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Home My WebLink About020-1353-50-000 v K 11 71 .6 * C e <, x = ,'t O w m O ( N s O W 0 C = W O `- • D (f N @ 3 d o „_. A O Cr- cn O. 9 .es, A N N .= , 0 . � _ � w 00 ro N o co w O N N N O- 0_ (O 0 v O N Q - . O 0 0 0 0 c 4) C (D �_ Ui O :, -r O CO A= C Q O p0 �. fn = 0 0 I '0 O 00A1 O N O N N IL.* A . a N 0 O _' 3 O '"' N O g -, 0 O CD Z CA O m 70 o 0 o n r 0 ,,, co m O o# 0 O c N O 0 -I -I - cn n CO a V ) ( / ) D c o v m v o X 0 m - ( c O H co g to S 71 c 5. I co CD A Z G Z 6 Z O o .. D N Al S N -o hl O O 6) O _., 'O co 0 !V n co N co C 0 Citil @ n N 0 v ( ° z c "or 52 O z n a 'A Z O m d - Cl 3 i CO m rn m 0 CO Z 3 '� X 1 O ,7,: Z N Z ( p A A 0 y m - _ a ) O a _ * v - c �D T N N N O co O Z Q O I = O CD 0 N 0 3 0 '� 3 O O a 0 n co N 3 -, N 0 w N O O 0 1 b O ti 0 0 w -r '% N tr, - O O N C::::' 2 0 O y r Wiscons Department of Commerce P RIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division . S anitary Permit No: INSPECTION REPORT 399449 GENERAL INFORMATION (ATTACH TO PERMIT) 'State Plan ID No: 1 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 Parcel Tax No: Scott Leonard Homes Hudson Township 020- 1353 - 50-000 CST BM Elev: Insp. BM Elev: BM Description: 1 Nal Of TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / � Benchmark 9 3r tco ,�' f DI D l..J �¢..t, (Z as Dosing ) ` ` Alt. BM b 4.60 ) . Aeration ' Bldg. Sewer A Z.rS f $ Holding St /Ht Inlet A 5•05 e l.. I D r St/Ht Outlet --- TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet .. Septic / ` I Dt Bottom 4 0.$17k32) ,; 83 r ' 7S (.44) 3 W (q40-1- Dosin u w t Header /Man. Dosing O lir Aeration Dist. Pipe __ / i .� Holding _ Bot. System `� ) + ' ' Final Grade PUMP /SIPHON INFORMATION Manufacturer ' _ , ° P and 'St Cover O• 8Z - �J Model Number l* it Or c-ev C.al \ (A � H (Lift f 0 Friction Loss System Hea•_ ITDH \v 2 •g orcemain Length Dia. 2 N Dist, to Well C-41) SOIL ABSORPT SYSTEM c.Qt "r(0.442..r •s ENCH (1 . S -. f► I t ot is * Lt.- 3a W idth No. Tre ches PIT DIMENSIONS No. Of Pi Inside Dia. 1LiquidDh DIMEN ( DIMENSIONS 1Length 1 42.50 y SETBACK SYSTEM TO `- �* P/ /LL BLDG WELL LAKE /STREAM LEACHING Manuf y�rpr: t �` ' INFORMATION - CHAMBER OR 1�•��y Type Of System: r f l ` I UNIT Model N be` i4^ DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ,/� es) 7 / � f Length i� Dia K Pip Leng Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil IN Yes El No 0 Yes El No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: t. / t i b Inspection #2: --1- Location: 867 Alex L t ne Hudson, WI 54016 (SE 1/4 NE 1/4 36 T29 R19W) Cottonwood Ridge Lot P. rcQl •i 36. ' . tt 1.) Alt BM Description 1 "`'� �� - - •( • 2.) Bldg sewer length = _ 12 . Ltt 3) - amount . o ' f yc c ' o ' ve _ r= �� / n -� �p,� (- , , n n (,,,y r 3 � _`[2.33 3 al Ar• >r".S T`Mrt� 1✓� 41;k.- ''� Z 7 J��. G�+� "` �1dM • CeO�- .01 Plan revision Required? A Yes No ►r� ' � (� U ME se other side for additional information. J 1 A\ ' _... M �I1t Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) I Ilw r . .i , , Safety and .4irgs l�iv:aion Count' .._— i 201 W. Washington Ave.. P.O. Box 7162 . 7 . .: l as naln Madao , WI $3707 - 7162 ; Site Address DO natant of C . mm rose Flo tile- (,4v ' ._. __,J Sanitary Permit Application . art' t Number t - - _ ha word with Costae 83.21. Wig. Ads. Cods. personal intbt do,t you provide '�` `' , O Check it itf taiotT - 1. App tiOlt -e OQ - Plitt Alt tleR date Plaa LD Number Ai 4 ""....' i Property 04999'. melee / T IWVN N 3 � . ef, ,q, -0,5-6! S , 0 Z ee d Yd / me5 � / 029 •• 0 _A O� - i P'M . KY • • to • . Props* . .oa _ O/ le "/ ,,, , ' 1 1 j k V 4 i‘' S City, Code I , • seNumbei • '' • "be+r 1 Number . 