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HomeMy WebLinkAbout024-1047-11-000 t Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 488101 0 GENERAL MATION (ATTACH TO PERMIT) State Plan ID No: J I i i v �sed, for secondary purposes (Privacy, Law, s.15.04 (1)(m)]. it Holder's Name. ! 1 r Village X Township Parcel Tax No: Hen , James -� /V L Ci Pleasant Valley, Town of 024 - 1047 -11 -000 CST BM Elev: Insp. BM Elev: f Description: Section/Town /Range /Map No: IN - 9 0C - S 1; - 1 4 ' Z, 04.28.17.304 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER K. --e CAPACITY STATION BS HI FS ELEV. Septic / z6O Ben- `m+ G _ I ( b /bo, O W . 6 Yj gyp Dosing Alt. B Co Ae�a#+en Bldg. Sewer Holding St /Ht Inlet >P I,{p Q7.47 TANK SETBACK INFORMATION S t/Ht Outle TANK TO P/L WELL BLDG. V ent o it Intake ROAD Dt Inle ep is / bottom 7 5o l i�5 3O 3 6 * IZ.15 93 I osing 7 5 ea er V / rS � b A - 00 — on — Dist. Fipe 16. t S .I 6 1. z o ing o . ys em t , 5 -Ss 51.J — I .� /06 - ST PUMP /SIPHON INFORMATION ma ra e �. l62 -24 4yS anu ac urer 1 1 eman over G Q 1 4L � ,, PM Fil * 3 ,, 1 /W.ti� 4 /62 . � 1 o e um De r 1 8� I UN IL i Friction ys em ea '7. 3 ZS i> t- orce main e uia. b 1 Z_ DIMENSIONS 5 I Z 4 1 � `� 1 '� INFORMATION CHAMBER OR UNIT M .O.O .J o.Sl � Vq 163' A14- 11 paunly illtdkt! Pipes) , I / v Length �' Dia Z Length Dia , 4 Spacing Z'S 3 �L 4/- v ary x Pressure Systems Only xx Mound Or At Systems Only Bed/Trench Center ).7 ► 7 Bed/Trench Edges \ Topsoil ) q—, es No Yes iY ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: r � / T / Inspection #2: Location: 578 172nd Street a mond, f WI 54015 (NW 1/4 NW 1/4 4 T28N R17W) Missy Meadows Lot 11 Parcel No: 04.28.17.304 1.) Alt BM Description 2.) Bldg sewer length - - amount of cover = / ' C NO") 6 k-- L'. L 6 vim. Plan revision Required? Yes No -��__ Use other side for additional information. i SBD -6710 (R.3/97) L/�� 1 �q� Safety and Buitdi V Division county -� 201 W. Washington Ave., P.O. Box 7162 8/ f$�p Madison, WI $3707 — 7162 Senitery Nw*w (to be erica in by Co.) Department of Commerce (608) 266-3151 l p t es p ion I.D. State Sanitary Permit Appli N umb In sword VdIh Co�nm:83.21, Wis. Adm. Code, personal hdbtmadon you p:vvi a Project Address (if difibrent dam mad may be used for s000ndaty purposes privacy Law, #15.04(1 X L AppHcxdon laformatton - please Print All Information 5 Z 's Name JJ * Block 1M Pmperty Owner's MW t ddrO Property Location a Z _A1W _ y N W �.. Berrien 1 -t City, State Zip code Phone Number /V w S_(('> r— T N; Xnlor ) IL Type of Building (ebeek an that apply l � ❑ 1 or 2 Family r veiling - Number of Bedrooms ( 5 � ` ` Subdivision Name - C M Number ❑ public�Catmrra vial - Describe Use S 4 1 151 4 ❑ Stets owned - Daedbe Use ❑city_ i ownakip of C 13L Ty" of per aft (Cheek only one bolt on Here A. Complex Hne B. if applicable) 024 A 94&W System ❑ Replacement System ❑ Tmosent/Holding Tank Replacement 9e1y ❑ Other Modi6Cadon ib Big System B. ❑ Permit Renewal ❑ Permit Revisions ❑ Ust Previous Permit Number and Data kned Befae � iratlon Owner Change of D Permit slander to Now Plumber ' � 1 V. of PO WTS C4eek all that 2 — h