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v > Wisconsin Department of Commerce County: Safety and Building Division PRIVATE SEWAGE SYSTE St. Croix INSPECTION REPORT Sanitary Permit No: 487958 0 GENERAL INFORMATION f (ATTACH TO PERMIT) pate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 20 ` 5 = Te*" • 1 &.* Permit Holder's Name: City Village X Township Parcel Tax No: Henry, James Pleasant Valley, Town of 6 � `f p 3 -cam CST BM Elev: Insp. BM Elev: BM Description: SectionlTown /Range/Map No: 100 3 V" I C j 04.28.17. a TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ,4 - 1Ov C- F lam, Septic Benchmark ' � S t✓2 1 2 E Q ArN C�:.14' lfXv . /cXJ Dosing r Alk BM Go J� Al, �W <�b� E Aeration Bldg. Sewer; , D 3 16 71 a. 0 Holding St/Ht Inlet 7 . 71 � • 22• �t ' + St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet $aJ Septic i 13Z 1 S c — Dt Bottom 0 �(0 Dosing m / 3L 1 5 `f Header /Man. S. 35 Idb , 3 Aeration Dist. Pipe S , 9 Ia .zip Holding Bot. System V3 95 , 53 Final Grade < S c,),, PUMP /SIPHON INFORMATION / � •'� y .ol � -1 �� � 3 1 Manufacturer GPM St Cover 3 0 \ 3 S �T i , 25 161,7<o Model Number 5 S D 34-3 �+�: � 7• Zlo 9";c 1 , TDH Lift 1� Friction L� System He d� TDH Ft ' •! Forcemain Length ♦ Dia. 11 Dist. to Well 3o Z /3Z SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenc es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth (.0 DIMENSIONS / Q ` \� SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: — CHA OR / r 1 Model Number: � DISTRIBUTION SYSTEM S Header /Manifold �I Distribution i l I x Hole Size f x Hole Spacing Ven Air 1 I Pipes) /j�{ L 3 I V L Dia /� Length ! IX Dia Spacing A �� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center I 7$ Bed/Trench Edges \ Topsoil 'C4— 1 ( s � No Ces No 1 c COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: �� � 08 /S Inspection #2: J / g / a� P1 "S ate, c � ` PT r" Location: 570 172nd St et Hammond, WI 54015 (SW 1/4 NW 1/4 4 T28N RI 7W) Missy Meadows Lot 3 Parce No: 04.28.17. 1.) Alt BM Description = %/ Ccj;.. C�a� s �. I if- `�2� 2.) Bldg sewer length = 51 - amount of cover = L• 2 "+ _ -- - — -- 'Yo Plan revision Required? Yes Use other side for additional information. Date Insepctor' Signat a Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division County l v iwonsin 20 Washington .O. Box 7162 M 53707 (�+E I / Permit Number (to be filled in by Co.) Department of Commerce 608 6 -3154e W �-- c f Sanitary Permit A ' ati OCT 2 6 20 (5 L LD f� Num � Q6 In accord with Comm 83.21, Wis. Adm. Code, personal infon you provide may be used for secondary purposes Privacy Law, x15.04( ST. CROIX COUN A 7 (rf drffae / nt than mailing �� L Application Information - Please Print All Information .6 / , 7 /J �V Property Owner's Name Parcel # # 1 -% .or,�s �,� Y �Nc. f 3 Property Owner's Mailing Address G /3 ti/Y /�� v, /r!!✓ '/., seotim City, State Zip Code Phone Number II. Type of Building (check all that apply) ,/� T o?8 N; Rf�,>so{�f � / � Subdivision Name CSM Num 0'C l or 2 Family Dwelling - Number of Bedrooms 7 i ❑ Publie/Commeroial - Describe Use /SjY �A Da r✓S ❑ State Owned - Describe Use Deity age ownship of 1" x ,r r - r IIL Type of Permit: (Check only one box on line A. Complete line B if applicable) A - New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS stem: Check all that appl ❑ Non Pressurized In- Ground Mound > 24 in of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass sand Filter ❑ Conshu led Wetland ❑ Pressurized ht- Cmound ❑ Holding Tank Peat Filter ❑ Aerobio Treatment Unit ❑ Rooiraulating Sand Filter ❑ Recirculating Synthetic, Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravolop Pipe ❑ Other (explain) / t V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Appliaati Dispersal Area Requirod sf) persal Area Proposed (s System Elevation / � L� ' '� 600 OHO 6 ��o 99 S �a„V 9 Gow row (/ VL Tank Info Capacity in Total Number Manufacturer 1 Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass Now Existing Talcs Tanks SqPtiooaoW-W4-k /.?.Sd �.S / ESt'2 a G r6r ✓ Aerobic Treatment Unit / ,, /L, Ax Dosing Chamber SO �$' � Z yr ✓ VIL Responsibility Statement I , the undersigne4 assume responAblUty for installation of the POWTS shown on the attached plane. Plumber's Name (Print) Plum MP/1V) W Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) e,. Foe 25r, 4k S �urvro G✓ S� 77G V11L /De artment Use Onl ved ❑ Disapproved Sanitary Permit Fce (' ludes Groundwater Date Issued Is g Agen gn ) Surcharge Fee) 7 l �- Q I0 3 / ❑ Owner Given Reason for Denial o! ' IX. Conditions of Approval/Reasons for Disapproval P ✓� SY�TEMOWNER: 7 3-S 7 7Y ^ ep ic anl filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber _ 2. se ac regwremen s as per applicable code /ordinances. Attach complete plans (to the County oolyj for the system on paper not lea than SW z inches In sirs SBD -6398 (R. 01/03) o � � v � t � h r v ® y Z �V Q t •a • a Z. o; V J � V a 'a, L � v t V ti r � c) M N h \4 v � Q t a � Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 f 9 Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: P Project Name and System Type: ,i,�,,��- s.✓.rr - y.8s. �ou�� .�owrs Location: �o ioa,r. Street Address .Sl/ itl •c% y "d,/ /7 ti/ r Legal Description i F Azwrwr Township /County Contents: Page 1: Pir[E SY�Errr Page 2: A o r A s.r co CD u� age 3: 1?5 ss - J e ri..✓ ,o..ro As.✓ ��-.✓ of /�....io � o W ° -_J >? m age 4: D,o� Z v r fw oA 2 r � ! $ Page5: �- � �c'Pr /L ,✓,r ���.rP G/✓.oiY,Olt C/1oJJ- .S ,e L rew! U CD W *Page 6: �uyr G'�6'ilFoa.�s,i.ra! �uA ✓I' Page 7: Osi s✓ 1's o a.✓r.c s �,�,rW,.G �.o.✓ .yslir�.✓ r ot..✓ Page 8: Page 9: " INS ` . pIVtS'rt),N �F ETY Attachments G �'vaLa t' /o.