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HomeMy WebLinkAbout026-1121-18-000 P P County: 7-in pi:pa4rnent of Commerce PRIVATE SEWAGE SYSTEM St. Croix safety and Building Division INSPECTION REPORT Sanitary Permit No: 399564 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Halle Builders Inc. R1 hmond Township 026 - 1121 -18 -000 CST BM Elev: Insp. BM Elev: BM Description: `p o , —r e s TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Ben hm k 30 0 / CAD 0 . , I- �s_ 11•0 I00 Dosing Alt. BM r .5 2 $ 6 g.o ofl, Aeration Bldg. Sewer 7 8 3 t oo. Holding t Inlet 6 Z• !3 St/Ht Outlet ' TANK SETBACK INFORMATION TANK TO P/ VELL BLDG. Vent to Air Intake ROAD Dt Inlet , w f Septic O �/^ I _ r 1 Dt Bottom �Ky.lo ' 9 ,y I b j (� d ou Dosing /O / � e '_ Hier/ Oap Z.� - 7 Aeration (avw' Dist U Pipe Holding Bot. System Final Grade / 214 PUMP /SIPHON INFORMATION n 'r 210a Manufacturer Demand St over GPM ,s � O 7, I ' Model Number TDH Lift Friction Lod ! System TDH Ft 3 . Forcemain Len / Dia. Di .t > �00 �y`OS S ' :5 h t&-Q " D 9611 C A PTION SYSTEM 3 UA'! X BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid epth DIMENSIONS � � SETBACK SYSTEM TO P/LW JBLDG W L LAKE/STREAM CHIN Manufacturer: INFORMATION Of Sy CH OR Typ stem: 1 � /� Model Nu g+ er: DISTRIBUTION SY EM Haa er /Manifold Distr r h x Hole p x Hole Spacing Vent to Air to h Pipe(•) �S� !� �I 1 / Spacin /�f / it 1 1-ength Dia 2 Len h Dia t/ g & 1 1 SOIL COVER x Pressure Systems Only xx Mound r At - Grade ystems Only Depth Over / Depth Over xx Depth of Seeded /Sodded xx Mulched Bed/Trench Center �1 `� Bed /,Trench Edges Topsoil Yes o [] Yes COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / 0 Inspection #2: (� / O Location: 1720 107th St tt U�krlgwn (SW 114 SE 1/4 5 T30N R18W) NA Lot . 18 A" J VM Parcel No: 05.30.18.733 1.) Alt BM Description = l .'57/� '' 2.) Bldg sewer length = 67 - amount of cover = ^ I Plan revision Required? Yes Use other side for additional information. Date Insepctor's 1i ignature Cart. No. SBD -6710 (R.3/97) -7Z ' Sanitary Safe & Buildings Division � ry Permit Application In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. �j See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes ti Madison, WI 53707 -7302 Department of Commerce (Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned. Attach complete plans to the county copy only) for the system, on pmer not less than 8 -1/2 x 11 inches in size. r State Sanitary Permit N ber ❑ Check if ievision to previous appirc`�GSn_ - State Plan I. D. Number C° Is / . 3� S Sb � 3Sc�� I. Ap lication Information - Please Print all Information Location: Property Owvcr Name Property Location j - 4 c ). i dV '"/ 1 /4S f l /4, S TJO,N, RI or tGJ roperty ces Mailing Address Lot Number Block Number p City, State o Zip Code Phone Num Subd' isio Name or CSM N umber 6 17 II. Type of Building: (check one) �� `.- „� �' , City 4d 1 or 2 Family Dwelling -No. of Bedrooms: e o >f L�'.r 1,VL �` Villa nn of ❑ Public/Commercial (describe use):_ ❑ State -Owned TF, , r we est Road / 0 7 S7— r: 1 S7 CRW It WUNTY 1 Tax Numbers _ NZ /- c III. T ype of Permit: Check only one box on line A. Check box on A) 1. pVNew 2. ❑ Replacement 3. ❑ Replacement of 6. ❑ Addition to System System Tank Onl 'r, Existing System Permit Number Date Issued B) ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line At- de t/ ❑ Aerobic Treatment Unit ❑ Recirculating Cl Other: V. Dis ersal/Treatment Area Information: 1. Design Flow (gPd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. R) (MinAnch) Elevation 