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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Sa?wty and Bliilding Division INSPECTION REPORT Sanitary Permit No: 499191 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: Andrea, Bruce I Kinnickinnic, Town of 022 - 1079 -30 -300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 28.28.18.434C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark io q Dosing Alt. BM Aeration Bldg. Sewer \ Holding SUHt Inlet /G• /• 5S TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic I Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding _ Bot. System r4 9-C /oo. C, V - Final Grade y /al • Sr PUMP /SIPHON INFORMATION )--, <. _ ) �S' t C Manufacturer Demand St Cover GPM Model Number TDH Lift riction Los System Head TD Ft Forcemain nth Dia. Dist. to 9 I ,• + SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 t b+ } ILCS + SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type Of System: v- 5 I UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake { Pipe(s) 6) L 4 Length Dia Spacing SOIL COVW Systems Only xx Mound Or At - Grade Systems Only Depth Over Dept Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench C nter Z Be rench Edges Topsoil Yes No Yes ]No COMMENTS: nclude code discrepencies, persons present, etc.) Inspection #1: / f� / eC - Inspection #2:__/ / Location: 199 Pine Tree Road Unknown (NW 1/4 NE 1/4 28 T28N R18W) NA Lot 2 , Parcel No: 28.28.18.434C 1.) Alt BM Description = T" V7 2.) Bldg sewer length = Z I' r - amount of cover = - r "` °e ` �" S � n Plan revision Required? Yes No Use other side for additional information. - — - Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7262 IN&VA 5����,� Madison, WI 53707 - 716 Sanitary Permit Number (to be filled in by Co.) Dep artment of Commerce (608)266 -3151 State Plan I.D. Number Sanitary Permit Application N►�- In accord with Comm 83,21, Wis, Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s t 5.14 I m Address (if different than mailing address) Qt I, Application Information - Please Print All Information N 4t / 7 7 (rc I Property Owner's Name / S E P 2 7 20 Parcel # # Block # A F' YtP - of Property Owner's Mailing Address ST. CROIX COUN I Y Property Location City, State Zip Code Phone Number r11 '.- �' ��`' Section S '�O�p 7 ✓Op T A N . R �eirco� ,-/ /. � C II. Type of Building (check all that apply) C k cub S ob *-% •' 0, C ❑ 1 or 2 Family Dwelling - Number of Bedrooms T1 a .I%— Subdivision Name CSM Number -,%5y ❑ Public /Commerciat - Describe Use ,�- //����� II e_5-.&4 ❑ State Owned - Describe Use Z I�-5d- ( - O_! , w Z9 { 3 avvsi02 (' ❑City_❑Village ayownshipof III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - 1 -• A. ANew System y El Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System I B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issuod Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a 1 tdNon - Pressurized In- Ground ❑ Mound >24 in. of'suitable soil ❑ Mound <24 in, of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter 0 Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter XwhingChanjber Q Dri a Gravel -less Pipe ❑ Other (ex lain) V. Dispersal/Treatment Area Information: rte Design Flow (gpd) Design Soil Application Rate(gpdsf) Disperse rea Required (sf) Dispersal Area Propos sf) System Elevation � / ✓ /�.ZS ✓ f <2S i3g,S 2, "�ee.o�J�oN�f✓ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units n L Concrete Constructed Glass T� Tom: s Septic or Holding Tank Aerobic Treannent Unit Dosing Chamber �v ✓ VII. Responsibility Statement- I, the undersign assume responsibility for ins llation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature PRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIII. County apartment Use Onl Approved 2±!v anitary Permit Fee (includes Groundwater Date Issued Issuin A ant Signature Surcharge Fee) Reasot nial (b • CC Zg o IX. Conditions of Approval/Reasons for Disapproval 1 SYSTEM OWNER: ,3J � ,� ,� 12- s • 1. Septic tank, effluent filter and dispersal cell must all be services / maintained l as Per management plan provided by plumber. 