✓ �i�ii T GE vG E CORRE PlumberA4esi�gn /��.r� �� �,r� Signed: l� Credential Number: Date: G/ s,ro .S - 06 9 / -P oNND / O/yPONrvr ~ /o yon -�° ���a�ssw� �il r��ou r.,r Lo,ysr.•�r•�r �.yi✓NA6 �� ddt tir .7.0 o 4 _Nrl V } o�I v V o h o < Q o h 3 0 Q 1 v Q `o h . � V t .. N ll Il o: \ In h tro ` k k Old N a = Q a V. V 0 0 • � � 1 O` s� t � R w •1 /I.1 1 0 1 1 co hl hj td v � 1 •o V Q • • � 1 1. 1 1'• +, 1 1 S o r k \ �t tp • . Oe N t l a A t M o 8 a N A o x• o - a •1 o `+ 114 o pt 9 x o i x? 1 n .0 to g l C 00 , c Pd b :0 Imo• . i C .. k 1 8y'bo RRR�x C � n It a R ° w � L M• b • � w y � z h (Al k o L ' Page .S� Of 9• SEPTIC TANK E'PUMP CHAMBER CROSS SECTIOW AND SPECIFICATIONS . A . d44. f'o. 4" Cl VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF ?' /o" FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E fi,��.rvdo WARNING LABEL 4 " MIN. INLET Z i� 1' GAS- ' WATER TIGHT SEALS TIGHT J Fic rEZ p SEAL vAPPROVED -hoc JOINTS WITH APPROVED --- APPROVED PIPE PIPE 3' B 3' ONTO ONTO SOLID SOLID SOIL SOIL' PUMP OFF ELEV . 9/. S FT. - -- '� RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL. 3" APPROVED BEDDING UNDER TANK CONCRETE .PAD SPECIFICATIONS SEPTIC,/ DOSE' TANK MANUFACTURER: 1, e"a,,c„rr NUMBER DOSES PER DAY: S.I OYe 9.) TANK SIZES SEPTIC /.75'o GAL. DOSE VOLUME INCLUDING 1175 t .T 3 = DOSE 7.56 GAL.. FLOWBACK: /.70.8 GAL. ALARM MANUFACTURER: ,5,� �No,�eN� CAPACITIES: A = 30 INCHES y83 GAL. -,-- MODEL NUMBER: SWITCH TYPE: -'1eAe4llfr /r � B = 2 INCHES .47. z GAL. PUMP MANUFACTURER /b�y� irors ar /G /NON C INCHES = do.8 GAL. MODEL NUMBER: fit✓ so SWITCH TYPE D• " _8.S INCHES = /��.9 GAL. REQUIRED DISCHARGE RATE Jy.?2 GPM PUMP E ALARM WIRING AS PER ILHR_ 16:23 WAC ,, VERTTCAL*DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 8 G FEET + MINIMUM NETWORK SUPPLY PRESSURE Y 3 FEET + FEET FORCEMAYN X a „s FT /100 FT. FRICTION FACTOR s FEET TATAL DYNAMIC HEAD = /,7. y FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH sS ; WIDTH 80 ; DIAMETER - LIQUID DEPTH-' 1,f HYDROVATI" SD33 VS33 SW50 SW/SD/VS33 SW/SD/VS50 Typical Application" Sum /Effluent p ump Typical Application' Su /Effluent pum Capacities SW/SD/VS33 - to 48 GPM (3.0 Vs) Capacities SW/SD/VS50 - to 44 GPM (2.8 Vs) Heads SW/SD/VS33 - to 26 ft. (1.9 m) Heads SW/SD/VS50 - to 24 ft. (1.3 m) Electrical SW/SD/VS33 - 115V,1e,10.0 FIA, 60 Hz Electrical SW/SD/VS50 - 115V, le, 8.0 FIA, 60 Hz Motor SW/SD/VS33 - 1/3 HP shaded pole w /theima) Motor SW/SD/VS50 -1/2 HP shaded pole w /thermal overload overload 1550 RPM 1550 RPM Minimum Recommended SD/VS33 =12' (304.8 mm) Minimum Recommended SD/VS50 =12' (304.8 mm) Sump Diameter SW33 = 18"(457 mm) Sump Diameter SW50 =18' (457 mm) Automatic Operation SW = Wide-angle float switch Automatic Operation SW =Wide -angle float (manual available) SD = Diaphragm pressure switch (manual available) SO = Diaphragm pressure switches VS = Vertical float switch VS = Vertical float switch Materials of Construction Cast iron and engineered thermoplastic Materials of Construction Cast iron and engineered thermoplastic Impeller Thermoplastic vortex Impeller Thermoplastic two vane semiopen Discharge Size 1.1/2' NPl (38.1 mm) Discharge Size 1 -1/2' NP1(38.1 mm) Solids Handling 3/8' (12.8 mm) Solids Handling 3/4' (12.8 mm) Power Cord 10', SJ1W,(20' optional) Power ford 10', SJTW,(20' optional) Superior Features a Carbon/Cetarnk mechanical seal Superior Features • Carbon/CeraWc mechanical seal • 01 -fiRed motor w /automatic reset • Oil -filled motor w /automgtic reset thermal overload thermal overload • Uses single row ball bearing construction • Uses single row ball bearing construction • Piggyback plug available for easy maintenance gnd • Piggyback plug available for easy replacement maintenance and replacement 9 30 40 SD33, SW33, VS33 30 SW /SQ/VS50 6 � 20 � 20 3 10 0 Ce ►M 20 30 4 0 50 10 20 30 40 50 60 10 4 � 4 r i 2 3 GPM 8a ack Swit A' Q `9 :a POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner E S e tic Tank Ca ci W7 o [3 NA Permit # 7 Septic Tank Manufacturer /Efdrc [3 NA Effluent Filter Manufacturer 40"L E3 NA DESIGN PARAMET RS Number of Bedrooms 100 droom ❑ NA Effluent Filter Model /oo O NA Number of Commercial Units — NA Pump Tank Ca ci s'o E3 NA Estimated flow (average)* fVoo al/day Pump Tank Manufacturer Xrt ❑ NA Pump Manufacturer ,O4o1Viri.0 ❑ NA Design flow (peak), estimated x 1.5* Goo g a Uda Pum Model .SV s ❑ NA Soil Application Rat r /.O al/day ft Pretreatment Unit �'NA Influent/Effluent Quality (NA❑)1 Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODD ::5 220 m g /L [3 Disinfection [3 Other: Total Suspended Solids (TSS) Manufacturer: Model: 5 250 m Dispersal Cells) Pretreated Effluent Quality [3 nthly Ave a * ** ❑ In- ground (gravity) [3 In (pressurized) Biochemical Oxygen Demand (BOD < 3 [3 At-grade 'Mound Total Suspended Solids (TSS) 5 m ❑ Drip-line ❑ Other: Fecal Coliform (geometric mean) 0 cfu/100m1 ❑ Leaching C ber Manufactuver Maximum Effluent Particle Size 1/8 inch diameter Model La ' g Length/Chamber *Wastewater Flow Verification and Calculations: Soil Application Rate ft Area Req. ft (Other than bedroom based) Infiltrative Surface/ r -ESIA Rating ft Minimum Numbe of Cham ❑ Aggregate Design Flow/Loading Rate= ft min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMMM and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625 /1 -80 -012 October 1980 ❑ SBD — 10570 —P (8.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 P (8.6/99) "In Ground Absorption Component Manual" ❑ SBD — 10705 —P (N.01 101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 —P (8.6/99) "Mound Component Manual" 'SBD - 10691 —P (N.01101) "Mound Component Manual Version 2.0 ❑ SBD - 10595 —P (8.