HomeMy WebLinkAbout026-1153-39-000 r Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
id Building Division Sanitary Permit No:
INSPECTION REPORT 453492 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:
Olstad, Chris I Richmond Township 026- 1153 -39 -000
CST BM Elev: Insp. BM Elev: BM Descriptio Section/Town /Range/Map No:
DQ - 0 J O / 19.30.18.1177
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / O UD Benchmark 2 v
Dosing i Alt. BM
Aeration Bldg. Sewer
Holding S Ht Inlet
TANK SETBACK INFORMATION S t Outlet �- b`� 13 • r -
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic , � / [ t Dt Bottom
Dosing a Header /Man. 12
Aeration Dist. Pipe i
2 -z-
Holding Bot. System
Final Grade
PUMP /SIPHON INFORMATION 5�3 ��
Manufactur Demand St Cover ? q V
GPM / 3 fi (� • ✓, (v / d -
Model Number �—
TDH Lift Friction Lo System TDH Ft
Force main Le Dia. Dist. to well
SOI SORPTION SYSTEM
BED/TRENCH Width ] Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS J h /
SETBACK SYSTEM TO u/ P/L BLDG IWELL LAKE /STREAM LEACHING Manuf rer:
INFORMATION Ty Of System: CHAMBER OR 1 O DI ���
—%' (Z f UNI Model Number. S �
947, RIBUTION SYSTEM U /, d
Bader anifold Distribution I x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s) 1 /
Length h Dia Lengt Dia _4_ !L _ Spacing_
SOIL COVER x Pressure Systems Only x x Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil xx S
Yes L] No Yes :No]
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Q Inspection #2:
Location: 910 148th Avenue New Richmond, WI 54017 (NW 1/4 19 T30N R18W) Glen View Lot 39 Parcel No: 19.30.18.1177
1.) Alt BM Description = 1 Uf 6 �`4 -
2.) Bldg sewer length = I G )
- amount of cover
Plan revision Required? 1, Yes No
Use other side for additional information. ����
SBD -6710 (R.3/97) Date Insepctors ignature Cert. No.
Safety and Buildings Division County Cie, f
` m 201 W. Washington Ave. P.O. Box 7162
�s�eonsin Madison, WI 53707 - 7162 Permit N her (to be filled in by Co.)
De artment of Commerce (608) 266 - 3151 4
Sanitary Permit rAP11 `' Ian I.D. umber In accord with Comm 83.21, Wis. Adm. Cod I rt, a may be used for secondary purposes 04(1)(m) Project Address
(if dif rent than mailing address)
1. pp on nformation - Please Print All Infos 1 v 1 O
NQ t ) c - mwV Wis(
Property Owner's Na me S•• f. CROIX P t N Block aI
ChR s Q OAD ZONING OFFICE p�(, 113-39 ��
Property Owner's M ailing Address'
Q k A (j t 1
City, State Zip Code Phone Number
I J( ' 4, W W.Section
H SA IDSWIJ ^ / �(, ' (y (circle one)
I1. T ype of Building (check all that apply)
Ji�1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number
r
. ❑ Public /Commercial - Describe Use
11 State Owned - Describe Use
]City_ - Willage Pfrownship of �/ Llkkip
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
DWe� ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal ;5,fermit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration �— Plumber Owner
IV. Type of POWTS System: (Check all that appl
Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ At -Grade U Single Pass Sand Filter
❑ Constructed Wetland ❑ Pressurized In- ound ❑ Holding Tank ❑ Peat Filter U Aerobic Treatment Unit U Recirculating Sand Filter
❑ S nthetic Media Filter ching Chant r ❑ Drip Line ❑ Gravel -less Pi U Other (explain)
V. D rsal/Tn ertment Ares Info ation: ) S Z
Design now (gpd) Design Soil Application Rate(gpdsf) Dispersal _ Area Required (sf) Dispersal A Proposed (sf) System Eleva
5 (( V a �4� � 8 )•%)
VI. Tank Info E:ew city in Total Number Manufacturer Prefab Site Steel Fiber Plastic
llons Gallons of Units Concrete Constructed Glass
Existing
Tanks
Sept ic or Itolding Tank I O U 0 eJ( S
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for Inslallallon of the POWTS shown on the attached plant.
