HomeMy WebLinkAbout036-1078-90-000 (4)
opal»e:•t:d cc„rcer`e PRIVATE SEWAGE SYSTEM ° t'
Salety and F:min ^a C u v,. St. l ix
INSPECTION REPORT Sw le•y Permo Nc
GENERAL INFORMATION !ATTACH TO PERMIT) 606985
°.tatehlsnl:lrao 0
Nerzc^a '~f>rmat on you :,(guide m::y F.e uzue (or sae, ;fare purposes lPnvacy Law', s'S G4 "~in'f 3159501
2nrJ Enid<:', Narce. p/ Vdid!~e "cwn:h o ::&¢H -ax Wo.
Riverside Park LLC TOWN OF STANTON 036-1078-90-000
7bl Elcv nW i!LI:.w: b'A l:escrip9c•t $«eluwToa-!Ra-;eMb1aa'd
31.31.17.487F
TANK INFORMATION ELEVATION DATA
TYPC `.1ANUFACT-URER - CAPACITY STATEN HS H CS FLI
Septic Den I'. '.avy~
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Dosn,y C, V_ Alt M1,
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itcraunn ~ Hldy Se•.
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St-Ht Outlet
TANK SETBACK INFORMATION + Z 1 8 C!
IAN,C'O P^L .v.LL HI DG. `Icnt :o ser h•. lase ROAD llmel
Sept C Ut Hctta,n
Uosmg licad-, •I
- D•
Aeraion L-... Dist Pipe
Holding Ro: System
1/•z .3
PUMPISIPHON INFORMATION IF nalG•ade Q Q
Manu`acWre' Uemand St Cover C,
GF'M
Mr,1 l NcmCO:
lull ['11 Prictio•r Loss -Tilem Head 75I1 Fl
'-olcet In I_ergth - ilia Gist Ic :<:ell
SOIL ABSORPTION SYSTEM 2J -f
BED,TRENCH ,imh I Le•°pt~ l1 ~-r r.:. :':f Trcnchcs ZK Pl t UIMEHSIQH
S L:f t Insldc C a
DIMENSIONS . Ligwc 7epdf-
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SETBACK Svc 6M I(_: 1 PA DLOii ,-1 C tLAKL:S IREAM LEACHING INFORMATION CHAMBER OR Z'r Ar UNIT
An.
DISTRIBUTION SYSTEM fLt M f
Le to Nl.lapiro0 1/ C s rib,LO' H It five .x r-Olc Spa: ^a 'ven to i.h make
ter
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
7e R: ~_:Cahre ~rl ropth of xx ccd:5 ddr.m - Liwcna~_ _
Bed ch :,-lc ry^I ]e:b «r-•-oyes J : Yes NO Iles Gl-
COMMENTS- (Includ)e cote, c'ee I s, p }F(~0?~e. 1 rlspect'on ac Inspection 7/2
Location: 1442 CTY RD ,CKlk~ ,t l v r,
d M
1 All IW Oescrlpaou~3~ .Vn
~ 1Ilf
2: Bldy sever length = IU ~J y~
- arnounl Cl cover = /r- LLD am r.PtIa al l 1~~1 •1 T.
~P(~ 01~ Si k (~~D~--
Use
Fl;ar r Rlot add I Yes I
Use othor her side or add tonal rfcnnah:lI
$dD-c 10 iN ?,3", Dade tor'< Sx;na:uw Cce. No.
rv-dolif - S)
- S i ti\~ ~ c;,nmy
l Safc(%and Bwlrjiings Di%iaiun St. Croix
US ~~1p A
2111 W \1,IShingwu Ave.. P. Bon .7 162,
P Samlaq Permit Number (ln he filled in by C.) 1
S - - Mau I'on' W1 5 71h'
- Sanitary Jack It Application State l'rimsactiioorn Number J
In aceoNancr wnh r SVS ?R' '11-1 . V', ,\dm. Cud,. whurissun: of rhea tirm to the approprian• _ J / ✓ ✓ O !
