HomeMy WebLinkAbout040-1327-33-000
vvl;cu""r Depagtrm rl of PRIVATE SEWAGE SYSTEM C""!v St. Croix
Safer, In Rw diro P,,st;n
INSPECTION REPORT Sanoawvei°'tNC
GENERAL INFORMATION AI TACTI 10 PERMIT) stale Pla- ID .vc 605096
Pr-,aryl lrlnlmal on yc_ pro; de -.ay bP used fnr SPNW..ary p„rp;nos IPr:vacy Law. s.15..4 i t limiI
Per--,t Homer`s Neme Clay ,,"I aya rvw-rsh n Farrel Tax Nn
DCCI Investments LLC TOWN OF TROY 040-1327-33-000
ST Rkt F er I^so. BM Lev. 61,1 Oesa pticr Se, %rn Town: R.;n9e l.1aF: Nc.
9_7,)4 I Q - l G5 17.28.19.2231
TANK INFORMATION ELEVATION DATA
TYPF MANUFACTURER ` S CAPACIIY SIAI ION BS HI FS ELEV
Sepik Benchrl21h
y 7. /
c S ° / Z~lJ its 9q,31
Al! BP.1
~'I e Sz S F'tl L'_ 66J /7 9s, 1, 7
Aeration Bldg Seww 17- 1? 5. z Z_
Holding SUHt Ime: b - $ /
TANK SETBACK INFORMATION SVHt Outlet 7
9, 7k5 4S. 59
TANK TO qPL V,'CLL BLDG Fero "AC I1taF:e ROAD Dl Inlet
rt 1 ~ rt^ ~
Seelic ~7 So / V Dt Bottom
Dosing Header.-Man
16,/(p 4Q, l S
Aerat en Dis; Pi❑e
16,3 ~.w .o
Holding - - _ - B;:I Sy's:ere 197, 02
Phil Grade
PUMP/SIPHON INFORMATION P J ~ CK • 3
F,lanufar.%iiw Demanc St Cover 5,17 t
GPM V Xi
tdodel Nvn ter _
TDH Liz Frict'.on Lcss system TDH F:
Forcerta.n I ergtn Da I>:Sl to :^iell _
SOIL ABSORPTION SYSTEM
DE WI RE NCH vdiwr' length Nn O'tr -h- PIT DIM€NSIONS Na D`rts 1 InSIee DIa lmwr. Depth
DIMENSIONS -3, 1 gO t-7~ y (rem , 1 - , J~ _ 1
SFTBACK SYSTFPA TO PrL BLDG WELL LAKEtSTREAPA IFACHING Ma'm'ac:wm /
! v J
INFORMATION CHAMBER OR r'/~
T. o ;.re- UNIT
C. J Mccel Nu"•oa•'
L "_~L I~ 33 ti
t 0..m
DISTRIBUTION SYSTEM N
Ili
-leacerrManilnd G r.r outer m Fn e Size x •IC.u Saaurl +Ferl :c Air Intak~
PiP-rs~ O{L~
rnm L D,-cth Ca Rp.1 Pro
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only e+.3 '0 mar!(.,
Depth 'er Jep~h r' 'er feptr rr SeededSetlcec xx Pd.ilchee
F!e~]!Iren Ceme' 19 3z r-" I n,h I dq, lp'c
Yes N6 es Vo
COMMENTS: flndude code discrepences, cersons p•esert ex Inyeaion Ft Inspection #2
Location: 366 MFAD(.P,V VALL Y TRI. 7' 3z Gory... O G/L F~~d u..l S U k-
1 ) Al! BM Descnpt on = ( C'6 U t'_
2.j Bldg sewer length = 1'5 . - amount of weer = y/ o(No
~ SQL Plan revision Required Yves
' ~I Use other side for add Ronal vionnal J ` J
Owe V,jrp 7n'[ 1.171.1p v N'
SBD-671G IR
f
arr~`, ,,I County
1 - I Safety and Buildings Division
F,I 201W. Washington Ave., P.O., Box 7162 St rm-iy Ma sambry permit Number (ter be
filled in by Co II
(~g. 4y6,537p7162
Sanitary Permit Application state 'I ac N her
In ace:ccwifl,S]1s t, r 211: , W rs Adm. Code, subrmssion of this form to the appropiate governmental unit NotrApplicatin (ou fur sLterowmd POWTS ate submitted to Pmject:lddrccc
lif do emat tat nailing mhtreas' the L*ent o(Safely and Profl-ssnoal SevierPervmal m(ormation you pnovdc maybe used for secondary accordance with the Privacy l.aw,,. 14.04(Ikm) Stat,
_
t..A r IiadOn Information - Please Print All lnformn-Wo 366 Meadow Valle Trail
Property Owner's Name D Parcel a
0 iv- 13»-33 axx
Propcrt-v Owner's Mailing Addrec, pmperiv fen noon
~ 17.99. q.aa3~
I 1505 Hwy 65, PO Box 445 New Richmond WI 54017 ,t,1,,, 33