Plumber's Na me (Print) Plumber's A gnature MP /MPRS Number Business Phone Number
9 00
Plumber's Addre ss (Street, City, State, Zip e) Vol
VIII ount /De artment Use One
Approved ❑ Disapproved Sanitary Permit Fee (i ludes Groundwater Date ssued ssuittg Agent 1 tur Stamps)
- ZS
❑Owner Given Reason for Dental Surcharge Fee) (316
IX. Conditions of Approval/Reasons for Disapproval -- /
SYSTEM OWNER:
C I) 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 .
Atbch complete plans (to the County only) for The system on paper not less than 81/2 x 11 Inches In size
SBD -6398 (R. 01/03)
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• Wisconsin Department of Commerce SOIL EVALUATION 1 of 3
Division of Safety and Buildings in accordance with Comm isJOURIQ A.C.E. Soil & Site Evaluations
Coup
y
Attach complete site plan on paper not less than 8% x 11 inches in size. Pla must Qlk St. Croix
include, but not limited to: vertical and horizontal referen t (BM), directi and (�
percent slope, scale or dimensions, north arr , a I distance to earest� Parcel I.D. 026- 1153 -39 -000
Please J 1 C Rp1G Date
Personal information you provide m purposes (Privacy Law, s. 1 4 (1) (,> b
Property Owner Pr ocation
Chris Olstad Govt. Lot NW 1/4 NW 19 S 19 T 30 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
907 Alex Lane 39 1 Plat Of Glen View
City State Zip Code Phone Number J City ` f Village 01 Town Nearest Road
Hudson WI 54016 1 Richmond 1 910 148Th Ave.
V New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
_ I Replacement Public or commercial - Describe:
Parent material Glacial outwash Flood plain elevation, if applicable na
General comments
and recommendations: Install two trenches at 92.50' using 22 leaching chambers.
M Boring # Boring
Pit Ground Surface elev. 95.02 ft. Depth to limiting factor > 108" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -8 10 Y r32 none I 2fsbk ds cs 2f 0.6 0.8
2 8 -16 1Oyr4/4 none gr sl 2fsbk dsh cs if 0.6 1.0
3 16 -21 7.5yr4/6 none gr Is 1 msbk mfr aw - 0.7 1.6
4 21-67 1 Oyr6 /4 none trat s&gr Osg dl gw - 0.7 1.6
5 67 -108 10yr5 /6 none strat s&gi Osg dl - - 0.7 1.6
Boring # Boring
Pit Ground Surface elev. 95.22 ft. Depth to limiting factor >1 11 " in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD / tz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -13 1Oyr32 none I 2fsbk ds cs 2f 0.6 0.8
2 13 -24 1Oyr4/4 none gr sl 2fsbk dsh cs if 0.6 1.0
3 24 -38 7.5yr4/6 none gr is 1 msbk mfr aw - 0.7 1.6
4 38 -80 1 Oyr6 /4 none strat s> Osg dl gw - 0.7 1.6
5 80 -111 1 Oyr5 /6 none strat s&gi Osg dl - - 0.7 1.6
ILL
* Effluent #1 = BOD 5 > 30 < 220 mg /L an TSS >30 < 1 mg /L t #2 = BOD . 30 mg /L and TSS <30 mg/L
CST Name (Please Print) 'nature' CST Number
James K. Thompson _ �} 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane Osceola, 154020 1022004 715- 248 -7767
li
Property Owner Parcel ID #
Chris Olstad 026 - 1153 - 39 Page 2 of 3
F31 3 oring # _j Boring h to limiting factor > 118" in.
Pit Ground Surface elev. 97.04 ft. g Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-6 10yr3/2 none I 2fsbk ds cs 2f 0.6 0.8
2 6 -15 10yr4/4 none gr sl 2fsbk dsh cs if 0.6 1.0
3 15 -21 7.5yr4/6 none gr Is 1 msbk mfr aw - 0.7 1.6
4 21 -56 10yr6/4 none strat s &g Osg dl gw - 0.7 1.6
5 56 -118 10yr5/6 none strat s &g Osg dl - - 0.7 1.6
- T - 1
F-1 Boring # --j Bort
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # -j Boring
f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
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.