1 9 s_ o /o , 'W ( ) F, ~y' VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks 1 °� S'e oa 1016 o ❑ 1 ❑ ❑ F0 X00 400 VIII. Responsibility Statement I, the undersigned, assume res on, ibili for installation of the POWTS shown o d t3lans. Plumber's Name (print) bed ignature tamps)i NIP Business Phone Number °s .t Plumber's Address (Street, City, State, Zip Code) d 7- S ,, 1, t S S'dA IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ZIssuin g en ignature (No stamps) roved 13 Owner Given Initial Adverse Surcharge Fee) Determination 3ZS � ° X. Conditions of Approval /Reasons for Disapproval: �,5 tiffs. FlpO T KG VV5 vuacter vv�U� 7'S ✓G�� A5�v s t tR,E`�° - i ttC n1+tt nlTevv /k ►•k� C3 %? �T�r' l E� t— P�L �LtQtt U t> i�Ac�Tt 146RS 5Pez - RUrnDrU C tµvST i3E N rvt(Aj A0� i ' �wbti„t �a 5 t►�t1t2 AND 64Mltj F6et j&a'0Wj TW6 / v Pc✓'7 rI T1�V5 S S �� S'� f3 l IUS lPtt��l� p t� 1 ry (� To i lfE (; A ✓LpJAti C 5/21,01 08:11 7152686637 GILLE TRUCKING PAGE 02/02 __............__... . ....... . _._ - _. -- M .:- W_. -- _.: or Q �b _ _.. .... ._ ........ y, _.__......_.._ _ ..... .... ._ . .. . . .. - - o _ ..... _ _ __. _ _. ........... ......... ................... �Y Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 Mff TDD #: (608) 264 -8777 Nvisconsin www.commerce.statemims /sb www.wisconsin.gov Department of Commerce Scott Mccallum, Governor Philip Edw. Albert, Acting Secretary October 25, 2001 CUST ID No.221471 ATTN.• POWTS Inspector DENNIS J GILLE ZONING OFFICE GILLE TRUCKING & EXCAVATING, INC. ST CROIX COUNTY SPIA 372 140TH ST 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/25/2003 Identification Numbers Transaction ID No. 683507 SITE: Site ID No. 637552 Halle Builders Inc Lot 18 Please refer to both identification numbers, 107TH St above, in all correspondence with the agency. Town of Richmond St Croix County SWI /4, SE1 /4, S5, T30N, R18W Lot: 18, Subdivision: Partridge Run FOR: Description: Three Bedroom At -Grade System Object Type: POWT System Regulated Object ID No.: 816560 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. 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 "At- grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems" SBD- 10570 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the at- grade manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. r DENNIS J GILLE Page 2 10/25/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Halle Builders Inc RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET !O� t�O Project HALLE BUILDERS INC. Owner HALLE BUILDERS INC. Address 1113 HWY 64 NEW RICHMOND WI. 54017 Legal Descri ption SW SE S 5 T 30 N R 18 W Township RICHMOND County POLK Subdivision Name PARTRIDGE RUN Lot No. 18 Parcel ID Number 026 -1121 - 18-000 Plan Transaction Number Index sheet Page 1 Con4 Tonally Calculations Page 2 APPROVE D At -grade drawings Page 3 Laterals and dose tank Page 4 DEPARTMENT OF COMMERCE Specifications Page 5 s+lOt! f F S/1FT BW NGi! Management & contingency plan Page 6 SEE CORRESPOND C�1 L S S , ice, i �• Designer DE t ILLE License Number 2214.71 Signature Phone Number 1- 715 - 268 -6637 Z �� Date 10/08/01 Designed pursuant to: At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 3.11 (05/01) Page 1 of 6 r PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 0.01 % Site slope 96.76 Contour elev. below lateral (ft) 40.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpd/ft ^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 7.00 Linear loading rate gpd/ft 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 90.