HomeMy WebLinkAbout181-4121-00-000 Wisconsin'Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
515169 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
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:
Johnson, Earl J. & Vick I Somerset, Town of 181- 4121 -00 -000
CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range /Map No:
T 25.31.19.1097
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
e
Septic �eW t I 3 Benchmark
/
Alt. BM
1144 wtoD a 2.p5 /8!.5
Aeration Bldg. Sewer c/ '
Holding St/Ht Inlet � !�P
7.79 9S . %z.
TANK SETBACK INFORMATION St/Ht Outlet � • 5 �1 S
S
TANK TO P/L WELL BLDG. Ve5 to Air Intake ROAD Dt Inlet
4Eu�--
Septic Z_7 Z,7 Dt Bottom .�
Dosing Header /Man. 12. 7o ' Q
Aeration Dist. Pipe I z. 1 9O .
Holding Bot. System 13. ' $r - 45k
Final Grade �
PUMP /SIPHON INFORMATION 8. 51-
Manufacturer Demand St Cover
GPM �l,h� S. TI
Model Number
TDH Friction Loss System TDH Ft
Forcemain Leng ia. I Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width J Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 1 11 1 1 — 17 C. & -L, I --- —_
SETBACK SYSTEM TO P/L I JBLDG IWELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Typey'st`em:` W / 7Z �� /� UNIT Model Number: � `�
DISTRIBUTION SYSTEM 614 V` � Z cN
Header/Manifold Distribution x Hole Size x Hole Spacing
Te%to Air Intake
Length Dia Dia Spacing Pipe(s) ra AJ ,
Length �' �
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only T. 4 4
Depth Over It Depth Over xx Depth of xx Seeded/ odded xx Mulched
Bed/Trench Center Z2. Bed/Trench Edges Topsoil Yes ❑ No rests° No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 730 190th Ave. Somerset WI 54025 (SE 1/4 SW 1/_ 4 �5 1 RlW) NA Lot 1 Parcel No: 25.31.19.1097
1.) Alt SM Description = ' w y �J�J�U /'""e "IS
2.) Bldg sewer length= Z43'
- amount of cover =
Plan revision Required fl Yes No
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor's Si ture Cert. No.
I
commerce.wi.gov Safety and Buildings Division County
�O1 W. Washington Ave., P.O. Box 7162 St. Croix
Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.)
I SCD n S ff ��
Department of Com /5l
Sanit ermit Application State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental / ;7 1z ?- g
unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS I Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you provide may be used for secondary 730 190 Ave.
purp oses in accordance with the Privacy Law, s. 15.04 1 m , Stats.
I. Application Informat - Please Print All Information Somerset, WI J.
Property Owner's Name , I�• t Parcel # 03 - 070 -80 -000 3
Earl Johnson T o
Property Owner's Mailing Address 14 2009, Property Location
1176 Sundance Pass „ �Kax COUN
Govt. Lot
Z ONING OFFICE
City, State Zip Code Phone Number SE %,SW' /., Section 25
Hudson, WI 54016 (715) 386 -8389 (circle one)
II. Type of Building (check all that apply) Lot # T 31 N; R 19 W 21 _
❑ I or 2 Family Dwelling - Number of Bedrooms Subdivision Name 6o6
Z ock CSM
7
® Public /Commercial - Describe Use Trnasmission repair shop
Na City of
❑ State Owned - Describe Use CSM Number ❑ Village of
CSM Vol. 2, Pg. 591 ✓ ® Town of Somerset
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. New System R Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain)
-�1• System
B. ❑ Permit Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued
Renewal Before Plumber New Owner
Expiration
IV. Type of POWTS S stem /Com onent/Device: Check all that appl
® No n- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade 0 Mound > 24 in. of suitable soil LJ Mound < 24 in. of suitable soil
❑ Holding Tank M Uffe Dispersal Component (explain) ❑ Pretreatment Device (explain)Hoot H -600
V. Dispersal/Treatment Area Information:
sign Flow (gpd) I Design Soil Application te(gpdsf) Dispersal Area Required Dispersal Area Proposed System Elevation
1 sue#- 0.40 gpd/sq.ft. 382.50 sq. ft. 405.80 sq. ft. 89.90' a.