1 �� CSM Number II. Type of teslradt W that oAFb`) , ,�.z. j' r I or 2 Pio *r DweSiag _ Soother of Bedroo �i / 0 � 4 �` I , 1 11I i 0 PubiieC ommu Warns Use 6' _ i ,sa'G `'' fitS t . • /-4 ,a/ 1 0 State owned ■ i ''`.. Nana i .t tit r o! laerestf (Cheep only ou* box on A (tsunb. rin` scheme for Wawa! woo). Con p1ete line D it np • We) A ' 1 • S 0 ltepleenews Systole 3 0 Repiscsmeat of 6 0 Addition to i Aw Cots* Yee w`" 1.. • - • L }... $ ., .. 8. 0 Cheek if &minty Pe tah Previously woe mil Nuiabt: Dstt Iw cd ,' "hp+ at Perniltilareak apply) Ina scheme is far internal we 49, yw�,,�f� `,/� Gu 44 if No -Pamadrised Jn.Oiound 240 i4taoad 47 0 Saud Piker S00 ConatnrAl Wetland 22 0 Psessorhed In.Ground 41 0 Holding Tana 4 0 Siapie Pau 510 Drip Cues(') 3 ' x Az S' 45 0 At c .. 46 0 _,,• - TIM MS ni Uitit 49 0 Rseirouia • 30 0 Odor _ .. V' 1- int.. __ •'t �. - �•� .,� :. ,. L: 00 i • sslgn • r'"•, iirr!" 1 ••• • , sat Area So Application Percolation • Sy �I anon 1 • mai Grads iVgt W 0o ?Weld 6 t s. /Days/S• - .) Maas* , FA, ; Elevation �6d 1;2=7 _ . . /� 1.21 I 1 , 967" _ 1 . Tank 17 - cell sum • v aotnete un Sits nteei�, 'iwibet Plastic ' �:.., , Galtams *flub ( Cotterata Coaattuctsd ; Guns ? F 4 , 4 r�� - - /a, o I vii . .. , , . , s t a m p l• ais , .. . .. , . , !er - a . pCVi►1'8 shown us the d_ _a_. ' 1"."57r o ' • , , •. err fir, Y Numb', . Mast. Business mambo , • J� Z 8Y � ,ii i 1 v?tv 7 q '7 ( J - .3,' 6 - .�/gl i ry[ e MidMidas t. CN, Sett. ) ! ' i '7d . /y t ♦ - d.../..1 �i i o Sfaaiesey Petanit Pan (toelttdot Grouddwtuee Agent Tfotuta (No Sams) fi e D Swamp Fee) i 0 Owner COM l Adven t. 1 as 70/1/0/ (OD I It • .. at AppreiraUAetnena for D pp • -- �' .•�� 4A a tt 4e 1 i" �,%. pct at.v�oc i } Pn4rw. — 0 f p ea,• ,¢ ``G'' O i , O l 1 li ea 4 ') 14)i - 7 , c tl Q - R (t. -6 5 d ' ■ ' W i • p 3 i Gte-eaV Sbre. ■ 4 ' `n 4.:o '- � h 44 ■ fi • e , � 92 O �1 '5' % - 40 V4i!j. ;''.e '13 v.k, i k V 4 _ C < ■ » d N c - b it S!' t 3 Y y �dtdi 41jv9 00 • qc.,,.7 1 1 7 ,,, ...9,,qb -- k . ,c 'N itt%1 . » % a b � 9 9 'AI 'Cr4 ° .3 '-� " Z o 9 S t n�- p er' e v to .,.,.. ' 'SEPTIC TANK a PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE a WEATHERPROOF >_25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER Nine \--- WI PADLOCK & FINISHED GRADE WARNING LABEL 4" CI RISER i MIN. \ii/ FL 18" IN. 6" MAX. ; .4-w___----1—d ** NLET i { `, ' sill WATER TIGHT SEALS GAS- , '' r A TIGHT , SEAL { /�JOINTS PP N �._ ; v -ALM APPROVED PIPE E 3' B ' ON 3' IPE 3' - � �" SOLOD NTO SOLID SOIL C � � OIL PUMP OFF ELEV . FT. - — 1 -- r`—'OFF '�* RISER EXIT D PERMITTED ONLY i I 1 I IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: l4,1ieSe'i NUMBER DOSES PER DAY: !/ Ow) �ot o ; TANK S (Q , IZES: SEPTIC c� 0 GAL. DOSE VOLUME INCLUDING GAL. DOSE GAL. FLOWBACK: /5Y''y ALARM MANUFACTURER: j. eue/e ny►- CAPACITIES: A = 26. INCHES = '/ ) GAL. MODEL NUMBER: ,eJ B = 2 INCHES = 4/..2 GAL. SWITCH TYPE: fae>-� PUMP MANUFACTURER: , = a/15 C = 7( 6.2 INCHES = /Z GAL. MODEL NUMBER: y/l SWI TCH TYPE: = B INCHES = % � GAL. c�� D 9 l� . �3� $�5 REQUIRED DISCHARGE RATE q( GPM PUMP 6 ALARM WI��.NG AS PER ILHR 16 � AC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE • • — + MINIMUM NETWORK SUPPLY PRESSURE FEET + _ FEET FORCEMAIN X •? L � 100 FT. FRICTION FACTOR . . (.5 TOTAL DYNAMIC HEAD = 71. s 7 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID DEPTH y?" SIGNED: 'L-- .4.1 -/ LICENSE NUMBER: 71" DATE: 1 . 