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) C Center or end lateral connection 2 Number of laterals 0.188 Orifice diameter (in) e.g. 0.188 Not a final 1.96 Estimated orifice spacing (ft) calculation 2.00 Forcemain diameter (in) 3.10 Forcemain flow velocity (ft/sec) 126.00 Forcemain length (ft) y or n y Does forcemain drain back? 91.00 Pump tank elevation (ft) y or n y Are laterals at highest point? NA 3.25 System head (ft) x 1.3 20.4 Forcemain drainback (gal) 5.25 Vertical lift (ft) 40.5 5x Lateral void volume (gal) 2.48 Friction loss (ft) 60.9 Minimum dose volume (gal) 10.98 Total dynamic head (ft) 30.4 System demand (gpm) Lateral Diameter Selection Gallons /Inch Calculator (optional) Pipe diameter Design options Design choice 600 1 Total Tank Capacity (gal) Designer 1 in 40 Total Working Liquid Depth (in) must select 1.25 in x 15.0 Gal /in (enter result in cell G46) one lateral 1.5 in x X diameter 2 in x Treatment Tank Information 3 in x 1000 Septic tank capacity (gal) HUFFCUTT I Manufacturer Effluent Filter Information Dose Tank Information Zabel Filter manufacturer 600.0 Dose tank capacity (gal) A100 JFilter model number 16.0 Dose tank volume (gal /in) HUFFCUTT Manufacturer Project: HALLE BUILDERS INC. Transaction Number: Page 2 of 6 f a AT -GRADE PLAN VIEW 1/6 B observation pipes (2 typical) A 10.00 ft D B 90.00 ft 1/6 B 15.00 ft W C 12.00 ft c D 5.00 ft E L 100.00 ft ° B W1 22.00 ft A x B 900.00 ft ^2 L ,-- cad' Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower 6„ and anchored = Plowed area L x W 0 securely. 6" AT -GRADE CROSS SECTION Svnthetic fabric cover � 98 ft Finished grade Lateral 'h. elevation invert elev. 97.25 ft Observation pipe •. at aggregate toe T E .d5 0.01 % Slope Surface contour 96.75 ft C A and system elevation D ® = 1 in. topsoil and subsoil over aggregate and tapered to toes. Plowed layer below L x W 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: HALLE BUILDERS INC. Transaction Number: Page 3 of 6 " . PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection I` P I 024) Laterals & Force main of PVC Sob 40 Last hole drilled next to end cap (per COMM Table 84.30-5] Hades drilled on t he bottom of the lateral, equally spaced 0 = Turn -up rw1bsll vahm or cleanoutplug Lateral Specifications tv 0.188 Orifice d m (in) Center Lateral connection point X 1.95 Orifice spacing (ft) 2 Number laterals f 23 Orificesllateral P 43.88 Lateral length (ft) 15.2 Lat. discharge rate (gpm) 1.501 Lateral diameter (in) 2.00 Forcemain diameter (in) E . 4 Sys. discharge rate (gpm) 125.00 F orcemain Length (ft 44111 Z6 b ".. "7Jr4,A- 10. DH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather -proof warning label and lacking device Final grade junction box disconnect 4" Tank corrponent is Alternate p vented �� outlet motion 18" min. Electrical as per NEC 300 and X ^ Approved outlet joint Comm 16.28 WAC Tank full o Inches Gallons JA Floyd o A 21.9 329.1 Alarm on Vep hbeo c B 2.0 30..0 B a>mis�rm E C 4.1 6D9 Pump on daioe D 120 180.0 92.00 C Totals 40.0 ®.0 Pump off D 3" Bedding under tank � 91.00 ft ZEOLLER I rump manuracturer LEVEL ALARM 98 _ DVL Project: P@W 6 , At -grade System Maintenance and Operation Specifications Service Provider's Name DENNIS GILLE Phone 268 -6637 POWTS Regulator's Name Phone <�- ► X rour--T Zi«JCI -- 7iS System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 900.0 fe Maximum FOG 30 mg/L Type of WaSteWater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD- 10570 -P (R. 6/99). Lateral Tum -up Detail Finished •.....