(',n. State ~7ip ('ode phone Number
SE NW !y.5ecnar 17
New Richmond WI 54017 715-246-2320 28 (cndcone)
II. Type of BufldinQ (check all that apply) \ ,,,k' Lot a 1 R -1A L or w
R1 tar 2 Fannly Uw'clhng Number of Bcdronnts `a ) W G3 33 Subdivuan Name
f-"* «<TT"' ~\w~ Block a v r
i J PubadCommercial Utscnhc lave _
G City of
1-\1A1e Owned - Descnbe Use - CSM Number O village of
` IxTown of Tiny-- _
IIt. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
Mew System ~ Rephacmrnt System I ❑ I Maim-01oldmg Tank Rcphicement Only O Other Mnd,ficaUOn in Fxistmg System (explain)
B. L Permit Renewal ❑ Permit Revuion ❑ L'han c of plumber List I'me me Permit Number and Dale Issued
R O Penn Tramfe m New
Before Lxpualion Owner 1' c
T'
IN.1 ' e of POWTS SvstCWCOM onenUDevi": Check all that apply)
,gi Noml4rssun7ed In-(irnm,d O Pressurized In-Ctound O At-Grade ❑ Mound > ]A m. of suitable soil ouad < 20 w. of suitable sod
Ll Holding I ank ❑ Other Digx+rsal Component mxplainl_. Prematownt Device (explain)
V. Dispersai7Preatment Area Information:
Iksn(,m Flow (R(x~1" 1 Design Sod Applicatmn Ratc(gpdsD Unslresal Area Required (sf) Utssppe+sal m PmposM (s() Sysem FI,,,t,oa
600 / I 7 I 858 900
V1. Tank lnf. C'apacio, to Tool J of Manufuctum
Gallon, Galloro Units
New zeds Existing 'tank, I ,tu r V a
eo
a i:J r. ..L a
kpA a Hrieag Tad 1
IM 1250 I Weiser X
sing ChsmM1Cr
r VII. ResponsihillR Statement- 1, the undersigned, uswnr rapnmslDlhlp for 'in, allation of the PO W'I:S shown on the attached pleas.
C Plumber's Name (Ptintl Plumber's Si atwNIP NIPItS N'umte Husuress Phone Number
Countryside Plumbing & Heating v-~ 664713 775-246-2660
I Plum(srr's Address IStrccl,frt. -Mje 7;p Ccdc( - - - - -1
321 Wisconsin Drive New Richmond WI 54017
Vlll. COunIx artment Use Only -
❑ Apprmrod r U,sappurved - Permit Fee Dale Issued Issuing Ag I Srgmmum
n Owner Given Reason for Uwiei
S`f8 ~Cr.~ot8
I Conditions of Approvab'Reasmns for Disapproval rJJ
YS ![M OWNER
Septic tank, emaert filter and
dispersal cell must be serviced i maintained
as per management plan provided by plumber.
AA 11 setback regu:rroments must be maintained
as per applicahlf ec.:a iOrtMY7npty?u+r yt.aa r r+r r+M1e a,ucm mA auGndt ro tM Coaery tardy nn payer eon kn IM1.o X t¢ x 11 inekea to site
SBD-6398 (R, 11 I I)
i
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name DCCI Land Planners Lot 33
Owners Name DCCI Lan Palaners
Owner's Address: 1505 llwy 65 PO Box 445
New Richmond WI 54017
Legal Description: SE 1/4, NW 14, S17, T28N, RI 9W
Township. Town of Troy
County St Croix
Subdivision Name- Meadow Val let of Troy I st Add
Lot Number: 33
Parcel ID Number: 040-1327-33-000
Page 1 Index and bile
Page 2 Plot Plan
Page 3 System Sizing & Cross-Seclioa_
Page 4 Fitter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cry Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber: Countryside Plumbing License Number 664713
Date: 07/25/2018
Phone Number (715) 246-2660
Signature
Designed pursW nt to the In-Ground oil Absorption Component Manual for POWTS Version 2 0 SBD-10705SP (N.01/01).