I nil is mluiied pus, I,2t,tH1H miter 1 m,a Note :\pplr dine liner lit leluosvred I'O A Iis arc suhmat, Project Address lit ilfercm than nailing addres..l
to the Delurtmcra 1Sat1•: as 111 f-,+,on,d Serxices. Pcnonal infirnr:niar w u pun ide may be used fin scondaly'
purpose: in aa:ordam i, wish Ilii Pri\a,v Law, s. 151411 it nu, SINK
1. Application Inform - Please Print All Information 1442 Olt K _
I'mpcrly t h,ncr's Nance li~ Parcel a
Riverside Park LLC 036-10^R-90- 00
- 1. 1_7. 487 r
Propcnv Omrcr s Mailing:\ddtes% Property I'vaunn
446 Highland View
_ C0\1 I or
Oily. Sale Zip Cide Phone Number SF MV., Section 31
"oultnn, W l 540R2
_ 1 31 N: R I- W
II. T) lie of Building (check all that appl)) I of
❑ 1.122 Family Dwelling Numhcr of Wxlnwn g all{}f t C~ Subdivision Name Rloe 10
® Publie'C'ununer..ial - Descnbc Ilse 1T:uIe, Pat 1, City of
❑ State Owned Dc cribs Use CShl Number ❑ Village of wl~ Z ll
,a Z/3 ~4 U _ ®Tnwnnf Stardon
IIt. pe of Permit: (C'h7 on line A. Complete line B if applicable)
A. ❑ Nrw Sys( eu El TrcatrnrntHoldin~l:mk Replacement (ady ❑ 01her Modification Io Fcislmg Sysle!FReplac,mov
m rr
B. ❑ Pu111I1 ❑ Pemul R,\i.u•n ❑ Change 0 ❑ Permit Tran,ter In List Previous Permit Number and Dale Issued
Renewal Rl k.tv plumber Ness' Uwner
F%juralaxi k? ii- S4
1\'.' W"f5 SrslenuComponenUDeaicc (Check all that apply) f(,Zp yl
Non-Pm utized In-Gnnnul ❑ Pre, mend In-Or,;und ❑ At-Gridc ❑ Mound - 24 in of suitable aril ❑ Moue., a» in. ofwilable soil
Holding lank Othot Dispersal Compuncnliccplamn ❑ Prerrvnr•tu Device lc'\plainl dl~
Dis ersa. I Icatntent Area Inform atl uick4 Plus
Dcaign Flow gist Design Sod Applicau n Ratn:gpd,f) Disposal Area Ke ire'd (s1) D;spersal Area Pro I'll Syslem Fie, it
4404- 1714 1730 , 94.5
VI. Tank Into CSgi is n,m Total 4of Manufacture q
Gdl n. Gallons 1Inus
nor lal:h 1 ai-n I,viA' ! i I TG~ J, C~~J I ~ ~ y
c v v. v. ii V a
4pdc nr l lalLnly dirk 2000 N'Ieser F-1 E_ F] Q
Is ISIq; Chamt,:r
\ II. Respunsibilih Statement- 1. the andersignttl, assume rnponsibilily for installation of the POWTS shown on the attached plans.
I'lumhcr',N:mrei1'nnll I'hunhcrSignalure MY\IYRS Numhcr Busmc-ss Phone Number
Travis Butterfield
(5?R?9 (715) 634-8126 I'Iomhcl SWIc. /IV (--del
14346 W State Road „llavward, WI 54943
\ III Counh Department I st OnIs
17
Y7~pI,o'eJ Cy ii•slppr /d poltut Fee Dale Issue Isxum; "I Signature
J•~a U~HS r (I'c`e n h : a:n I": Dcnidl S 70~ , 00
MC ondi canons for Disapproval 111" ROVW '
3upl 1. '~i1r11t, f*iM lWP
as a - ' Iai II1A raw ups f (Waitivizu ~9,,se ~p~ ~r~ r I as pl r alR:tt 0 10 Pro AOMI ItV 0 ►
k. 490MOW:ll-feCLI, •'~•nf~ Z, AN IIl1h~Gtf lrfl,lw.-MRS nvjA to ramirAd
M par lippkilkils tro& Imfurtil
Awch In oumpWC I'll 1 n rla e\errm and submit In it.. Cuann ooh nnfpap,, no/tJleaa than x I I inches m sire
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3K= rowt~ ,N 6e.~cTt~,er
4o>.S
Z\VE2S1pE PARK LLC
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R. o. w, c T ra K
7 DIVISION OF INDUS I RY SERVICES
10541 N RANCH RD
HAY''Y%ARO V0 S4f!43-b462
S p Con-,ac: Through Relay
1 r S nttr:tAsps. wi gcviprogramsiindust'y-services
m w.wis-o-isie t00v
- - Scott Walker, Governor
Laura Gutierrez, Secretary
t_lctobcr 1 1, 2018
Cl_ ST ID No. 6523?9 1'OIFTS lo,pc.