1/88 OS/11/2001 1014 17154256864 WEGEREF SOIL TE5TING PAGE elS . , . l i'''L m it-F(Y1?-eliTAJ a cfe,\IE. to%. 7 o f 7 ,..,_ ___ _ Goulds i I N 0 111, —_, , i • Submersible 4 ....1. Effluent Pump imim ra . .. - . . • • : , 3871 i p p 0 0 4 , 4.,.......__ APPLICATIONS .' • Fasteners. 300 series 'FU submerged in high 1 Motet Housing: Cast iron stainless steel. grade turbine oil for for efficient heat transfer, Specifically designed for the , capable of twining lubrication and efficient strength, and durability. folk:wing uses: dry without damags to heat transfer. Sib* Cow Thermoplas- ' • Effluent systems . components. tic cover with integrai handle • Homes Mdse. Available ler automatic and and boat twitc attachment menial rotretlen. Mooed. paints. . i f Hef • EPO4 Sicily._ phase: 0.4 HP, models mo id Wate buffer , • 116 or 23o v, 50 Hz, 1550 Hod Immo alsam an d • r power Celtic Severe duty • Dawatifithg .:,‘ , ,q,.;,,, RPM, built tri overload with plant et the Odom. road oil and water realetert. ,. automatic reset. • Bearings: Upper and laver heavy FI duty bail bearing SPICIPICATIONS • : • EPO5 Single phase: 0.5 HP, 116 V, 50 Hz, 1560 RPM, ATVIg$ , ----- ontrucCom Pon* EPOA . - built in overload with II EPS4 Impeller Thermo- ' ".SOlids handing capabifity. automatic reset. plasdc Semi-open design ASEIICY LISTING ,-,''.., -; ': •,: , • .... , Itop t t • • Power cord: 10 foot with pump out vanes for ,,---. Oapecitlee: up to 65 GPM. standard length, 16/3 SJTO me chariog set protection. 9. canlibalteftgemoodoke,4 . Mal pude; ,up to 2 with th 4 feet. . three prong grounding Tahiti o EPO5 Infesiler: Thermo' — ,. -. .. • , ,„,tize: llie NPT. ortra plug. Optional 20 tilt (0$A hated model nurribers '.7;1, — • • ' seal: canon iength, 1W3 &MN with plesticovidassiesarfdesitsgn . •:!' — rnio-stalionary, three Prong Wounding Plug impr pe o .:. hUNA elititomers. (standard on EPO5). • Codas od Bas, Rugged • .. . . ,, ..,. • TerflperatUre: • therrnopWc design provides .. .... . 104°F (40°C) continuous superior strength and 1401„(50°C) Intermittent. corrosion resistance. • ... ...‘,..,' r , ..,,,:,:-:-,..„....,' D.Faittinere: MO settee , METERS MIT . . r .1111i - • Hstikka5,15teei. IIIIIIMII I . IIMIIIIIIIIM , , i 'tenable of running ' 11111111.1111111110111111M . . - 01,Y without damage to 8 1 .. , . . 6 . — 312 f 0 nlifirlyn . 1 1494c EPOO ,.:.. - . - ' . .4:.. , • g - '7 ';' I ""MW11111111111111111 Igi., - ,4),' ' .': ,,,, .... ., i.,.....„,: 81:4 1 6 6 0 #4rialti; ''':'.tirto .:'' V. t. iiiiiiiii111-418r.-1.1111111111MIErriMaiikniin - . L , . , r'... :11, olota1.h8808::UP tO ,..'.:?,. . ' . ..,,Olischarge1411: IrKtiP,Ti ', . ; ' 5 .• IIIIIIIEMIEIBIRSIIIIrB ■ Mechanical mil. arbori=. ' tar 6 . • . 1 4 18 11111111111N111.11111111 T ui ur . , _,........,,____......, is■ -, 7 7.7.7----1 ,,, , .7i t •”,..:0 ' . . ' 'r$: . ..,,,H••—•NTc.-...........iowsnm..w.m.==.....cinrw 1111—.. aroimmmnm ,R Tifilifituraki.:',..':':'■V.- . , . i .. lc' V amilillill ME1447C) '.' .. 1 .0(:;* - • .:'' :::. . 1111111111111110 /1 1111",VNIIIIIIIMI.: , , .1, '''1'147F:(W.C) '''''' '' .q 2 -6:: - ' . . . 11111111111111111111111111111111111111110 ,....,.; . . ... ,.. 5 . ,.,,,. , , . . '71' ''t' 11111111.511111111112113101111111111111111111110111111killiF 7 ; * o ' l' IL. ' , , ......,4, ,. ... - ' .... . „ . . . 0 2 4 . , :,' I ,.., ,,, a., toe . „ 12 . , .