Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
022-1070-60-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430412 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Moutra , Corey Kinnickinnic Township 022 - 1070 -60 -000 CST BM Elev: Mot BM Elev: BM Description: Section/Town /Range /Map No: ld D • D 0 3 /y " PdG P, Pe 8 m I 25.28.18.392A TANK INFORMATION ELEVATION DATA I S 9 S /0 D 'a TYPE MANUFACTURER CAPACITY STATION • / DD. / laa Septic Benchmark nob I , a3.y �o.� Dosing / Alt. BM Aeration 1 � Bl Sewer Holding SUHt in ' St/Ht Outlet TANK SETBACK INFORMATION r TANK TO }/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet i � tUb Septic `_ - Dt BottonhW �p Dosing / eader /Man. 2 7 '70 Aeration Aeration Dist. Pipe 3.7S' Holding Bot. System i Final Grade PUMP /SIPHON INFORMATIONC D`� - /oy.�1 /� Z• Manufacturer -Demand 51 Cover G� GPM Model Number t% Z2 • T y y 9 9 TDH Lift D Fricti Los System Head TDH Q Ft ' S 3 Forcemain Len th ia. „ Dist. to ell SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSI No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' SETBACK SYSTEM TO P/L Vj I BLDG AEILL LAKE /STREAM LEAQ Manufacturer: INFORMATION Type Of System: CHAMB OR NW 1� / ' O " ,✓ IT Model Number 7 -� DISTRIBUTION SYSTEM 3 c Header /Manifold W' istribution / Hole Size v Hole Spacing Vent to Air Intake 1 L / Dia. P ipe(s) ength ' Dia l Spacin / e / 3 / SOIL COVER x Pressure Systems Only xx Moun Or At - Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx S [i'll Yes C] No Yes i No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:)u / 30 / b3E 'h1L.. Inspection #2: 0 / 20 ' 0 -3 Location: 1449 Evergreen Hudson, WI 54016 (SE 1/4 NW 1/4 25 T28N R1 8W) Evergreen Estates Lot 1 Parcel No: 25-21.18.3 1.) Alt BM Description = � cav I Si¢e t/ ISI (I) FON.rA gpri Y"-rj 2.) Bldg sewer length = I V 'Z) SV I D r C " b� c � PIOU, � amount of cover = �15) 0 A L.0 tj Plan revision Required? Yes o `� �'l�YV►� tltB� Use other side for additional information. �� -_ � _ A _ _ ------ SBD -6710 (R.3197) Date In Signature Cert. No. � 0 0611_4V-� 201 W. WashiogWn Ave., P.O. Box 7162 S T . le D l lViscoitsin Madison, WI 53707- 7162 Site Addmu Dep artmo,nt of Commerce Sa itaiy Permit P«m Application - u umber is accord with m. 1. Wis. Ad C � . ponan d iofonsation you provide ❑ C6eck if Revisi� may be used for secondary purposes Princy Ltw s15. 1 m li L Application Information - Please Print All Information R E C • Number P L d Property owners Name Puce! NamK SEP 2 L ` ©` fib, ° b� °31 Property Owner's Property sT. N , M G ( a o2� � ZON!N E• Si ;l S T N . City, State Zip Code Phone Num Lot N= Block Number 6 51 - )ff- 3aa . �� & Subdivis5on Nam CSM Number U. Type of Building (check all that apply) (3 t�l� 2 S — 1 oc 1 or 2 Family Dwelling – Number of Bedrooms Be ❑ Public/Commercial – D e s c r i b e Use iv iT ' �r �(,�� 9 X o Yt Nearest Road ❑ state owned ' 9 �bN b III. t: (Ch only one box on line A (numbering scheme for Internal use). Complete line B if applicab 1 IZNew 2 ❑ Replacement System '3 ❑ Replacement of 6 ❑ Addition to For County use stem Tank Onl Existin S stem B. ❑ Chec - Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) . 44 0 Non – Pressurized In- Ground 21`12 Moun -eZy " , L-47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank , 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At-Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' (/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Graf Required Proposed Rate(Gals./Days/ .Ft.) (Min./Inch) Elevation , --� 4e VI. Tank Info Capac in Total umber facttrrer Prefab Sleet Fiber Plastic Gallons Gallons of Tanks 2 / Concrete Constructed Glass New Existing z Tanta Tanks Septic or Iiowiag Tank - Ow % � x Dosing Chamber I t VII. Responsibft Statement- I, the undeltilfgaed, assume responsibility for POWTS shown on the attached plans. Plumber's Name (Print) PI Signature RS N Business Phone Number 's Address (Strect City. Sift, :4 ) VIII. !De artment Use onl pproved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Ag Signature (No ) Surcharge Fee) �� / > J / L ❑ Owner Given Initial Adverse . '-' 0 j Determination EL Conditions of AppronaUReasons for Disapproval - C Septic tank, effluent filter and arhl^l �'3-r dispersal cell must all be serviced I maintaine as per management plan provided by plumbs 2. All setback requirements must be maintained as oab') tar the SYSM040 papa sot lwthan gt/2 login to atxe z SB"398 (R. rLUT PLAN Scale 1 " =L1 Q ' ' Page 3 of c7 S S hn Y J .t C \ ° N O • I N 1L-i I Cr- Ro' or- Z ' ' pue F. 3aDR`M jC r - pp T AZ l z� I j - L OH - maim 1Z� NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1 ASO gallon capa city manufactured by W � �5 �SZ COaJ c�� (w�> >.