k Info Capacity in Total # of Manufacturer a
Gallons Gallons Units ` 0 a
New Tanks Existing anks P /Q 0 H w a
g w k $ZS
Septi or Holding Tank 800 800 1 Weeks Con rete
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume r sponsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) P MP/MPRS Number Business Phone Number
Jim Boumeester 222904 (715) 386 -9020
Plumber's Address (Street, City, State, Zip Code) - 7(.06 — 6 ft
1070 Hwy. 35 N., Hudson, W1 54016
VI oun /De artment Use Onl
Approved Permit Fee Date Is ed 1 Issuing a Signature
Owner Gi rt ea e r Denial $ ,J � �O �5
IX. Condit . 914NN easons for Disapproval? 3 I ' i 5 Z 0
1. Septic tank, effluent fitter and u �
dispersal
ersal cell must all b services / maintain r�'( r� J c -
p e se d � tr4 � � t� thC. 'z.. 2f .
as per management plan provided by plumber.
2. AN setback requirements must be maintained 1
as . r code / ordinances. :44 ✓V r 1
Attach to complete plans for the system and submit to the ' Cmy o on Pape no {{��ss than 8 1/2 z 11 inch size
t��iricGc.�F' =1 tF .-A
SBD -6398 (R. 01/07) Valid thru 01/09 (/
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Safety and Buildings
commerce.wi. OV 3824 N CREEKSIDE LA
g HOLMEN WI 54636
Contact Through Relay
i sco n s i n www.commer isco govsb,
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Richard J. Leinenkugel, Secretary
September 23, 2009
CUST ID No. 222904 ATTN. POWTS Inspector
JAMES W BOUMEESTER ZONING OFFICE
BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA
1070 HWY 35 N 1101 CARMICHAEL RD
HUDSON WI 54016 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/23/2011 Identification Numbers
Transaction ID No. 1712294
SITE: Site ID No. 751795
Earl Johnson Transmission Repair Please refer to both identification numbers,
730 190TH Ave above, in all correspondence with the agenc
Town of Somerset
St Croix County
SETA, SWIA, 525, T3 IN, R19W
FOR:
Description: Commercial Non - pressurized POWTS / 23% slope
Object Type: POWTS Component Manual Regulated Object ID No.: 1242395
Maintenance required; 153 GPD Flow rate; 58 in Soil minimum depth to limiting factor from original grade; System(s):
Conventional POWTS Compone anual, SBD- 10567 -P (R.6/99); Commercial System, Effluent Filter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code
requirements.
s
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06,• •�'�},•�'"
stats. Co n d it i012
The following conditions shall be met during construction or installation and prior to occupancy or use: ph i RO)
Reminders: i � 3
DEPARTMENT Of C01
• A sanitary permit must be obtained from the county where this project is located in accordance with the DIVISioN OF SAFETY ANI
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be in CO OI
the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats.
• Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent
filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval
conditions.
• The discharge of hazardous wastes to a private sewage system is prohibited by state and federal regulations.
Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department
of Natural Resources (WDNR) or the Wisconsin Division of Emergency Government.
• If there is an existing POWTS it shall be abandoned per Comm 83.33, Wis. Adm. Code.
• A copy of the approved plans specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors.
I
JAMES W BOUN FESTER Page 2 9/23/2009
Owner Responsibilities:
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS
occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
• Fee Received $ 250.00
Balance Due $ 0.00
Gerard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jeny.swhn@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business" means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website:. www.commerce.wi.gov/SB/SB-BuildingContractorProum.htm
I
JAMES W BOUMEESTER Page 2 9/23/2009
Owner Responsibilities:
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• The owner of a POWTS shall be responsible for ensijring that the operation and maintenance of the POWTS
occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
Fee Received $ 250.00
Balance Due $ 0.00
Gerard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm W15MART code '7633' y.
jerry.swim@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business" means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimmingpools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website:. commerce. wi. gov/ SB /SB- BuildingContractorProgram html
RECE
NON - RESIDENTIAL IN- GROUND POWTS SEP 18 2009
[S II
Design based on Component manual:
BU/L DSNGS
In- Ground Soil Absorption Component Manual SBD- 10705 -P (N.01 /01)
Project: Johnson Transmission Service
Contact: Earl Johnson
Address: 730 190" Ave.