2. All setback requirements must be maintained' � �"" 7 as per applicable code / ordinances. ✓ 1_ � Attach complete plans (to the County only) for the system on paper not kis than 8112 ill inches in size SBD -6398 (R. 01/03) AT E B� r r. 00 �4 f% t �Yw •�- /�N �r'•J�U— 4,0 kje St/ � fey r /32 �� Nrf z �w' 5a Wisconsin Department of Commerce SOIL EVALUATION REPO. Page. of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Sj r_ Attach complete site plan on paper not less than 81/2 x 11 inches in%IZe. Plan must O ZZ - io79- - a Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and local 'WED nearest road. - 6y / % LpT Please prin all l�btilr E� Revie by Date Personal Inrormation you provide may be use for seoondary purposes (Privacy Law, 13.04 (1) (m)). 9 Q (' Property Owner S [P 2 party Location 6 no e vt Lot F, 1/4 g 114 T� N R! E Property Owners Mailing Address S t # Block # Subd. Name or CSM# 450 S H city State Zip Code Phone Number ❑ City C1 Village ® Town Nearest Road .9" ei k9 54(kZ I ( 9 9 Lig K 11 W iv i 0. 1 ii� ry CC" Piy e 710C I9- N ew Constructlon Use: ®.Residential / Number of bedrooms �_ Code derived design flow rate 4.50 GPO ❑ Replacement ❑ Public or commercial - Describe: ro Pant material .54'j %rP� } Flood Plain elevation If applicable N A ft and recommendations: ��S�j�h- c�v Cc !� S 0,3 0i,dIO LJ co mments � prat 0e k, ��7`� ons: y). r, . %�tlC 1r I Sj„ool� � �i tio,�- o,4 q � 1 Boring # ❑ Boring " � Q a Pit Ground surface elev. _ ft. Depth to limiting factor -- - -- In. li Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ff° In. Munseii Cu. Sz. Cont Color Gr. Sz. Sh. I 'Eff#1 I 'E; 0 J U s/ aTs6K I u 0 d a m c s o. `E 0 .4, it ik ®Boring # ❑ Boring �w Pit Ground surface elev. 10-?, fL Depth to limiting factor - '� o l ye In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Con sistv—nca ^,e;:n„ r; o Gpn/f¢ In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 old �aM ' s a� �, c �v - ram A — 51 1 OT S 3 ' Effluent #1 = BOO > 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) CST Number P Il e, `? Address Date Evaluado Conducted Telephone Number P " q,,, w Brice I7`Nr1' re- - , Parcel ID # 7 5 q 113 `OT O Z Page � d ! p Baring /�� 'j � F 57 Baring # l�- Pit Ground surface elev. f � ft. Depth to i"F19 factor In Soil icwtlon Flats i Horizon Cepth Dominant Col Redox Description Texture Structure Conaistence Boundary Roots OPOM In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 04—) 2 i lk � S 2 a- 10 Y 5 I WK � f ❑ Bomg # Borino G Pit Ground surface alay. _ ft. Depth to IirnitMg f actor In. sos Rift Honzon Cepth Dominant Col Redox Descnntlon Texture Structure Consistence Boundary Roos GPOO in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Effltl I I i 1 a Sc'ng # C1 Boring' Ground surface elev. - - -• � _ -- it. Depth to lim iting factor in. D pit Rate Hcdzw. Depth Dominant Colod Redox Description Texture Structure Consistence Boundary Rants G P In. Munsell Cu. Sz- Cont. Color Gr. Sz. Sh. Tff#1 'EM2 Effluent #1 s BOD > 30 1220 mg/L and TSS X30 1150 mg/t- ' Effluent #2 = BOD, S 30 mg/!.. and TSS 130 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. sac- 8330(P -") 4.7 rtx: e- � � Parcel ID# 7 S�f Y 13 LO? Z Fege d Property Owrrsr .L' ! 0 Boring Bork # pit Ground surface elev. L �'�3' ft. Depth to limiting factor In Soil Rate Horizon Cepth Oominant Cdod Redox Description Texture Stn,chre Consistence Boundary Roots I ff In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. �Et1 1 *Ef #2 a-12 r a- nil S 0 W413 4: �J I i a �# ° Baring G pit Ground surface alay. _ n. Depth to finudnp factor in. Soli Rate Horizon Depth Dominant CO Redox Descnntion Texture Structure Consistence Boundary Room GPONf in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. f*1 TK#2 i 1 I a Bc.-wQft Boring' Ground surface alev. _ - -. ,_ -- ft. Depth to limiting factor !n. 0 pit Soil Rate Horizcr. Depth Dominant Colod Redox Description Texture Structure Consistence Boundary Roots POII! !n. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. 