•:-I-N: • 4.. • • . . „., , k 411/ \ - t3e 7-4. i `Wiscons n Depart!nent of Commerce • SOIL EVALUATION REPORT Page / of 3 / Division of" afety and Buildings in accordance with Comm 85, Wis. Adm. Code County S. Cr0 / X 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 Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed (�� Date Personal information ou rovide ma be used for seconds ur oses Privac Law, s. 15.04 1 (m)). , ( 4 U 1 Ifs /q Y provide may secondary P (Privacy O( )) c, < Property Owner ,, Location -� 0 /Sbh Govt. Lot S E 1/4/U E1/4 S 3 6 T Zct N R 1 Ct E (or) 1D Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1 Z o? y U - a r\4 Lore 5U 0440 n tiJooc 1. r'ol9,..( City State zip Code Phone Number 0 City ❑ Village ® Town Nearest R8ad p-pP(p leilI -ey I416 1 5C/ZY I ( 27SI5 4dsovt 1 Hillary party► ad. ® New Construction Use: I Residential / Number of bedrooms ,. - y Code derived des'•' rats / l 1 6 GPD ❑ Replacement ❑ Public or commercial - Describe: \\ . , 4 ` Parent material 00 4 - LAJa� S Flood Plain ele a applicably. 4J - 2 ft. i e General comments Sy.sr i e1ty. d-vp+v-tnctf\ gz.Fs0 low-e- 1 • RE E ~' ,' and recommendations: 4 LI..Q(.e. V. gz.36 c iUri .2 5 ?fI i ST CROV r cC�\, COUNTY 1 0 Boring ..,\\ ZONM G O4FfCE Boring # n IX / pit Ground surface elev. 9y gv ft. Depth to limiting r f y Lp0 in ! ! , Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisteflc0.- Beun(ary f -- Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 a - /t5yr3 /2 -- 5L Zmabit m1 s I v4 . 5 . 8 . Z % -2 O /6yr `— L5 1 m5_5 m c5 — . 7 /. 2 3 26 /0 yr LIN `" L S / ni5i mrwcr — – . - 7 /. Z r' Qy r yysk�l tie. = gx•9'o L Boring # fl Boring pit Ground surface elev. (C) ft. Depth to limiting factor Co l. LO in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 / - /b — ' Si. Zm abk P c s 1 vI ' . 5 . g 0 yr3IZ 5 M r . Z _ — — / O r LS 1 m n cs _ I. Z 1a `f &) Y illy 5y M*r " 3 % -Lt0 I o y r (!/3 — SL 2trtabkk tyr es _ • 5 . 9 UG -G(e /a yrWY t s 6s3 m! . /. Z s v „ .7: 6 45. (0 11 - * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 m L CST Name (Please Print) Signature _____...- Number ilia. Cc Ai wl�.�.o.r /, 0 - zs33 Address Date Evaluation Conducted Telephone Number 2 1/3 - >i <s/. sP .r_ -�. 1...1/.. 7 -/B Gl ( 7 is) 2q ? - 9aa 8 , Property Owner (Sisal-) Parcel ID # Page Z of 3 3 Boring # Boring ac/ > A. Pit Ground surface elev. i x•36 ft. Depth to limiting factor / c in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I o- (4 , /a yr fZ SL 2rrnbk m cs Iv . 5 . 2 (o -zg /D yr(lb+ LS I r nso i mcr C 3 — . -7 /. Z 1D yr9/3 SL 7 ma& mer (3 , 5 . 9 q NDJ 18yrntN -- r - s mt -- . /. CD® Boring # El LI 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring Boring # El Pit Ground surface elev. ft. Depth to limiting factor in. I Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOO, < 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.07 /00) • 1 PAGE 3 OF 3 1>, __ O O A • # SO : • _s _ • ■ S E % 1 4 i Z \ ,. + _ _. ; SCALE: 1 "= /C BM 1 ELEVATION /on. o BM 1 DESCRIPTION n ,, j, , / y Ca / 1 e 1,✓ /F/o — - 1- — BM 2 ELEVATION go./0 I X BM 2 DESCRIPTION4 o.(: [a'( -M +i "4.0, 4. 5 round See 3 � SYSTEM ELEVATION 4,P4r.e 9 Z• $0 Lowe 9T So ALTERNATE ELEVATION 72 . 3 0 CONTOUR ELEVATION 7 4- 95. on (vv '''''' es.- "''‘'" --- ''''' ..r.s- '"' ev ' iv‘ M7-1 -v -rec.,1 in C. A t g,z • ` • 1342- (0 • .a A I • zJ W Uv cis- SIGNATURE " ; _ DATE O - o / 1 Wisconsin Department of Commerce SOIL EVALUATION R OW s / Page ( of 3 Division of Safety and Buildings • in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County S - C is / V include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R, 1 l0/Q A/ Property Owner Property Location �� C— 6k-\ �IJ Govt. Lot Z 1/4N 'o 1/4 S T // V 1 N R\ E(or(2) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1 a oS 4 (7 (1,1,3"\" R \\ k.A Lc N e.