(�o !6 SD - �2 w � ►�- aSioc� Zr� j — � L`t�T2 , 4. Bench mark _ "6\j �. Divert surface water around system to prevent ponding at the uphill side. r Safety and Buildings t 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 A � 2 2003 TDD #: (608) 264 -8777 2 iseonsin '4 erc www.comm .wis onsin.gov De artment of Commerce www•wisconsin.gov p �olx. cou N ZONING OFFIC -- Jim Doyle, Governor Cory L. Nettles, Secretary September 17, 2003 CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 40 CONDITIONAL APPROVAL 7 3o PLAN APPROVAL EXPIRES: 09/17/2005 Identificati Numbers Transaction ID No. 905558 SITE• Site ID No. 664597 Corey & Christina Moutray PIease refer to both identification numbers, Evergreen Drive above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SE 1/4, NW 1/4, S25, T2 8N, R18W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 919488 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes L'Qndh and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. p The following conditions shall be met during construction or installation and prior to occupancy or use: E RTMENT ! M OF General Approval Requirements: SEE CORRE • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Orsitc `'Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) 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. ARTHUR L WEGERER Page 2 9/17/03 Owner Responsibilities: • Comm 83.52 Responsibilities. 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). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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 $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART'code: 7633' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 l I TITLE SIIEET 1?E 1/ e 1 of SOUND SYSTSAcc EP 62 003 FOR II''C A _ B DROOM RESIDENCE B1D GS DIV. This plan has been p ared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 101) (N.01 101) LOCATED IN THE S � 1/4 OF THE NW 1/4 OF SECTION ZS , T Z8 N, R )S W T OWN O ST �X COUNTY, WISCONSIN. Q)Y QY 0 - S M V dt_ . y INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MAI•dAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR CUR -� Pt}V� C°��> >1,� 1.1 � ►^�plJ�l�� 1 Q 1�p12�11- 2cT� ��Z -LwUU� � ti`�N SS110 D 2 COA#MERCE � Q11VG PREPARED BY SPONDE WEGERER SO S L TEST I t�2G AND. DES I (Sfq SERV I CE P.O. Box 74 421 N.ilain St. River Falls, W I 54022 � Phone 715- 425 -0165 �SCON'T Fax 715 -425 -6864 ••••.. j �R!IU9 i . wEGekEP � PL151 BLLSYigF i?+ f V ��' �_LS -o3 JOB NO. PLOT PLAN Scale 1 " =�4) Page J of 7 — � �` LIZ 61� �1J �1 Z.► � L tiSC) `T")4 ST_ y J -(t C/1 �J o o rn h 0 N_ O� N & ' s3 cTo� of Z`��ve F.r'► ^ p 33D2`M 1 1t� 'F �1 i PVC 4 T1Z f 3tvl l = L=, a 0 �at P P1 NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1. ASO gallon ca acity manufactured by �� 4. Bench markg S. Divert surface water around system to prevent ponding at the uphill side. Page �� Or —] .Approve Synthetic Covering ASTH C33 Distribution Pipe Medium Sand Topsoil --� r� -H 1G J � E D 3 b °a Slope Distribution Cell of- Force Main Flowed z" to 2- Aggregate From Pump Layer a . b Ft. F CROSS SECTION OF A MOUND SYSTEM F 0- Ft. G 0- S Ft. A Ft. FI 1 -0 Ft. Linear Loading i--- 8 S 0 Ft. ` Ra ��- t1.O CpD /Iu'� FT Design Loading Rate= '0.36GPD /SQ FT I 1 ( Ft. AAAO' J Ft. I a25'7� K 1Z Ft. L - 7 U Ft. W 3 3 Ft. �} - Observation Pipe A e- --- X - -- --- - - - - -- -------- - - - - -- =-- - -- RFarce - yy e---- - ! - - - - - -- - - - - -- Main .Distribution 1 „ � ,� L�� Cell of � to 2 z Pipe aggregate Observation. Pipe (Aachor s ecurely) . - PLAN VIEW OF A MOUND SYSTEM I Distribution Pipe Layout Page 5 of • 1 Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. 3 Extend the end of each - h lateral u - o p wi th the use of long turn or �� fitting to a point within six inches of the final made. Terminate the ends of the laterals with a valve,.threaded cap or threaded plug. Provide access from final grade for the valve, threaded can or threaded plug. - Lcc`ss Box_ _ L �Z OS S S�L71 F VC Lateral Manifold PV C Lateral X x x x x/2 V2 X X x X Lateral Length — Lateral Length — P Ois*tb ion Line a- _ F r PrCr.