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 —P (8.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual" ArSBD - 10706 —P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Fre uenc Inspect condition of tank(s) At least once every ❑ months 3 ear(s) (Maximum 3 s.) Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cell(s) At least once every ❑ months 3 year(s) (Maximum 3 .) Clean effluent filter At least once every months ❑ year(s) Inspe p ump, Pump controls & alarm At least once every ❑ months 3 ear(s) ❑ NA Flush laterals and pressure test At least once eve ❑ months -,3 ear(s) ❑ NA Valves At least once every ❑ months ❑ ear(s) ❑ NA Other: At least once eve ❑ months ❑ ear(s) [I NA Page�of� START UP For new construction, prior to use of the POWTS check treatment tank(s) 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. i System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fait peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. O Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. O(Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. ❑ In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page 8 of 9 "Mound, At- Grade; In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any ground surface must be promptly reported to the regulatory ' har e. An discharge to the p p Y po gu ' n f surface seepage or disc g gr evidenc o g Y r 75% of the height of the component may authority. r�nimg greater than gh 1H Y indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 shat1 be removed nind properly disposed of by a Septagc Sen:cing 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 other 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 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. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 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 LETHAL GASSES AND /OR INSUFFICIENT C OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE RgTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name E,ed Name ,tQ *t�r! Gciirei�� Phone 71-r / 7.?- S.t 9 Phone /S L7-? SEPTAGE SERVICING OPERATOR (Pump LOCAL REGULATORY AUTHORITY [ PhN e Agency .fir Liroi Z >•�i.✓< aor ne Phone 71s -a. yLBo KAWPDATA\EH \POWTS OWNER'S MANUAL.doc Page 9 of__?__ • t; ,r AM Maintenance The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel'" filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self- cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter m alarm, you will be notified by an alarm when the filter needs servicing. To service the filter: 'Servicing any zabel filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. P' t Firmly pull the filter hdndla and slide the cartridg6 Ullt . Remove the tank of the ca and um the P P Note: A tee handle may. necessary to pr to be used it the filter is r; any solid below ground level to Contact Zabel for info I escaping to th I' �l when the f handles rem While holding tt1 d.. C�rttld o "qV8 , +C the access open(h F �d Insert the Ol ` cartridge with fr back in the careful to rinse 11 ;K sure the flit *Note: It is not nece proj�erl completely i spotless' The biom aides in the pretreatme be left on the filter. (Ifn may be disass Replace t 4 ' N. MADE IN USA The product(s) shown are covered by one or more of the following patents: ,U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482,621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824, Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 - 221 - 5742 - Website http: / /W".Zabetcom A100/300.1- M,61499 10/11/05 TUE 11:16 FAX 715 986 4686 ST CRX CO ZONING 4 002 SAFETY AND BUILDINGS DIVISION oottttnWl:gaY- Integrated Services Bureau .. :..: 1 t price soi ,.. .:. :... . r':':: Chippewa Falls, WI 64729 INSPECTION REPORT W,ww.comm roe.wl, n (316) S 25M ... .. .� Date of Inspection: September 26, 2005 Plumber Name and Address: Project Name: Missy Meadows Subdivision Unknown Use: Residential Legal Description: W, NW, 4, 28, 17W Lot Number: 3, 7, and 10 3ubdivisiom Missy Meadows Certified Soil Tester Name and Address: Municipality: Town of Pleasant Valley Donna J, Stark, CST 221746 County: St, Croix 276 200 Street Star Prairie, Wl 54026 Plan Transaction Number: NA Sanitary Permit Number: NA Owner Name and Address: Allen Nyhagen Wastewater Flow: 450 - 600 gpd .2952 2 % Ave Persons Present: D. Stark, P. Quinn, New Aubum WI 54757 K. Grabau, J. Kruegar (715) 237 -2135 This Investlgatlon was requested by county staff to assist them in verifying soil conditions on several lots with low chroma -high value matrix colors (white to very pale brown) characteristic of weekly consolidated sandstone "bedrock that has been mapped (Arland series) in the county's detailed soil survey for this area. O ,} R .- Comm 85.30 1 lc 9, Wis, Adm. Code requires certified soil testers (CS'T) to report the occuirence of bedrock, Comm 81.01(28)(b), Wis, Adm. Code, defines weakly consolidated sandstone to be the point of increased resistance to penetration of a knife blade. The test parameter for weakly consolidated sandstone bedrock Is somewhat subjective but has been In use for 25 years or more in Wisconsin. Other resources such as the detailed soil survey and detailed geologic maps of an area (if available) help alert CST's to the potential of bedrock limitations. Bedrock is considered a limitation to treatment and/or dispersal and Comm 83.44(3)(a), Wis. Adm. Code, requires at least 24 Inches of vertical separation, 6- inches of which must be in -situ soil, above bedrock. Lots 3, 7, and 10 were reviewed for depth to weakly consolidated sandstone bedrock, Two soil pits were constructed on Lot 3. The first pit was located adjacent to and up slope of CST Stark's 9-4, The initial 12 inches consisted of soil