1-012 f Effluent #1 = BOC > 30:E 220 nxyL and TSS >30 1150 mglL ' Effluent 02 = BOO, 130 mglL and TSS 130 MWL 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. sac•wottt.awoo� ZRUUCE ANDREA .=.PLOT PLAN _P, 3 3 PARCE - 7 5 / t 3 I_CT Z 4 0 A C PA R CF SC ALE 1 to VtiG lrt�e Je Ro6� S� f e1 I Trews 8M�2 i0o _ q d2 - B2 i o3,41 k to 334 8F�' ( SPIKE` tN T RIM 1 A60v GRADE E L 100.36 I _ B 2 I''PUG .9 A BC Ot 6 DF ASSyMF_ EL, 100.00' i i R E ` , qq y�amP�j;; .yy OWN S w i e . - ST. CROIX COUNTY, WISCONSIN 45 structure; friable; thin continuous clay these soils are irrigated and fertilized, they are well films; slightly acid; clear wavy boundary. suited to potatoes and other special crops. 1322t -25 to 34 inches; dark yellowish brown Representative profile of Plainfield loamy sand, 6 to (10YR 4/4) heavy silt loam; weak coarse 12 percent slopes, in a cultivated area, 200 feet south and medium subangular blocky structure; and 50 feet west of center of NEl /4 of sec. 21, T. 31 N., A friable; thin patchy clay films; medium R. 19 W.: acid; gradual wavy boundary. Ap-0 to 8 inches; dark brown (10YR 3/3) loamy 1 133 —34 to 37 inches; brown (7.5YR 4/4) loam; sand, pale brown (10YR 6/3) dry; weak weak medium subangular blocky struc- fine and medium subangular blocky struc- ture; friable; strongly acid; clear smooth ture; very friable; common roots; slightly boundary. acid; abrupt smooth boundary. IIC-37 to 60 inches; yellowish brown (10YR B-8 to 24 inches; brown (7.5YR 4/4) sand; weak 5/8) sand and gravel; single grained; coarse subangular blocky structure part - loose; about 10 percent coarse fragments ing to single grained; very friable; few by volume; contains many dark colored roots; slightly acid; clear wavy boundary..: minerals; slightly acid. C-24 to 60 inches; stirptl,g_ brgWa � .:5 ))4. The solum ranges from 26 to 45 inches in thickness. wand'; aitigle grained; loose, slightly acid., The silty mantle is 24 to 40 inches thick. The A horizon The solum ranges from 18 to 34 inches in thickness. is very dark brown or black and 10 to 18 inches thick. The Ap horizon is very dark grayish brown, dark The C horizon is 0 to 10 percent coarse fragments. brown, or dark grayish brown loamy sand or sand 6 to The B horizon is slightly acid to strongly acid, and 10 inches thick. In some wooded areas the Al horizon the C horizon is slightly acid to medium acid. is a very dark brown or black loamy sand that is 2 to Pillot soils in St. Croix County contain less clay 4 inches thick. The C horizon is 0 to 10 percent coarse than is defined in the range of the series, but this dif- fragments. ference does not alter their usefulness or behavior. Plainfield soils are near Boone, Gotham, and Hubbard Pillot soils are near Dakota and Sattre soils and soils. They have a thinner, lighter colored A horizon Jewett, sandy substratum. They have a silty mantle than Hubbard soils. Their B horizon contains slightly and contain more silt and less sand than Dakota soils. less silt and clay than is typical of Gotham soils. Plain - They have a thicker and darker colored A horizon and field soils are underlain by loose outwash sand, whereas a thicker silty mantle than Sattre soils. The B horizon Boone soils are typically underlain by weakly cemented formed mainly in silty sediment, whereas Jewett, sandy sandstone bedrock. substratum soils have B horizons typically formed in Pm. B— Plainfield loamy sand, 2 to 6 percent slopes. sandy loam till. Pillot soils also have a thicker, darker This soil is on outwash plains and stream terraces. A horizon than Jewett, sandy substratum, soils. Most areas are oblong or irregular in shape and range PIA— Pillot silt loam, 0 to 3 percent slopes. This from 10 to 40 acres in size. soil is on outwash plains and stream terraces. Most This soil has a profile similar to the one described areas are oblong and range from 10 to 160 acres in size. as representative of the series, but the surface layer is Included with this soil in mapping are small areas of slightly darker and contains slightly more silt. Dakota and Sattre soils. Also included are a few areas