�s soX — -o S i _ Gq P Ft. Hole Diameter � Inch S = Ft. Lateral a 1 Inches) X 3� Inches Manifold n I l �7 - Inches Force Main " Z Inches # of holes /pipe Invert Elevation of laterals 1 .: I Ft. C Y- -0. <l = 3.69 x 6 = z ty 6p,*-i ` - Combination Sept�ic; and PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ` PAGE OF VEIJT CAP WEATHER PROOF JUUCTIOU 8Ox . ti C.I. VEMT PIPE APPROVED LOCKIJIIG 110 ' FROM OOOR. MAWHOLE COVER 1NIv '.iIIJoow OR FRCSH wARfJ1 LNSEL,. BPEg10►J C'tPE ALP IMT�lKE cosaDu�T w /HtR- S1sttT��nP , r , G V- C i' �__ � Ie•MIU. IAILET �" PROVIDE I -- AiRTII.HT SEALI I 4�FVt Approved A Approved joint ca/ _ 1Sop I joint w/ PVC pipe I Il A LARM PVC pipe I 1 I ow C I CLEK�u�f� I PUMP �� — OFF D COLICKETE t (fib' DLOCK Y RISER EXIT PERMITTED OQLU IF TAWK MAMUFACTURE:It HA S 3 "ApPQo.�n . S SUCH APPROVAL��� 5EPTIC E SPECIFICATIOUS DOSE TALJ V1A( SS V- eUhlC�e TANK MAt<JUF/►CTURER: WMISER OF DOSES: M0 /� �p PER DAB TA MK SIZE . GALL01J5 DOSE VOLUME Z • ALARM MAIJUFACTURER: S -, - `� S INCLUDING 5ACKFLOW: l �2 GAi.LON: MODEL IJUMBER: 10 1 NlN CAPACITIES: A= 1 t9 3OrD ����� IUCHES OR GALLOys SWITCH TzPE: 5= Z IMCHES OR 3 � C, �LLOUS PUMP MAMUFACTURER: GOVLpS �OZ C oe - IUCtiES OR CALLOUS MODEL HUMBER: — �C� S' D e J M _ I �HES ` OR 2 `U t GALLOAJS SWITCH TYPE: W MOTE: PUMP AUD ALARM ARE TO DE MIEIIMUM DISCHARGE RATE ZZ. ` G INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE CETWEEiI PUMP OFF AIJO.DISTR18UTIOLI P tPE., 16 ` FEET + Mlu►MUM METWORK SUPPLY PRESSURE , ; , , , , , , , , , 6 •23 FLET r5:r� k q D , T. - FEET OF FORCE MAIM! X t �Z F �o FtFRICTIOU FACTOR.. FEET TOTAL DyWAMIC. HEAD F EE T As per manufacturer h.(� gal /in. Liquid depth 3� �� I GouldsG 1 °r Submersible Effluent Pump 11111 u 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to . heat transfer. ■ Motor Cover. Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and •Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. a ■Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, g Pump: EPO4 built in overload w ith construction. ■ EPO4 Impeller: Thermo- - Solids handling capability: automatic reset. plastic Semi -open design /a maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP Canadian standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- • (GSA listed model numbers Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for improved performance. end in "F" or "AC ".) rotary/ceramic-stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 i • Capable of running - — dry without damage to s 30 components. #— -- Zp , Pump: EP05 e r- - - - - -� FT • Solids handling capability: 25 -�-- 1 maximum. a z • Capacities: up to 60 GPM. ; — I i • Total heads: up to 31 feet. 6 2° i .. • Discharge size: IIN NPT. a ' • Mechanical seal: carbon- 0 5 15 rotary/ceramic- stationary, _j i 4 BUNA -N elastomers. ! - -- -- -I EP05' -- • Temperature: ° 3 10 104 °F (40 °C) continuous j 140 °F (60 °C) intermittent. 2 — EPO4 - — 5 — OL 00 10 20 30 ..40 50 GPM 0 2 4 6 8 10 12 m ,, /h CAPACITY ®1995 Goulds Pumps, Inc. Effective May. 1995 Mound System Management Plan p age Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code Septi_ c Tank ����'VY�(1T X3 Z The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. 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 continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its conents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain Less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, s Division. P merce Safe ry and Buildings Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps be tested to verify proper operation. If an effluent filter is installed within the tank it shall be. inspected and serviced as necessary. ry . Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and th mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetrate ne Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate fate that the mound be' heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg/L TSS, and 30 mg/L FOG. Influent flow not exceed maximum design flow specified in the permit for this installation. may The pressure distribution system is provided with a flushing oint at the end of ea era lateral be flushed of accumulated solids at least once every 18 months. When a p essureltest s performed it should beeach compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance wi component manual th Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' re rtin j and local or state rules pertaining to system maintenance and maintenance p° s �8t� � to bq No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv 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. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance: If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced In its' present location by increasing basal area if toe leaka and dispersal media, and related piping, and replacing said components as as deemed necessary n to ' brin g � th system prope em into on operating condition. rY g Questions about the operation or maintenance of this system should be directed to: The County Zoning-Office at 1 �S.