•........ ................ Grade \ 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral A. Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: HALLE BUILDERS INC. Transaction Number: Page 5 of 6 At -grade System Management Plan Pursuant to Comm 83.54, Wis.. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD- 10570 -P (R. 06/99) and SSWMP Pub. 9.6 (01!81)] and local or state rules pertaining to system maintenance and maintenance reporting No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flavus or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than mabmum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Departrnent of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. At -grade and Pressure Distribution System No trees or shrubs should be planted on the at- grade. Plantings may be made around the at- grade's perimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at -grade is not recommended since sal compaction may hinder aeration of the infiltrative surface within the mound and snow compaction In the winter will promote frost penetration. Cold weather installations (October- February) dictate that the at -grade be hoevily mulched as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5, 150 mg/l. TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 nVL FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing pant at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components became defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring beco mes defective the defective component(s) shall be inrrnediately repaired or replaced with a component of the same or equal performance. If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, It will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: HALLE BUILDERS INC. Transaction Number: Page 6 of 6 MAP r� �I, aw + �iawryn� .� I fi �,, •R /� f � r r rr � j � Ywr.. � r M d�1Fhd� �n ^P� p1 /(Y 7 5,:riJ r"i.,> rnrnl I?YMAhfla Hr nt�/raPnc:ftr PER WN Ll Pn.61T.. on.mnlr.. 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SiflflM 9BOOMAOJFMrlf5tlar/ m r lar+fivfi(a, 9v 4O ➢,47 1951 (5i1E1 p78�9f • 711)IlA1l8 PIAt?f' r�' Rn ds 79 �gf 10,!25/2001 08:11 7152686637 GILLE TRUCKING PAGE 02/02 zor -- S" 1 �yo" _.-- � ..... ....... ............ .....�. - - -.. .._....�.•• - ={- _. .....w_. d Wad- Fs- ..._,_.. / ✓ ? 8' ._.................._ ._— ___- .__..�r.r.rru;y. P . — _ ...._.. _•_____._.. __.._...._- ....._ .......... . _�.- ..__.._ —.w ___ -._. . ...... ..... _.._.._.__._._.- ._...._ p..w .rrMw.. ...�.�. -. .. _... __.._... ...... ... .......... ....... �....... ...... .. ..._., .. ....._... -_ ..... .. ..... ... ... _.._.�. ...... ..,_..__ -._ . ......... ........ ....... .... _•_•_ - -___ :......... .. .. .._....._ _... .. .. -_.. .._._u.. ..._ _ _.,...._. .._.. ...._ .. __. _... _._. -. _..:..r _: _+. _.._ _wr_.`. ten. .re... -_ 3Y •L+ �C .� r�1M1C�........... t... A^.....�.:.v.: __. ,..._.. ..... :- .+r�w+�..�1 .....:....... ..' . ^TT.V_..- ....:.:,..�w�.�.� -• +- ..wt^a +... 0 r ..... - .......... ._. �._...I _ ..... _...�_ .. ...... _.. _. i __:._ v.:... -- --- _._.......