lc~r
TRAVIS ANTIICINY Bt1TTFRI ILLD %ONING 01 FICI[
BU ITFRFILLD FXCAVAI ING INC S1 CROIX ('OC\TN' SPIA
14'46 W S'I' RD 7'i 1101 CARMICIIALI. RD
HAYWARD WI 54843 IILIDSON WI 54016-T?08
(0NDITIONAL APPROVAL
PLAN APPROVAL F.XPIRFS: IWI L2020 Identification Numbers
Transaction ID No.31j9i81 -
SITL: Site ID No. 853881
Riverside Park Units 2, 4, 6, 8 Please refer to both identification numbers.
I~I.1' Cth K above, in all eorres ondcacc with thc• ay~ency.
I own of Stanton
St Croix County
•S;I,l:3IN,RI'•W'
FOR:
Obis , [)PC: POWTS Component M1lanual (it'lated Object 11) No.: 1797 150
Maintenance required: Replacement s)slenl:-6l"KiPD Floe` rate: Svstcm( I: In-,round POWTS Componcn: Ver. ? o
SHD-W05-11(N.0101. R. 10121 Flflucnt I iltc~ ,'n~UV,hn\
the submittal described above has been reviewed for conformal'(', 5th ahpl`nble 1V isconsin Administrative Codes
and \N'isconsin Statutes. l he submittul has been CONDI"I'10A.gLl.l' :APPROVED. this system is to be constructed
and located in accurdancc with the enclosed approve plans and wish am component muoual(s) referenced above.
I he owner, as define in chapter 101.01(10). Wisconsin Statutes. is responsible for compliance with all code
rcq a irentcrns.
copy of the approved plans, spccif ications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors All pcnuas
required by the state or the local omn.icipality shall he obtained prior to commencement of
construction/ installation opcrationr
In "'ranting this approval the Division of Industry Services reserves the ri_ht to require chan'es or additions should
conditions arise makine. them necc•ssarn for coda compliance. As per state smts 101. 12(2), nothing in this review
wall relieve the dcsitmer of the responsibifity for desi;,nin, a saf huilding. structure, or component.
L
loquiries concernin,, this correspondence may be trade to one at the telephone number listed helow, or at the address
on this Iclterhead.
DEPT OF SAFETY A
I be above left addressce hall provide a copy oflhls letter and the P(A IS rnenarenlent plan to the owner and any DIVJSIJN Q
others who arc responsible for the installation, operation or maintenance of the PO\\' Is.
Sincercly,
Fee Required 5 325.00
~
I his Amount Will Be In4iccd.
\ J When You Receive *1 hat Invoice. -
]l in A Taylor Plcase Include a Copy 1Vith Your - - SSE CC)
Wastcwalcr Specialist , Division of Industry Sel'v-ices Paynlellf Submittal.
(715)634-31&1 , Mon-hi. 8:00 a.m. - 4:30 p.m. WiSMAR I code: 76;3
c dwirmav for avvi._ov
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
RECtivr-,-
Component Manua! Design References:
Version 2.0. SBD-10705-P (N.01101. R. 10/12) Cr,l ] 0 218 'MDUSTDN
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Fig 3 of 4 Dispersal Area Cross-Section & Plan View
Pig 4 of 4 Management Plan
Attachments: Enclosures:
POWTS Application for Review
Soil Evaluation Report & Site Map
i _
Project Name / Description
Riverside Park - Units 2,4,6,8
Owner Name(s): Riverside Park LLC Phone:
Owner Address: 446 Highland View . Houlton, WI Zip: 54082
Project Address: 1443 County Rd K
Govt. Lot: SE 1/4 of SW 1/4, Section 31 T 31 N-R 17 Ell or W
Township: Stanton County: St Croix
Project Parcel ID 036-1078-90-000
Designer Information
Designer Name: Travis Butterfield Phone: 715 _634 _8176
Designer Address: 14346W State Road 77; Hayward, WI Zip: 54843
E-mail: butterfieldinc@hotmail.com
License Number: 652879
Remarks:
Signature: _ -z_ - - Date: /G iX
Original signature required on each submitted copy.