— 3�.b` ;Th'e system installer at 1tS The tank manufacturer at T3zs (16e)6 LJ!f'�QR The effluent filter manufacturer at S"lIL Z Zt'� The pump manufacturer at�=$�.(_.l.�S t� - C�aut✓�S Wisconsin Department of Commerce SOIL EVALUATION REPORT Page \ of 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 1 inche County i 71onand include, but not limited to: vertical and horizontal reference oint re Parcel I.D. percent slope, scale or dimensions, north arrow, and locati n and distance road. O Z,2 Please print all informati S E P Re wed b Date Personal information you provide may be used for secondary pure es (Privacy Law 6 ZONI t;PKgK*Eocation M 13 V F Govt: -LOt SE 1/4 N W 1/4 S Z.S T Z� N R 1 S E (or W Property Owner's Mailing Address Lot# Block # t Subd. Name or CSM# `' ` ( 7 r� N�EU—VJDQZ� State Zip Code Phone Number E] City ❑ Village a Town Nearest Road ran/ SSI I ( 6s1) q2? -S lr- \QN1(- z 0tjtc I EVkz'�z De. Q New Construction Use: ( Residential / Number of bedrooms J Code derived design flow rate U 5 C3 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material LU F5S � `n LL y 14,j 0 yr Flood Plain elevation if applicable it� ft . General comments and recommendations: M Q uy'—� IN Q X � p �S j Ql BU - o" CL-Tz L , "1t /v [ M U � O "-� F° LL, Boring # ❑ Boring n I I ® Pit Ground surface elev. a' - 7 ft. Depth to limiting factor Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 0 -Ili Lo`1.tz 3 1i — S t� Z �`i�'r�4 �v`f►- C� Z'�' • S : 43 Z 10 Z lu-12 31 L 3 ZC -3L 1OyR 6 a Boring # ❑ Boring tti�nn pit Ground surface elev. `7 ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 m \J`f)r- • S '8 Mfl- cw 1�`F •S • 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 Name (Please Print) Signa re CST Number Arthur L. Tiegerer C) 220254 Address N e g e r e r Soil Testing ' & Design Service Date Evaluation Conducted Telephone Number }'Z q 3 �� 421 N. Main St. River Falls, WI 54022 3 715 -425 -0165 s q - 1S -t► P Z. 2- 1 v� �— O y° � U Q � o 3 o Owner UV �'�PsY Parcel ID # f 17�1 Page Boring # ❑ Boring 1 1 ® 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 �- L�`� — siI � ht V'F►- �v Z�' -S . Z -l� l0 -Irz 31L Si I Z''r�> m`f� Cw 1v�F •S -g -L 2y/ �rtf �.s�as /g Sicl le sb Boring # ® Boring ❑ Pit Ground surface elev. q6 , o 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 D - 8 I V -3 i — s' 1 z� k s CS Z .S B b1� �n cS lv •5 • g F—I Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L • Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6/00) •\ PLOT PLAN Page of Scale 1' (L EN G 12 P,�� u L -- \ S 0 `►�1 S-r _ 1� J -ft O O W �o M � Cr- �j o N_ O� a , o r n 1 1T\AZ } `mss & MME � p \z na C t=L 31 11190 P P Wj -Cv_ -- � r 715 - 425 -0165 2 20254 p3 -1 1 Z CST Signature Date Telephone No. CST No. Job NO. Wisconsin Department of Commerce SOIL EVALUATION REPORT of 1 Division of Safety and Buildings Page -' in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and w percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 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 ' V � ) 1 Property Location p s� Q '^ ,�> ' �` \1V f�lf� 1"��V'Z Gevt- bet_SG 1/4 NW1 /4 S T Zv N R �U E(or W� Property Owner's Mailing Address Lot # Bl7c,* S 0L 4, Pq 11 7 City State Zip Code Phone Number ❑ City ❑ Village 0 Town Nearest Road ��Ll_�. loon 11N SS 1) (6sf �12q -Sg�,� k� NLC EV�I Z6IZ D�. [� New Construction Use: [ Residential / Number of bedrooms 3 Code derived design flow rate U S GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L-ta T1 LL �r C'iz Flood Plain elevation if applicable General comments - ft. / and recommendations: V� p � U .v Cr jc S(Z)' DVST 0 �,3� L ` of S_P'� F!LL, Boring # ❑ Boring ® EE pit Ground surface elev. aC1.1 ft, Depth to limiting factor Z 6 in. Horizon Depth Dominant Color Redox Description Texture Structure Application Rate Gr. Sz. Sh. cture Consistence Boundary Roots GPD /ft I in. Munsell Qu. Sz. Cont. Color 'Eff#1 •Eff#2 0 -ll� Lo `1.fZ 3 !z — s 1 � Z I` �v� C�.J z, Z l0 2 1G - sicl 3'�sbyc m�i- IC-3L 1 D-M L L 3 _ LS BR Boring # ❑ Boring fin ® Pit Ground surface elev. f. Depth to limiting factor 1 in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 -9 1 0"11Z3 )Z - Sl 1 Z `P s b k rn \j - Pr aw 2-�' • S � � Z C1 - \1 10-1 S �h mf- C 1 v`F • S . $ 3 ) - 1 Z 1 sl8 s�cl 1�sb 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 Name (Please