gal) Maximum BOD (mg /L) Soil Absorption Component Size (ft) 220 Type of Wastewater Domestic 150 Table 2: Soil Absorption Component - Limits of Reliable Operation Table Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 'u:p 5'Z Maximum Influent Particle Size (in) 0 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). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Thq ou let filt shall be cleaned as necessary to ensu -.- groper operation The filter cartridge should not be removed unless provisions are made to retain solids 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 NOV -01 -02 FRI 02:49 PM FAX NO. S`t' CROIX COUNTY SEPTIC TANK MAMMANCB ACI MMF1TT AND OWNWIW CERTIFICATION FORM p,,,,M,yer - T :r J'A'I A 61 , . Mailing Addt'ess property Address Y X -4 n " (Verification required fkom Planning Depattuleat for new er.- W, P. 02 city/state r, parcel Identification Number .��,��` -- W- grRTPTI0N ftl � W jig T -R W, Town of tDS property Location/ /�, /�� sec. Subdivision Lot # R Certified Survey Map # Valtjrne „ , Page # Warranty DeeA # Volume Page # Spec house Q yea Q no Lot lines identifiable 0 yes 0 no �verr�t� x�d1fN"Y' to baudle wastie6� n A ms NCE e r use and intena►neeof your septic system could result {n its premature failure P oonsisbt o f puraplr;g out the a"00 tank every three Ye&O or sooner. if n eeded by a lieeascdPumper. � con affect tlx faaotiou of the septic tank as a treatment stage is the waste disposal system. a ceriificatiou fond, signed by ft owner and by a '�'prol►ertY owner agrees to oubmit to St. C�vix Zoning pepart�� that (1) rite on-sibe wastewaterdisposal system pier, journeyman Plumber, rtsbdctedplumber or a lie0ased pumper � fbe septic tank is less than 113 fWl of sludge. is is pto� � condition aadlor (2) Act inspectio�p end tsumP�g (if aooessary), uuemcna sad agree to maintain the private sewage disposal system with the s VWr batre read the above redi of Natural Reeoaroes, Stetc of Wiswusin. Cg tiCcatioc Set fotth, herein, as set by tha Department of Commescc and the Depu tO tutaed to the St. Croix County Zoning Di'�►C° v,ritbin 30 aq�og that your septic rystem hoe been maintaiacd must be comp days of three Year irati�on date. J 1 J 2 C71� 2 e DATE SIG PTAT'tJFtL� OF Al'PS.I "! �'��1v�6%✓��d.� � �c.� a� C 4 C e Y (we) am (arc) the owaer(s) of I (we) certify that all statements on this form are true to the best of my (our) kaowled8 • the property described above, by virtue of a warranty dead reoordrd in Register of Doeds Office. tl J r x�x _ DATE GNA1ZJttR OF AP 1CANT Ir/>'/y�it l/,S+rr� '/Ac' t. * * * * ** Any i nforma ti on that is mis- represented may result in the sanitary permit being revoked by the ZOniag Dep t•• * *. 06 IncIttde With this application: a stamped warranty deed fmm the Register of Dcods off►oe a CM of the cerdf od survey WP if rdc=c0 is M& in the .vaaanty deed - f - - MA GN q 5o,-1 6 AJ -- (A/ C— Combinatio.n Septjc;Tank and SPECIFICATfONS ' - PUMP CHAMBER CROS5 SECTION AND WEATHER PKOOF NEWT CAP JUUCTIOQ BOX �4 C I. VEh1T PIPC � C. APPROVED LOCK1tiIG M A)JMOLE COYER 1v1 j FRAM DOOR. tup,Rr.)IU4 t.A.BEL. •.ilNnow oK FRESH co�DuIr �rJspo� P IpE qLR 1uTAKE 'I ib °MIDI. I K J LET APPROYCD JOIIJT zf�8t Ft�R W1C.T- PIPEOR Tank construction shall comply with TLHR (13.15 and 33.20 � le'Mlu. � 11� PROVIDE ! AIRTIGHT SEAL. I I I I ( ALARM C, a ! +I I I I f oN i OFF D CONCRETE 6LOCK APPROVED J0141 W /C.T. FIPE-�p L 3 APPS R15EK EXIT PERt' IITED OIJLU IF TAWK MAUUFACTURZR HAS SUCH APPROVAL E3EODING SEPTIC F 5PEC 1FICATICQS 705E INl'�cJ>~ TnuK; MA) IJUMBER OF QOSES: PER DAB TA),JK aIZE: r V"Q ALL01JS DOSE VOLUME ALARM MA1.7UFACTURZR: II.ICLUDIAJG bACKfI pW- GALLONS - 1 1JUM6ER: CAPACITIES: A= wCHES OF, ! _ � S � �C � GALLOWS 