Page 1
Bm 2
Lot 33 parcel id 040-1327-33-000
o Two 90 ft trenches ez flows
0
Bench mark 1 100.00 top of electric trnaformer
3% slope Bench mark two 5.85 top of steel lot corner pipe
Slope 3% scale 1 "+40 ft
System elevtion 93.5
0
0
n ~
I \
\ 1
N
i
i Wieser 12 alt k
i `
525 p lock filter
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i Proposed well
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SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT p•ge_of
Project Name: DCCI Land Planners Lot #33
_l- No. of Cells Per Cell
.3 ACell Width Total Noof 2
90 n Cell Length Sv sq ft EISA Per Cell
3 ft Cell Spacing qoo sgft Total EISA
Manufacturer Model l.e In Len th EISA Ratl
L Inftltraw EZ12031-1-511 50 25.0
E212031+10ft 10.01
So.o
Graveiless Leaching Unit Manufacturer: 17 Flow
Gravelless Leaching Unit Model: 12 17 ba d _ I
Typical Cross Section
Finished
Grade It
Observation Pipe with
approved cap or vent
n
1rSoil8ac11
n in
rGeotextile Fabric
f
v
O
12 in ft Infiltrative Surface
n
---y 8 n Limiting Factor
to I~ Slotted and Anchored Vent/
W _ Observation Pipe with cap
Plumber/Designer Signature:
License M 664713 Date: 07/25/2018
PaLy~q]C Inc.
°~ermaa, ."Pic".s„,..,~. Zabel' PIS 525 Effluent Filter
dh'as1PWlar VrN:c6 ADamo~<"'tl.br M:.
I'I: 525 Filter
I he PL-525 Filler is rated for 10,0110 GPD (gallons per day) making it one of the largest filters in its class. It has
525lineai feet of 1 /16" filtration slots. Like the Polylok PI.-122, the Polylok PL- 525 has an automatic shut-off ball
installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shirt off
the system so the effluent wont leave the lank.
Features: 1/16" Filtration Slots
Alarm Switch
• gated for 10,000 GPI) (gallons per dap). n
10 rt00 GPD (Optionali
• 525 linear feet of 1/ 16" filtration. r V lJ
'C. Accepts P' %'C
• Accepts 4" and 6" SCHD 40 pipe. Extension Handle
• Built in gas deflector
• Automatic shut-off ball when finer is removed,
• Alarm accessibility Pw d for
lo.tlno CPD
• Accepts PVC extension handle
I'L-5215 Installation:
Ideal for residential and commercial waste flows up to 525 Linear Ft
10,000 gallons per day (GI'D'). nt Ij 16'
Filtraoinn Slot,
1 Locate the outlet of the septic tank.
" i
2 Remove the tank cover and pump lank if necessary.
3. Glue tire filter housing to the 4" or 6" outlet FIPe, If SeHD au pipe ~
On, filter is not centered under the access opening use a
Polylok Extend & Lok or piece of pipe to center filter-
4. Insert the PI: 525 filter into its housing. i - - r
S Replace and secure the septic tank covet' Certified to
NSF/ANSI Standard 46
PL 525 Maintenance r---
The PL- 525 Effluent Filters will operate efficiently for i
several years under normal conditions before requiring
cleaning- It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm, i
the owner will be notified by an alarm when the filter
needs servicing tiwrvicmg should he done by a certified 1 )L c"" ~`~1101
septic tank pumper or installer. I Automatic
Shut-Olf Ball
1. Locate the outlet of the septic tank.
2 Remove lank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed, f-~
9- Pull PI -525 cartridge out of the housing.