Somerset, WI 54025
Legal Description: SE1 /4SW1/4 Sec.25 T31N R19W. Tn. of Somerset St. Croix Co. WI
Subdivision: CSM Vol 2, Pg. 591. Lot No.: 1
Parcel ID Number: 032-1070-80-000 fx
Plan Transaction Number:
iNIERCE
BUILDINGS
Index and title sheet a e 1
Site Plan abENCE Page 2
Daily flow, Dispersal cell Page 3
& septic tank calculations
System Cross section Page 4
System Management Plan Page 5
Attached soil evaluation report Page 6
Designer: Jim Boumeester. MPRS #222904
Signature: Phone No.:(715) 386 -9020
Date: Aug 28, 2009
i
System Design Calculations
Earl Johnson Transmission Repair & Service Center
;i_,:7iLKIP HUN: Earl Johnson Transmission Repair - Office and garage space. Four (4) employees all shifts,
i snower ror owners use only, & I restroom , 2 floor drains with catch basins (no petroleum products, cleaners or
Solvents to enter floor drains), no retail use.
DAILY DESIGN FLOW:
1. Design Wastewater Flow: 153.00 gpd (102.00 gpd estimated flow)(150% conversion factor)
(4 employees all shifts) (13 gal. / employee) = 52.00 gpd
(2 floor drains) (25 gal. / drain) = 50.00 gpd
Estimated wastewater flow = 102.00 gpd
ABSORPTION AREA SIZING:
1. Existing grade elevation: 91.98' at B -3
2. Depth to limiting factor: 58"
3. Proposed system elev.: 89.90'
4. Infiltrative capacity of soil at or within 36" of system elevation = 0.4gpd/sq.ft.
5. Absorption area required: 382.50 sq. ft.
i 53.00 gpd design flow / 0.4Gpd = 382.50 sq. ft, absorption area required
o. Hosomuon area proposed: 405.80 so. ft. (absorption cell to be oversized to accommodate available area)
miiu atvr " Ouick 4 standard -W" EISA oer chamber= ?0.00 „ ,t F!S n /„ , , n1. , . - c q , a
382.50 sa.ft. - (5.8)(1 hair end cans) = 376.70 so. ft. / 20.00 = 18.83 chambers required
(20 chambers)(20.00 sq. ft per chamber) = 400.00 so. ft. EISA
t l pair end caps)(5.8 sq. ft /pair) _
Number of trenches: 12 20 Infiltrator "Quick 4 -W" units each = 20 chambers total
trench width (A) 2.9-
trench leneth (B) 82.0'
trench spacing Na
total area required: 2.84' x 82.00'
SE PTIC TANK CAPACITY
1. Design wastewater flow = 153.00gpd
153.00 gpd / 75 gpd = 2.04 gpd person equivalency
2. Minimum required capacity: 2,1 19.76 Gallons
(153.00) (11.61 x 2.04 x 3*) + (46.77 x 2.04) = 3 19.47
*(Requires a three year maintenance cycle)
3. (153.00)(2.088 "magic conversion number ") = 319.47
4. Proposed Capacity & Manufacturer: 800 gallon Weeks Concrete Septic tank
5. Proposed effluent filter: Polylok PL -525
EQUALIZED EFFLUENT DISTRIBUTION: Distribution header to be constructed to equally distribute effluent to all
trenches. See detail at page 4.