SCRLC= 1: GO jDLor
Btt= Nw~t_ ~N ELECT II~C~
Pati6
9%vE9-51pE PARY. LLC-
sae. 31, T31n11R~7w ELEvAT) 0NJ
TOWN OF sTAN'C-pN
ST cRot x CoONTY 8M 1 o o . 00
1~at. 03(d l0't 8- %0-000
no $t 99.?S~~
14LI covfv'TY Rt~ 1~ t g, 4 s . as ~f
yZ ~s
133
34 9s.oafE
Qs 48.a~~F
N bi t, 1T DT3n kr,'s M~ .1000 ~<l )o n.Lcb e.v.e nleyatpl:<T<n K3
$rY P..~a<.a las Ogat, P..•46 C.wcn<). irp+f~7u..%.+I. by
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PAGE 4OF4
In-ground Gravity Management Plan
IMPORTANT:
the owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin Code. Pursuant to SPS 383.52 (2). Wisc Admin Code. this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383 3) c. Admin. Code
Maximum Dis e I Area O erat Limits:
Design Flow = 1200 gpd; BOD5 220 mgL''; TSS :5150 mgL'; FOG 30 mgL"'
Inspection Checklist INSPECT EVERY 3 YEARS
type of use
age of system
nuisance factors ().e. odors, user complaints, etc.)
o mechanical malfunction (i. e., pumps, valves, switches, floats. etc.)
o material fatigue (i.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc )
o extent of pending in distribution cell prior to dosing
o dosing irregularities - if applicable (i e, pump re-cycling, float switch settings, etc.)
electrical components - if applicable (i P. wiring, connections, switches, controls, timers, alarms, etc.)
distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
c surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s 281 48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance Disposal of contents shall be pursuant to NR 113, Wisc Admin Code.
Effluent filterfs) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Butterfield Inc Phone 715-634-8176
Local government unit St Croix County Planning & Zoning Phone_ 715-386-4680
Local government unit address 1101 Carmichael Road; Hudson, WI zip 54016
Any defective part of this system shall be repaired. replaced, or removed pursuant to SPS 383 51 (1), Wisc. Admin.
Code Repair or replacement of failed or malfunctioning components shall comply with SPS 383. Wisc. Admin Code
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33 Wisc Admin Code
ST. CROIN COL NT)
S I' i IC TANK \'1.11NTF\.~\CF .aGRF;F:~T~:N C
AND
O`wVNLRSIUP CLRIIFICA I ]ON FORM
r
Owner, Buyer
lvfailing Address f C~ . r 3~ is - r•, c
U(~' KC t i:J / ✓ iC- o . f u1 > U~ 7 > y` S~
T Iapenv Address ! ! < . -
.j
i Verification uirec trop: f lannm_ k 7mmr, Department for new construction
Cirv`State M Parcel Identification Ntunber
LEGAL DESCRIPTION
Property Location Sec. S 1 , T 3 1 N R 7 w. Town of `j
Subdjvision Plat: Lot k
Certified Sun'e\ Map .4 Volume Page
N\arran»' Deed ti (before''007)Voiume . Page
Sncc house yes no Lot fines identifiable 7 yes - no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use anti maintenance of your septic system could result in ifs premature lri!urc to handle wastes. Proper
ataintanance c-ousists of -pumping out the septic tank even threc "ears or sooner, if needed, he a licensed pumper. What You out into
:hc sveaem can aficc! the lunctxm of the septic tank as a lrl'atlOCn: Slate in the ssaSIO 4isoosal systea:. Owner maintenance
responsiniiiries are specific:: in ASPS. and in Chapter I' ofthe St. Croix C om[s Sar.itan Ordinance.
The n'opcny owner x trco, to ,ubmi. to S[ Croix Coumy Piano:ng fi lon;rg Department a certification form. signed by the
owner and bN Master pnnnber, journeyman plumber. restricted nlumh.r or a licensed pumper verifying that (I ) the on-site
wastewater disposal svs:c:n is in proper operating, condition and or (21 after inspection and pmnpin (if necessim the septic tank is
less than I'_ I'uilofsludgc.