5. Hose off filter over the septic tank. Make sure all 111011,
solids fall back into septic tank. I Ell`
lr
G Insert the filter cartridge back into the housing making
sure the filter I% properlyaligned and completely inserted. uutd,L11SnWio-ill. I Alarm FaendkIukr^•
I nhl-t, 7..1 I N Nast filters incept F.,,dN installs
7. Replace and secure septic tank cover. o,.I.....offiu,r•s,,itchanda;ain,. nfl"..,amgtank,
Polylok, Inc 3 Fairfield Blvd. Wallingford, (7 06492 Toll Frec: 877.765.9565 Pax: 203.284.8514 ,seaw.polylolc.com
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 12,
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner DCCI Land Planners Lot #33
Permit 0 Septic Tank Capacity 150 at O NA
Septic Tank Manufacturer Wieser 0 NA
DESIGN PARAMETERS Effluent Fitter Manufacturer PolyLOck 525 C NA
Number of Bedrooms 4 0 NA Effluent Filter Model
525 ❑ Nq
Number of Public Facility Units RNA Pump Tank Capacity
at X~+
Estimated flow (average) 450 al/da Pump Tank Manufacturer ~A
Design flow (peak), (Estimated x 1.5) 600 al/da Pump Manufacturer IaNA
Soil Application Rate
•7 allda /h` Pump Model - J$NA
Standard Influent/Effluent Quality Monthly average • Pretreatment Unit
NA
Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Filter 0 Peat Filter
Biochemical Oxygen Demand (BODr) 5220 mg/L NA 0 Mechanical Aeration 0 Wetland
Total Suspended Solids (TSS) 5150 mg/L O Disinfection 0 Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s)
0 NA
Biochemical Oxygen Demand (BODE) 1530 mg/L ;Kln-Ground Igravity) 0 In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L RNA 0 At-Grade 0 Mound
Fecal Coldorm Igeometric meant 510' ctul100m1 0 Drip-Line 0 Other:
Maximum Effluent Particle Size Ya in dia. QKNA Omer Q(JA
Other
EYNA Other: P(NA
' Values typical for domestic wastewater and septic tank effluant. Other ❑ NA
MAINTENANCE SCHEDULE
Edispersaf ervice Event Service Frequency
ondition of tankls) At least once every: .7 months! (Maximum 3 years) 0 NA
~Q year(s
contents of tank(s) When combined sludge and scum equals one-third %J of tank volume 0 NA
spersal cell(s)At least once every: =oar
lsl (Maximum 3 years) 0 NA
i
ent fitter At least once even: lsl DNA
)
mp, pumF conttols & alarm At least once every: lsl
) ANA
als and pressure ter. At least once every: (s)
) ANA
At least once every: lsl
RNA
O NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and disper
sal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POW'fS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(sl to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory, authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, snall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 1C days of completion of any service event.
START UP AND OPERATION Page 2 of Z
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
(list may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tanklsl removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the Collis) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or ai-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or-must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and she evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
The-s4s has no! bee evaluated to ide itify 1' 111 1 !!1! 1: team _UPQR ta"we a# 0, PQ1'CrS_a,.~
slue '
be' a ai 9ZD14115nE1~ fbR_AJ ys/ - mg tank
`-0IJSTR (iCTl D
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Countryside Plumbing & Heating Name Paul Koehler
Phone 715-246-2660 Phone
715-246-2660
EI
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Darrel5 Septic Name
tl 20rv AJ
Phone 715-425-1025 Phone L-7/fT-
Tn!s document was dratted i, compliance with chapter Comm 83.22(2)Ib);1)(d)W11, and 63.5601, (21 & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer DCCI INVESTMENTS
Mailing Address PO BOX 445, New Richmond, WI 54017
Property Address 366 Meadow Valley Trail
(Verlficarion required 5om Planning it Zoning Departrnem for slew twnstruction.)
City/State Hudson Parcel Identification Number 040-1327-33-000___
LEGAL DESCRIPTION
Property location _ Sea 17 . T _28_N R_jk_W, Town of Troy
Subdivision Plat: _ Meadow Valley of Troy First Addition _ Lot k 33
Certified Survey Map 8 Volume , Page k
Warranty Deed 8 (before 2007)Volume _ , Page $1--
Spec house E3yesQmo Lot lines identifiable pyesC;no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a ficemed pumper. what you put into
the system can effect the function of the septic tank as a treatment sdge in the waste disposal system. Owner maintenance
responsibilities an specified in §SPS. 393-52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zo'ning Departmem a certification form, signed by the
owner and by a master plumber, journeyman plumber. restricted plumber or a licensed pump" verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) aft" inspection and pumping (if necessary), the septic talk is
less than 113 full of sludge.