-- S'', _ Q,b h c VAC . KaG �. City State Zip Code P hone Number ❑ City ❑ Village ' Town Nearest Rod q \. muISsia 4 1 ((oi1)59 -a 9g3 c t' ) Ia ��1gRy ro.Rr• New Construction Use: ® Residential / Number of bedrooms 3 - 4/ Code derived design flow rate +/3- 0 O GPD ❑ Replacement Public or commercial - Describe: Parent material 0 V'rt. ,, C` 3 Yl Flood Plain elevation if applicable /e'/ /4 ft. General comments sysl-e W‘ -e% V. 9$ ,S and recommendations: I ( '.Taut QA 9'? ' Boring # ❑ Boring ® Pit Ground surface elev. ? 70 ft. Depth to limiting factor ie 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 0 -1 /oyr 3/z - SL 1074#13.. 1114 L S 1 ti-C /6.4P • - 2. is -/g /vv r3/3 — 5z._ T Sbt in r c i s , 7 3 /g- /ayr W3 P2 F 7.s Sc--1 &tisb k 1�'I- - 1' , " - _ 4 ..6 Z Boring # ❑ Boring 5 Pit Ground surface elev. 97, 5 ft. Depth to limiting factor / k 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 I O / U / 6 y f 3 / Z — S L 1014.44 111-4'r CS / k 4 .( z_ t0, - /J'' pyr3 /3 SG z s.L / C »i /i''r C S -_ , ,5 • / 7 3 >0 3 L/ /ijr 5//3 c z p 7. $ r 3P/`'/ / SC/ , 3m sbk m -t, ` �- A `/ i b * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Na to a Print F� S' re 2 CST � N 3 umber 7 .fi > G .� Ad ress Date Evaluation Conducted Telephone Number Z/(3.6 Sru ir-e ,1 Gv/, 5',/2-s" /D- 3- G/ C`l /s_,)2 y7- y'? SBD -8330 (R07 /00) Property Owne Dtt 0 t SON Parcel ID # Page z of 3 Boring # El Boring S Ls Pit Ground surface elev. 9'4- 9 ft. Depth to limiting factor Z/ 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 1 0 / q / & 1 , 3 / 2 - S c. Zen.? ke to' c s 1 v-i , 5 . 7 Z. Pi -2 ( Boyd /3 — 5' z o rdbe , fir- cs _ , 3 z/-3u Ay, / 7 1 /3 �� r 7 Sir .3/6 Sc, / z, h 11 4mi - — • 4 , 6 Boring # ❑ 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 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑Pit 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.07 /00) Scoff,- 0 ..SON) $ 4 it /'_ die , /O r s/ too /An I,ico e' IC. " °)L loa c/ 1 2 e d" dM / I 1 6 '' s 9 I 1 f . ,p oJ, , .� I 4 i.1 i t, Tvu welt v ti 5 y5I t 1f a" .e d 0 - P -104(1 1-1 01 6 ( /00. c) AV ,4 , - e.6 ,,_ t/.ecl. P Z 9:5 8U kt o e /., .L"� °K ®, i°t sys v-- 9X• 5 ( 4 /O' et /* �tiA_ - 97. o O .../-----..-----t-e: .....------- els/ .I Wisconsin t partmer't of Commerce SOIL AND SITE EVALUATION 9 0?I Bureau of Integrated Services in accords ` v . 14., A9, Wis. Adm. Code • Attach complete site plan on paper not less than 8 1/2 x 11,nchelin si „ Pl4 must \ 'County include, but not limited to: vertical and horizontal referent poirit (BM) lecl i a 1� j -1- . C RD IN �/ percent slope, scale or dimensions, north arrow, and locajion find distance to nearest road f. Parcel I.D. # /' APPLICANT INFORMATION - Please print al in format -; lan,. pia, l , I Reviewed by Date Personal information you provide may be used for secondary purposes ( iivacylaub;Qt-1N.0 (1) (m)). � I A } . 4% � � U .r - ( r�(� GtAtiilC;r G Property Owner , . Property 1k9 ton i KCcC c--Oli ,, I ` :G o vl . 