Included with this soil in mapping are a few small where the depth to sand and gravel is 40 to 50 inches. areas of Hubbard soils, a few areas where the surface Runoff is slow, and the hazard of erosion is slight. layer is sandy loam, and a few areas where slopes are Most areas of this soil are used for crops. The soil is less than 2 percent. moderately well suited to corn or other row crops. Main- Runoff is very slow, and the hazard of erosion is taining tilth and organic matter content are important slight. Soil blowing is a hazard. factors of good management. Capability unit Its -1; not This soil is used for farm crops, but crop yields are assigned to a woodland group. generally limited by low available water capacity. Some areas are in woodland or planted to pine tree planta- Plain' d Series tions. This soil is poorly suited to most farm crops. Where irrigated, it is used for such row crops as beans The Plainfield series consists of gently sloping to and potatoes. Controlling soil blowing is an important moderately steep, excessively drained soils on stream factor of good management. Capability unit IVs-3; terraces and outwash plains. These are sandy soils un- woodland group 3s1. derlain by loose sand. Native vegetation was mainly oak PmC— Plainfield loamy sand, 6 to 12 percent slopes. savarma k This soil is on outwash plains and stream terraces. in profile the surface layer is about Most areas are elongated or irregular in shape and mchos of dark brown loamy sand. The subsoil is about range from 10 to 120 acres in size. This soil has the fi thick. It is brown, very friable sand. The profile described as representative of the series. b , to a depth of about 60 inches, is strong Included with this soil in mapping are a few areas of Aid Emmert soils and a few small areas where slopes are e`water capacity is low, and permeability is less than 6 percent or more than 12 percent. Pld'' oral fertility and the organic matter content Runoff is slow, and the hazard of erosion is slight. ace layer are low. Soil blowing is a hazard. as of these soils are in pasture, woods, or This soil is used mostly for pasture and woodland lantations. A few gently sloping soils are or pine tree plantations. It is poorly suited to most farm m..rn, soybeans, and garden vegetables. Where crops. Slopes facing south and southwest are more w k .5 4 V } ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �.^4/ C_ cl — , vti,r Mailing Addxess /tea S s gam► # 2 - w v',l! ,� t S U ; �Z 2 n - - _ AL Property Addr6s \ , `1 � ��,Q.cz K U / v`'((S GG'r .S� Y 02Z (Verification r required from Planning & Zoning Department for new construction.) City /State , `v,t , 0r Parcel Identification Number LEGAL DESCRIPTION � Property Location d ) \ l '/4, W1, 1 /4 , Sec. 2V , T Z R_ ( � W, Town of i � c �G � no c- Subdivision CS M y 7S' Lot # Z . Certified Survey Map # , Volume _ , Page # Warranty Deed # _, Volume , Page # _ Spec house yes ito Lot lines identifiabl yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Conan. 83,52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. 1 /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this fonn are true to the best of my /our knowledge. Iiwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ** *Any 'information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08(05) i VOL 1& PAGE 02 KATHLEER H. MVR REGISTER OF DEEDS RECEIVED FOR RFMRD N CERTIFIED SURVEY MAP No. 02/12/2004 12:1 -- CMMFIED SURVEY NAP LOCA7ED IN THE NORTH 112 OF THE NE 114 OF SEC 770N E NJ37.908 W., TOWN OF K/NN /CK /NN /C, ST. CROIX COUNTY, W S 2 em W E S o : UN�PIA LANDS a � NORTH 114 CORNER, NE CORNER, SEC. 28, T. 28 N, R_ 18 W NORTH LINE, N 112, N£ 114, SEC. 28, T. 28 N R. 18 W 4t COUNTY SECT /ON CORNER, _ -SEC. 28, T. 28 N. R. 18 W COUNTY SECTION CORNER, Oe• - BERNSIEN CAP 66.00-, 2 INCH IRON PIPE - - - S88 ,52'E 2311.76 It �• y 51 9.26_ — _ 510.20 - 58854 32 "E 1029-46 I i 3.601 T ACRE, > SOO 30'30 E I \ \ L - 33.00 3 156,863 SO. FT. i 30221 I 4 1\ X33 FT. DRIVEWAY p ck� 0 2 2 EASEMENT PER 00 W o N88 54 32 W - �n � `- h 519.26 Z N DOC. NO. 329071 W W 2 3 ® LOT S W I mo°° W 0 ° 25.771 ACRES Li ^ W�,ao zt 1, 122,580 SO. FT. 0 2 y !h W a LOT 2 p 40.000 ACRES O , Z - -WEST LINE, N 112, NE 114, 1,742,400 Sq. FT. SEC. 28, T. 28 N, R. 18 W 4 1280. 