I: we. the undetsatncd hasr read the above requirements and agree to maintaw thv private sewage disposal m mcm with the
standards set firth, herein, as set by the Department of Salery And Proics ional Services and the Department of Natural Resources,
Shag of isconsir., Ceni-5cation smtine that pour septic. system has been maintained :nus! be cornplcled and rParned to the St. Croix
C ounty Planning & Zoning Depanmcn: wilhin 30 days of the three year expiratior date.
I'we certif\ that all statements on leis form are :rue to the best of ms"our knoMed,c. I we ma are thu owncrls) of the
p-opem de,crihed above, bs Yirtuc of a w arrawq decd recorded in Register of Deeds Office.
Number of bedrooms
SIGNAILRIL OIL APPI.ICANI(S; DATE
Am information that is m:srepresenred may result in the sanitary permit heim; revoked by the PIan Tiing ~l• 7onin~ Department.
Include with; this application a recorded warranl) decd from the Register of Deeds Office and a coa'c of the certified sur%-N map if
rtercnce is made in the warranty decd.
iREV 04 ,1]i
State of Wisconsin Scott Walker. Governor
DEPARTMENT OF NATURA: RESOURCES Daniel L. Meyer. Secretary
- - _
West Central Region Headquarters Dan Baumann. Regional Director
1300 W. Clairemon; Avenue luc:phone 71~--.35.311T':
k4w1vIF -
Eau ClaVe W. 5470i
UC - St. Croix County
r.
rt\ ERISIDE PROTIF.RTIES. IT.
;CN' .RS;DF '17i_)BLLF HOME CT
PO BOX I
SOty S \ 54r1^;
re:,nc C l- nrhlted user S.lppi
D rSli-Prope:Ties.LLC.
The Depa rnnLrr of \aural Resources i Depa^nnent i ita lu i d;ctior. ov;r pubii: drmk4na,vale- SUpplie_ per
Wis:ans;c, Administratve Codc. Chapter, NR 8:14, Sale D. inking Rater. and Nk 811. NR 81 Crcli C onsiructior.
rlc Purrip Ins:ahtI ion. These Adminiinative. Codes and :a_IC- d^nkina and Lyo:mdwater inibnnatlon are available on
aw ~\R website a: hunt dr .wi.,;*owtopic )rini:iae\~ ater:'. The dleftnition of.t7.. C1Cn:.r-Than-b9ttnicina: water
w:Ln' te-?'ll•f" is' ;r \eater svst:.m ttrn: rcFnilarc paves at Icast ! sen•icc Donn: ctiotts used '2c year--nund residients
nr ru:~u:arly' serves at lets: 35 vear-round recidcr•ti Ors •.rater system Sen'ing ' or more Sinele`arnilp homes, f0
or more mobile homes. 10 or rtos apa^nen' uruts. ] T, or more Duple;: i:,'rng unit or 1J or rnorc conoonitniurt
rlrttts seal. be :*nsl derec a Coal Cllrll tl' waleT s,'Stern tm,es ntfbrniavon is provldec t`Y the owner indieitang that
_5 year-round residents will nct be served. Examples of OTMs include mobile home pari:s. subdivtslons. apartment
bu:ldi:s. aria condorrr nuln associatio:s'
Riv;,rside has been regulated as a pubiic water supply since :9?8 wirer, it he,arl sampiiiw it: water. Ovei time it hati
had ttc capacity for 3% :comes bin currcntl, ::as Z' homes. BPc2' was the p:itran well ib- du• fazili:N unti..2-: 1-
'01> when XT' 36 i wa> dnlicd as a renlac✓mtent well. I z ul levels ',egan to increase in the d s:rinutior. svs7em and it
the entr, point. R°ve:side Properties decided to aril: shallower welts wid; hoac`ul`y di17eren: water chtniistn than
weL XT C. This was listed a,, !h- cmective ac:ioi. on the Corrosion Cxttroi Recommendation N'orisheet
stir- med to the Depavnax or. 06 01N ''Cv 8 with a duc• date of 08312018. Cm 18 J 1i2C : S. waver sunpl % speciailK
-slue IN', - eondu~nvd at ons'.te visit of KivCmoac lviobiie Home CI to verif\ car. eerie. getters. AI tlt<r. time it N-m
,erll=* that:
I four new weh> were installed: ZS;48. Z.S= 4, ZI~^58, and ZS= 59. Al'. four wells are 65* deep witi c sire li
4~ and'iranul<u' beiuo`Ltc'to 3C''. See anaCtte wc1: eCA6rllchor Teporls
=-T well had a separate ward- line corn the pi:iess ada:rr_ into the well hose 14 total i
eaci: vat - line corr. the welis had a separate pressure tart. conventional pressure switcl'_ and a sanirI~e :a,
ear.: pressu-e shit: h had it separate power line cumini! guru the ciuztrical bax
all On- lutes had wad- to them attc waer pressure Dine out to the dis i'~utian \ aurr
h. lour water lines euien dlc bit; lam¢ tc otfierent portons of !be dnsmouion s} ster:
cad row o` homes had z separate iinu w,_-11 fceamu is
8. eac:n hric'well had nine or Ics~ homes or Service connectians tha: it fe2
4 welt XT",( ,7 did not have pressure and was not connected t;. the sysle r tats::lore. It w71 be zS nuor,cc in the
nca- future.