Print) Signa re CST Number Arthur L.'Wegerer ,:. p 3 � � Z 2217254 ' W e g e r e r Soil Testing -& Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, WI 54022 '� `L 3 � -9 -D3 al - 715 -425 -0165 property 6wrter �"��SY Parcel ID # ` 1 �� y — 6 (7" U Page Z of 3 R Boring # ❑ Boring ® Pit Ground surface elev. Z ft. Depth to limiting factor a 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 l 0`'112.31 Z Z °1 —l9 WIT y/ `�trA �.s�2 sib Slcl 1 sb V4 i Boring # ® Boring ❑ Pit Ground surface elev. 6 , o 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 t D - F ►oyV-31 Z — 5) \ � k s CS Z - Io-I cz. 3l — s j 1 Z 1 0 1, � c S 1 v S 3 w -11 lo�l `Z3 � hF - l.s�rz sly s1 c 1 `/`ns ❑ 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 i • Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L • Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L T'he Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. SBD -8330 (R.6/00) PLOT PLAN Page 3 of Scale 1' 1;V LZG12 � t.1 ,� -u y f cD • S S W1 1 1 S 0 `T y J s -fit o O �o M � N O L ? J r / � � / bo DoT Cam � �•T � s. 3 �D2`M W � J 0 ���-I -= LS?= =5 � o- t7` a- t�?►_-g ��t1.C.., 3��'.c_� 119 : �j PLpz -\S --03 71 5 -4 ' 25 - ' 0 165 • 220254 p3_I CST Signature Date Telephone No. CST No, Job rio. ST CROIX COUNTY �/��� SEPTIC TANK MAINTENANCE AGREEMENT / ` j� _ r AND rll �— OWNERSHIP CERTIFICA ION FORM () /P Owncr/I3uycr r r JY Mailing Address n1 l I � Q Property Address v ,y 9 �lu 1P ) — (Vaiftcatioa trgccimd from P " foe new eo=truc oa) aty/Statc AA 1b A 0 Paned Ideatification I1 L« Q - 0 7 D C LRGAi<, UESCk�P' ON paty Location �� ° 3 X . T Pro ! <, /ti Scc. N g�w� Town of Subdivision Lot # L___ Cecfitied Satvey Map # volame, Pagc # _ L`.0 wa maty Deed �, vurYC 9 2 P rags # �' 7 Spoo.bo = ❑ yes tk no Lot tiam Mcatiftle yes D. no - ' .Tm�p°°pcc+csesrdm�mmoauaaoeof - .. ooasists oaf 3�s9tbcmtaooldttmttmit� aolnadZe P � ° ' ga � tQ � etad ccvorYt�ey�aaeaoa� {s�i�oodo3bTo oe� - cmat�re�aacttiom�c�t6caIaQre�ratc _1t3oaP!�a�ol5esystcm 'T rmrvaty�o�= m m a to = Oast &a4 waresnd -a is iapao e n , , �oarsodpPer' j'°'g { Qre°��'°ce ,ontcy* ' p�SC¢ .dreu�6rt�isslcss�anu3#a�[ofi�e. .�dcvieo�adme.ba�caoa m �*�4.jreaia�,�caat drt +� am�Gr�nQreptiritescr�t�o�pdsysi0r�trr�QtQie�uda�ds - �i�xer:�c�ys�' �� st�eofarmoomne.. dz� of the Qnroe a C1ro6uCoimty Z.oaua�QWoewi6iia 30 DAZE DWN$ AU I � � that aft sCrtcarc�s oa this form tae flue to Qre bat of my (oat) JoQOwLodge. I (wc amt (are) fire owuo (s) of Qre y tnia3rc of a wnmp dwd wootdod is of Doody O@'rc, • OF alPPI2 DATE Atigr inf«mutiou that is �sodmay r�dt Ia the sxaitaty P� nwo{cod 6 7► � - "•••• " Indnde �r[th this appti tioaL a ftwfa wamu dwd 6am the ftjcW of Doody oMft a Dopy of the mdifiod mycy mp if trl=om is made is the w mmty dcod �; 2y25P 31V 742 1 03 �y KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., WI Document Number Document Title RECEIVED FOR RECORD St. Croix County 10/01/2003 03 :15PM ZONING AFFIDAVIT Occupancy Affidavit EXEMPT # REC FEE: 11.00 TRANS FEE: Gore GLhd COPY FEE: 2.00 CC FEE: Name (Owner) Typed or printed PAGES: 1 being duly sworn , states, under oath, that: 1. He/she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume Z 3 Page 1Z Document Number St. Croix County Register of Deeds Office: Recording Area Name and Return Address A parcel of land located in the '/. of the /l0 '/. of Section Z S ( -u,� C V) d T N - R --19 W, Town of X, " nJ ; L K i N 1J ) L , St Croix 10 Do County, ti'.:;,c ::.sia, being d,:! y d- .:.,critic d as follows (include lot no. and Mh 5 S 11 O subdivision/CSM or detailed legal description): Dt - Iw e o d OZZ- /o (g — 00O Parcel Identification Number (PIN) As owner of the above described property, l acknowledge that the septic system serving this residence is sized for a 3 bedroom home, or a design flow of D gpd. The design flow is calculated by assuming 150 gpd for 2 individuals per bedroom. There are currently_ occupants living in this residence; - occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, l understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and /or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this I day of 0&4y , J L'�r 1 Nh Movt►- AUTHENTICATION ACKN WLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenttcated this day of St. crely rounty. 1 Personally came before me this day of < < 1 k3o 3 the above named TITLE: MEMBER STATE BAR OF WISCONSIN to me knovm to be the person(s) who executed the foregoing (If not, authorized by § 706.06, Wis. Stats.