1029.41 / / 75 _ N89 '14 "W 2310.16 \ SOUTH LINE, N 1/2, NE 114, �- SEC. 28, T. 28 N, R. 18 W 5: Q. I A.- �- UNPLATTED LANDS X: I SEC. 28, T. 28 N, R' 18W PREPARED FAR: I I BRUCE ANDREA BEARINGS REFERENCED 70 THE NORTH LINE I i OF THE NE " OF SEC77ON 28. O 400 800 SOUTH L/NE, NE 114, - � -- --SEC. 28, T. 28N, R. 18W SCALE. 1 ' = 400' NO TE: LEGEND THIS 7H /S CER77F /ED SURVEY MAP IS EXEMPT FROM THE ST. CROIX COUNTY O SET 1 X 24' IRON PIPE RE7GHOW SUBO /VISION ORDINANCE 1.68 LB.S PER LINEAR FOOT. (SEC77ON 18.05(A)(1)) AND STATE • FOUND 2' IRON PIPE STATUTE (SECTION 236.45(2)(1)). - "Will ® EMS77NG BUILDING MARK F. MAISTRO CH S -2624 PASSE ENGINEERING, INC, THIS INSTRUMENT WAS DRAFTED DATED z/���'✓ BY MARK F. MAISTROWCH SHEET 7 OF 2 SHEETS Tom_ Vol 18 Page 4702 POWTS OWNER'S MANUAL & MANAGEMENT PLAN pa of FILE INFORMATION S rn L -� SYSTEM SPECIFICATIONS 7 ]���� Owner Septic Tank Capacity add al O NA Permit # Septic Tank Manufacturer +C O NA DESIGN PARAMETERS Effluent Filter Manufacturer fj O NA Number of Bedrooms �? ❑ NA Effluent Filter Model ff© ❑ NA Number of Public Facility Emits ❑ NA Pump Tank Capacity o al O NA Estimated flow (average) � Q g al/day Pump Tank Manufacturer J6s� ❑ NA Design flow (peak), (Estimated x 1.5) �� g aliday Pump Manufacturer �' ❑ NA Soil Application Rate gal/day/ft' Pump Model O NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfec ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand MOD,) 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ® NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :51W cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA other: ❑ NA Ott: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other' O NA MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once eve months) (Maximum 3 ears) ❑ NA ever ear(s) y Pump out contents of tanks) When combined sludge and scum equals one-third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: months) (Maximum 3 years) O NA .3 year(s) month(s) ❑ NA Clean effluent filter At least once every: /, / ,�yearls) Inspect pump, pump controls & alarm At least once every: ,� O month(s) ❑ NA _ ❑ year(s) Flush laterals and pressure test At least once every: O months) O NA ❑ year(s) Other: At least once every: 113 month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shelf be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and eny servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page ___ of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankis) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a Septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellis) in one large dose, overloading the cell(sl and may result in the backup or surface discharge of effluent. To avoid this, situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain {sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system if properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. d site AIIA ❑ T sit tank e • Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DU NOT EN TER SON FROM THE INTERIOR OR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE- CIRCU M S TANCES. DEATH MAY RESULT. RESCUE OF A PE PE RSON COMME POWTS INSTALLER POWTS MAINTAINER Name ��` /l,' ,wa A'V' 1.- 1 ,, Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name �. C Phone 715 ' 3�� — `' 0M Phone This document was drafted in compliance with chapter Comm 83.2212Nb)(11(d) &If) and 83.540 ), 42) dr (3), Wisconsin Administrative Code. START UP AND OPERATION Page __ _._ of For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high co ncentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Sep tage Servicing Operator. • After pumping, ail tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a coda compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing, and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. _f PnW �A ❑ T sit d site If a e tank ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DU NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name jQ,` 4'u Name Phone 7 / — _ _ ,g' ,; Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name �, Cr o., Zo✓��, Phone Phone This document was drafted in compliance with chapter Comm 83-22(2)(b)(1 1(d)&(f) and S3.54(1), (2) & 13), Wisconsin Administrative Code. f SEPTIC TANKS PUMP CHAMBER CROSS SE CTION A ND SPECIFICATTONS I 4" Cl VENT PIPE 12" MIN. ABOVE GRADE 8 WEATHERPROOF y 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK E FINISHED GRADE .