Pg. 3 of 6
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Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10567 -P (R.6/99). All local and/or state rules pertaining to system maintenance
and maintenance reporting shall be complied with.
i an
Septic Tank
The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The
septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The
contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to
service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment,
maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge
accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge
should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed
from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank
manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for
service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective.
or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured b} an
effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank
as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with
Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or
chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be
approved for septic tank use by the Department of Commerce, Safety and Buildings Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
egetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface
within the system and will promote frost penetration during cold weather months. Cold weather installations (October -
Februar-,) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Continency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing
biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a
new soil absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to installing plumber, Jim Boumeester at (71 5)
386 -9020, or the St. Croix County Zoning Department.
$RAID
2179
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D.
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 032- 1070 -80 -000 37 `/
t
Please print all information. Reviewe Date
Personal information you provide may be used fo y Law, s. 15.04 (1) (m)).
Property Owner Property Location v
Earl J. & Vicky L. Johnson SEP 0 3 2009 Govt. Lot SE 1/4 SW 1/4 S 25 T 31 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1176 Sundance Pass ST CROiX COUNTY 1 CSM Vol. 2, Pg. 591
City State ZipRl;6FI@Il er I City J Village 0 Town Nearest Road
Hudson WI 1 54016 1 (715) 386 -8389 Somerset
New Construction Use: I Residential / Number of bedrooms Code derived design flow rate 153 GPD
Replacement 1 f Public or commercial - Describe:Transmission repair shop ,
Parent material Glacial Till �' ��" f
S _ / on, if applicable na
Flood plai el ati
General comments
and recommendations: Site suitable for conventional POWTS with 0.4 gpd /sq.ft. loading rate. Dispersal cell to be installed at
1 - 22 " below existing grade.
a Boring # I Boring
Pit Ground Surface elev. 87.67 ft. 60�� in. Soil Application 0 Depth to limiting factor ppl' cation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 I *Eff#2
1 0 -11 1Oyr3/2 none sl 2fsbk mvfr as 2fm 0.6 0.8
2 11 -23 1Oyr3/3 none sl 2fsbk mvfr cw 2vf,f 0.6 1.0
3 23 -36 7.5yr4/6 none fsl 1 msbk dsh cw 2vf,f 0.4 0.8
4 36 -60 7.5yr4/6 none gr Is /sl Osg /2msbk dl /dsh gw 1vf 0.6 1.0
5 0 -96 7.5yr4/6 ii2 2f 10yr&2 & Is /sl /sil Osg /1 msbk dl /dsh /mf - 1 of 0.4 0.6
7
Horizons #5 consists of an unsorted mixture of 0 sg gr.ls, 1msbk gr, sl & pockets of lfsbk sil. Redox. concentrations found within scattered sil
inclusions.
Boring # - Boring
Pit Ground Surface elev. 90.71 ft. >89" in. Soil Application Rate
✓J Depth to limiting factor ppl'
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2
1 0 -12 1Oyr3/3 none I 2fgr mvfr cs 2vf,fm 0.6 0.8
2 12 -25 1Oyr3/2 none sl 2fsbk mvfr gs 2vf,fm 0.6 1.0
3 25-40 1Oyr4/3 none fsl 2msbk dsh cw 2vf1 fm 0.4 0.8
4 40-61 7.5yr4/6 none gr sl 2msbk mfr cw 1 vf,f 0.6 1.0
5 61 -89 7.5yr4/4 none � 1csbk mfi - 1vf 0.4 0.7
1t y1
Effluent #1 = BOD? 30 < 220 mg /L and iSs >30 < 150 g/L luent #2 = BOD < 30 mg /L and TSS < 30 mg /L
CST Name (Please Print) ignature: CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 8/23/2009 715- 248 -7767
Property Owner Earl J. & Vicky L. Johnson Parcel ID # 032 - 1070 -80 -000 Page 2 of 3
3] Boring # J Boring
J Pit Ground Surface elev. 91.98 ft. Depth to limiting factor 58" in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -13 10yr3/3 none sl 2fsbkr mvfr cs 2vf,fm 0.6 1.0
2 13 -22 10yr3 /2 none sl 2fsbk mvfr gs 2vf,fm 0.6 1.0
3 22 -33 10yr4/4 none sl 2msbk mvfr cw 2vf1fm 0.4 0.8
4 33 -58 10yr4/4 none gr sl 2msbk mvfr cw 1vf,f 0.6 1.0
5 58 -85 7.5yr4/6 f2f 7.5yr5/8 sl /sil 2msbk/1 fsbk mfr /mvfr - 1vP 0.4 0.7
17'
Horizons #5 consists 2msbk sl with Ifsbk sil inclsions comprising approx 20% of horizon. Redox. concentrations found within scattered sil
inclusions.