Fro77.:h' 8 .'31 0: sit: ?isi: t w._' uuoc IMA tn_ .t' lor - In,; tale. u-ugi;wn o d•: Tha:rtvluni-inr
water $y terr a~d_ woutc not ;;osidered_+u:?ii:N'•~i,:-:u;-??i?.
F uture ::,mansions were discatissc :is it iikl N Iha: more hame= will h_ add_-d. tm o- more mobiie it;,mes or one
t+' wip quaiii: this l si nl x t! 1m' a nbii war.-: sunp*N Si
.l,!inL'S mC?P' Cb'ir 7oni...?C- N,ai..i IW°_. 1r: obse- d on .7. Urc)1-R.
1: was also dism_;Ss;c u: tic Drmixu: and':.,roxidwaw. o.o,.arn mo-otrae_• all xwat`'vtr owmcr~ tr samnie v'_wls
i0' hacly-la anC n* aL£.. Ines: Twc iL•S13 are mesDen Slve ane ven' %D C19~ x?I rn-cm in ]UC:C. hLal tt. in aaJb :A. Li"
lead and CODDer sartlj?nn~ 11 en:;DUra^ev IO see -ION Lile :?tn;':F -COOn;th: t;~ :;.7F{7I2e.' ti. <at:':;: Ci ate:.
'i n;c a>rLSide- be5c reams r'or ea t of trye well or. ar! ann a :rya is.
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F'.,ut . •~I o: d:e.: buildri_ IIIIC Ih '111.1 the quit o.! -h,::~:ur
disL _;~.:liorl y stem, an, line per home rO. N.
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Mack ' H)YI lino " om Tf,e pi k adapter1 the the wel: ~ou~e door on the
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ur ii I n:'I oill to the illq b :1i"IL . _1 I 'I ,1 _nl~: nP I I L T I II ;bove and not in use.
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\1 ell Construction Report For c ~,I p zv,tI ~r- : Natural ke r n\?;-1 IC e: aoi -IT If LW O:N'SL.\ L.':\70/ E WELL ~\I)VIBER ZS548
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Lnnafia - mn4Ax : Uracr I,, Cicrw er 14. A...I Yard ar Snc:w
&clt4rF Guenany Pm:ntsnm D.. Sewer 76 Sr:c
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Departmcm of'N atural Rewurecs 1C'clI Construction Report Comment Sheet
1 orm 3300":A Re%. 8!00
%k ell Codes and Identifiers
.Cr7t 1'tmiM+'
Commw: 9 ti. Nalrlc
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lAell Construction Report I or [rr'wu: 1 rSa ~r,l A;~„ .Ao. 'I au:r
IVISCOASIA CNrnt E HELL. NUMBER ZS549 I.ad,.,,., tI S..:.
Pkasc mf t-1 v r-_I n6,'rn
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':dnr. Sr.-c.r it 31 N:k17 ❑ t a lv
395 REED ST 1'ubL_ V;dl Pmn ifpr, enl ..acranc 7.452
rnplu:o: n[: -92 `-tin 31.I88
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SONTERSFT \1'I 54025 PI❑ So: Lo^L f i.i[t61,i
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1 I xn1n1I I I Pnurinwr .Grain q.:lkarunmr .5 .vcmal Yad or tiF.ctr;i
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Department of Natu r:d Resow ces Nell ( mi truclion Repon Comment Sheet
Form 3300-?'A Re%. 811111
N ell (udrn and Identifiers
Stalc:!wi FT.:_In P'a.ci S~st[us-Di, Ion:u'gf.