4 P1° ` ,ve 1/4 1/4,S 56 TZf ,N,R /cf E(ore Property Owner's Mailing Address - Block# Subd. Name or CSM# 1353 4t.. 1:-1-u Kee_ +r, 50 _ Ca Hor\ Goo o ok 2 t'cl( 2 City State Zip Code Phone Number ❑ City ❑Village ® Town Nearest Road ILG&. or I AA) l I5 I ( 7 /S 5"/7 (731 N-ud 40 ,A 1 c -ty erg kl L1 New Construction Use: X Residential / Number of bedrooms 3 ^ t Addition to existing building Replacement / ❑ Public or commercial - Describe: Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd /ft • 8 trench, gpd/ft Absorption area required 85 7 bed, ft 7S' trench, ft 2 Maximum design loading rate • 7 bed, gpd /ft • trench, gpd /ft Recommended infiltration surface elevation(s) upprr Q3.10 border 92./0 ft (as referred to site plan benchmark) Additional design /site considerations 44 ver f 3. 4) L.awtr 7 Z O Parent material tom! 0.G 1 1 0 cri-cdocts k Flood plain elevation, if applicable Al / A" ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® s ❑ u ®S ❑ U E S ❑ U ®S ❑ U ❑ S I. U ❑ S L U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 o- 'I 10yr.3 /z. 3 /vnolok h C-S 1 -- . y.,,s as 1-16 1oy� 1- 1/ 1 4 WI 5 v...SL W\ I C ,S - .- , 8 Ground 3 /ro ib 10yr 4/b --- rns v .st Ifni c, 5 - • 7 '. .g elev. 94.40 ft. Depth to ' limiting factor ,� 110 in. 5 Gi Remarks: Boring # 0 Ioyr3 /.3 SL jmalok 144r CS • Y ..5' I`l -y8 1� y /`� -- ms OS vY' J (..s _ . 7 8 3 yt -us i o y r yr //d n S O, yvi ( C.S — • 7 -8' Ground elev. 9ft. �� U$Q1 I S . f In "(11111. (iii)ciOil. Depth to limiting factot 1 ! S in. Remarks: CST Name (Please Print) Signature Telephone No. A �W kvW / 7/.5--- ;y —G /0)2 Address Date CST Number i / 5 i ce r-- 5 7 1 7` `7 -S o ro. r -f - k.) ( sgozC ' -F-f9 Z533 0 `f '. PROPERTY OWNER S - b - SOIL DESCRIPTION REPORT Page ;c of 3 PARCEL I.O.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Gl'D /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 l o -iz )01r3 /3 rnclo& wlcr CS ii . :.sr Ground 3 HA- us'io /O m S oS3 wt 1 c-S 7 •Q elev. 97 30ft. Depth to limiting factor 1 1.5 in. `k yv Remarks: Boring # 1 o -to Ioy r 3/3 V S /noabh yncr Ci (-c . `� ; •C (90 10-c.p u o g ; r r q t./ f / 6 1 1 n.53 04, c -S — .7 Ground elev. 9 .to ft. Dep limiting th to � �b factor alt) in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # I rrl o loyr 3 /z. Si" /Mai, YVl- r G S 1-r • y ; • <.r 3 Pi-is / o7r y /(p --- 04-3 0,5n vitt 1 c) . - 6 Ground elev. q_ft• Depth to limiting factor in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) � i r s-tou+ t.ar- t$. 63+- br.,�,nod Qs'd a e._. -4/4-- SCQ.k 1 &°' r 1 .;, ,......,"e i„^ on^ 1 elev. Tno•O r I:•• Ib''elw tam z eleu• iao•0 N ' x urimr 4re.1C In 93, /0 5./5k en ele• Low<. - 4.rcnc.b.4Z. /0 .............r 3 6 C1 C( ?3./o i 4J4 0 elev. Low 4Z/C.) 0 �r a 1 1 a b ass - 3 anz OM I 4 t 1 \ I • POWTS OWNER'S MANUAL 8L tnhruavcric t ra.r". r FILE INFORMATION S YSTEM SPECIFICATIONS Owner LomaAd 4,../.A._ , Septic Tank Capadty Per) gal ❑ NA Permh # Septic Tank Manufacturer - t° r ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer (0,� ❑ NA Number of Bedrooms a ❑ NA. Effluent Filter Model A1 00 ❑ NA Number of Commerdal Units XNA Pump Tank Capadty WO gal ❑ NA Estimated flow (average) &DO gal /day Pump Tank Manufacturer W l r ❑ NA Design flow (peak), (Estimated x 1.5) %51.. pp M l( rzal /day Pump Manufacturer ❑ NA s Pump Model ❑ NA Soil Application Rate �� g al /day /ft NA Influent/Effluent Quality Mo t b hly average* Pretreatment Unit ❑ Sand /Gravel Filter ❑ Peat Filter Fats, Oil 8t Grease (FOG) 55.30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) 5220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) 51 50 mg /L Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s) ❑ In-ground (pressurized) In- ground (gravity) g p Biochemical Oxygen Demand (BODs) 5_30 mg/L ❑ D (g Total Suspended Solids (TSS) 55.30 mg/L ❑ At -grade ❑ Mound 510' cfu/ 100ml Fecal Conform (geometric