F ] Boring # - I Boring
JPit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # Boring
I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
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 S.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 altemate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.07 100) A.C.E. Soil & Site Evaluations
• � 5oi /e da /cca lion �f)t E.
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ST. C ROIX COUNTY
SbPT'IC TANK MAINTFNANCE AGREEME.W,
AiJa
OWNFRS11 C',crRTI"FiCATION FORM
Ovmer/Buycr
Mailing Address 1j6 ..DtJ
Propert -f Ad ;rES��j� t � _
(verification required from Planning & 7oning Departrnet!t for neu Cor:stTucti`,n.)
City /State GU Parcel ldentifcatior. Number
0.3� �v� �'o.•
LEGA:. DEaC1RiP'f`If�N
Proiaerty xA�atio11 L %, _ /o , Sec. _, T dL__N R W, Tatum ,,
Subdivision , Lot # �.
Certafled Survey Map # �8 � g� , volume _ ; ;�, Page #
Warranty Deed # g __ page # -
Spec house qes PO Lot lines identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICA'T'ION
1- m- Proper use and ;maintenance of your septic system could result in its premature failure to handle wastes. proper
o'— ° mtemrxe caneists of pumping out the septic tank every three years or sooner, if needed. by a licensed pur•qne.. w. bgt you put irto
tl:e eyate:r< can affect the function of the septic tank as a treatment sage in the waste disposal sys ent Owner maintenance
rese :.sJ. I; ties are specified in �Corrun. 83.52{ !)and in Chapter 12 - St. Croix Cool." Sanitary Ordisaznce.
The p:oparty ;•finer agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed b the
nwner and b; a rnns plu;rdser. ' ►une an lurnbe
..lo y�►n p r, restricted plumber or a licensed pumper verifying that (1) the on - site
wast4v gta dis; oral system is in proper operating condition and/or (2) after inspection and pumping (if neces,"ryl the s Y..ie tank is
less than 1/3 feel. ^£sludge.
l / :rr, the undersigned'nave read tI >1►i►tr,tt:aments and agree to neainta>an the private sewa.g�y ditrFatN! stew sv:L tine
eanilards set fc:tli, herein, as set by ce and tSie a :
�(. s; � system � rtitiCllt of Natural Resrnvicew, State of l�V.ec�ah;.
icatio t stating that yours tic s t has d most be completed leted and retumed to the St. C` nm CoW.Vy Planning &
Zonisigartmcnt witlnirc 30 days of clue tines on date.
YW-- cer4if' M all statements on this fotn%iucn true to the best of my /our knowledge. Uwe andare the o mens; of the
;zrc described above. by virtue of a wetrsaty tex ded in Registe. ad'Deeds Office.
Number c t;
/�/ D�
c t�Nr, TURF OF APPLI ANTS jS) DAI
`* *Aiiiy ittf0nMti0n that k! misrepresent may tt:Wh iii the sanitary permit being revoked by the Plaming &. ?.using Department. • +*
r.4'
Include with this application a recorded xa - ,ty & d from the Register of Deeds Office and a copy of the certified surrey map it
reference is Trade in ibe warranty d
348684 70
R " a: ae O, C ON
•it eq ya
LAND
89 _30' cu
�e 69 0° 3517. 90' 9 °
$_
o_
2W pi Zi
( "n
rq t v� S, 0oo RCR£S t S. 000Sf AGQES !
217, 82D SQ.FT. 217, 82o so. FT.