t ❑ Noe -'�s� ed 1n-0round Q9ound > 24 in, of suitable s ' 13 Mound <24 in. of suitable tl O At -Oracle ^ ❑ SWOOP= Sand PilW Coeetruaw wedand ❑ pre mind in- Ground ❑ Holding Tank © Peat Filter ❑ AorW Tratrrrertt Unit ❑ Racirmlethtg Sand Fitter ❑ thede Media Pilter C Opripune ❑ 0ravel4ess Other lain V. phoersayrr eatment Area Information: zo i low (iPd; Design Soil Application licadon/. O� Dlspeesal Area Regletrtd (t� Di Area od (SO Si'semn, l C I �(�p) 9 r VL Task Info Capacity in Told Number Manuicturer Preiitb Site Steel Fiber Plastic Gallons oallons of Units W /� Tan crete Constructed obw Now ( c f 'teats Tsa1a lT�f SV* er Hokfas i u k Aeobio Teeotmmt Ll Alt r f G( -f VIA bi Staxmeat -,i, the as , ad, me respo 1 for iaatatiadon of the POWTS shown on the attaehad plam R mews Name (I"M) 71wn S MPMIPRS Number sinew Piton Number Plotnber's Address (Street, City, State, zip e) ZZ Z Llj z VEL cantym Use Apgoved 13 Die / S��y Permit Fee (' eludes Oroundwater Date issued Issuing t Sigttatr:rs Sttmtps s urctavge pee) S :JI/ -- [3 0ixerrit"eum 20 DL COndltlon3 A SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attack aoeepleta'Phs (to IM Comfy os y) for the ystass on paper mot bas than 8112 x 11 Nets N Also �ww iw�n, ♦,.. w. .ww+ I Nom- tvV,') ICA k , G ,, i � �.:I�•(,. �i �(YQtZ_� �.� iZJJ O•n (Z �� t� 4 (� � \ '� ` (�Ua. I AO („ ' � J C ryi Q� � 4 �' ` v � ✓ U 2 0 4 CICA CL� � I CP \ 3 0� Safety and Buildings 4003 N KINNEY COULEE RD commercemi.gov' LA CROSSE wl 54601 -1831 O �' #: . co erce. i.gov/ b/ www.commerce.wi.gov /sb/ I t , , of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 06, 2006 CUST ID No. 222774 A7TN.• POWTS Inspector HENRY F GROTE ZONING OFFICE CERTIFIED SOIL TESTING ST CROIX COUNTY SPIA E4366 353RD AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/06/2008 Identification Numbers Transaction ED No. 1245151 SITE: Site ID No. 709813 Allen Nyhagen Please refer to both!identification mumbers, 60th Avenue above, in all correspondence with the a enc Town of Pleasant Valley St Croix County NWI /4, NW1 /4, S4, T28N, R17W Lot: 11, Subdivision: Missy Meadows FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1063463 Maintenance required; 600 GPD Flow rate; 32 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual, SBD - 10573 -P (R.6/99); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the PO WTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. P.O.W.T.S. Conditionally AMPROVED HENRY F GROTE Page 2 3/6/2006 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 e POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Kent Hoke, H & H Plumbing LLC (Plans Mailed To) FEe 2 E'O Allen Nyhagen –Missy Meadows, Lot 11 -Mound `SAF� � Z��6 c�c 8 Ui4 p INGS Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: Lot 11, Missy Meadows NW 1 /4, NW 1 / 4, Sec. 4, T 28 N, R 17W Town: Pleasant Valley County: St. Croix Date: March 6, 2006 Owner: Allen Nyhagen Address: 2952 2 '/Z Ave. x . �� N Hilt" New Auburn, WI 5474 c � • H ENRY F. Designer: HeiRry Grote `,ROTE 4 E NOMONIE Signature: / , WAS• License: WI D – A99-007 �i -, 1111 � Attachments: SBD -10577 - Plan Approval Application PP