fill material. A buried sift loam A horizon extended from 12 to 20 inches, and the silty clay loam subsoil terminated at the paralithk: contact with weakly consolidated sandstone bedrock approximately 4146 inches below the original surface elevation. The upper few inches of this sandstone deposit was loose to very weakly consolidated and passed the knifes penetration test. However, this may not be true across the entire site. In consideration of the ground slope, fill depth, and depth to bedrock a below grade distriMon cell will likely not work out at this location unless highly treated effluent (HTE) was dispersed to the distribution cell utilizing a vertical separation credit of one foot, in addition, a mound or at -grade system could only be used if an Individual site design foe over a filled area was submitted to the department and approved. It would be less problematic and more cost effective to relocate the distribution cell to another location on the lot The type of system to be used would likely be an above grade system such as a mound or at -grade system. An at -grade system requires at least 35 inches of suitable soil unless HTE is used. One soil pit was reviewed on Lot 10 near Stark's B -1, This area appears to be suited to a shallow below grade or at- grade system. Depth to bedrock was recorded as 66 inches. The CST and county should be able to work out a reasonable and code compliant depth to install a below grade distribution cell but an at -grade system would likely be acceptable on this lot too. A soil plt on Lot 7, near Stark's 6 -3, revealed the A horizon to be 10 -12 inches thick and underlain by 2-4 inches of loose fine sand. Weakly cemented sandstone bedrock is at 12 -15 inches and hard sandstone bedrock begins at 21 10/11/05 TUE 11:17 FAX 715 586 4680 ST CRa CO ZONING 10003 Missy Meadows Subdivision September 26, 2005 Page 2 of 2 inches below grade. The harder bedrock condition is easily identified since no penetration by a knife blade is possible. This area Is not sultable for a below grads system and Is only sultable for a mound system. Considering the transition from the A horizon almost immediately to weakly cemented sandstone bedrock there was some discussion as to whether this site had been cut and filled during construction of the interstate highway in the late 1950's. I am unable to make this determination. I would have expected a deeper soil solum but the observed sequence is possible, and a properly designed mound system should perform well on this site 9 the depth to impermeable bedrock is considered. There is also another site on the far east side of the lot that is natural and would also be acceptable for a mound system. If there are any questions regarding thls report, please fell free to contact me.. Leroy s k y, a ate.wi water Sp " list .us 1_ -mail 7151726-2544 Voice 7153726 -2549 Fax cc: County ❑ Plumber ,Q� CST ❑ Owner ❑ Other k:i ASV LoPErr �RoNC (3-7 A,&,G5) 02/ -- 1000- CI5 -000 • c Z8. 8a A��� a 2 �- Iboo 4a - �ao Wisconsin Departrnentof Conxnerce SOIL EV N REPORT pa 1 of 3 DivisionofSafwandBuildi gs in aooddarwe ' Attach complete site plan an paper not less than 8 r2 x 1 in size. Plan i County S T' G IQ o I �C include, loin not rnnrtad to vertical and tiorizorrfaf i (BA4. Parcel I.D. S EF 13 V E p sbpe.scWeordmensions.rwMan Please pdrrt all info do GpUN�Y R by Date 6e�;6 PerwW ration tm proAde may be uUd tot owo ub" \X F m} }. S Ptopertyowruer PropeAyLocation A L - L, E PJ N `/ H 1= Govt Lot W 1 3.14 W IM 4 T 28 N R 1 E (or) w Property Owner's MaWrg Address Lot # I Block # Subd Name or CSMN 2Z 2 Y AV Eni vt 6 M 155V M EADOW S State zo Code Phone Number ❑ Gty ❑ Village f3) Tom Nearest Road flew A u b urn I rui -2135" ('LEAS6111 VALLE - r" ve p Near Constrtxction Uw �} Rol / Ntsnber of bedrooms Code derived design flow rate — CVPD ❑ � /❑ Public or commercial - Descrie• Parent notarial Flood gain elevation if applic _1V tt and Area K Spot Tested suitable for a _5 mound (P.O.W.T.S.) system using sand fib. fit, ►, °• y p Buft 3� El Pit G B«i� 98.90 37 a ro„nd stufaoa fir. . 1 Depth to Soil Appkellon Rate 1•f0rizon Depth DorrAnant Calm Redox Description Texture Structure Consistence Boundary Roots GPDNf in. Munsell flu. Sz. ConL Color Gr. Sz. Sh. *M1 'ice l -1 /OYR3 /2 - .Q a►»5bK mfr a5 3 F 2 i3 -26 /vYR 3/4 Si I 2i C $Wc m G5 3 \(4 3 a - - 371 10 VR 'q4 - S'Gl 3 e sblc m f di - avf �} b 4 87- 62 ) u YOz 4 14 G If to YR- ' S /g 51 G air, a loK M v� l I of 10 Yit 64 # p Bartrg F 2_ ® Pit Ground surface elev. � / R Depth do imti'ng 9 2 Sol Axiceition Rate Horizon Depth Doninarrt Redox Description Texture strucdae con =o Boundary Roots GPDHF in. Mansell QL s7_ Cont. Color Gr. Sz. Sh. -Etff TdW I —12 10Y(t312 5bk mfr 3vF •S 2 12 - 10 `1q e 2 -fSbK -!=1 CL 5 3V4 r 3 3)-42 10 Y 5 af5 b m•F aw 2d-� 4 -42•Gb it7�'Q51 -�s 5 rr► i I ✓f I •O • Event #1 =SOD > 30 _ <220 "Q& and Tss >30 S,So MX ` Eflkierd 92 = BOD <M a* L and MM < 30 "A. CV Name t P� �3R f GH T Signatu CSTNurriber Address Oats Evalrar6an Conducted Telephone Nwd)w 2-0 12- /O TN \/E SPIQ/niEr VALLVY ✓ rol 5+767 ''' 1 14i 772-39�i Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 O RIGINAL P Property Owner _ P arcel iD # F'a9e d F eodng ❑ BMks ❑ Pit Ground surface elev. tf. Depth to rrrrtir factor in. Sol Applearion Rate Horizon Depth Dom*mM Cokm Redox Ow="on Texture Structure Consistence Boundary Rods GPOW in. Munsel Qu. Sz Cont. Color Gr. Sz. Sh. •EW1 'EM F Boft # ❑ ❑ Pit Ground surface elev. R Depth to fmi ft factor in. Sol Rafe Horbw Depth Donftwt Color Redcac Description Texture SUuctnue Candshince Boundary Roofs In, Munsel Qu Sz. Cord. Collor Gr. Sz. Sh. 