� - .._ ...... _ ,�r 10/05/2001 03.03 7152483588 SUPERIOR AUTOMOTIVE PAGE 01 wrsoRlnsln Department of Convnarre SOIL EVAL UATION RE PORT Page —j— of of RafBty and Buildings In accordance vft Comm tl5, vft Adm. Code Attach Oonviete site plan on paper not less then 81/2 x 11 iltfta in size. plan moat CWilhr I indude, but not bn tad to: vertical and hoftpntal ref mom point (BM). dWedion and Parcel LD. Percent elope, scale or dimensions, north arrow, and location and dietpncs 10 nearest road. a f.. i ;,) Please )print all i nfrWmW OO. Reviewed by Date Pommel Intmolim You Pmvidp may km used for seo n"y pugsoses 0 Law. s, 15.04 (1) (m)). Pn�perty O�nmer "�� Property Location GovL iot :6 W 114SF 1/A S S T 3t> N R 119 E (o* W Pn erty Ownees MMalfing Address Lot # Block # Subbd. Name or CS p ` dt * 1� City 1p , uode Phone Nurn er nCiry ©Village lovm Nearest Rpm (� New Conoruction Use. fj Residential I Number of bedrooms Code derived design flaw rate GPIs (� Replacarnent 0 Putrlip or cornrmdai - Describe: parent material is, e j fi, Flood Plain elevati if a pplicable � emterat oomme gtrons: �/. r f and regonunend ��` w V e- 4 L n f� • 8o>9ng # 0 Bortng ) Pi( GroU" surface elev. n, Depth to limning factor - _' 7 � In. $oi AppStcaSgn � Horizon Depth Dominant Cokw Redox Description Texture $trucWm ConslMeft Boundary Roots GpD/W in. Mdse" Om Sz_ Cont. Color Gr, Sz. 5h. *Eff#1 'Em L.. a G L+ cad f �3:2 Q 10*10/2 01 F.;�b V_ Boring # �[ Boring Pit Ground` surface elev. ft. Depth tD flrMng factor 0 in. Soil hcation Rate - 0OZOn Depth Dominant Color Redox De cription Texture Structure ConsWenc;e Boundary Roots Gp5m in_ Mun+;elt Qu. 5z. Cont. Color Or, Sa. Sh. 'Eff#1 ,E VVY is I- F_ 2d ' [:Muent#1 = 000, >20 < 220 mg1L and TSS >30 < 150 mg/L • Effluent #2 = BOD. < 30 my/i, and TSS < 30 mg/L :ST Name (Pleases Print) lgnature CSl Adumber nh M � ���� Zk . ` iL G 't" h S Date Evaluation Conducted Telephone Number b L k 7 9B — D-030 (R07100) r - 10/05/2001. 09:03 '7152483580 SUPERIOR AUTOMOTIVE PAGE 03 Prep" Omar �. � U' Paraal ID # - - Wage � Of Ej - 0 8o+in9 # Bannp Pit orak,nd surfaCB elev. x.75 !t. Depth to Wnift far -tor , in. suoil Application Rate Horiyton Depth Dofni trrsn C0101 Redox Description Texture Structure Consistency Boundary Roots GF4W in. Munseil Qu. Sx, Cont. Color Gr. Sz. Sh. 'F-f(#1 'Eff#Z S L. 3 s -ss Su-1/Y' 1 405 5 R Boring # D Boring pit Ground surface Slay. - .___ ft. Depth to Iimltinp factor � M. 5oit iioation ft is Ho4zon Depth DMInant Color Redox Description Texture Structum Consistence Boundary Roots GP©/W in. Munsell Qu. Sz_ Cont Color Gr. Sz. Sh. 'E(Nkf •Bff#2 Borm� Boring * 0 Pit w ce Gn nd surfa elev. ft. depth to limiting factor IJ - -- - in. Sod AP01=WnWaV hbrizo Depth Dominant Color Redox Descrmptlon Texture Structure Consistence Bmr4 ary R00% GPDJFiz in. Munsall Qu. Sz. Cont Color Gr. 3z. Sh. `t=_ff#1 *0102 Effluent #1 = SOD, ? $o c 220 mgrs_ and TSS >30 -c 150 mg/L ` Effluent #2 = SM, K 30 mg/L and TSS 30 mgA- The Department of Commerce is an ecltaal opportu "ity service provider and eMployer. rryou need assistance to access satvices or need material in ma alternate format, please contact the depaT mcnt at 608 - 266 -3151 or TTY 648- 264 -8777. ss¢e330trrr07ro0l � � 5 f�M r� � �i ■ 1�. r � �� � 1 �� ■ �w �, � ��� c: � ■ i ' � ■ i � �� � � ! �� �, �i� �. , ■ s � �� :� ■ �,. t �, : �! i� 511 M��� � ����- � 1 � r ■ �� t ��: Q� �4 -17 -0,1 Wisconsin Department ofCommerce SOIL EVALUATION REPORT Page Div Division of Safety and Buildings in accordance with . 9w 85, Wis. Adm. Code ,, �`, � County C Attach complete site plan on paper not less than 8 11 inchds )Qie lan must J� • 1 include, but not limited to: vertical and horizontal ante point (B a and Parcel I.D. percent slope, scale or dimensions, north arro a ,nd location distan t �n rest road. a .. I a 1 Q O (7 Please print a fbm �� 't e Zev by Date Personal information you provide may be used fo secondary p rppses (PAJ w, S. ;5'0_4 1) (m)). �(_ �O Property Owner Prop Location �` �` 9i Gbvt.'Vot S W 1 /4SF_ 1/4 S 5 T 31D N R I$ E (or) W Property Owners Mailing Address, t Block # Subd. Name or CSM# 1 Q�r'�' Rvh City State Zip Code Phone r i 4. E] City Village Town Nearest Road t,v.