pp SBD -8330 Page 1: cover G4 Cp;� INGS 2: design criteria & calculations A51�� ajtg- 14,ECAp B 3 : plot plan OV 4: system cross section J oNpEtNcs 5: plan view, lateral detail c 6: pump tank exit detail 7: pump curve 8: system management page 1 of 8 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD5 < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 �"� gallons /day hydraulic load Design Calculations In situ designed loading rate - gallons /sq. ft. per day Depth to estimated high ground water % 3 2� in. Depth to bedrock in. Cross slope at system % Force main length fi. of in. Z .44- Manifold/header length ft. of t z in. (9 ,z3 Drain -back gallons Lateral length @ - c> ft. of X1 in. Lateral elevation o ft. @ bottom of lateral Lateral hole size �l� in. @ S te. b in. ( 4 ' $ ft.) Spacing 3 holes /lateral S holes total Lateral volume gallons Total lateral discharge rate 14-111- gallons /minute @ 2— S ft. head Network pressure compensation losses 0 Elevation difference Friction loss `� ft. @ s gallons /minute Total dynamic head ° ft. `C6 Pump /sioon 40 gpm @ I ft. of head Manufacturer (_'�� 'r q , Model # 3� Dose volume gallons i Lift /si*n tank gallons Septic tank I 2 S — b gallons Effluent filter i -k4 Q A Measurement pump on and off C in. Height alarm from tank bottom I o in. Reserve capacity gallons specs.calcs.res Page of g S � G N6) 1 CZ� Zo � 1 , 5 x X2 roc l� ce - Qfj, YS C„�a wt_ Pvc Sj� • `�' TWVC.Q. W0.. , \ u. � ey 1. 3 4 r -- �- 3 ck 4 ` t� VC.- c IL T� �o or.. �, o �.Q \ a � G�,r � p^, .... ; ,..... � � =0' �„ .,..� Pi•- -�X. -ti c9 � M � �C b 4ra�. i 3 PVC 4� �r,�ea �►1al UC "\o -C latar�1S 4,0..alUw TI �pO�O �OrO 0. o' _ 3 C } 0% t-4 x 1T �� k TVA WEA'P1IERPROOC 'I LC)CKING,GOVER JU NCTION r E�cc lv.Fi�'n�We A 48EX . NICK DI�CDU��GT --1 , T S ° co P v 3' �c oK1b N p gT uR6ED \ I SOIL. 24" =.D. I \ 4,,4-c Va NT M4�luQLfc ' i.�.t r s , - �, ;Mi(ET 3t1XTS WFLE 3' ago li.. PI/C p i lAL S� \ > ( n n �w (R*w E LT 10 1{b �"`� � K �o. 1 \ - ` ( lrQ � � w � ri RO U ►.tG Fl.ev, l 3 aF j pvKp U C�2 a C `` o SEPTIC t _ SPECIFI 005E ` TAuKS MAWU FACT URCR: w 4-%A-A.- (JUMDER OF DOSES: PER DAz TAWK SIZE: }�� GALLOWS DOSE' VOLUME cg0 5 ALARM MAIQUIFACTUKER' Sz IAICLUOING 6ACKFI.OW: CALLONJS MODEL WUMDEK: � �`` CAPACITIES: A= 31` o INCHES OR CA LLOUS SWITCH TYPE; '"� " 11D B e Z INCHES OR �Z 2 C.AL.LOu5 PUMP MAQUFACTURER: L ' ` G '_` Y C ■ Sl D INCHES OR � LA�.60U5 MODEL WUMDER; ' D 9.0 INCHES OR 14�'y g �AL',O�,JS SWITCH TYPE; ��"`�b MOTE: PUMP AW ALARM ARE TO CE MIWIMUM DISCHAPt" RATE 3 ' GPM INSTALLED OW 5EPARATE CIRCUITS VERTICAL WFFERENCE bETWEEU PUMP Off AWD 013TR1DLITIOW PIPE.. � O FEET 1 + Mi�IMUM ►JETWORK SUPPLY PRftSUR FCCT + FEET OF Foacc MAiw X 2 ,Sg FF /00 /T.FKICTIOU FAGTOK. FEET — TOTAL DtIWAMIC. HEAD = FEET IQTERIJAL. 