% Nell C (instruction Report I or p - rpmm:nl zti Naur m r tloa 7121 V FUO,
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Addrex: SLANTON
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Ucpartmcot of Nalur:l Rcsourec> Nell Construction Repurt Comment Shect
ell Codo and Identifiers Form 3300•77A Rey. 8110
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Nell Construction Report For n Impamra .Nan.;,"ko + :.>•.srrrr.
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Department of Natural Itesomcc•s \icll Construction Report Comment Sheet
Form 33011-77A Res. WOO
Well Codes and Identifiers
S.ii knmbe~
24';1 1
CSr-a~IS- ash
L"u, ~t irl -'"CI ~,~i Lr,„ram, SOILEVAI UATION REPORT ,9,,'_ rf ?
r accmdarec v;rn SPS 385 'J✓s. Adm. Code -
County St.(-:rolx
rzltErp~j or paper not less than 8 1:2 x 11 inphec in size. Plan must
rercifo-a"l, (200o vertical and horizontal refererce no m tB i mrecnor and Parl LU. 036-10?8 90-0110
p!e CA}Ma~VC s 7c or d ensions no.lb arrow, and 1061.01 an lar tc n fesl d
ti 9 2~~8 lease print all information.M 47 Reviev.•e y Date
IJko~l irto na4c' you o' :r •nay be sea for xcconeary purposee art~1W /A/Z,4
peny Ov~ec unty Proprrly tocaton fn
rside Park L.LC Govt. Lot SE 1;4 SN' V< 5 JIT~ N R 'opery Owner s Mailing Address Lot # Block # Sued. Narne o44611ighland View
ady State Zip Code Phone Number U1y Village own Nuawsi Road
nnu]fon I WI I W82
r i Stanton
New Construction Ose ~ Residenhal : Number of bedrooms 32 _ Code derived design flow rate 4800 GPD
Replacement El Poblic or commercial - Describe Tr• ;1 r park
Parent material flood Plain elevation 0 applicable R.
General comments A
and recommendations
I Boring d Boring
J
Q Pit Ground surface elrv. 99.75 ry. Depth to limiting factor 744 :n.
SodA ficahon Rate
f lonzon Uep:B Dominant Color Redox Description Texture Structure :onsistence ountlary Roots GPD/fl
in. Munsell Gu. Sz Cort. Cobr Gr Si. Sh. 'EH#1 'Eff#2
I 0-4 10yr2iI sl 2msbk mfr 96v 1M 6 10 ,
2 4-20 7 5 14.4 scl 2msbk 11rv8 9xv i f 4
G
3 20-17.5yr5/4 osg ml
? 1.6
ZP
L
❑ Boring 98,25 14
2 Boring If
Q Pi! Ground surface elev. ft. t>eplh to limd:ng facto' - in.
_ Soil A location Rase
Horizon Depth Dominant Colo, Redox Description Texture Structure onsistence cunday Roots GPD91 '
In. Munsell Do Sz Cont. Color Gr. S2 Sn
'EH#1 I'EH#2
1 0-4 10yr2A st 2msbk mfr Lrsv .m 6 LU
4-22
2 7.5vr4:4 scl 2msbk mvfi Kw' If 4 6
3 22 144 7 5yr5:4
s osg ml 7 7,6
l~
1
E -1
'Effluent#'=BCD > 30< 22C mg-11 and 7SS>3 'SC rrgi •Lffluen!#2-BCD 3C myL anc 'SS < 30
Name (Please Pint) - to ur
Cc,..- NJmber
_
Travis llut!crfiel ~?-_{rl _ _ 6v2879
Addmss Dale Cvaluition Corducled Ielepnonc Number
141U; StztcRd! H-oward,P:I 8 2' !N 04 K -6
- 3] Boring # ❑ Boring
® Pit Ground surface elev. 97_75 ft. Depth to limiting factor >144 in.