Uwe, the undersigned have read the above requmem"KS and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification sating that your septic system has beea maintained must be completed and retuned to the St. Croix
County Plarming & Zoning Department within 30 days of the three year expiration daft
Uwe certify that all statements on this form sire true to the best of my/our knowledge. Uwe anvare the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms 4
/aT
SIGNATURE OF APPLICANT(S) ? DATE
.**Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty docd from. the Register of Deeds Office and a copy of the certified survey map if
referen" is made in the warranty deed.
(REV. 01/12)
r; a't 1 P a l l KAMMU IL VALSR
sr. I Ix oo°EYi
RECEIVED FOR RECORD
LDWTED WARRANTy DEW W14/2W et:gWN
Document No. Y DI !DEED
RU FEE$ 17.9@
71la Dead made between VALLEY LAND / COTRANS AT F r Aft. Se
DCCI~ ~tGtwtm sad Y ~ r 4
WhOmeth, That the said Grantor conveys to
emottie oatain real eaxate in st Croix Comfy, swc
"'iisin, legally dc8m%ed on Exbrbit A hereto
Obe "PmpatS' l
Together with all and singular beeditamenta
aP howet t t to belonging ~ TO
~
retanoing, bowiever, wnintur ~ an easement as
set forth in Exhibit B haem;
except Grantor covenants ands Frye Tea LD.: / _ ^psa
Grantor has not made, done, rcWtsents the
executed or 2-1~i8'9~n
suflEned any act or thing wbeaoby the above*
described Property or any Part tbernOt now or - at any time hatter, sbsB or may be
imPailod, charged or encumbered in any - -
ma>mer, and Cmmtar will warrant title to the abovedouribed Pagoaa the bowevag that thgame e from or ftiMugh Grantor as a result of any 6 ~ ~ all
conveyance: hereby made and the warranty of Grantor is rung pray A d,
sobjart to those Matta act forth on Exhibit C hereto. fin ma limited by and
Dated thid day o0 nuary, 2005.
VALLEY Lkm ooNTANY,
A Minnesota an
Q oa
Roger D. Bevers
AMNOWLS»cEME,T Notary Public
STATE OF State of WisCOnsin
COUNTY Ozx ) SS
P~
PCrSOzi0Y dent ofc'~ Wire me ~s ~ day of January, 2005, the above named
Land may, a hf=eaota Gall B. Valley AS m me ]mown to be the person who eamwted the Alegomg n~ having full hy to do so and auth Saint-,
' >IIatrlrment annd d ac aelmOWledgOd the
blip, $1121c or_ tijj~9y+ -
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~a► D 'f nt k-U-bOIL EVALUATION REPORT 'Sj f 0 191895
_ in accordance with Comm a5, wit, Adm. Code 0V'
"Pape 1 3
r SVBJpESECE9 RE Sot+milt Sii red sting. Inc.
Attach complete sae plan on paper not leas u..,. Bp tree in size Plen moat Courtly JU St.
iwJWe, but nd Fmied to: vertical and horizontal reference point (BM), direstion arM,lpvr"„o1J,E~
percent slope, Scale Of dimensions, north arrow, and location and distance to nearest road. Parcel J.D.
R
1xv
Please PAnialllnlormatlon.
Peraonel inlo'meaon You provide may be used br seoorae Revbwed ale -
7 punxxes (PrrvacY law, s. 1s 01 (1) Im)).
Property Owner Property Locelbn
DCCI Lend Planners Govl. Lot SE114, NW1/4, S17. T28N, R19W
Property (Turrets Meiling AdOrece - Lol • Blodt 19 Subd. Name or CSMM
1505 Hwy 65 P.O. Box 445 _ 33_ _ -Meadow Valley Of Troy 1St Addn
CRy Slats Zip Code Phone Number I City - -
-I n Village .Town Nearest Road
New Richmond WI 54017 i Troy
Meadow Vale Trail
Frommmenuions' lon LISe: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Public or commercial - Describe:
utwash In Pilot Series
- _ - - - Flood plain elevation, 0 applicable NA A,
Area is suaebie for a conventional system with a 0.7
ons: 3%, 9Pd tale. Passible system elevation for Area 1 is 92.65' . Slope of area is
F-11 L7 Boring 19 i - Boring
Pa Ground surface elev. 97.14 _ fl. Depth to Funning factor 98+ In.