0IMLW610WL OF TAWK: LF -W&TH `zl'L 1 TH — ._;WIDTH � � ; LIQUID DEP Q A l,. � 6 u ►- v 9 E SERIES SUMP /EFFLUENT PUMP 9.60" 4.65" 1%" DISCHARGE 6.80" 2.85" SCREEN TO PASS %" SOLIDS Specifications 15 FT. POWER CORD MODEL ITEM SOLIDS SIZE RUNNING PERFORMANCE (GPM @ HEAD) SHUTOFF PWR. CRO. WEIGHT DIMENSIONS NO. NO. LISTING HP VOLTS (Dla. In.) AMPS/WATTS 5' 10' 15' 20' (FL) P.S.I. (Ft.) (Lbs.) (H x L x W in.) 9E -CIM 509200 UUCSA 4/10 115 3/4 12.3/1000 57 53 40 15 23 10 15 26 9.15 x 9.6 x 6.8 9E- CIA -RFS 509300 UUCSA 4/10 115 3/4 12.3/1000 57 53 40 15 23 10 15 27 9.15 x 9.6 x 6.8 9E -CIM 509250 — 4/10 230 3/4 6.2/1000 57 53 40 15 23 10 15* 26 9.15 x 9.6 x 6.8 9E- CIA -RFS 509320 UUCSA 4/10 115 3/4 12.3/1000 57 53 40 15 23 10 20 28 9.15 x 9.6 x 6.8 9E -CIM 509225 UUCSA 4/10 115 3/4 12.3/1000 57 53 40 15 27 10 25 26 9.15 x 9.6 x 6.8 • W /out plug FLOW— LITERS /MINUTE Construction 3o ° 100 100 '0° 4W Cover Nylon Motor Housing Epoxy Coated Cast Iron :, Impeller Material Nylon Impeller Type Vortex °o . Volute Epoxy Coated Cast Iron W Power Cord SJTW -A " Mechanical Shaft Seal Nitrile with carbon and X r ceramic faces 1 p Fasteners Stainless Steel Shaft Steel ° Bearings Upper Sleeve and Lower Ball Bearings TM 0 0 o p 100 FLOW— GALLONS/MINUTE ^ • 9E Series 115/23 60HZ Little plant Pump Co. w�• PO Box 12010 Phone: 405.947.2511 '� r Okla. City, OK 73157 ` Fax: 405.228.1550 ` ISO 9001 CERTIFIED www• LittleGian qcy tPump.com A Form No. 994341 - 11/99 f ✓y ' System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, H and H Plumbing, 715 -962- 4155, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. The upslope toe of the mound system must be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run -off, final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. ' Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 g f3 rrl tj LT Asv L o P ED 1PR lboo'gd ^Ibo Yttoondn Depadnwd of Comrrerrx SOIL EVALUA PORT Page of 3 17ivisionafSafetyand8u'Id'ugs cmxdy Attach complele site plan on paper rrd t fies in si irckxW but not lied tm va lical and haQOn � Eb n Pavel W Pen�tslope. scale ordurrerrsions. norms crow. road. Please PF" all Inform n. by bate 7. CROIX COUNTY �as onetew ►r«i�oaaenwrt�eu�sarorssoar �@g ®I4S-tBFplt� - P,q)wyp Properlylon A L r, E n/ N Y '4 A- 6rj5 ,'j Govt Loot W 1& 1J W� •4 T28 N R 1 E tort w PwpatyownWs MaftAd&e= t / Bock # subd Nave or CSW 2-g5'2 2 "/2 AVGfJkA6 1 -" M155V M0ADoWs Stale Zip Code Phone Number 0 ❑ ® Town Nearest Road ICI W AkAb V4 1 411 t 231 -2135 0 VA W.E 0 Newconstruclion. Re all Number of bedrooms - Code dermed design Aow fate Q ReplaoemaK Pubic or cornmerdel - Descille: Parent materiel x Food Plain elevation dappiiMW Z o ft cts Area / ` Spot Tested suitable for and mound (P.O.W.T.S•) system using sand fill. fill. F Boft* ❑ ® Pit Groundsurface /�Q f� Cepmfo tin8fir 3 � n• Soil Rafe Hainan Dept Dominant Cdor ft*W Dee x"M TeA a Structure Consiftnce Swndl" Rods sum in. Murrsdl am St. Cont. Color Or. S7. Sh• 11M1 I low 1 I 10Y12 21 — a am o M a S v . (o 2 J 8-2-4 1 0YR 4 /3 5i o/ 0IMSK mf i CS 2v-F 3 2-9-YJ I U YR5 /( S i C 1 4 5 by- M-1 l cl W l VT- (o 4 :?1-71) luYRgl(. r6312 IuVR Siel 3T5bK rnv -F i F21 * 0 Boving ® Pit Ground elev 100.0 tt DepthtDknMM odor -4 0 •__ S A Rafe Haimn Depth DomkvytColor Redar Desaiplion Told," Strrrcltae Ca me Baurwry Rods GPDR in. Mrs CAL Sr- Cart. Color Gr. Sz. Sh- 'M1 I 'EW2 I 0 _ 110 10 WR 2 /z P M 5b m C S v- • (0 $ 2 1b I L2 YR y 3 2"D 1 u YR 4 1 "t - 5 i e I 3 m f1 a W 1 v-� �• . ('o 4 4 