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Safety and Buildings Division County
m m 201 W. Washington Ave., P.O. Box 7162
tlseonsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
De (608 artment of Commerce ) 266 -3151 53 9'Z
Sanitary Permit Application State Plan I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, sI5.04(t)(m) Proj Address (if different than iling address)
_
M W
1. Application Information - Please Print All Information ° " } ° Y
(y
Property Owner's Na the I Parcel N Lot N Block #
Property Owner's M ailing Add ' Property Location
1
Q NL `� Lbi-JA
0
City, State II � Zip Code Pho i '4 u ,Section \ / ""
D (circle once)
of Building T N; R�E
II. T or W
Type g (check all that app S
�4l or 2 Family Dwelling - Number of Bedrooms A A, A Subdivision Name CSM Number
.❑ Public /Commercial - Describe Use I ! '-Q I
❑ State Owned - Describe Use L ]City_L "]Village NTownship of , (.
III. Type of Permit: (Check only one box on line A Complete line B if a licable) 2( _ 3 _ _ 6 R 5 1 : 77
A.
]O1New System ❑ Replacement System NChanof lding Tat Replacement Only ❑ r Modification to Exi System
B. ❑ Permit Renewal 11 Permit Revision E ermit Transfer to New Li rev' Date Issued
Before Expiration t►er
IV. Type of POWTS System: (Check all that a i) 3 ly, S ZZ b
Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil X7und < 24 in* of suitable soil 11 At-Grade U Single Pass Sand Filter
❑ Constructed Wetland 11 Pressurized In- Ground El Holding TanPeat Filter U Aerobic Treatment Unit U Recirculating Sand Filter
Recirculat S nthetic Media Filter Leaching Chamber ❑ ❑ Gravel -less Pipe ❑ Other (explain)
V. D rsal/Treatment Area Information:
Design Flow ) Design Soil A iicadon Rate(gpdsf) Dispers Area R uirel (sf) Dispersal Area Proposed (sf) S stem Elevation
VI. Tank Info Capacity in Total Number Man acturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units 'Z �� Concrete Constructed Glass
New Existing
!1 I t _
Tanks Tanks tL t'w
Septic or Holding Tank j b 00
y Aerobic Treatment U
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, antne responsibility for installation of t POWTS shown on the attached putts.
Plumber's Na me (Print) PI is re MP /MPRS Number Business Phone Number
Plumber's Addre ss (Street, City, State, Zip C )
b lh 0 �j
VIII. Couny/DepartmentiBse oul Ar
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
❑ Owner Pee)
�{
r Given Reason for nisi
IX. Conditions of Approval/Reasons j
isapproval
MAIN 11�IA
SYSTEM OWNER: 3�
1 Septic tank, effluent filter Sw 0
dispersal cell must all be d / maintaine 1- n
6M K "�
j
as per management plan provided by plumber.
c�`� �
2: All setback requirements must be maintained 4
as per applicable code /ordinances. �� t °"�
Attach rnmplete plans (to the County only) for the system on paper not less than 8112 x 11 Inches In size
SBD -6398 (R. 01/03)
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
btvision of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code n
County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must ` �' i
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Re wed by Date
�, �
Personal information you provide may be useQfor'secondary purposes (Privacy Law, s. 15.04 (1) (m)). 2AZ
Property Owner Property Location
' S— / it Pl� Govt. Lot !1K A/4 S /� T3 N R E (o W
Propeq Owner's Mailing Address Lot;; I Block # I Subd. Name or M#
City tale Zip Code ` P �,on e Number ❑ flY ❑village To Nearest Road
r o New Construction User Residential / Number of bedrooms � Code derived design flow rate � `.> GPD
Replacement ❑ Public or commercial - Describe: ____�__- -------- , - - - - -- - - --
Parent material Flood Plain elevation if applicable _�1/% /`� -- ft•
General mnieterrts ndations:
and reco /�� ys✓ ��� t/��l'i✓
mme
2
❑ Boring
❑ � # 1 P i t Ground surface elev. � ft. Depth to limiting factor —�-- in. F
Soil Application Rate 4
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
0-60 D r S
,3 p ,�- W
YT Z9 q - 24
Boring # Boring
® Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ADDlication 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
fto
� f � 1 � - ✓' vvt,l�v' S 2� r • �
mss -
�.
' Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 1 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Plea Print) i re CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 4017 � �� 715 - 246 -4516
Property Owner _ Parcel ID # Page of
FT Boring # ❑ Pit Boring
Ground surface elev. L IZ-ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0-1
Z 3 P30 10 �� W 4 �.
t
F—I Boring # ❑Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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
Boring
F-I Boring # Ground surface elev. ft. Depth to limiting factor in.