5WITC.H T�PC: �� -CU`s 8 = Z- IucHES'OK � t -Z G�LLOU5 PUMP MAW ,, UFACTUREA: W k�Z.s C- //� J JCHE5 OR - LaALLOUS MODEL NUMDER: �(� `� D - - fO — inicHES OR j CALLOUS SWITCH TYPE: Y'I�CCC"CJ JJOTE: PUM AMD ALAF Jn AKE 1 dl MI KIIMWI DISCKARGE RATE GPM INSTALLED 0�1 SEPARATE CIRCUITS VFKTICAL DIFFEKEKICE DETWCEU PUMP OFF AUD..0I5TRI6UTIOU PIPE.. 1 hEET t MINIMUM KJETWQ SUPPLY PKE55URE , ; .. , , FEET + �� " FEET OF FORCE MAIN X ( � Q � T I / OP FT �L.e FKICTIOI.J FACTOR -. / S FEET TC)TAL 0y JAMIC HEAD = � FEET As per,manufacturer C/�,p gal /in. �0 "r'j M E40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve M M U- H 25 20 J H 15 O h- L MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 35 5 v cv vU +U oU oU /U oU yU I Ul CAPACITY GALLONS PER MINUTE 5� S c F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 12 10 to 8 f Z H 6 Q 4 0 F- 2 IN K3326 7/91 Printed in U.,S.A. V N Q H ad W Ln a Z U O mom J U . Z 0 a , z , � H W a O Z J � r Uj 1 n N .L t l.�_ N E L U x o � ;~ O •o x — N �•- M O r c D •- N E C 0 t l.�_ N J� -9 1473 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach comp lete site an on not less than 8 %x 11 inches in size. Plan must Cou St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and — -- — percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 020 - 1083- 30 -000, ID #29.29.19.334C Please print all Information. Reviewed B Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Midwest Con st. & Development Of Hudson„ INC. Govt Lot NE 19 S W 19 S 29 T 29 NR 19 W Property Owner's Mailing Address Lot # Block # �Subd. a me or CSW P.O. Box 932 Plat Of Walden Woods City State Zip Code Phone Number � �C / .�> ° illage lM Town Nearest Road Hudson WI 54016 715 -760- 1 �\ ids Glenna Drive 19 New Construction Use : Residential / Number roornrl _ design flow rate 600 GPD Replacement Public or / cribe: Parent material Glacial outwash F �- lain elevation, if applicable na General comments and recommendations: Install 2 trenches using 29 high eilyy infiltrat foie et below grade at elev. = 94.0'& 93.0' on 99.0'& 98.0' contours. F-1 Boring # A Boring jo Pit Ground Surface elev, 99.85 ft. _ >98" in. f Rate Depth to bmttrrrg factor Sal App rcabon Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz *Eff#1 *Eff#2 1 0 -25 1Oy none sl 2fsbk ds as 2fmc 0.5 0.9 2 25-40 1Oyr4/3 none Ifs 1msbk ds cs 2f,1mc 0.4 0.6 3 40-68 1Oyr5/4 none IS 0 sg dl cs if 0.7 1.2 4 68 -98 1Oyr6 /4 none s Osg dl - - 0.7 1.2 F-1 Boring # _j Ong >99" jo Pit Ground Surface elev. 99.60 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 1 0 -12 1 Oyr3 /2 none sl 2fsbk ds as 2fm,1 c 0.5 0.9 2 12 -25 1 Oyr'3 /3 none Is 1 msb ds cs 2f,1 m 0.7 1.2 3 25-61 1Oyr5/4 none s 0 sg dl cs if 0.7 1.2 4 61 -99 1Oyr6 /4 none s Osg dl - - 0.7 1.2 * Effluent #1 = BOD ? 30 < 220 mg/L. and TSS > < 150 mg/L t #2 = BOD <30 mg/L and TSS <30 mg/L CST Name (Please Print) Si u CST Number James K. Thompson �A:Eva - 3602 Address A .C,E. Sal & Site Evaluations onducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 9/15/01 715 - 248 -7767 property Owner Midwest Const. & Development Parcel ID # 020- 1083 -30 -000, ID# Page 2 of 3 '.� Boring F 3 13oring # Pit Ground Surface elev. 94.93 ft. Depth to limiting factor >94" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -18 1Oyr3/2 none sl 2fsbk ds as 2fm,1c 0.5 0.9 2 18 -27 1 Oyr3 /4 none Is 1 msbk ds cs 2f,1 m 0.7 1.2 3 27 10yr5/4 none gr Ifs 0 sg dl cs if 0.7 1.2 4 66-84 1Oyr5/4 none s Osg dl gs - 0.7 1.2 5 84 -94 1Oyr6/4 none s Osg dl - - 0.7 1.2 5 81 -90 1Oyr6 /4 none s Osg dl - - 0.7 1.2 Horizon #3 contains approximately 10% gravel & cobbles. 