0- Ivye-A /At M3,0 wypt Sic 34 SbK m yfi 3 • gent *1= BOD 2- M malt. and TSS >30 150 mg1L. • Bk=1tj 2 - 80D :30 mgiL. and TSS = 30 rrg1L CST Name (Pieria Pliki) - CSTNumber J E/V N 4( u L 81 C-H T 5993'x' Address Date Evilkwoon Carduded Teiepmne Number 28 12 /o T'K fijf SPfir-Je - IIAI, L-eY W1 ,x.47 A J !4,15 2cn5 ( --7 is3- 772 - 34q Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, Wl 54767 ORIGINAL � 2y - lo -R5 -�D P age owner A/� 14 A 6TE /J Parcel io # e, z 9 - lo oc - 9b 2 o f 3 # ❑ Bins 3 F El pit Ground st.�oe ate» — -. 4a R tirtttiv fades► — soil t Haim DepM C55ant0oAr Redox Deso%Mon Texture Shuck" C.onsislence Boundary Roots GPQgF A MunseA Qu. So Cott Color Gr. So Sh -ems, 'HM 1 "20 0 1 2 /2 - .9 ;? h 3 v-f 2 20- 32 i o'rt2 `E /3 sicl 3-f 5br, re)-Fi O f A 3 2 -T7 ! n VR 4/1i- m 3P .I 0 YR, V / t 5 i c 1 3 e SbK. rn El ❑ Pit Ground suriaoe eiev. R Depth to ii n ft factor k- Sol Ajp3p&kM8dkMn Rate Hodmn Depth Domutartt Redact Oe MvIon Texture Sh ow . Oauisteme Boundary Rods GPDAt: ht OAunseA Qu. M Cott. Cotes Gr. So Sh. *804 *802 F-I Bodru ! ❑ &Xis ❑ pit Ground sutfao a elev. R Depot to knft factor to SA AvapAkmarWean Rate Hoiaon t?epth DombantOW MMQ De =0lon_ Texture Shudure Consistence Boundary Rods "`` t Gtr it NUM A Qu. Sz. Cott Cobr Gr. So Sh. ism" o Bahg ❑ Grottndsurfaoe slat► R Depth b factor in SoA ApgpkNcW&GWonFRjafz Hnttz n Depdt 004tant RedaK Win. Texture Shudws oxaWance Boundary Rods WON A 1Atstsett Qtr. So Cont. Color Gr. Sz. :M 1 55 y M E s LoT `- NORTH P ROP FRTy L-//V 5 17� 9a' LU J A--- _._ _ 3 ° la B:3 n 1 90' N b D ■ �„� • � oo� M 2� I00 F3 2_. iUr�.c�4 81= Ib0•o I to'o.00 Vnl i Fo}ZM tiI UVNp [,pNTVVi� ar �' ST. CROIX COUNTY WISCONSIN _ . PLANNING & ZONING DEPARTMENT " 1 N N w w ■ ��,�, ST. CROIX COUNTY GOVERNMENT CENTER - 1101 Carmichael Road �•• ' . yam Hudson, WI 54016 -7710 f a 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 ST. CROIX COUNTY � oT SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer Nt �1 Mailing Address Property Address 02 rr (Verification required from Planning & Zoning Department for new construction.) City /State ��dSa.� e�><- Parcel Identification Number (,y - - _ K LEGAL DESCRIPTION 02q_ (oq-T —f' _ cm C 3D4 Property Location _�/V '/a , r 1/w° 1 /4 ,Sec. 4 - , T Zt NR 17 ,Town of Subdivision 14, 1�fg�o,,- r ,Lot # �. Certified Survey Map # , Volume , Page # Warranty Deed # 780zV Volume , Page # Spec house 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. I /we 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 SIGNATURE OF APPLI A (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) U ; 2802 P 141 ti 794886 State Bar of Wisconsin Form 11 - 2003 LAND CONTRACT KATHLEEN H. WALSH (TO BE USED FOR NON - CONSUMER ACT TRANSACTIONS) REGISTER OF DEEDS ST. CROIX CO., MI Document Number Document Name RECEIVED FOR RECORD CONTRACT, by and between Allen C. & Linda L. Nyhagen 85/13/2005 12:30PH ( "Vendor," whether one or more), and Jim Henry Inc. LAND CONTRACT ( "Purchaser," whether one or more). EXEMPT # 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 Note: The above described parcel includes Lot 2 Jt„i; Hak3g!z7 /Oc— Certified