- WARNING LABEL 4" CI RISER 7 Z, r .. ......4" M? N . 1.8" IN. b" MAX. 4 ' 1 NLET s WATER TIGHT SEALS GAS- TIGHT AL \,/APPROVED A SEAL OINTS WITH PPROVED --� , ALM PPROVED PIPE I PE 3' -._ ON ' ONTO NTO SOLID OLID SOIL OIL PUMP OFF ELEV . FT. - -� ! 1 OFF RISER EXIT D ERMITTED ONLY F TANK MANUFACTURER HAS APPROVAL 3" APPROVED. BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: NUMBER DOSES PER DAY: TANK SIZES SEPTIC GAL. DOSE VOLUME INCLUDING DOSE `6 GAL. FLOWBACK: GAL. ALARM MANUFACTURER: r p/,w & CAPACITIES: A = `�l 4 / INCHES'--= GAL. MODEL NUMBER: i. v SWITCH TYPE: me r B = 2 INCHES = - �2 GAL. PUMP MANUFACTURER: Go��;�cL C = S INCHES =GAL. MODEL NUMBER: ,�✓ a D = G INCHES = + GAL . SWITCH TYPE: nierG REQUIRED DISCHARGE RATE _ GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE • . � FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . FEET + FEET FORCEMAIN X :?. FT /100 FT. FRICTION FACTOR . 1,�? �'E£T G TOTAL DYNAMIC HEAD = FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH; DIAMETER LIQUID DEF"'n , / /,o . , / " SIGNED: �,.,, LICENSE NUMBER. DATE: �_... 1/88 [IGOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- s Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing p y g lubrication and efficient improved performance. construction. following uses: • Effluent systems heat transfer, ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion Canadian standards Asmda ion • Heavy duty sump matic models indude resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C "J factory, strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Goulds Pumps 4 150 9001 k9istered. FEATURES cover with integral handle and •Solids handling capability: float switch attachment points. 'le maximum. ■ EPO4 Impeller: Thermoplas- III Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1 NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104°F (40 continuous 140°F (60 intermittent. METERS Feer • Fasteners: 300 series 10 � stainless steel. ; . • Capable of running dry without damage to B *2.5 Fr components. 25 _ Motor: i 20 • EPO4 Single phase: 0.4 HP, g fi _. _ 115 or 230 V, 60 Hz, 1550 RPM, built in overload with s 15 automatic reset. ar epos • EP05 Single phase: 0.5 HP, o 115 V, 60 Hz, 1550 RPM, r 3 ro . -. -... _..._.__ _. . _..� ....._ built in overload with ePO4 automatic reset, 2 ,, Power cord: 10 foot standard length, 16/3 1 - SJTOW with three prong grounding plug. Optional 20 01 0 0 10 zo 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug a - 2 a s s 10 1�2 ml /h (standard on EP05). cArauTr Goulds Pumps 0 2000 Goulds Pumps <& ITT Industries Effective February, 2000 53871 +rAaAa 4E' .rla�lraar +rrf�fr STANDARD ChA MRER , ' .._ _ _�.�_. i8 ., __ _ .._. � �uick4 Standard Chamber ,, _ _ _ . - __._. -.- .... - - - -_ .�_� f (EFFECTIVE' LENGTH) i 34" - -- — - - • &OF VIEW SECTION VIEW MuftiPort End Cap T I , , .� '�t �, 4 � i ce . • • - -- 34" -t.. - - - - - --+ SIDE VIEW TOP VIEW FRONT VIEW r +.,. !:r }'• 44 .M. � b Qui &Undhrd Chombit.No�mi 1 Spscittsatio rtSEnd Ca �tomlm! Speaiticetiaas _ I �.+.... � �+e Ara A . i Siz M x L x H W .�.._ ..__34 x 52" x t2' 3 x ? 6 x t2" f _._ Ettective mall tr, d8" 1�9ve1t Nei nt ___ W of 1 .25' ^ever, Height _.�... @• I f t� +F11,IWi?14 S "r.ST_IaM>&. KCATANj?M •.• •.r -1 III " r i M I h lt1t' IY - r r4ian watlAe' r 1 ttY.aA ArrtlFrTV tAJn rC' '�U•. , tly 4 -Up ltta • • 6. 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' f`i fY + � ;.,5b Afw 5.3'!i -Di 7, 5•AO 1 tE; 5,147 ?