4� Boring # 16 Pit Ground Surface elev. 90.62 ft. Depth to limiting factor >90" in. Sal Application Rate Horizon Depth Dominant Coo Redox Description Texture Structure Consistence Boundary Roots *Eff #1 *Eff#2 1 0 -18 1Oyr3/2 none sl 2fsbk ds as 2fm,lc 0.5 0.9 2 18 -30 1 Oyr3 /4 none Is 1 msbk ds cs 2f,1 m 0.7 1.2 3 30-42 1 Oyr5 /4 none gr Ifs 1 msbk dl cs 1 f 0.4 0.6 4 42-81 1Oyr5 /4 none s Osg dl gs - 0.7 1.2 5 81 -90 1Oyr6 /4 none s Osg dl - - 0.7 1.2 Horizons #2 & 3 contain approximately 10% gravel & cobbles. Horizons #3 & 4 contain approximately 20% gravel, cobbles & stones. 5 Boring # 1 JIM Boring Pit Ground Surface elev. 90 .8 4 ft. Depth to limiting factor >89" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -121 1Oyr3/2 none sl 2fsbk ds as 2fm,1c 0.5 0.9 2 21 -32 1Oyr3/4 none gr Is 1msbk ds cs 2f,1m 0.7 1.2 3 32 -75 1Oyr5/4 none gr. s 0 sg dl cs If 0.7 1.2 4 75-89 1Oyr6 /4 none s Osg dl - - 0.7 1.2 Horizons #2 & 3 contain approximately 10% gravel & cobbles. * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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. Iy7 A d So,'/ e ✓a %cc a 9 !o / E8 /ae off' CJQ /dew, ds. Sec. 29 6.3 , Ere 55L(mw elko = loo.00: 8 iob, Co' Confo4 bz 98. '7 5 sf4m p S/ Pe 960, ■ 94 0 , a cQ-vn 'o4,'j 5 �res� 9o,0 ray I !� 6 -de- 5ac- h` t� . �IaF 3 U 2026P 022 I STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between Renton Inc., f/k/a Midwest Construction and Devlelopment of Hudson, Inc., a Wisconsin Corporation Grantor, and TI Magnuson Enterprises, Inc., Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Walden Wands located in the Town of Hudson, St. Croix County, Recording Area 696020 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 10 -29 -2002 8:30 Alf WARRANTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE: 360.00 COPY FEE: CERT COPY FEE: PAGES: 1 Namy Return Address p4 1 l - -75� Fi6;�C O K &r m 0 55413� 020 - 1083 -10 -000 Parcel Identification Number (PIN) This is not homestead property. (j) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. l S�" Dated this O? 1 day of October 2002 * * AUTHENTICATION Signature(s) authenticated th ENqY r ATZINA TA IO UBLfiC STATC OF 1A/I R-G- ONSIN * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUME T WAS, A D BY Attorney Kristina Ogland C� Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) Renton, Inc., VWa Midwest Construction and Development of Hudson I I t -FfWo� r �e n * ACKNOWLEDGMENT STATE OF WISCONSIN 1 ) ss. County ) Personally came before me this day of October f 2002 the above named Renton, Inc., VWa Midwest Construction and Development of Hudson, Inc., a Wisconsin Corpor 'on by its o t 1 n A R r W r% o to m4k%Vwn to be the per on(s) who executed the foregoing ibstruh - Vnt and acknowledjk *Atha same. * MC/ ct_, Notary Publi , State of Wisconsin My Commission is per n not, state expiration date: F Names of persons signing in any capacity must be typed or printed below their signature. Information P rofessionals c ompan y, Fond du Lao, WI WARRANTY DEED STATE BAR OF WISCONSIN soo sssmz1 FORM No. 2 - 1999 I . — I _J Itl8i7 44"" MONUM£NTM SOUTH UNE OF QHWRTYS AWITION. ' r . J6 OF WISCONSIN, iS PLAT TO BE ° : TION ac o A LOT 6 0 OR 5.236.12 TO A . )SON AND THE ST. 2 C t}�, 2.50A ACHES ; Z �L (109.29:3 30. Fr.) y M CAUSED THESE �Z 0 a Z a m N (] A n L� 7 � 2.8tD8 ACRES (117,428 SO. Fr.) CS = FF WARREN, N 8°0715 I f �/� JTED THE FOREGOING l V6 EDGED THAT HE )N, BY ITS VZ ACRE.$ _ �! (127,401 8O. Fr.) /EYED, DIVIDED, 15 REQUIRED - BY Y OF HUDSON, TOWN BENCH MARK: TOP OF 1' • / IRON PIPE. ELEVATM ea6.as BENCH !`HARK: TOP OF 1' t IRON PIPE. ELEVA11ON \ m ol l 1 489.9 1' LOT • 2.446 ACHES \ \ • . / THE ABOVE NAMED .]0 (1 ) 6 , W4 SO. FT.) RUMENT: AND LOO C� 111• M sic Lr j CID - 0v a t TOO l sma dO uaisi5au L996 I RC 9% TVJ RZ :9T 11H.L ZO /tZ /OT � n � \ 'D I/ (tp-` �ov ) �I �