'Efttfi 13ft, I 11 V F-1 Bo dng# BorhV ❑ Pn Grnund ft Deupfh to factor in. seal Rate Horizon Depth DominardCalot Redwc Description. Texture Skucdxe Caublence Boundary Rods GPOW In. Mu>sd Qo. Sz. Cunt Cdor Gr. SL Sh. 'EW TW soft ❑9 ❑ Pit Grotnnd suufaoe eieV. ft. Oepfh to firrr�rng factor In Sol AMk mftn Rate Harimn Depth Doninant colm Redorc Desc*don. Tom" Strum" Co wstence Bondary Roofs GPW in. Munsel Qu. Si Conk Color Gr. Sz Sh. `EW Etlirernt #1= BOD 30 a 220 nV& and TSS - 301150 m9ti EMu nt #2 = BOO, <_ 30 mgt. and TSS a 30 nnVL The Department of Commerce is an equal oPP Mnity service provider and employer. If you need assistance to access services Or need material in an altemate format, Please contact the department at 608- 266 -3151 or TIY 608- 2644777. saoa3MOL6 ► 2y —1000— 45 -0W Property Owner A/ Y ET eN Parcel iD # � z 9 - ro oD - 90 - io paw 2 of 3 F 31 � ❑ ® pd can td surface tnie,► q 9 R Depth tD tor � 9 3 in Sol Apokaffm t;bft Hodmon Depth Doa*mtt Calm Redax DesoxpGmt Terre Shuchre Consistence Boundary Roots G PM in. Musa QL Sr- Cont. color tar. Sz Sh. 'EM I 'EtM2 4 -1 JOYA - V- ;?msbk M-f-r 0.5 3v4- -t 2 ► - t0'eR`Ej4 bK ro - Fi w of . y 3n. sbY, Mfr a w av4 1 Ai '4 i0 a l5 5 O s YY1 1 IY4 I• D F-I # ❑� ❑ Pit aw d surface etev. R Depth to ltrnift factor rt. Sc�7 Application tie Horizon Depth Dm*=tCdw Redax Desci%Mon Textzre Stuctue . Consistence Bamfty Foots GPM in Munsell am Sz Cat Color Car Sz Sh. ' ❑ C;tvuM surface slant. tL Deptft to 1 factor in Sul Rate rtz Hnon Depth Don*mMColm Redox Desalption. Textue Stntct m Consis Boundary Roots' �_ CROW in. Mutseft am Sz. Cott. Color tar Si. Sh. 'Eta 1 - me , Boring F-I 9 ❑ s ❑ p {round snrbaoe dev R Depth to factor in Stti Rate Horizon Depth Dort*Wtt Oaks Redox Desai on. Texhae Shuchre Consistence Boundary Rods QnW In, Muted OLL SL Com Color Cyr: Sz. Sh. *E=l 'E�2 ►5 S MI N SOW 5 v t PA C-- E 3 bF 3 Sc. is/ GQ) ,Q, = GONTc�vR Ulbricht & Associates Private Sewage Consultants 2812 10°th Ave. Spring Valley, Wl 64767 V� c 4- Cl f?. 4o Z I 5 v c- 51'rv- D I U ri I Fora M Cc>rJ To OR S a� I F3 m 9 9.3_7 • 0 82= 9!g.q 33 - �`► I bo' o too 3 -7 0 5 o F-'E � l /2 S� T 9 6.90 I Om *t I o = too .00 t 1 i C cP -70 '� 5� r � �. !. i � L tv ' � � p tr � N �-•�- � � v �. � h' C'D r f�0 Nt (3'7ActktrS� ld00 - 95 -000 2 8. $ a 4GR�S� a 2- 4 . - l boo - 4 0 -100 Moorish Department of Corrrmerce SOIL E1/ N REPORT Page / of 3 Division of safety and awmings in accordance Attach complete site Wan on Paper not lass than 8 12 x 1 in size. Plan t cou* $ T- G R o i �C include, but not rgrrded tD: vertical and horizontal poht percera slope. scale or dimenstorm north arrow. (g t Paroel J.D. S E6 .4s V E Please print a!I info do �� by Date PMrsontl idormtaLion You provkre may be vasd for seowr4t+ry � m)). U� PropertyOwner PcopertyLocation A I- L E PJ N `/ Al .4 O'E Govt Lot W i& J WIM '4 T 28 N R 1-7 E (or w Property owner's MaBng Address Lot # 1 131oclug lSubdNamsorCSkW zg5 2 Y2 AVG,J 3 — I M 155 ME ,4 lDoWS UF Slate Number Q City ❑ Village ® Town Nearest Road r\IeW u n I 54 (w15) 23'1 -2t3S PI- EASAA11 VALLE - r" VE P New COnSIM rUM User ResidenW / Number of bedrooms Code derived design flow rate GPD ❑ Replacement / ❑ Pubic or commercial - Describe: Parent matedei Flood Plain elevation if applic tt General comments and _ Area Spot Tested suitable for a mound (P.O.W.T.S.) syste using ' l sand fill. ��-- B orin g F Ekx^g 0 98 90 ®Pit Ground surface elev_ R Depth to 3 7 taoi An Rate Hortam Depth Dan*Mt Red= Desm"on Texture Structure Consistence Boundary hoots GPQX K Munsei tau. SL Cont. Color Gr. 87- Sh. •ER#1 'Ef#2 1 -� �0YP'3 /2 - .e amsbK mfr aS 3-ic 2 13 -26 1 0 Y R 3 /4, V_ 3 24 iv *04 - S ic 3C sox I V17 f I C1i avf • b 4 87.6Z 1 u YA 4 /`F C, If /0YkG /8 51C avc, a 1qK M 1 of .. ja / v y/Z s / # ® pft Ground scaface elev. 7 0 R DepMD knft 4 2 W AppiCoWn Rota Horizon Depth DominartColor Redox Description Texhrre Structure Consi Boundary moots GPOW ' in. Munsell tau. Sz. cant Color Gr. 8z. Sh. *M1 TIM 1 -12 10 W1z 312 ,e 5 b m 5 3 v-F 2 12 - 31 10 VR 4 /4 0- 11, 2 -F s bK ro -1= i 5 3 V4 3 3) • 42 10 Y 5 1 .3 - C !1. a f5b K. mil 0,w 2%14 4 5 5 rn I 1 ✓f 1 .O ' lJArrent #1 =Boo > 30 _< 220 rngll. and T > 30 _< 150 mgfl. • S kient #2 = Boo —< 3o melt. and TSS _S M melt. CST Name (Please Pri><} � =Nurrf�er 1A cl 61 L 8 R ► GH 7 Address Date Evaluation Condrxeed Telephone Number 2-0 /D Tn AJE SPRIrJEr VALLEY✓ W .59-7,7 P. I 14/ l5 2,05'( l )- - 772-3q.y Ulbricht & Associates Private Sewage Consultants 2812 loth Ave. Spring Valley, WI 54767 ORI . IIv� ft-we 0 MOdS Ampurmalsouesspuco axWn4S &MM Q # &+oe a lid D fA If qs b. - T . M I f Q 7 - fif+; 4f-4r[ Z v)- +AS S b J WA S u� � � - "Z/E a► ai b - � mss. "W30 'W -zs XW3 woo zs MO a�w MwJ lemsoppmo I axwnjjS axvojL Uowkomo XWWH -C.; 4 xwq fkam ot 4090 'u trb'"Pam' &408 0 #&4xM- El £ Z �d oo► - ob - av o► - b z — aI Ira M.3'g V N ow -Sb - coo l - 4i z 4 L4-7 1`�1 t � J `i 1� C �!'�1c IJ v v v .