} instrument and adcnovAed a THIS INSTRUMENT WAS otu+F rEO BY AmIlIfthk DRAI(E L, ANDERSON NOrMV PUBLIC Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not state expiration date: necessary.) Date: (�1C4 [� "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" Tills Information must be corgpleted by submltter. d ocuming name 6 return address. and S1(Nrequhed). 0therk4ba ation such as the granting douses. leagal description. etc may be placed on MOW W page of iris doc NW9 or may be placed on 8"Vonal Pages of the door Wt &gW Use of this coverpage adds one page to your document and 6200 to the reooAN lee. VAsoonsfn Statutes, 59.517. l� U 2397P 997 - 7 Z3 8sI d+ STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Terrence R. Stenglein and Betty L. RECEIVED FOR RECORD Stenglein. husband and wife. Grantor, and 09/03/2003 09:30AN Corey P. Moutrav and Christina MoutM, husband and wife, WARRANTY DEED Grantee. EXERT # Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00 TRANS FEE: 390.00 (if more space is needed, please attach addendum): COPY FEE: Lot One (1) of Certified Survey Map m Volume Four (4) of Certifi CC FEE: Survey Maps, page 1167, asoc. No. 377705, filed in St. Croix County PAGES: 1 Register of Deeds Office on May 20, 1982, being located in the Southeast Quarter of the Northwest Quarter (SEI /4 NWl /4) of Section Twenty -five (25), Township Twenty -eight (28) North, Range Eighteen (18) West, Town of Kinnickinnic, St. Croix County, Wisconsin. Recording Area Name and Return Address Kerri Olson River Falls State Bank P 0 Box 89 River Falls WI 54022 0 QA - 10 7D - 60 Parcel Identification Number (PIN) This is homestead pr rty (is) (is not) Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any. Dated this - ZIX day of AZZ 2003 -* -- — - * Terrence R. St tut - - -- - - -- * -- -- - * Betty L. Ste glein - - -- AUTHENTICATION ACKNOWLEDGMENT Signature(s) Terrence R. Stenglei and Betty L. §ten leis, STATE OF _ ) husband a nd wife, ) ss. - - - -- `� �' County ) authenticated this day of 2003 -- -- - - -- - - Personally came before me this day of the above named * Kristin Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Oland -- Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond du Lac, W STATE BAR OF WISCONSIN 800 -655 -2021 WARRANTY DEED FORM No. 2 - 1999 X i f - f 1 J co RL i <ti PAGE 0:3 F I[t A'Niy IN L CORFY & CI RI- S`iI:I"A of Svr'iq : _ ;"Emit, Cat k 4 -- �- -- STATE OF WISCONSIN ) 88, AFFIDAVIT OF SELLER I li�u� COUNTY ) The undersigned Seller, being first duly sworn, certifies with regard to the property described on the attached Exhibit "A "; That I have owned the property on the attached Exhibit "A" continuously for :— years past, and my enjoyment thereof has been peaceable and undisturbed and the title to said property has never been disputed or questioned to my knowledge, nor do I know of any facts by reason of which the title, to, or possession of, 'said property might be disputed or questioned, or by reason of which any claim to any of said property might be asserted adversely to me; That there are no proceedings in Probate Court, no bankruptcy or divorce proceedings, and that there are no unsatisfied judgments of record nor any actions pending in any Courts, State or Federal, nor any tax liens filed against me except as herein stated; That any judgments, bankruptcies, probate proceedings, State or Federal tax liens, of record against parties with same or similar names are not against me; That there has been no labor or materials furnished to the premises, described on the attached Exhibit during the last 120 days for which payment has not been made; That there are no unrecorded contracts, leases, easements, or other agreements of interests, relating to said premises, of which your Affiant has knowledge except as stated herein; That there are no encroachments of fences, buildings or other improvements appurtenant to the property onto any easement of onto adjoining property, and no encroachments of any fences, buildings or other improvements appurtenant to adjoining premises onto the property; The undersigned Affiant knows the matters herein stated are true. Dated this da of AtwB19b 2003 Terrence R. St714i ein Betty L. Stenglein Subscribed and sworn to before me this day of A t, 2003 * 1 s'C t r eft i./�Y�/ i Notary Public n ",r.,ce CL;x4 , w My commission 1'.0 (1.L,✓Y�y�z --�" EXHIBIT "A" Lot One (1) of Certified Survey P Ma in Volume Four (4) of Certified Survey Maps, page 1167, as Doc. No. 377705, filed in St. Croix County Register of Deeds Office on May 20, 1982, being located in the Southeast Quarter of the Northwest Quarter (SE1 /4 NW1 /4) of Section Twenty -five (25), Township Twenty -eight (28) North, Range Eighteen 18 Town of Kinnickin nic. g ( ) West , St. Croix County, Wisconsin. CERTIFIED SURVEY MAP Wler 6 N1 /4 CORNER SECTION 25 T28N, R18W SCALE IN FEET �I 1 0' 200' 400' '1 4,di tV W TRUE U N PLATTED ° a , BEARING L A N D S m e THIN - EV RGTt EN D RIVE o`-- n A89°L7{'3�TE- 873;15' S 9 ° 48'12 E dyo 63.22 209.93' 71.35' 332.00' y0. UTH RIGHT-:)F- WAY LINE Point of a� Beginning d I 1 1441 N �. r f ✓ C �Vfili{6F�`- N a X S- NW Z L O T 3 Acres o I LOT ? - v o LOT 1 21 F. 9.62 ACRES 9.58 ACRES = mI ¢I u i i House 9' o ip O .d+ u _ z JI u N a N w/ w �Ipl O >I I H N N N F OI w ? ❑ Shed o` p = I . ti� = H N 3 ^�° w wlvl a _Z O 01 1-I O ro ^ w QI ° -' W zl N z "' W UI0 w w ^ I ° .y 9' B 10' 0 65.10' _ 333.10' 35.23 .9. 116.0 ' 4 332.00' d 14' S89 ° 22'25 "W 1330.20' \ SOUTH L NE OF THE SE1 /4 OF THE NW1 /4 M UN P ATTED LANDS APPROVED MAY 1 I5R2 . ST. U cowr.aw�m P•us � This instrument drafted b =owNC CJALwtiB y Robert K. KNsak. Volume 4 Page 11 -- ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 EROSION CONTROL PLAN (715) 386 -4680 • Fax (715) 386 - 4686 For 1449 Evergreen Drive -Lot 1 (Kinnickinnic) — owner(s) Corey & Christina Moutray Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement. The nearest tributary stream of Nye Creek is >800 ft. away from construction area, the nearest road ditch on Evergreen is >400 ft from proposed septic system. 2. Route contaminated runoff into vegetated buffer areas on owner's property by creating temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (this includes road ditches). Do not allow diverted runoff to be directed onto neighboring properties. (See specification sheet for temporary diversions provided by Zoning Dept.) 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with the diversions and vegetative buffers. The POWTS inspector will evaluate ESC plan effectiveness and make recommendations to owner and building inspector for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation - do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass/vegetation can get established. Erosion control matting can be applied any time of year and, if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion &fe control i allation. Pre aced by: Pamela Quinn, Soil Erosion Inspector #66505 GG •. •. •. •. •. •. •. •. Owner acknowledgement of ESC Plan requirements: �2U�3: •:' OWN ° 0 � e 1 J 83 / + ' 965 — O 4974 ❑ — r innicki is - d 55, 0 0 946 14 o 3 O ii 69 73 ° 9 p0 \. o 92� e 40 0 I O 09 12 R 943 ` s� \� II 2 997 4 I. /080 _ 958 - -- \ o 4971 QII 7 5 26 -- O I -_.. i 1970900 -N � I I l - — — i /n _ - I I °p I . o o //yy 32 5 37 0 INTE IOR— GEOLOGICAL SURVEY, RESTON, V RGIN A— 000 44 ° 52'3 V s39000I9E 92 °30' i MILE ROAD CLASSIFICATION EEEE:E3 Primary highway, Light -duty road, hard or T hard surface...- _.___.. improved surface.... Secondary highway, hard surface Unimproved road........___ —____ WISCONSIN n U Interstate Route 0 U. S. Route 0 State Route r w N - 4 4 v tr s on di a ss 01 ry Helnbuch tr 94 :. 40 G w s..aae•t 5 w j Robert & Trust g Th— � u 0.3 H & e Z Barbara '� v 59 Barbara q O q e 40 �' w ; ya e k S Om Y I ICkler a v 5 BROOK Gatbe it w 469 389 _ 60 v� 1 �C &A 20, 170 E x r 7 RD 72 12 t "sae " 50 7 118 Schmitz 52 etal .B MP o usan w - — " '"1 - tr 34 _ N r tuaaem. 3) i ' 1 Pinski o; 8 , a James lsk� , w 10 omas c 2 y Os. j 35 tr Arnold & &lase a 14 21 X& Bur( s B Sumner tvin Marcella s K&D Van- D&N 0 Hut Beek I Bede M a � wwak Marvin / I& m '� Rae Lueek LE dM ° r C h C �1..te. t ^ W &G 3 W 4 Johnson 180 I 45 """ m 160 I Trust c 1 I 80 80 0 u 7 ^ 7 Q M 4I 65 Q 1 dm - J .� 35 to "0 I 0 4 _ 1U I i p P W s7 160 F OP�nheimer 266 , 104 0 3 a �P tr aiwhrm raredRkt , a W STEEPLE DR I GC& n ua m Soft rcam, PLEA ANT en as ai I� j _ _s F f= 40 8 2 �_ 40 _ _ 159 _ , IB xo AVE �a o N 1� G 14, john 2 O a s s -- Mad— t� z ( '� MIckelson Gerald Harol Domtlty Emho� Morro I huupps A p l gronomIa h 1 100 / Z c raa I u „ 222 122 2 9. 