mean) _ , ❑ Drip -line ❑ Other: Maximum Effluent Particle Size % inch diameter * Values typical for domestic (non - commercial) wastewater and septl tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months -- year(s) (Maximum 3 yrs.) volume ftankvo ) Pump out contents of tank(s) When combined sludge and scum eq uals one -third 15 o ( Inspect dispersal cell(s) At least once every ❑ months ❑ year(s) (Maximum 3 yrs.) Clean effluent filter At least once every /a- ,months ❑ year(s) Inspect pump, pump controls 8t.alarm At least once every & ,months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) Q Other: At least once every ❑ months ❑ year(s) 13 'NA Other: At least once every ❑ months ❑ year(s) ❑ NA • MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an indivpuacarrying aintainer Septage Servicing Operator. inspe Plumber; Master Plumber Restricted Sewer; POWTS Inspector; O must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersa cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent or 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 (Ys) or more of the tank volume, the entire o' contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 1 13, Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new com pede t the treatment ment eo u p r ocess and/or amage the dispersal a cell(s)f o If high paindng products or other chew detected have the con that may impede e tret p Ar rl,n ran4(s1 ramovPd by tentage servicing operator prior to use. L Page of System start up shall not occur when soil conditions are (roan at the Infiltrative surface. During power outages pump tanks may ff11 above normal hlghwater levels. When power Is restored the excess wastewater will be discharged to the dispersal cell(s) In one large dose, overloading the cell(s) 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 ncrmal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at•grade soil absorption area. Reduction or ellmination 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; (at; 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. ARAN DON EM ENT 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 ch. Comm 83.33, Wisconsin Administrative Coder • All piping to tanks and plu 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 falls 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 utilhed 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 soli and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. O 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. O The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area Is available a holding tank may be Installed as a last resort to replace the failed POWTS. O Mound and at•grade soil absorption systems may be reconstructed In place following removal of the biomat at the Infiltrative surface. Reconswctlons 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 IMpk1CCWRI F. ADDITIONAL COMMENTS • POWTS INSTALLER POWTS MAINTAINER Name e /Pre. 'r friz a . Name Phone go— "0124 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name _ Agency �4� . . ..I Il to �i1h.G�� Phone 'hon IMITTVE1 . ;ltd JUL -30 -01 MON 07:38 AM Scott Leonard Homes 631 686 0734 P.01 • FROM a 5chuma,ker Plumbinq FAh; NO. ; 7153883121 Jul. 30 2001 07:27AM P1 ST CROIX COUNTY SEPTIC TANK MAINTBNANCB AOR88MENT -. 3s (.0 1 al AND OWNERSHIP CERTIFICATION FORM Owns /Buyer Mats Address I o2 D 8 � ? Y L � I s� S /o2 Property Adhines kV 7 4 4 e,t /1k iS'o,ti (Veeifatioa re quit peat Pl,rnIt Dspapdoot for are ssattrost ) Clilyattite Farad boa Humber s Property I4ostiort . 