11 pit Sal Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM
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 mgll. 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 -8730 (1.6/00)
• Soil Test Plot Plan
Project Name Lakes and Hill Development Shaun B'
Address P.O. Box 10598
White Bear Lake Mn 55110 CST 226900
Lot 39 Subdivision Glen View Date 7/18/03
1/4 N W 1/4S 19 T 30 N /13 W Township Richmond
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post g
System Elevation 95.2/94.7 *HRPSame as Benchmark
( 0BM _Top of Survey Iron @ 96.1'
193' Property Line
a�
Please Note: Tested area
Please note: survey was not may not be suitable for a
completed at time of testing, desired building area. o
setbacks from lot lines may Check system location
change. Installer must verify before excavating.
all lot lines and setbacks 97' 99' `
before installation. 95' B-
Scale is 1" = 40' BB- -
unless otherwise
noted 4
lope 80 a
40'
M
40'B-
15'
' B.M.
Alt.
.M.
a
0
v�
Pro Town Road
i
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System ( POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on rile at the county
zoning r health department.
9 P
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit mgt Nu
tuber S X92
Number of Bedrooms
Design Flow - Peak (gpd) b
Estimated Flow - Average ( d) Qp
Septic Tank Capacity (gal)
U bo
Soil Absorption Component Size ft
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak ( d) 5
Maximum Influent Particle Size (in) I 1/8
Maximum BOD (m /L) 220
Maximum TSS (mg /L) V 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Ins ect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the sept' k and outlet filter shall be assessed at least
once every 3 years by inspection. The 6uCe_t_f4br shall be cleaned as necessary to ensur
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. if the
r
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge 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 an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank. I
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 the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or Impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption components operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual Inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
Impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
I
2
c
a
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep - rooted trees and shrubs directly over or within ten feet of the .
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
When system fails, we will replace with another system
at owner's expense. Alternate area must be left undisturbed.
St Croix County Zoning Office 386 -4680
Boumeester & Sons Excavating 386 -9020
03/13 /2001 16:21 7153868473 _ _.... COPY CAT PAGE 81
.ST CROIX COUMW
SEPTIC TANK MAINTENANCE AMSEMRNT
AND
OWNBRSHIF CERTIFICATION FORM
OanMWBityer
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, C%(1`' `� � � „� ptu�ael Icietxtilfwation Number _�„ �� .� � 1 <J Of>' �• �l ��)
pn Location —'/,, %,, Sec:. tt 14.R W, 'tow oUL 12yt G�i
Stebdi (' , ec t— _. Lot # �.
Cwtined so"" ?Amp g Volume. page 0 n
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Spa house 0 Yes /0* no Lot Braes ideardifiable 'yes 0 no
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SIGNATIAM OF APPLICANT
.. DATS
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U 2633 P 08`f - 7 ?tb ISO 63
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO,, WI
This Deed, made between Hillvale Development Limited Liability RECEIVED FOR RECORD
Partnership Grantor, 08/06/2004 01:15PH
and Christopher C. Olstad, a single person and Sasha M. Well P, WARRANTY DEED
a singe person Grantee. EXW It
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00
(if TRANS FEE: 128.70 re space is needed, please attach addendum): COPY FEE:
Lot 3 q Plat of GlenView, Town of Richmond, St. Croix County, CC FEE:
wconsin. PAGES: 1
Recording Area
Name and Return Address
026 - 1153 - 394000
Parcel Identification Number (PIN)
This is not homestead property
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any.
Dated this 340 day of August 2004
Ht1lvale Development _/ - --
AUTHENTICATION �
Signature(s) _ _ STATE OF 1 /� �t�6JW&4 )
-- (� ) ss.
i!t , County )
authenticated this day of ,
Personally came before me this day of
Roger D . BeyerS August , 2004 the above named
Notary Public Hilly le Development Limited Liability Part nership
TITLE: MEMBER STATVA5&%P Vl$ WSin -- - - --
--- ------------ -- --------- -- --- -- _ -- -- ---
(If not, - _ to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrume owledged the same.
THIS INSTRUMENT WAS DRAFTED BY _
Attorney Ogland _
Huds WI 54016 Notary Public, State of
My mission ' permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du lac, wf
STATE BAR OF WISCONSIN 800. 655 -2021
WARRANTY DEED FORM No. 2 . 1999
PARCEL IN
GSM
VOL. 1 7 VOL. 1091 °D (i22�A
�-__�
PAGE 454 PAGE 2 84
---- -
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tp
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(5.12 ACRES)
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I t 124.079 S.F.