> " C6 V0 214 L) 5 I _7 1\ I 0'1 T V � s ($ New Construction Use: (g Residential / Number of bedrooms Code derived design flow rate GPD M Replacement I q Public or commercial - Describe: Parent material Q 1 d– C_ Flood Plain elevation if applicable ft. General comments if and recommendations: M 5V °� `� 4 n 4+ -� ,,, m O h : �; r"Q IM D V r`a • S e-+ r-J ° I 6,75 f�G �du�Ccw I 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 /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o`i 04 3 L_ x612 a ►, 45 ,5 ,9 .ay S / 5 �. 'h ew S . 3 Y- 7 "S' _ Nca�►y m sb k. J0, c 1 J . 5 q 3 :0o y a/a ESL a F5 v- 45k q tA-> — , s 69 1 F Boring # © Boring Pit Ground surface elev. b a ft. Depth to limiting factor —s O in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 - I 7. � ..�.... —.-.. s L- e. F 3 1r5 k.t w t �f' ► . SD -10 S y ) F `/ 8 6 Lw r<Y 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 ' a r StJ2 aa►1 Y Address T Date Evaluation Conducted Telephone Number :1 7 d ;Lb 0 s"1, r %C Y D ;t ID-q-61 a y8 -3s SBD -8330 (R07 /00) � o . Property Owner TIA 11t. B OJ ItV S Parcel ID # Page of Boring ©Boring # ❑ Pit Ground surface elev. 9 G.75 ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 sL � &k AA q5 aF s 19 -;I )5 -a5 2 t' 5 ' 1e- S L- a it w S 3 as -5s s y P.Y/ --- - ---- -- L- I - T F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. SAiI Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F I I I T F-1 Boring # [] ❑ Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsel! 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.07 /00) T - 9a ' _ s ; h h c j / Ji open - r y c o Q t �3 U -7s :_ __ -__:_ ,, _. � _ ._ - ., , __ __ _ I '� - -_ __ _ _ __ _ _ r _,_ _.._. _ . i i __ __.. _ _ - _. _ _ _ - _ i ,_ _ ___ r _. ... _ _ _ __ �- -- r -____ __,.___ . _._ _. _ _ - - � - _ . _. __ _. s 10/04/01 10:12 FAX 17152467227 HALLE BUILDERS 202 RUN 1- A(ew AZ' Cl-j pond, Wisconsin Lot Prices & Directions on reverse side':` �� + f Rural Eols, 1+ Al e : � 18 Natural Gras 1 17 °� i fEtcRrol , IAN { X 11 = * ; ■ 44147 to n IAIT to= ,r "in to rT , 1 ��'\ 8 ears , i �, 1 �sr sr ,• ( o 9 13 .�....� ! KffO 01 R �• 7 :L g 14 t` 24 I. /// tA.f 0� I ° r } 04r1t 706 rF . 1 40,1t3 ZA R ° IL FT. t 25 1�t! AM Y��elf�iy. � I.OI S 4 R r 4...., ism fa FT. I sarn ft rL fir. �y�t ,� _._ _._ w 3y +A ` nnt.va,.r.rn• ri�n nuvernr.TT ¢ "tdat"4C1°Q•" I 1 ; :20 ........... q rf, ' t ', •• I 40.010 ' °.000 Af1Rf MW 11.10 JIMTM'ju as ll nt� ss rt. HALLE !BUILDERS and REAL ESTATE 1113 Hwy 64 ' New Richmond, Wl 54017 715- 246-6813 fax 715 -246- 7227 ST CROIX COUNTY SEPTIC 'ANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owtler /BLiyer Mailing Address Property Address 7a 54- (Verifieotiort required from i Planning Department for new construction)„ __a , ...___. CitylState l 1� j ,-d . Parcel Identification Number 1 18- _ L E GAL DESCRIPTIO Property Locadon _ 51n1 _ i /., 5 %, St C. T .