5 � 14 � tr 186 2 "',2 4 113 tr s p OgO HALL J Todd Ew ¢ p �� F & Jeffrey 2 Wt'If ,_ u is"' v v • 0 g ' 40 t Q .3 Esther & Nancy IVER Kirtmo- �^s & ¢ o ¢ d & Fuller Christensen 9 kinnic 2 oe a c m m . , GemsLam T �� River i m caaw a LLT 21 >L V V E 8 J A 12 ]Borer PB & Inc 72 a o a� Bloom m 4! m" f z v I s7 z _ 154 BR ' aazsavvear LH " 21 D&c Z nI �� ET 80t E 39.1. erese a¢ 1LI tr « �" — teter�oe T U c w 1 ¢ J J o a Glenn & 80 3 Thomas & u W john Emu & I H1 6 3 B¢ p Donna a �I w0a 49 teu � 102 Fuller Mary , 80 - al � LL i- s Badje 80 z >x 20 ~ Nelson ;i I up Reb ecca \ �iNN\G tr ¢ 140 Fa,nily ( Rita N 5 g cwev o 21 Ilkla�hue3rta DHORT 176 ' G o tl cse x 4- d & 1aa 3� S3 P+usda N .. Howard a oward Kac 00 OAK DR dWT D15 ^ a a Cv „ « W mw 30 DR ER L"M tT of 3° Gri Robert & ° 3 , c 40 Gordon a ff j r J a s� $g = v � , I � & _ _ _ a a ¢pa e`7 1mee w I , Keam tleya c o b $I ss h ¢ as Thompson 9 F ° x y wB,ae 1t R&K Keith & _ '" — `"'®" _ s 250 37 30 _ _80I 160 A 0 d; c 1E ' 7 Debora Leota O'f . a o N i4bi & W 1 1W. Andrea Andrea � N 4/ Lkw. r ' ^ yy $$tt U Dominic p d U� MEW 33 M ¢ s �� G X' 65 9 w S m 41 " n 6 , W 25 r )Bek 40 ctiK E 1 E R tr 17 1 Trust 2 Cotmty o N DR 40 1 VL 29 .9 V ' St lac „ ! tr N Wayne 2 9 1 ,Mae ram & t r m ernon & ' 315 beck ajane a « E uge suz,m,e S _, Stan ley ► 5 41 Hinz 38 b stanm s7 Wolfe & Be Kramer ion ey Adeline aM a rtY ar 104 Peskar Rose 91 " Peskar tr nth Harry John ✓ 63 Trust Em _ 316_ Y 2 Y 10 � 6 I Hinz p F swen- Mdcs 22 a " _ J 114 6 21' 4Q 39 Trust 4o SoO 35 Kessler 200_ C P � N & h 14 �° J i' lidith I Q Gk- LO au+>«. _ — _ _ C� 33 - 1 — 40 i0 M R ON ' '" O w �n0a wo 1 p , Pa dt vA L 73 54 40 ¢ 40 save, +o I Gary W ¢ &L r v ermn a Jn Stavkr r a p David a mm P M eat" O ' Ste- Gary $ ' q 8 M 8 Tuccci 55 Lentz Grimm I 0 O + f>i Luke & 00 area ' 40 3 \� O 40 q 196 > 2 , Kelly .. j & Ruth - Q OM Grace I A an Todd & p o :er Lee 130 L _ 100 40 t' �Gv N gang Patricia 1 Robey Trust A U H 141 L _ 1 _ ' _ 80 168 PIERCE CO. COTTONWOOD LN — — Rick McMonagle Executive Director 219 N. Main St. PO Box 87 River Falls, wl 54022 W EH 115 8 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH Q P.O. BOX 309 RFcE,� MADISON, WISCONSIN 53701 DEC 19,9 i� REP!ORRT ON SOIL BORINGS AND PERCOLATION TE T; U 01 Q �~+ LOCATION: S -Z-%, X1' /0, Section , TV �D � N, R E (or) ownship or Municipality n C j .�Y• Lot No. ,Block No. —,— County a 3! s Subdivision Nam Owner's Name: (� (►L Mailing Address: "`G to T eem b r, TYPE OF OCCUPANCY: Residence NO. o. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW /` ADDITION REPLACEME T p DATES OBSERVATIONS MADE: SOIL BORINGS / Q _ A40 P TESTS – d r " SOIL MAP SHEET" ' 70 ' �- / YPE 1 ►✓ `. PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P - r a2''gtsl "� 1�rs►�E 30 � y� P -a ay'' l9uel s s "�� 1$ 30 1" 17, r P -3 ay J� " gtSC C��`ghSl , 3l) SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) � yN S t B �b' 116 C~" > boI a f A IN 1 �,f S ga t�) �9 ry g s B - YI c+ /?JI $/ s ta i 8 -n SI .3 g sy b © '' s 1 A d " t B )3 " k " k 31 a9 "RS PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate nu ber of square feet of absorption area needed for building type and occupancy. 1 Indicate scale or distances. Give horizontal and vertical reference points. Indicate Al e. q�_ �( t, $L ax e ev D riv e . x thi i o0 r 5 010 o r • ' 1 Ad v r a= o 6 �8- 6 to S te D 5T S�FeI "Yv I�cd woos Z,orneV' I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures Qosrt 64Ck and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. p� Pane' O Certification No. �1 Name (print) // ,, Address Ob 9 4lb W/ s – Name of installer if known CST Signature COPY A —LOCAL AUTHORITY, 3 Z COUNTY VISCONSIN E ZONING OFFICE ST. X C O UNTY O UNTY GOVERNMENT CENTER ` 1101 Carmichael Road Hudson, W(54016-7710 EROSION CONTROL PLAN 015) 386 680 • Fax (715) 386 - 4686 L For 1449 Evergreen Drive -Lot 1 (Kinnickinnic ) — owner(s) Corey & Christina Moutray Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stoekpuEd untii final grading anu stabilization is complete. Septic system excavation/ installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement. The nearest tributary stream of Nye Creek is >800 ft. away from construction area, the nearest road ditch on Evergreen is >400 ft from proposed septic system. 2. Route contaminated runoff into vegetated buffer areas on owner's property by creating temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (this includes road ditches). Do not allow diverted runoff to be directed onto neighboring properties. (See specification sheet for temporary diversions provided by Zoning Dept.) 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with the diversions and vegetative buffers. The POWTS inspector will evaluate ESC plan effectiveness and make recommendations to owner and building inspector for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. Erosion control matting can be applied any time of year and, if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion a tm control i allation. Prepared by: Pamela Quinn, Soil Erosion Inspector #66 0 I �� Owner acknowledgement of ESC Plan requirements: ld /�` /'2003