Horizon Depth Dominant Color Redox - Soil Application Rate
Deswfplbn , Texturo Seucture Consists Boundary Roofs GPDMt'
in. Munull Du. Sz, Cont. Colo Gr. Sz. Sh. -
*owl 'EMe2
1 0-10 10yr3/2 none
L sit 2m9r_ { mvfr as 2vf 0.6 0.8
2 10-23. 10yr4/4 none 1 grsl 2msbk I m6 I
{ { - i 1 lvf 0.6 1.0
3 123.32 I IOyrS/6 - none I 15 l-tsbk-{I mfv 0.
r ~
0.7 1.6 1,15
q2-72 IOyr6/4 none ~s~---. p~ m~
as 07
5 72-98 I SOyr6/4 none os~ 059 ml --0.7 16
0
.2 Boring a Boring ,
pill Ground surface elev. 95.94 fl.
_ Depth to limiting factor _ 9g+ In, Soil oil gpplicatbn Rau
11
Hinant Color I Redox DeewipTeture Stu Consbten
Mansell Ou. Sz. ComlColorBoundary RGPD/M'
Gr. SzSh. ,EM1 .EM
10yr3/2 nonesil 2m9r mvfr as 2vf 0.6 08
.
30yM/4 none grsl 2msbk mfr f ( W lvf L 1.0
~ 10yr4/6 none sl Imsbk mfr gw 2vf 0.4 0.7
~
10yr6/4 torte Osg l as 0 .6
-t- 0yr5/4 none groos pyg ml - - as 0.7 1.6
0Yr6/4 .none s - -_1 _ml - - 0.7 j 1.6
' EMuent et • BOD,> 30 < 220 mg1L and TSS 30< 150 mg& ' Effluent 192 = BODs < 30 mg/L and TSS < 30
CST Name (Please t Print) - - Signature:
~ //f= CST Nummg&
ber
Thomas J. Schmitt _ _ 227428
Address Schmitt Soil Tasting, Inc Date Evalumion Condu_cted T - -
1595 72nd SL New Richmond, WI 54017 6/22/2017 715-760- umber
1978
Sena). M07M)
Property Owner DCCI Land Planners - Parcel ID a Page 2 of _ 3
Borirq a E, PBoring -
Ground surface elev. _ 95.49 it Depth to banking factor _ 98+ in. dl Application Rate
Horizon Depth Dominant Color Redox Description Texture Sinch. a Consistence Boundary Root GPD/M
in. Mansell Qu. Sz. CoM. Color I Gr. Sz. Sh. •Emt •EIIal
I 0 5 I0yr3/2 none i sit 2mgr mfr as 2vf 0.6~ 0.8
? _r12 1Dyr4/4 none ITl 2mst* mfr gw~lvf 0.6 1.0
3 4 12-19 IOyr4/~ none 9- t 1~ M F ~ 7 f 0.7 6
1.
419-% 30yr6/4 , tgne 5-_x
~9 ml - 0.7 1.6
n Boring
Boring a Ph Ground surface elev.. R Depth to IlmtOng factor in.
Horizon h oil Application Role
Dept Dominant Color Redox Desert Ion Texture Struaure Consistence, Boundary Roots GPDMM
in. Muroell Ou. Sz. Cont. Color Gr. Sz. Sh. •Ella1 •Eas2
❑ Boring N Boring
Pit Ground surface elev. -.-,-it . Depth to limding factor Sod Application R81e
Horizon DepM Dominant Color Redox Descrp8on 7exluro Strtkturo Consistence' Boundary Rods GPD/M
in- Mansell Qu. Sz Cont Color Gr. Sz. Sh. E01
•Eaa2
'Effluent a1 = BODS> 30< 220419A. and TSS >30 < 150 mgrl 'Effluent 02 = BOGS 5 30 mglL and TSS <_30 mgtL
The Department Of Commerce is an equal nppommity service provider and employer. If you need assistance to alxcss services or
need material in an alternate format, please contact the department at 608-266-3151 Or TTY 608.264-8777.
saPAUO ploi ~lal
Srrr.la Sol TWO. sec,
Coodvcted b - ; - - I Page 3 of 3 . t -
r - Y _ Condocfed-IF6 - r - 1 -i- -
i - Schmitt& Sons Excavating, nc..