+ �--� -- � ✓ FPM cam' C � ° t' ,� Sc A L- 1' = 5b' p BO'R 11 1 L-T Ulbricht & Associates Private Sewage Consultants 2612 10th Ave. Spring Valley, Wl 64767 l� 4-7 cl Gg, qo ? p, a r 5 L I Uri I PO rat rA ^ MouNn Cpt�l TouR J 0. J g tit 2 9 9 3 '7 • 0 8 2= q8.9' loop -7 % 51_oF>E 98.90 y O = 1 00. o0 % I i 4W f Sov`rtt F> L-t N Ie7 i C co '� g� A- I i ST. CROIX COUNTY , WISCONSIN PLANNING & ZONING DEPARTMENT l N N N N ■ rnN. ST. CROIX COUNTY GOVERNMENT CENTER 1 1101 Carmichael Road �•�- Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo to File From: Pam Quinn, Zoning Specialis Date: 9/30/2005 Re: On -Site Soil Evaluations for Lots 3, 7, and 10 of Missy Meadows Subdivision (N 1/2 NW' /. Sec 4, Town of Pleasant Valley) On September 26, 2005 Ryan Yarrington, Kevin Grabau, and myself, met CST Donna Stark and Leroy Jansky of DCOMM for an on -site evaluation of soil conditions on the above - referenced lots. Our office had received three updated soil reports from CST Stark for relocating POWTS system areas from the original soil reports completed by CST Jenny Ulbricht (who could not attend the on- site). Both soil testers had documented that fine sands were observed with dominant Munsell colors of either 10 YR 8/1 or 10 YR 8/2. Low chroma/high value colors can be indicative of bedrock weathered in- place, as opposed to soils weathered and then deposited in another location. Per Comm 83.44(3)(a) the infiltrative surface a POWTS must be located at least 24 inches above bedrock. After a review of the submitted soil reports, Mr. Jansky agreed that the soils should be evaluated to determine whether or not conventional POWTS were appropriate options for these lots. Following is a summary of Leroy's assessment of appropriate POWTS for each lot: Lot 3 — Two test pits were excavated (one in CST Stark's tested area, another in CST Ulbricht's area) and fine sands with banding were observed at 32" below grade in the latter pit. Leroy determined that the fine sands were weathered in -place from underlying sandstone bedrock and agreed with the original soil report's recommendation for use of a mound POWTS. In addition, it appeared that some fill material may have been deposited in CST Stark's proposed area that would preclude its use for a mound or at -grade POWTS. Lot 10 — A pit excavated within CST Stark's proposed POWTS area had sandy loam soils that extended approximately 60 inches below grade, overlying 10 YR 8/1 fine sands (weathered bedrock). The four test pits previously reported had 50 — 54 inches above the fine sands. A conventional POWTS would have to be installed at least 36 inches above the "bedrock" limiting factor, so must be extremely shallow and will require a minimum of 12 inches of soil cover mounded over the system (per In- ground Soil Absorption Component Manual). Lot 7 — A test pit was excavated within the proposed tested area and another approximately 20 feet NE of pit B 1. As reported by CST Stark, fine sands (weathered bedrock) were encountered within 14 inches of surface grade, which would meet requirements in Comm 83.44 (3)(b)1 for a mound with at least 6 inches of in -situ soil. This site is not, however, suitable for a conventional POWTS in either of the tested areas identified in submitted soil reports. Mr. Jansky will provide written documentation of his on -site evaluations and specific conditions to be included on sanitary permits issued by the county for each lot. A copy of this memo will be attached to all soil reports for this subdivision and, unless proven otherwise by county on -site, fine sands will be considered "weathered bedrock" for use in designing appropriate POWTS for each site. Cc: James Henry, Subdivision Developer Jim Krueger, General Contractor Donna Stark, CST #221746 Jenny Ulbricht, CST #859934 Leroy Jansky, DCOMM Regional Wastewater Specialist Soil report file -�' I'r�,u � au ,�e trL.. ��� •� races -}� . � d a a� �- ,� �1- a5 Wisconsir2 4epartment of Commerce OjqFVALUATION REPORT Page J of_] Division of Safety and Buildings in a= jXdm. ode County Attach complete site plan on paper not less tha 1/2 x 11 in s in size. Plan mu include, but not limited to: vertical and horizontal fereWnt I an Parcel I.D. percent slope, scale or dimensions, north arrow, nd to a d' to near t road. a ' Please print ll i or Re we Date �5OIX COUNTY Personal information you provide may be used for sec ndary pt�gi�s. 15.04 1) (m)). Pro ertyOwner rope Location N l' E t y , I A Q , Govt. Lot 5 w 1/4 N k , 1/4 S T d $ N R E (o - Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# j5 aYa. C-, 3 ila, of "h1;ss w5 " City State Zip Code Phone Number ❑ City E] Village EX Town Nearest Road„ New Construction Use: W Residential / Number of bedrooms _ Code derived design flow rate _ to ib d GPD El Replacement Parent materi y �t h S Ft d Plain elevation if applicable ft• General comments V g — ''rtr�e,c -..a v° e t�.c and recommendations: * t!5?3.108`� T,' 91.73 s,�g, � . '1'•� (93.0�`� ��`�c. w: -r,S (SI,cB'� 6 M Boring # ] Boring F n fi Ground surface elev. 9` • ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 L— ; ss � �, a � , I, e a 10�so p --- 046.04 t M5b W - cls 6 t F . H . 10 3 YE �.s� X0.14" i ►v iv l � r .`7 ❑ a Boring# Boring q9 as �© in. pit Ground surface elev. ft. Depth to limiting factor Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 - t) R L- d c-I F • to . 8 a 1 0-1 2, - 7. 54 Y 'y ! w6b tt—I as dr W,' l co r 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) Signature CST Number V-- L. at� A a v7 Lt- L, Address C5 Date Evaluation Con ucted Telephone Number ��. I Property Owner ��� Parcel ID # Page _ of T ! Boring # ❑ Boring t •J 1 - 3 - 1 pit Ground surface elev. - 7.7 0 ft. Depth to limiting factor � a p in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munse Qu. Sz. Cont. Color ^ Gr . Sz. Sh. 'Eff#1 'Eff#2 J 0 - S by -✓ z L l rhsb dt� Ct.v . to 3 3� 7.5lk F 6 L I FSbk- a , F-91 Boring # ❑Boring O t �] Pit Ground surface elev. / 10 J ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o -I It) L afsbK &)N aw l . to 3 IS -3 0 7 � 1 Mib a 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 -= 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) Cc� CA �cs co kp Loa S t i _.. �. � o �. .�. �. �- i � ' , � - � '-? t cam-•. � �_ -" b CP G N 1 886 r ° S S b �4 LA `� I -- lb� Q ` \\ �� 9'8601 x O'fTilx ® \ ;QOLL 0O - I - 'YB'N / IX 3' 'Q 'EOLt 'O'B / '9111x L10 , 6'f 0V . W , / / / I CUM 9101 \ I z'ff[[x • L-• 9101 � 1 11 I' I[k \• I — ' �vlo1 •'® �. c o `h LLa` • I �I 3 °5. 