�b_Y-R_ I W, Town of Subdivision Lot 0 Certified Survey Map # . Volume �, Page # _ Warranty Deed # Volume 5 Page # Spec blouse 0 yes Q no Lot lines identifiably yes ❑ no SYSTEM MA29ENANCE Improperuse and maintenanceof your sel pc aystem could result in its premature failure to bandte wastes. Proper maiut consists of pumping out the septic tank every torte years or soo>ter, if n6eded by a licensed pumper. What you put into the system can affect the funcdon of the septic tank as a tmi �meut stage in the waste disposal system. The property owner agrees to submit to 5t, Croix Zoui,ng Depar a cortik?catzan form, sighted by the owner and by a amter plumber, iottrtteymanp1mber, restt'ictedpl itnber or a liecnsMpumper verifying that (1) the on -site wastewaterdisposal system IS in proper oNratiug condition and/or (2) after in: tpection and pumping (if natessary), the septic tank is less th= 1/3 full of dU486- I/we, the uudersi&%ed have read the above requirt, hunts and agxeo to maintain the private sewage disposal system with the standards set forth. herein, asset by the Department of Cam. ,"me and the Departtnoet of Natural Resources, Stato of Wisoonsin. Ct t4;Sfaation stating that your sWie system has been maintain I must be completed and returned to the St. Qrolx County Zoning Office within 30 days of the three year ex ' 77 1� J� ATUR$ O PI,ICAN DATE OW NER CERTIFIC I (we) ce ztafy that all statements on this i irm are true to the best of my (our) kmowiedge. I (we) am (are) the owner(s) of the property describvirtue of a watra ity decd recordc i iu Reg;strr of Deeds Office. GNATUILE O DATE "sY"* A.aay information that is this- represented R ay result in the sanitary permit being revoked by the Zoning Department. •' * *"' Include with this application- a stamped warrittty deed from the Register of Deeds Office a copy of the c4 rtified survey tnatp if reference is &ade in the warranty deed V State Bar of Wisconsin Form ? =. 1932 5 4 0473 WARRANTY DECD ; DOCUMENT NO. i - 7- - REGISTERS OFFICE M �. ST. CROIX CTY. - WI Gerald M. Lametti and Mary Kay Lametti, Reed for Record n� h usband and w e, as survivorstilp mari M property, an 1V ctor G. Lametti MAR 5 1996 M 1.4 at 3:30P M; !Wesley W. Halle and Linda R. conveys and warrants to J! ,,;phi ( ... Halle, husband and wife, ` Register of Deeds THIS SPACE nF.SERVED FOR RECORDING DATA NAME AND RETURN ADDRESS — — _ EQUITY TITLE SERVICES II — S Cr oix 400 SOUTH SECOND STR' yl the following described real estate in — -- HUDSON, W 54 016 County, State of Wisconsin: i f (Parcel Identification Number) I l ; SW1 /4 of SE1 /4 of Section 5 -30 -18 EXCEPT in Vol. 11 728 1 " , page 136, Doc. No. 407700. T NjgER FEE This — ] - S n homestead property. XXi (is not) Exception to warrantiCs: Fa.SementS, restrictions and rights -of -way of record, if any. i I Dated this day of i l i (SEAL) w (SEAL) ei * Victor G. Lametti SRAL) (SEAL) r j: AUTHENTIC ION t/ ACKNOWLEDGMENT i� Signature(s) STATE OF 'WISCONSIN ss. - - -- - -- - - - - -- -- - - -- St. Croix — County. authenticated this ___ ___ da_ of ___ _.. -_ ,_ , 19____ Personally came before me this - - -- - 19- - the ahm e P - - -- - -- - -- __- - - - - - - -- - - - - -- Gerald M Lametti and Mary Kay 1,,'- 11711 husband a nd wi fe,_ and Vi ctor G. ii TITLE: MEMBER STATE BAR OI- WISCONSIN Lametti I� (If not, li authorized by §706.06, Wis. Stats.) to me known to be the person who executed the I foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS pRAFTED BY Diane M. Barron Kri 0 1_and Notary Public - - 00-and - State -o #- Wisconsin Attorney at La�a Notary Public County; WIS s (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration "date nhhl•.NNarv.) /I— P . 19 �D l *Nam- -d apnri1V should he Ivped nr printed hehnv Ihrir siKnnlures. 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