{
Thomas -NOme ^ DCC'LLaad RLiaa s
586 Va -Tra cty; Slate' ZIP: -N~ Richmond. M 540)i7 I
I S reel, 025._ -
i -
I Phone 1715 76 1978 L_ Subdols or: Meadoiv Vj11"jof Troy pst ~dda~ - - I i
I 33 f L-Y~- I
t- - =o 1. - - 1-Legal Deseriptbn . 4Mw144st-7 j-MN*f9W-- - --F- I
i ■ Backho Pit L - _ Townsbip County , T Tb"him' St ~rolk_ Cdunty I I
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DepaMrfenlof:', ~O
;t SOIL EVALUATION REPORT #1895
SPS in accordancx with Comm 85, Wis Adm Code ~V Page I of 3
i5vajoesece9g Schmitt Soil Testing, Inc
Attach complete site plan on paper not less wa„ ties in size. Plan must County 01st N~ ENT
Include. but not limited to vertical and horizontal reference point (BM), direction and O` percent slope, scale or dimensions. north arrow, and location and distance
to nearest road. Parcel ID Please print all information. Reviewed Date
Perscnal in'cr^..annn you pray ide nidy be use? iw secondary pulocses i Pm/ucy Le, s. 15 M i Ili imb
Property Owner Property Location
DCCI Land Planners Govt Lot SE114, NW1/4, SIT T28N, R19W
Property Owners Mailing Address t of # !i Block # I Subd. Name or CSM#
1505 Hwy 65 P.O. Box 445 33 Meadow Valley Of Troy 1 St Addn
City State Zip Code Phone Number City Village Town Nearest Road
New Richmond WI 54017 ! Troy Meadow Valle Trail
New Construction Use Residential l Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial - Describe.
Parent material O_u_twaSh plaid (Pillot Senes) Flood plain elevation, if applicable NA ft.
General comments area is _trlabl? far a ccnaenl,onal system w4h a 0 7 gpdisgft rate Possible sysleai e evation for Area 1 is 92.65. Slope of area is
and recommendations. 3a,
1 Boring #
1- 1 Boring
Pit (;found surface elev 97.14 II. Depth to timihng factor 98+ in Sod Application Kale
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in Munsell Du. Sr Cont. Color Gr. Sz. Sh. T"i ! -E11#2
1 0-10 10yr3/2 none sit 2mgr mvfr as 2vt 0.6 0.8
-I
2 10 23 10yr4/4 none grsl 2msbk mfr gw 1Vf 0.6 lA
3 23-32 10yr5/6 none Is Icsbk mfvr qw 2vf 0.7 1.6
4 32-12 10yr6/4 none s Osg ml as 0.7 1.6
5 72-98 10yr6/4 none cos Osg ml ! 0.7 1.6
21 Boring # Boring
Pd Ground surface elev. 95.94 It Depth to limning factor 99+ in Sod Application Rate
Horizon Depth Dominant Color Rodox Description Texture Structure Consistent Boundary Roots GPDitl'
in Munsen On Sz. Cont. Color Gr. Sz. Sh. -rtt#i •1111#2
1 0-6 10yr3/2 none sil 2mgr mvfr as 2vf 0.6 0.8
2 6-16 10yr4/4 none grsl 2msbk mfr gw ivf 0.6 1.0
3 16-26 10yr4/6 none sl Imsbk mfr gw 2vf 0.4 0.7
i
4 26-41 1Oyr6/4 none s Osg ml as 0.7 1.6
5 41-64 10yr5/4 none 9rcos 0sg ml I as 0.7 1.6
6 64-99 10yr6/4 none s 0sq ml 0.7 1.6
i
Effluent #1 = 80D.,> 30 220 mg+L and TSS 130 150 mg:L 'Effluent #2 = BODS <.30 m91L and rSS <.30 mgrL
CST Name (Please Print) Signature+ /,4_,,4-1- CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing Inc. Date Evaluation Conducted Telephone Number
159572nd St. New Richmond Wl54017 6/22/2017 715.7601978
Page 3 of 3
Conducted by: Conducted For:
Schmitt & Sons Excavating. Inc.. Name. DC('1 Land Planners
Thomas J. Schmitt, CST 227429 Address: 1;05 Ilw, 65
586 Valley View Trail City. Stale, Zip: New Richmond, wI 54017
Somerset. W 154025
Phone 715-76 -1978 Subdivision: Meadow Valley of Troy 1st Addn
Sgnat~e_ - _ Lot No. 33
GMe '1 --i- Legal Description. SE114 NWI14 S17'h28N RlgR'