111 LGI[ x ( ._�� - � �, � \ _ /</ /, _ Rte/ I _._Y. b►10 l i ` .. 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Plan mu t include, but not limited to: vertical and horizontal eferenp�int), on an parcel LD. �,h percent slope, scale or dimensions, north arrow, nd to an di to near t road. Please print all i or Re •� Date '201X COUNTY a, Personal information you provide may be used for sec ndary ptw "Mgi )oP0tns. 15.04 1) (m)). j Pro ertyOwner rope Loci ion N O lie Govt. Lot w 1 /4 N to 1/4 S T a `j N R E (o W Pro Owner's M�a dress G Lot # Block # Su i�Name SM# 00t� / / 3 {� it Ir l SS w4s City State Zip Code Phone Number Cl City ❑ Village 515 Town Nearest Road. IOW 547 7 (5)AP-A Q�e�tSa e l721r 5 - f' - �. New Construction User Residential / Number of bedrooms Code derived design flow rate — �b id GPD ❑ Replacement Parent mated 4.v% A S n ib FI d Plain elevation if applicable _ ft. General comments v g - rre•e. �p v' E r+ -G I . �- and recommendations: * (43.+�8 T, y ( 9),73 o T " (93.ola SA*- �: 7.S (91 - r. 3 L q .2 .3 't' !p f 9P.Y3') U J Boring # P t ng J Ground surface elev. _ 74 • (oJ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descriptiorf Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I - Eff#2 a -� o�tF 3 l L- a�ssk a� ..b 1f? - 7.5`i y/ -- NG�Vy P ►"Is V F .7 I! oy2$ I r ►�. 1� -- S ►. t� S tc, rti — iie Ai Q CA ® Boring # a Pit Bori 1 1, o2 r J r in. Ground surface elev. _ ft. Depth to limiting factor Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sl I `Eff#1 `Eff#2 ►— aFS6�t All ' S Y • Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number o - �"a.,tr. a Address 'C Date Evaluation Con ucted Telephone Number d'- . ©o 9 -1 - S - a �Ig- 35:�? Property Owner Its 17a� Parcel ID # y Page _ of _ 1 Boring # ❑ Boring Pit Ground surface elev. g 7 7 _ � O ft. Depth to limiting factor a 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 5 -3H ,S1 P-2 I M:5b K- dL k G w I F . , to 3 3Y-5 (, 7,51As)b F5 L jF5b A� C w i \)�: . a , to y -i oyRa1 FS IFS6 slN F-91 Boring # — Pit Boring Ground surface elev. _ 9s'�3 ' ft. Depth to limiting factor � � � in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 )6-3o Is ION 4 t K 1 sb -1101 1 1>1 AV — FS i FS b �t. 46 F-1 Boring # F] 11 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 T 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.6100) •� � JJ -�` r 1• o- r •r, r�- CO c a r t _ ' 2 1 / 00 ILL i ry a cl __ -_ • __ __ __ _- - ._ _____ ___ __ __ __ __ ___ __ __ __ __ __ __ __ ___ __ -__ __ ___ _.__ __ _.. __ _ _ __ __ - -_ __ _ __ ___ __- __ _. __ _ _ _ __ __ ____ __ _.___ -_ _ _. __ ___ ____ ___ _ _ _ _ _. __ __ _. __ ..........._..... __ -- d 4 I I I. I vam ,. 6 to I� I I 1 offt P. I 5 as I oa x1j27. 1 N86-( Wg P OT I 3 WonG N.BA .3AC.s I 1:1"e .0. -1119- Pa� -ee OI e 5B3.68 3? 1 37 ' I eerie �e aIe EXISTING POWERPOL ( P.- y HOUSE Q BENCH O o TOP OF IRON PIPE TO BE REMOVED AT THE I I • . • • F • aN oll I Qo TOP OF IRON PIPE - ELEV. = 1 738.38TIME OF KM4. IP IP ELEV. = 113e.W I QI� ` 7- 9 '00-w I.Em "h 107, c0 I �' .s 1 3 0 OT 11 6.1 - 5A AC N,BA. 6 5.1 AC, \ 1 _ -- 3 . A.�I a+s�� \♦ CH K G Ip Q la P\ SHED I� BARN I _+• = -.- j -_ - -.. V. 113 ] 1„x11 •.• X.W BENCH K / rj ' T P OF IR PIPE E = 1 4411 - - / 7 2 El T IP -52. N L� m ✓ / x1159.5 6.4 AC. 1.8.0.-/162.20 A so ' / / • • •kit 8.7 I I 3 y l 5.0A _ O 1R I� l I L.B.O. 11 I I A � tar I s tar o $ x 1162.9 _ I x1160.7 ° I° �... ±11125.1 1 I I � D e _ i .. 11•J V P Y'a••, . 144. S a5 L.B.O.- +1127.00 p T 1 I / X117) 11 E T X 1174.8 \ a I I x 1 I B - - -_ ®� L0T4 x115 > x1143.0 K 2 V It I \ xIl p I ®• III I �� 1 c LOT 9 • •• se fll .BA. =4.3 AC x 1133.2 LOT 6 NBA. - 4 7 AC.- I • / / R \ /wy1 � I / •� 'o •'` 2 X1122.7 I , I / OT B 5. AC. x 1116. / N.B A. 39 x OT7 _ 1102. 6. C. - x1 NBA.- .s L.0-0.- 1113.00 a x109B.�L. x1113.0 J ST. CROIX COUNTY SEPTIC, TANK MAINTENANCE AGREEMENT ' AND OWNERSHIP CERTIFICATION FORM Owner /Buyer Mailing Address (9 ( � 1 1� 0" Property Address �o "� /Yt�3t v o �S S 1 S+ (Verification required from Planning & Zoning Department for new construction.) City /State WL ,,,,�,,�. , Parcel Identification Numbe LEGAL DESCRIPTION / 1 Property Location �,� 1 /�+/ 1 /4 ,Sec., T NR W, Town of Subdivision T & J i �l c- �C �-.1 j , Lot #. Certified Survey Map # p� / _ , Volume Page # , / ar ant e0 /-� Gr ? 9 q 0 � l� Volume �f U 2 - Page # l7 Warranty Deed P g Spec house yes no Lot lines identifiable 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 §Comm. 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 1/3 full of sludge. I /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 form are true to the best of my /our knowledge. I /we 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 L ' SIGNA OF APP ICAN 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) 2802 P 141 �1 7'94886 State Bar of Wisconsin Form 11 - 2003 LAND CONTRACT KATHLEEN H. MALSH OF DEEDS (TO BE USED FOR NON - CONSUMER ACT TRANSACTIONS) ST. REGISTER STER CO. MI Document Number Document Name RECEIVED FOR RECORD CONTRACT, by and between Allen C. s Linda L. Nyhagea ("Vendor," whether one or more), 05/13/2005 12:30P1! and Jim Henry Inc. LAND CONTRACT ( "Purchaser," whether one or more). EXElPT # REC FEE: 17.00 Vendor sells and agrees to convey to Purchaser, upon the prompt and full TRANS FEE: 1500.00 performance of this Contract by Purchaser, the following real estate, together COPY FEE: with the rents, profits, fixtures and other appurtenant interests "Property ", in CC FEE: St. Croix County, State of Wisconsin: PAGES: 4 W 1/2 of NW1 /4 of Section4, Township 28 North,Range 17 West, St. Croix County, Wisconsin lying North of I -94 EXCEPT Lot 1 of Certified Survey Map filed July 6, 2004 in Vol. 18, Page 4782, Doc. No. 767995. Recording Area Name and Return Address (1 Note: The above described parcel includes Lot 2 J�; , „ Ha K3P -Z7' l Certified Survey Map in Vol. 18, Page 4690, Doc. No. 752728. C 4'Lti •iJ�a - 9t�- ft�D ,9Nr� oZ�lr000 -3,- Parcel Identification Number (PIN) ppp This is not homestead property. (is) (is not) This is a purchase money mortgage. (is) (is not) Purchaser agrees to purchase the Property at the sum of $ 500, 000.00 in the following manner: (a) $ (b) the balame e 11— ifiWAM &BIR OR a Seller to be repaid in 13 installments of $38,461.54, with no interest being charged. Each installment is due and payable at the closing of each of the buyers 13 "to be" subdivided lots. provided the entire outstanding balance shall be paid in full on or before ( "Maturity Date "). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE OF THE FOLLOWING OPTIONS• IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY: ffF A. Any amount may be prepaid without premium or fee upon principal at any time. ❑ B. Any amount maybe prepaid without premium or fee upon principal at anytime after ❑ C. There maybe no prepayment of principal without written permission of Vendor. State Bar Form 11 - Page 1 REAAAX Team 1 Realty 2217 Vine St Ste 200. Hudson WI 54016 -5864 Phone: (715) 381 -5700 Fax: (715) 381 -5720 Missy Meadows. Jim Henry & Associates Produced with Z1pFann- by RE FormsNet, LLC 18025 Fifteen Mile Road Clinton Townshlp, Michigan 48035, (800) 383-9805 www.zipfbrm.com CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN OPTION A SHALL APPLY: X A. Any prepayment shall be applied to principal in the inverse order of maturity and shall not delay the due dates or change the amount of the remaining payments until the unpaid balance of principal and interest is paid in full. ❑ B. In the event of any prepayment, this Contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as specified above; provided that monthly payments shall continue in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded from this Contract. Purchaser shall pay prior to delinquency all taxes and assessments levied on the Property at the time of the execution of this Contract and thereafter, and deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the amount of the full replacement value of the improvements on the Property. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of Vendor's interest, and evidence of such policies covering the Property shall be provided to Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided Vendor deems the restoration or repair to be economically feasible. ❑ Purchaser is required to pay Vendor amounts sufficient to pay reasonably anticipated taxes, assessments, and insurance premiums as part of Purchaser's regular payments [CHECK BOX AT LEFT IF APPLICABLE]. Purchaser shall not commit waste nor allow waste to be committed on the Property, keep the Property in good tenantable condition and repair, and free from liens superior to the lien of this Contract, and comply with all laws, ordinances and regulations affecting the Property. If a repair required of Purchaser relates to an insured casualty, Purchaser shall not be responsible for performing such repair if Vendor does not make available to Purchaser the insurance proceeds therefor. Vendor agrees that if the purchase price with interest is fully paid and all conditions fully performed as specified herein, Vendor will execute and deliver to Purchaser a Warranty Deed in fee simple of the Property, free and clear of all liens and encumbrances, except those created by the act or default of Purchaser, and: CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY: ® A. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination, at the time of execution of this Contract. ❑ B. Purchaser states that the following exceptions set forth in the title evidence submitted to Purchaser for examination, at the time of execution of this Contract, are unsatisfactory to Purchaser: ❑ C. No title evidence was provided prior to execution of this Contract. State Bar Form 1 l - Page 2 Produced with ZipFormTM by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 www.zipfbrm.com Missy Meadows. 2.80 1 Dated J VENDOR: PURCHASER: (SEAL) �i /� //�(�� (SEAL) *Allen C.N ha en *J a Inc. ) . ' t l _I (SEAL) (SEAL) * Linda L. Nyha9 AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) cc ) ss. authenticated on •J, �rm /' ,X- CO ) � Personally came before me on 1 7 -- Y ' X 0-0 , the above -named * cf N •.14 TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the (If not, foregoing 7instrumand acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: -5 I n" Notary Public, State of Wisconsin My Commission (is permanent) (expires: 0� (Signatures may be authenticated or acknowledged Both are not necessary.) f - 6. 1 11 1 N NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY LAND CONTRACT STATE BAR OF WISCONSIN � *Type name below signatures. 1 t4 State Bar Form 11 - Page 4 Produced with ZlpFomlTM by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383-9805 www.zipform.com Missy Meadows. 51 1 SUPERIOR AUTOMOTIVE ---------- Ll lot .. — • • ,• a �' �.,�uus„•a -- __ -•- -- «�""- i i i I LOG►, /� + I i Nwu• l .. 1 ----- r-F-Flf \\ MAP A/ L0719 11 1 I.\ F �1 e�e.yp I LOT 11 1 ` 1 r1iCf. .. I N �- b 0 f i •, LOT t 'p 1bb I ' Nw I t `` �rr++4 • YW .. •LII i I ` � I , 01.11, it � 1 , rrN A�+ wa ... r LOT ■ ........ .• 3 � 1 11 I ..srcww f LOTH LOT d cyj u,w . 1 i ` � � •, v I `\ LOT • � ,5 LOT � �i PILE �• •• •, / ,tip Qd �7 DoT > r' r ✓ LOT ..., aM1Y •/lJ / err its .r• C gt MY .. --- - -- 4y - - - •- ---- •a' ^µms- ....w�� .. .tom'°'"' ,�.: ��� .,�`r�� . .f `