Q I 3 v O l l 01
d 43
I N LoT 1 N o LOT 2 N o Qj
MAY 17 1978 v,
Sr. `;OIX COUNTY
C0MP.;E"::151Vc PARKS PUNNING
AND Z0.41.VG COMMITTEE L O i >
26 +2 w 132 0. 0o' g c
35 6 0 � 3f�7.9o'
9 °3 o'E 6 .8o' 9 ' - W
n
APPR AL OF THIS M:SdA? SCV L'SFOR
ERTI F FED SURVEY R �
DOES N' ( rn " AI, A` - Y rer�' PA R of THE S ` 2 _ OF THE SW � /4
Buttot o 5• < r_ s :,si: SECTION 25 , T21N , Rl9LV , TOCUNOF
so ° 2.:0. SOMFRSET, ST. - ROIX COUNTY, W /S.
I �A
DESCRIFTICN
Fart of the S of the SW4, Section 25, Township 31 North, Range
19 West, Town of Somerset, St. Croix County Wisconsin described
as follows:
Commencing at the Southwest Corner of said Section 25; Thence
S 89 30' E 1320.00 feet to a point and this beins the point of
beginning of this survey; Thence continuing S 89 30' E 695.80
feet to a point; Thence F 0 30' E 626.10 feet to a point;
Thence F 89 30 W 695.80 feet to a point; Thence S O 30' W
626.10 feet to the point of beginning. This parcel of land con
tains 10.0009 acres more or less including land released for
I right - of - way purposes.
SURVEYOR'S CERTIFICATE
I, Richard D. Booth, being a duly qualified surveyor, do hereby
certify that by order of and under the direction of L.W. Brown,
I have surveyed and mapped the property described. The plat shown
on the sheet is a true and correct representation of the exterior
boundaries of the land surveyed and that I have complied with the
provisions of Chapter 236.34 of the Wisconsin Statutes to the
best of my knowledge and belief.
r
�r4v Registered Land SiArveyor
�• Clear Lake, Wisconsin
S RICHggpp. e April 25, 19'78
o
BOOTH
AKE ,
� a
CLEAR L. W``: _
, -,,-
Volume 2 page 591
r 1 111111 Illll IIIII IIIII (IIII Illff IIII 111111 IIII IIII
* 8 8 0 9 5 3 1
State Bar of Wisconsin Fortn 2 -2003 880953
WARRANTY DEED VUUti7
KATHLEEN H. WALSH
Document Number Document Name REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
09/04/2008 02:45PM
THIS DEED, made between Keith D. Johnson, a single person WARRANTY DEED
EXEMPT t
( "Grantor," whether one or more), REC FEE: 11.00
and Earl J. Johnson and Vicky L. Johnson, husband and wife TRANS FEE: 309.00
PAGES: 1
( "Grantee," whether one or more).
Recording Area
Grantor, for a valuable consideration, conveys and warrants to Grantee the following � )
described real estate, together with the rents, profits, fixtures and other appurtenant Name and�q�`q�d rfss Estreen
interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is 304 Locust Street
needed, please attach addendum): Hudson, W1 54016
That part of Southeast Quarter of the Southwest Quarter (SE1 /4 SWI /4) Section
25, Township 31 North, Range 19 West described as follows: Lot I of Certified 'mil . (77 I F�
Survey Map recorded in Volume 2 of Certified Survey Maps page 0591 as
Document No. 348684. St. Croix County, Wisconsin. 032 - 1070 -80 -000
Parcel Identification Number (PM)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated Z� G
(SEAL) (SEAL)
* KekDJohi;t
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Keith D. Johnson, a sin$leperson
It STATE OF )
authenticated on 0 5, ) ss.
COUNTY )
*Kristina O land Personally came before me on
TITLE: MEMBER STATIE BAR OF WISCONSIN the above -named
(if not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
s
Attorney Kristina Oeland Notary Public, State of
Hudson, WI 54016 My Commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARI,Y IDENTIFIED,
WARRANTY DEED 9) 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003
' Type name below signatures. INFO -PROTm Legal Forms 600- 655 -2021 www.infoproforms.com
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