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y ,3r
I MIEa7 OUARIER CORNER
' SEC. 19, TSON, MSW
FOUND 3/4' O.D. Oft PIPE Y
1846
Wisconsin Department of Commerce SOIL EVALUATION REPORT p age l __of - --
tions
Attach complete site plan on paper not less than 8% County x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and -- - -- -- -
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
026 - 1153 -39 -000
Please print all information. Reviewed By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15 04 (1) (m))
Property Owner Property Location
C hris O ls ta d G ovt. Lot NW 114 N W 114 S 19 T 30 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
907 Alex Lane 39 Plat Of Glen View —_
---- - - - - -- - —
City State Zip Code Phone Number City _ Village ✓i Town Nearest Road
Hudson WI 54016 1 Richmond 910 148Th Ave.
✓ New Construction Use: ✓i Residential / Number of bedrooms 3 — Code derived design flow rate _ 450 GPD
Replacement Public or commercial - Describe:
Parent material Glacial outwash Flood plain elevation, if applicable na -
General comments
and recommendations: Install two trenches at 92.50' using 22 leaching chambers.
FT] Boring # Boring
✓ Pit Ground Surface elev. 95.02 ft. Depth to limiting factor > 108° in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft'
i n Munsell Qu. Sz Cont. Color Gr. Sz. Sh 'Eff#1 'Eff#2
0 -8 10 r3/2 none I 2fsbk ds cs 2f 0.6 0.8
I
1 � � y � � - - - --
y none _ — ; �_— cs 1f 0.6 1.0
2 r 8_16 10 r4/4 gr sl 2fsbk dsh
3 16 -21 7.5yr4/6 none gr Is 1 msbk mfr aw - 0.7 1.6
4 21 -67 1 Oyr6 /4 none trat s&gr Osg dl gw t 0.7 1.6
5 _', 67 -108 10yr5/6 none strat s &gn Osg dl _ - 0.7 1.6
' I
Boring # J Boring
_ Pit Ground Surface elev. 95.22 ft. Depth to limiting factor >111" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ G P_D_I_ft' _
n Munsell Qu. Sz Cont. Color Gr. Sz Sh 'Eff#1 'Eff#2
1 0 -13 1Oyr3/2 none I 2fsbk ds cs 2f 0.6 0.8
2 T 13 -24 10yr4/4 none gr sl 2fsbk dsh cs 1f 0.6 1.0
3 ! 24 -38 I '1 7.5yr4/6 none gr Is 1 msbk mfr – aw 0.7 1.6
4 38 -80 1 1 Oyr6 /4 none strat s &g Osg dl gw - 0.7 1.6
5 80 -111 1 Oyr5 /6 none strat s &gr Osg dl - 0.7 1.6
Effluent #1 = BOD s > 30 < 220 mg /L an TSS >30 < 15 mg /L ant #2 = BOD < 30 mg /L and TSS < mg /L
CST Name (Please Print) nature' CST Number
Ja mes K. Thompson - 360
Address A.C.E. Soil & Site Evaluations / Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola. 15 4020 10/x/2004 715- 248 -7767
f
Property Owner Chris Olstad Parcel ID # 026- 1153 -39 -000 _ —_ Page _2 _of - 3
73 # _ J Boring -
✓; Pit Ground Surface eiev. _ 97.04 ft. Depth to limiting factor > 118" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in Munsell Qu Sz. Cont. Color Gr. Sz. Sh. Eff#1 'Eff#2
1 0 -6 1Oyr3/2 non I 2fsbk ds Cs 2f 0.6 0.8
2 6 -15 1 Oyr4 /4 none gr sl 2fsbk dsh I cs if , 0.6 1.0
3 115 -21 7.5yr4/6 none gr Is 1 msbk mfr aw 0.7 1.6
4 21 -56 1 Oyr6 /4 non strat s &g Osg dl gw - 0.7 1.6
5 56 -118 1 1 Oyr5 /6 non strat s &g Osg dl - 0.7 1.6
F -
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 'Eff#1 P /nEff#2
in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
!
I i I
i
❑Boring # Boring - -- —
_ Pit Ground Surface elev. _ ft. Depth tc limiting factor in. Soil Application Rate
Horizon i Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
- ----------
—t—
I
i
i
Effluent #1 = BOD ? 30 <220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD 30 mg /L and TSS < 30 mg /L
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 fonnat, please contact the department at (08 -266 -3151 or "TTY 608- 264 -8777.
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