Survey Map in Vol. 18, Page 4690, Doc. No. 752728. LLt7 (/ /A)1 Z;7. DO I ort; dyaa - gy -Ira AA>L 64y •1000 Parcel Identification Number (PIN) p C-*p This is not homestead property. (is) (is not) This is a purchase money mortgage. (is) (is net) Purchaser agrees to purchase the Property at the sum of $ 500, 000.00 in the following manner: (a) $ (b) the balance of , outs to time at the fmiih P p 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: X A. Any amount may be prepaid without premium or fee upon principal at any time. ❑ B. Any amount may be prepaid without premium or fee upon principal at any time after ❑ C. There maybe no prepayment of principal without written permission of Vendor. State Bar Form 1 l - Page 1 RFAAAX Teen 1 Reeky 2217 Vine St Ste 200, Hudson W154016 -5864 Phone: (715) 381 -5700 Fu: (715) 381 -5720 Missy Meadows. Jim Henry & Associates Produced with ZipForrn- by RE FormsNet, LLC 18025 Fifteen We Road, Clinton TownsNp, Michigan 48035, (800) 3839805 www.zipfortn.com S ;d 2802 P 142 CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN OPTION A SHALL APPLY: % 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 t I - Page 2 Produced with ZipFormTM by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383.9805 www.zlpfbrm.com Missy Meadows. r t802 P 143 CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN, OPTION A SHALL APPLY: ❑ A. Purchaser agrees to pay the cost of future title evidence. ❑ B. Vendor agrees to pay the cost of future title evidence. Purchaser shall be entitled to take possession of the Property on Time is of the essence as to all provisions hereunder. Purchaser agrees that in the event of a default in the payment of principal or interest which continues for a period of 15 days following the due date or a default in performance of any other obligation of Purchaser which continues for a period of 15 days following written notice thereof by Vendor (delivered personally or mailed by certified mail), the entire outstanding balance under this contract shall become immediately due and payable at Vendor's option and without notice (which Purchaser hereby waives), and Vendor may singly, alternatively or in combination: (i) terminate this Contract and either recover the Property through strict foreclosure or have the Property sold by foreclosure sale; in either event, with a period of redemption, in the court's discretion, to be conditioned on full payment of the entire outstanding balance, with interest thereon from the date of default and other amounts due hereunder (failing which all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property); (ii) sue for specific performance of this Contract; (iii) sue for the unpaid purchase price or any portion thereof; (iv) declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchaser is insignificant; (v) have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits; or (vi) pursue any other remedy available in law or equity. An election of any of the foregoing remedies shall only be binding on Vendor if and when pursued in litigation. All costs and expenses including reasonable attorney fees of Vendor