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I Jennifer Shillcox J • 3 0> From: nrts @frontiernet.net O2 t060 -7G-GW Sent: Wednesday, October 17, 2007 2:45 PM To: Jennifer Shillcox {J� Subject: Re: Special Exception Application Materials for Contractor'sStorage Yard - New Richmond Tree Service Hi Jennifer, I would like to meet with you to make sure all paper work is done correctly, let me know when next week I'm usually available. Our goal is to run the tree service as low key as possible, this would mean no signs or customers entering the property. The only problem I foresee in the future is the wood and brush pile along the back yard. As of last year the wood and brush is hauled away and brought to Minn. for energy. The City of New Richmond just started the processing this year, so maybe a join effort could eliminate any future debris brought to our location. I see this being a problem when the property is sold next to ours. At that time I may be interested in buying the surrounding property. This will make it easier on creating a good buffer zone on a joining properties. Quoting Jennifer Shillcox < jennifers @co.saint- croix.wi.us >: > Hi Greg, > • Thanks for your call. As we discussed, you will need to apply for an • after - the -fact special exception permit to continue operating your • existing home -based tree service business in the Ag Residential • District in the Town of Richmond. I have attached the special • exception application form and supplemental information sheet. The • next deadline for submittals is November 5th, after which the • public hearing will be scheduled sometime in late December /early • January (date pending). Feel free to contact me with any questions • once you have had a chance to review the materials. I would also be • happy to schedule a meeting with you next week to review your • application before submittal. • I am copying this message to Ryan Yarrington, who is processing your • sanitary permit. I am not sure what his plans are for issuing the • permit, but will let him know that you are planning to apply for the • special exception permit ... he may intend to issue the permit as • soon as you have submitted your application. He will follow up with • your plumber. > • One more question ... do you currently have any signage or do you plan • to add any in the future? If so, you will need a separate land use • permit for signage. > Sincerely, > Jenny Shillcox > Land Use Specialist > St. Croix County Planning & Zoning Department > 1101 Carmichael Road > Hudson, WI 54016 > Phone: 715- 386 -4682 > Fax: 715 - 386 -4686 > jennifers @co.saint- croix.wi.us 1 ST CROIX CO &A IL UNff PLAT NNG &. Z®1®tNG March 31, 2008 File Ref: SE0150 Greg onn g es E>> 1461 County Highway A New Richmond, WI 54017 Re: Reconsideration of St. Croix County After- the -Fact Special Exception Permit Parcel #: 20.30.18.298D, Town of Richmond Code Administrate 715- 386 -4680` `> Dear Mr. Bonnes: Land Information 1!k Planning The St. Croix County Board of Adjustment (Board) has reconsidered its decision dated 715 -386 -4674 January 3, 2008 regarding an after - the -fact special exception permit for a contractor's Real P "``rty storage yard in the Ag Residential District in the Town of Richmond. After the hearing on 715 -4677 March 27, 2008, the Board voted to approve your request for reconsideration with revised A conditions. The enclosed document is the formal decision regarding the application. R cling' -386 -4675 you must obtain an other required local state and federal permits and approvals. Please Y q p Pp feel free to contact me with any questions. x:. Sincerely, ennifer Shillcox Land Use Specialist/ Zoning Administrator 4 Enc: Decision : £t , Cc: Timothy Scott, Attorney A` ` Clerk, Town of Richmond Pam Quinn y g g p St. Croix Count Planning and Zoning Department Jeff Durkee, St. Croix County Highway Department Don Gillen St. Croix Count Assistant Corporation Counsel Y 1 P 01 ST. CROIX COUNTY GOVERNMENT CENTER 1101 CARM/CHAEL ROAD, HUDSON, W1 54016 71538 &4686 FAx PZPCO.SA/NT- CROlX.WI.US WVWV.CO.SAINT- CROIX.WI.US FINDINGS, CONCLUSIONS, AND DECISION OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN File: SE0150 Applicant: Greg Bonnes, New Richmond Tree Service, LLC Parcel #: 20.30.18.298D Original Application Received: November 5, 2007 Request for Reconsideration Received: February 12, 2008 Hearing Notice Publications: Weeks of December 17 and 24, 2007 and March 9 and 16, 2008 Hearing Dates: January 3, 2008 and March 27, 2008 FINDINGS OF FACT AND CONCLUSIONS OF LAW Having heard all the testimony, considered the entire record herein, and reviewed the site, the St. Croix County Board of Adjustment makes the following findings of fact and conclusions of law: I . The applicant is Greg Bonnes, property owner and owner of New Richmond Tree Service, LLC. 2. The site is located at 1461 County Highway A in the SW ' / 4 of the NE '/4 of Section 20, T30N, R18W, Town of Richmond, St. Croix County, Wisconsin. 3. On January 3, 2008, the Board of Adjustment (Board) approved an after - the -fact special exception permit to allow the applicant to continue operating a contractor's storage yard in the Ag Residential District pursuant to Section 17.15(6)(d) of the St. Croix County Zoning Ordinance. The applicant requests reconsideration of Conditions #3, 4, 5 and 12 of the Board's approval. 