51, v, *1K St1a 3G. , T •RLW, TowD of He a.50A) . SubdlvWdon l; IZ a) 1"") 1 a Lot # Certtfte4 Garvey Map if _., Velame , Pep II i E Warranty i)erd 1I.,' A7 Y ..,..,_..,. 'Volume ,(x'77 _.. Psge #: 4 ( 7 47 Spec Leo E3 yes%no Lot bee ide bleXyee 0 tto PaghtlitatiRtigiNg II I - ooas9sle w aa ameser etrseptiateneeaaoa�d�dtastdtit taut atidatiis .Pmps:� .upiiat icemayttmes yaas cc w, it 1�► IiMdpe ,Whet yes pat late the maws eat e�tiwt age s.a assaawasaps is ihs wsstsdi posstagstuat. ee oiposs to Igo** Oh Orois Kraft Dooms esnitlisnaa ana eliegd by isomer and* s millecl posiptclp + owa mgt■a ey ptc retet> Mipa +ar'r ilk !(t)fat wastenraisrdbpoistoploot is is pow o melba a s+sdloc (2) sae atsioatett puogles.f'atostsw).4 r wpllat sk is Lse ilost 113 MI negate, NM, the tmdaadpaii haws seat do sbo s sweat satogame m istsla the pivot amp *awl system with the *waists at Deti, leaula asadl4a thveztassatafibtealbaaccosa ecule., Grand& s est your beta aitiaadxatstbseromp1 M(sddataassd Btk, t toitc.t Faatag Mee 30 dytroftits s . aae. SWAIM Of DAIS M ltrarisCElY I aetti*► brut an Mattes* oa ttds ban sus We to the best array NE) wedge. i (we) are (sr) the moods) of the prepstiy by vine et a ammo" dui twessds4 is Rallest of Dads OBioe. • 'n1RB OF APILICANr DATE **no* is ea Oat to asiscoptsoseista sy mwskis tits reeiaa y potait bad rid by the to dag Depulmeet. •"." + Yaelada 'kith this appttemiers s *watt timid ban the WAN art"' a *toy et the astll sd storey lap >s aisrsace made la the WNW* deed �! ' VOL 1 6 I7 1 1475 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 -1982 WARRANTY DEED 650742 KATHLEEN H. WALSH it REGISTER OF DEEDS ST. CROIX CO., WI ! This Deed made between Mike R. Nielsen and RECEIVED FOR RECORD I 'I Cheryl A. N husband and wife 07-10-2001 9 :30 AM II ... I1 WARRANTY DEED _ , Grantor, ii EXEMPT 8 • and. .Scott Leonard._i ;omen, Inc. 'I CERT COPY FEE: i. COPY FEE: TWINSFER I Witnesseth, That the said Grantor, for a valuable considerat on ntee, i PA OSDING i0 ?000 i conveys to Grantee the following described real estate in St • Croix I RETURN To County, State of Wisconsin: I Stillwater Title CO. I� PO Box 206, Stillwater, I I — - — 5 - @6- -. _ —. ___ _, ,- . ; ' • Tax N 1 Lot 50, Plat of Cottonwood Ridge in the Town of HudsonParcel : 020 - 1353 -50 -0001 , I St. Croix County, Wisconsin. • I • I ii I I I This is, not . homestead property. I ,I (is) (is not) Together with all and singular the hereditanienta and appurtenances ;hereunto belonging; I And II warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except I and will warrant and defend the same. I Dated this 26th day of June, 2001 Xq 1 i �� II (SEAL) (SEAL) . Mike R. Nielsen I! (SEAL) IR 1/4,^ n . Cheryl A. Nielsen 1 II AUTHENTICATION ACKNOWLEDGMENT I �i Signature(s) STATE OF *T4I Minns ota 1 1 I SS. ,� _Washington County. fi ll I authenticated this day -, , 19 Personally came before me this 26th day of II June, 2001( the above named � . Mike ..R....Nielaen_an.d._.Cheryl..A, TITLE: MEMBER STATE BAR OF WISCONSIN - Nielsen ,...T1.ushan.d..and..mi.£e II (lf not, authorized by § 706.06, Wis. Stets.) to me known to be the person ............ who executed the foregoing instrument and se ow the same. THIS IN STRVME'NT WAS DR gFTEU 6y 1. — zs / IK.. 5 David M. Newberg PO Box 206, Stillwater, MN 55082 Notary Pub • Wis. (Signatures may be authenticated or acknowledged. Both My Commt to permanen no , sa expir,tion are not necessary.) ! L DAVID ILNEWBERG date' — ,1 . 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