I Soil Application Rate
horizon Depth DDminent Color Redox Description Texture Structure I Consistence Boundary Roots GPD_!F_t2
-In. Munsell Qu Az Cont. Color Gr Sz Sh -EthpH -Eff#2
1 04 10YR2i1 sl 2msbk mfr gw 1m O6 1.0
2 418 7.SYR 4i4 set 2msbk mvlr gw 1f 0.4 0.6
3 18-144 7 SYR 514 --_7_.-- 5 Osg ml 0.7 1.6
I
,4~ Boring # ❑ Boncc
® Pa Ground surface elev. 98.08 ft. Depth to limiting factor >144 in.
Soil A bcation Rate
Horizon Depth I?ominant Color I Redox Description Texture Structure Consistence Boundary Roots - GPD/Ftz
In. Munsell Qu Az Cont. Color Gr. Sz. Sh. *Eff#1 'Eff42
1 _ DA 1OYR 211 sl 2msbk mfr gw _ tm 40.6 1.0
2 4-19 7.SYR 4!4 ! scl 2msbk mv!r qv. 1f 0.4 0.6
3 19-144 7.SYR 5:4 s Osg ml - 07 1.6
Boring
Boring # ❑
5 I
Pit Ground surface elev. 98 92 N. Depth to limiting factor >744 in.
Sou A cation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft'
In. Munsell Qu Az Cont. Color Gr- Sz. Sh. •Eff#1_ 1 •Eff#2-
1 Y2144 1DYR2/1 s 2msbk mfr gw tm 0-6 1.0
7 /5YR 414 scI 2msbk mvfr w if 0.4 0.6
3 1 7 5YR 514 s Os9 ml 0.7 1.6
-
- - - -
Effluent #1 = BOD, > 30 5 220 mg.rL and TSS > 30 5 150 m~L ' EffLrent #2 - BOD > 30:5 220 mg/L and f SS > 30 s 150 mgiL
I
S C R l.~ = 1 ~ (~O
(i11= Nw1~ two EtscTAict-
Pot E
RivERSIbE PARK LLC-
5a0. 31 , 731 N I Rl'7W E I c v A T I O tj
ToLJm of STwNTota
ST GRot x CoOfJTY BM 10 0. 00 ;4
Pct. 03(.- 10.1 8' 90-000
nod{ $t 49.'7
IL4L4 covtvTY RO K
BZ) 48.as ~f
4-7.7
133 4Z. 7s ~>L
84 58.0 b
ti5 Q8.q~F~
N
..e~ Silk
t)
VN~ T H (1
Q
V ~ T ' V1
I1A^ n
ty
VN 12 3 1.~N\T
J
¢ uNts ~ ~
VN~T ~
ST. CROIX COI-\T1 ZONING OFYICV
CERTIFICAT10N STATF.NIE! -F
FOR CTILILATION OF EXISTING SEPTIC TAKK(S)
Tni~ is to crtif* t:lat I have inspected the existing septic and or dose :aub:
nresendN sen im_, the R tk-)v%-in;, residence:
Street address') _ ionlcd
Section Tow,i N. Ran'-,_ `k .
1 own A - S:. C'-,:x CountN A~'isconsin.
i pop inspection. I cerLC~ that I hav: found the tankis). to tine hest oCmv
knitAP le~~~.:. w:li Conform io the 1'ejUi-:-iI)C'II~ h~ SPS. = 54.15. and it itheV'1
appcatlsj to be fiinctioning pronerl\.
Most recent date of inspection or service
Diu' IioN 'Duck oeCUr horn absorption system.' ties No
if no. skip nex! line. j
:%nproxil atc VC)~umC o- lent}1 Oi 11 n1C: - °allOnc IIIt)ll?eti
T:mK CapactT:
( ,,nstruction: Prtiah Concrete _ Steel
M.MUfacturcri* kno~~r,i:
_c of Tani: ! k-)oN'TI
Pcrtnitnumier(ik,)ov',n--
Lie; used Piuntbe- SiLjiamrci (Print Namc)
- JS-o ~I I-- -
Titl_ 1-icernsc \su;tberi MP"NSPRS
~2-Iz-jB
Fore. to he completed by licensed plus=tire:' (Dept of Safety and Proiessionai
services Cnapter _ 05 and s. 14 ~~.06, NX isconcin Statutes) or licensed disposer
\h 1 '.3 Wisconsir. Administ'ative Cod--l