`�fl t, ,,11,87. v-- ( - a 1M' .NEMp�a A I� 9a' /AyA uatants pert I etP 8.1 lsxw v r" : rytK,6, 4,laurla s!M-" ;i ;J .. W - . i' 4X'i Mj'+ �� ttArc7arnnMt• JA rAllrptryl 0,'7lM +, Ir t. 'd r {JketlY R ++LI' d VJ!CkVU i/t'' -•" I Ci .n•- 19rt1.� .aln 'tJ'" MYnK:O- .of+lou +, �Qn1ou S«Ivr3f CiAM4Wn4r. M...,x14.rin,Mlp pflpyfvH 14nAG6 nuk. hrNMA►fj'(yCM. n •xrl! V64, Ater 8vstems Ar:c. PrrrAld in ii 5.k U 2 5 18 P 13 2 -7 55398 t( STATE BAR OF WISCONSIN FORM 5 - 2000 KATHLEEN H. WALSH PERSONAL REPRESENTATIVE'S DEED REGISTER OF DEEDS Document Number ST. CROIX GO., MI Ardys McDonald RECEIVED FOR RECORD 02/27/2004 12:30PH PERSONAL REPRESENTATIV as Personal Representative of the estate of Leota M. Andrea EXEMPT I REC FEE: 11.00 TRANS FEE: 501.00 ( "Decedent "), for valuable consideration conveys, without warranty, to Bruce COPY FEE: CC FEE: Andrea PAGES: 1 Grantee, the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 2 of Certified Survey Map in Volume Eighteen (18) of Certified Survey Maps, Page 4702, as Document Number 754113, filed in St. Croix County Register of Deeds Office on Recording Area February 12, 2004, being located in the North 1/2 of the Northeast 114 of Section 28, Name and Return Address Township 28 North, Range 18 West, Town of Kionickinnic, St. Croix County, Wisconsin, Leo A. Beskar more fully described as follows: Rodli, Beskar, Boles & Krueger, S.C. Beginning at the North Quarter Corner of said Section 28; thence South 88 degrees 54 PO Box 138 - 219 N Main Street minutes 32 seconds East, along the north line of said North Half of the Northeast Quarter, a distance of 2311.76 feet to the west line of the East Quarter of the Northeast Quarter of River Falls, WI 54022 -0138 the Northeast Quarter of said Section 28; Thence South 00 degrees 26 minutes 37 seconds East, along said west line of the East Quarter of the Northeast Quarter of the Northeast Quarter, a distance of 1305.08 feet to the south line of said North Half of the Northeast Part of 022 - 1079 - - 000 and 022 - 1079 - - 000 Quarter; Thence North 89 degrees 01 minutes 14 seconds West, along said south line of Parcel Identification Number (PIN) the North Half of the Northeast Quarter, a distance of 2310.16 feet to the west line of said North Half of the Northeast Quarter; Thence North 00 degrees 30 minutes 30 seconds West, along said west line of the North Half of the Northeast Quarter, a distance of 1310.34 feet to the point of beginning. Subject to any and all easements, right-of-ways or conveyances of record. Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated this 074 day of February 2004 gm k (Le-n o� * * Ardys McD &1d Personal Representative Personal Representative AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF Wisconsin ) ) ss. f County ) authenticated this day of Personally came before me this cj*A day of February 2004 the above named Ardys McDonald TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who execute�4.A"o'Wg instrument d acknowledged t sa �;•� S V E A�. authorized by § 706.06, Wis. Stats.) ,�� THIS INSTRUMENT WAS DRAFTED BY «. Leo A. Beskar Notary Public, State of Wisconsin = ce 'gyp 00 Rodli, Beskar, Boles & Krueger, S.C. My Commission is ermanent. (If not, t e'Sy a • .� i (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. �'�. �i1VISC0 STATE BAR OF WISCONSIN 11 '.1111600 4 " PERSONAL REPRESENTATIVE'S DEED FORM No. 5 - 2000 INFO -PRO (800)655 -2021 www.infoproforms.com Parcel #: 022 - 1079 -30 -300 09/28/2006 11:18 AM PAGE 1 OF 1 Alt. Parcel #: 28.28.18.434C 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/12/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner BRUCE ANDREA O - ANDREA, BRUCE 1450 S WASSON LA 12 RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: 4702 -CSM 18 -4702 022 -04 SEC 28 T28N R1 8W NW NE CSM 18 -4702 LOT 2 Block/Condo Bldg: LOT 2 (40.00 AC ) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/27/2004 755398 2518/132 PR 02/27/2004 755396 2518/129 TI 02/12/2004 CSM 18/4702 CSM 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 17.000 2,600 0 2,600 NO PRODUCTIVE FORST LANDS G6 23.000 57,500 0 57,500 