incurred to pursue any remedy hereunder to the extent not prohibited by law and expenses of fide evidence shall be paid by Purchaser and included in any judgment. The parties agree that Vendor shall have the options set forth in this paragraph available to exercise in Vendor's sole discretion. Following any default in payment, interest shall accrue at the rate of 8.000 % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. Purchaser may not transfer, sell or convey any legal or equitable interest in the Property, including but not limited to a lease for a term greater than one year, without the prior written consent of Vendor unless the outstanding balance payable under this Contract is paid in full. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full at Vendor's option without notice. Vendor may mortgage the Property, including the continuation of any mortgage in force on the date of this Contract, provided Vendor shall make timely payment of all amounts due under any mortgage, and the total due under such mortgages shall not at any time exceed the then remaining principal balance under this Contract. If Vendor defaults under such mortgages and Purchaser is not in default hereunder, Purchaser may make payments directly to Vendors mortgagee and such payments will be credited as payments hereunder. All terms of this Contract shall be binding upon and inure to the benefit of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. State Bar Form 11 - Page 3 Produced with ZipFormT° by RE FonnsNeL LLC 18025 Fifteen Mlle Road, Clinton Township, Michigan 48035, (800) 383 -9805 www.zipform.com Missy Meadows. r 1 2 1 44 Dated VENDOR: PURCHASER: ag,t (SEAL) C (SEAL) i�� //�1�� *Allen C.N ha en *J a Iac. X l z d � • ) (SEAL) (SEAL) * Linda L. Nyhag AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. authenticated on CO Y ) Personally came bef re e on the above -named -- TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the (If not, foregoing instnun and acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: —, Notary Public, State of Wisconsin My Commission (is permanent) (expires: ova (Signatures may be authenticated or acknowledged. Both are not necessary.) A ll NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IElD •••.• ./ ` -, LAND CONTRACT STATE BAR OF WISCONSIN ♦ No. * Type name below signatures. : v z co a r t .k State Bar Form 1 l - Page 4 Produced with ZipFormTM by RE F o rmsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 www.zipfbrm.com Missy Meadows. o I rh 100 I y 1oa W 305.11' Z ; I U C , ° I 217,9 i to 16210 421.56 ( L.8.O 589 °33WVi 583.6330 I 33 33 I ( I J BENCHMARK BENCHMARK 0 TOP OF IRON PIPE TOP OF IRON PIPE EIEV. = 1136.38 I I ELEV. = 1138.94 - x-- x - -x —x - — --x- x— x- -x--x- 99 °33'00 "W 101.51' I ( , i LOT 11 Z 0 I 5.07 ACRES I N88 °4' j j I 221,02e SO. FT. W I s88 °4E x' - "x'l / / J � S81 °0 a 10a x ^� X x BENCHMARK TOP OF IRON PIPE &\ / ( ELEV. 1144.71 3'00 "E 472.5 I X `� (�- __._ ._.- - -- ___ .__ _ __ _ _ _ r f 66.62 � S89°33'0OW 230.60 /��- ' / /-- 72N D STREET ____ —__ S89°33' 230.60 10 r ,/ . . . . . . . . . . . . . . . . • . • L: J • i Jf �f Ull