■ Backhoe Pit Township. County troy Township, Sl. ('roix ('.ounty
A Bench Mark 1 El. 100.00' Top of electrical transformer
Bench Mark 2 EI.5.85' top of 1" steel lot corner pipe
Slope= 3%
Scale 1"= 60' M 2
S-6
~Y" ` z ~ ~ Y3 h~Ca
93 qu
/2
tot 33 1j 100
A0
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w
wis I)ept. of Safety and Professional Services SOIL EVALUATION REPORT page I of 2
. Division of Safety and Buildings
in accordance with SPS 385. Ws. Adm. Code
County SI' C'KOIX
Attach complete site plan on paper not less than 8 112 x 11 inches in sine. Pop narsl
include, but not limited to: vertical and horizontal reference point (Bn~,, pir@cl:on and Parcel D 040-1327-3.31-000
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. C!i
Please print all information. Reviewed L Date
Personal information you provide may ou r."rl Inr secondary pri'pcsos (Privacy Law S. IS U: ;1 l^16171116
Property Owner Property Location a
DCC'ILAND PLANNERS Gov.Lot SL Ira NWttaS T 2bN R 19 S
E(or)W
Property Owner's Mailing Address Lot # Block # Sulad Name or CSM#
1505 11\Y'Y 65 110 BOX 445 MEADOW VAI.I.F) OF TROY I ST
City State Zip Code Phone Number ity ❑Villaoe a own Nearest Road
NEW RIC] IMOND Wl 5401, ( ) TROY MEADOW \,ALLEY
❑ New Construction Use❑ Residential f Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe
Parent material Flood Plain elevation it applicable _ ft.
General comments DUG A HOLE BP.TWFFN 2 AND 3 120INCHES TO VERIFEY SOIL . BI AC'K DIRT TO RE REMOVED .
and recommendations FILL TO BE TYNKLN FROM TOP Oh SY'STLM AND BLACK DIRT' RE INS I ALED AF'FLR SYTEM IS
INSTALLED. BASMFNT N AS DLG SOILS APPAIK TO SPAT CONSI'I'EN'I 7I IRLW 011''I BE LOT,
4 ❑ Boring N ❑ Boring
O Pit Ground surface elev. 95.9 _ ft. Depth to limiting factor 120- in.
Soil A lira ion Rate
Horizon Depth Dominant Color Redox Descnption Texture Structure onsislence Boundary Roots GPDrft
in Munsell Cu Sz. Cont. Color Gr. Sz. Sh. ll:tt#l ' ff#2
A 06 10 YR 3r2 SIL 2M(iR MVFR AS 2VF .6 .8
B 6-16 10 YR 44 GRSL 2MSBK MFR CW I VF .6 .1
BI 16-26 IO YR 4r( SL I MSBK MFR (W 2VF 4
C IOY'K64 -
?6-4D S OSG MI. AS 1,6
C'I 40-120 10YR64 COS OSG ML AS 1.6
lr~
a
Boring # FiBoring
❑ ❑ Pit Ground surface elev _ ft Depth to limitin factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsislence Boundary Roots GPDtft '
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, ff#l ff#2
Effluent #1 = BOU > 30 < 220 m91 and TSS >30 < 150 mg!L 'Effluent #2 = BOD < 30 ru91 and TSS < 30 nig.L
CST Name iPlease pwt) Signature CST Number
/v.IU . O .22,,Q/,r
Address Date Evaluation Conducted Telephone Number
SBD-x?3011t1Ir'I I)
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SOIL ABSORPTION SYSTEM DETAIL/ GRAVELLESS LEACHING UNIT Page-J-od
Project Name: DCCI LAND PLANNERS LOT 33
2 No. of Cells 9 Per Cell
3 t Cell width 18 Total No of EZ1203
90 n Cell Length 50 sq n EISA Per Cell
3 o Cell Spacing 900 sq n Total EISA
Manufacturer Model La ing Len Ut EISA Rahn
Infiltrator EZ12C3H Sf 5.0' 25.0
EZ1203H-101t 10.0' 50.0
Gravelless Leaching Unit Manufacturer:
Gravelless Leaching Unit Model: EZ1203H-10
Typical Cross Section
Finished Grade 92-9 ft
- Observation Pipe with
approved cap or vent
Soil Backfill
36 in
~Geotextile Fabric
fl Infiltrative Surface
12 In 0
W
X F fl Limiting Factor
36 in Slotted and Anchored Vent/
Observation Pipe with Cap
f................
Plumber/Designer Signature:
License#: 225410 Date: OCT 2ND 2018