NO Totals for 2006: General Property 40.000 60,100 0 60,100 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 60,100 0 60,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CWIX COLT PLANNING & ZONI EROSION & SEDIMENT CONTROL PLAN Site location: 199 Pine Tree Rd, Lot 2 CSM #754113, Town of Kinnickinnic aM. Owner(s): Bruce Andrea lm Parcel ID # 28.28.18.434C Code Adminis 715 -386 -4680 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." In Land Infonnatio addition, Wisconsin Uniform Dwelling Code Comm. 21.125 requires the building permit Planning applicant and /or landowner to follow erosion control procedures and maintain them until 715- 386 -4674 the site has been stabilized (Uniform Dwelling Code Comm 21 is available on -line at: www. commerce. state. wi .us /SB /SB- DivCodesListing.html) Real Property 715- 386 -4677 The Owner of the above parcel is responsible for notification of all contractors performing construction activities on this site that an Erosion & Sediment Control Plan is in effect and the Recycling following activities will be required in order to maintain compliance with the plan: 715-386- 5 1. Maintain existing vegetation wherever possible to minimize erosion and sediment movement. 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 installation adds to temporary disturbance, but establishing cover on exposed } soils will prevent erosion. Apply seed and mulch as recommended in #5 below. 2. Install construction entrance before any excavation begins!! 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 require access to the property during construction. 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. s 3. Do not allow diverted runoff to be directed onto neighboring property or into surface water conveyances. Contain runoff by installing temporary diversions graded ALONG CONTOUR between construction areas and any potential receiving waters (includes drainage ditches and retention basins). Temporary Diversions specification sheet is available from county. ry6 4. If sediment cannot be contained on owner's property with temporary diversions and vegetative buffers, then installation of approved sediment control products (straw wattles, silt fence, and/or erosion control matting) will be required. The POWTS inspector and/or building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 41. ST. CROIX COUNTY GOVERNMENT CENTER 110 1 CARM/CHAEL ROAD, HUDSON, W/ 54016 71_5386 FAX PZ @CO. SAINT-CROIX. WI. US WWW.CO.SAINT- CROIX.WI.US Page Two — ESC Plan Acknowledgement Form 5. Stabi Sze exposed soils (septic system included) with seed and mulch immediately after instal ation - do not wait r final stabilization and/or landscaping of entire site to establish permanent cover on the sit . When late - seas , weather conditions will not permit seed germination, a heavy straw mulch cover will preve rit erosion until veget*gn can be established. Erosion control matting can be applied any time of year and, if instilled properly, will proeprotection even if seed germination is delayed. The owner 4 rd during site construction will be responsible for compliance with state and county code requiremen ecified in this Erosion & Sediment Control Plan. Please feel free to contact me with questions regarding er & sediment control product installation. PLAN PREP D BY: RYAN YARMNGTON, POWTS INSPECTOR # 683475 Owner ac k: bwled ement of ESC Plan re uirements: L21/2006 (Please.gi& and return original ESC form to Planning & Zoning Dept. A copy is attached to the owner's permit and maj , tbnance agreement, which is given to the plumber at time of permit issuance.) opies provided for excavation contractor, plumber, and town building inspector r x � 'w a. k f +4 e µ 4 F �r,. >.aw..,+.w.r.....e ...... .,.:, ,. ...�., ..:......,..- ,. -... a. ,:..�.x e.. a..::._,..,,...., M.e.. . , w . .:,.:..: a....a..v.: .: ....,..., .:: xi.;.... a. a,......:,.... w....... a ..,. >w.w..:a�w..w:F.. -.... ST. CRO /X COUNTY GOVERNMENT CENTER 110 1 CARMiCHAEL ROAD, HUDSON, W/ 54016 71 5386 FAA PZ9CO.SAINT- CROIX.W1.US WW .CO.SAINT- CROIX.WWS