4. Regarding Condition #3, the outdoor storage areas for woodchips, lumber, firewood, and brush and woodpiles are not currently screened from County Highway A or from adjoining properties. Section 17.15(6)(d) of the St. Croix County Zoning Ordinance provides that any contractor's storage yard "shall be so placed or screened by planting as not to be visible froth any public highway or any residential building other than that of the owner of such yard, his agent, or employee. " The Board has consistently required vegetative screening for all proposed contractor's storage yards in order to meet this requirement. The Board takes into account the existing density and type of vegetation in the vicinity, local topography, and surrounding development. The applicant's property is surrounded by land that is currently or had at one time been predominantly agricultural croplands and as a result does not feature dense vegetative cover. Evergreens, or conifers, are not common in the area except where planted around residences. The topography is flat and the applicant's property is highly visible for a considerable distance from all directions. The applicant's 3.5 -acre lot is not within a major subdivision, but is surrounded by low- density residential development and agricultural uses. The closest existing residences are located approximately 400 - 550 feet away, and a residential subdivision, Waldroff Meadows, exists to the east. In after - the -fact situations such as the applicant's, time is of the essence in providing immediate screening of existing outdoor storage areas and the Board typically establishes a deadline for planting. Given these considerations, as well as the large area to be screened, the high expense to plant six -foot evergreens, and the applicant's concerns about providing a natural looking buffer, staff finds it reasonable to allow the applicant to provide a mix of native coniferous and deciduous trees and shrubs and supplement it with forbs and grasses, which is more consistent with existing vegetation in the area. Staff also finds it reasonable to reduce the height of the trees and shrubs to four feet at the time of planting, provided the buffer attains 80 percent opacity and at least eight feet in height at maturity. A timeline of two years for all plantings would reduce the financial burden for the applicant and would allow the Zoning Administrator to review the screening at the bi- annual compliance meeting as required by Condition #15. There also appears to be sufficient space on the property for the applicant to move the outside storage areas further to the west/northwest to reduce the length of the required vegetative buffer and thus reduce the landscaping costs. The Board finds the revisions proposed by staff to be reasonable. 5. Regarding Condition #4, the Board has never allowed a contractor's storage yard to store vegetative materials, wood, or brush from job sites. According to the records on file at the St. Croix County Planning and Zoning Department, the Board has processed 33 special exception applications for contractor's storage yards in the Ag Residential District from 1989 — Present. Of these, four were for lawn care or tree service business, and all approvals except the applicants prohibited the storage and burning of any job- related vegetative material, grass clippings, wood or brush on the site. In fact one applicant was given two months to remove e a pp an existing g brush pile from his site. The Board's reasons were to protect health, safety and welfare, particularly with respect to attracting rodents, posing a fire hazard, and negatively affecting adjoining property values and the enjoyment of adjoining property owners. At the time of the staff site visit, the applicant had been storing a large pile of wood and brush along his 201 -foot rear lot line at a height of approximately 20 feet. At the hearing on January 3, 2008, the applicant testified that 2007 was an unusual year with a lot of heavy storms resulting in more wood and brush on the site than usual. He also testified that brush and wood used to be burned on the site until 2006, but are now hauled away by Ever -Green Energy upon request. He also stated that he was pursuing a contract with the City of New Richmond to take brush to the city's drop -off site. Given all of this information, staff finds that it would be reasonable for the applicant to store up to the equivalent of 45 cords of wood and brush at any given time, provided it is screened by a vegetative buffer and removed at least annually. This would allow the applicant to store wood along the entire rear width of his lot (minus a ten -foot vegetative buffer on each side) up to a maximum height of eight feet. This amount is less than half of what the applicant currently has on site and will reduce the risk of rodents and the potential for fire, and improve the appearance of the site. At the hearing on March 27, 2008, the applicant submitted evidence from Environmental Wood Supply that the minimum amount of processed wood waste required for the company to come out and grind wood at the applicant's property was 20 100 -yard trailer loads. If the applicant can meet this minimum, there is no cost to him for grinding. The applicant testified that 45 cords was the equivalent of one trailer load and would not be sufficient for grinding, and submitted a revised plan that featured three wood and brush piles not to exceed a total of 2,600 cubic yards. The Board finds it reasonable to adopt the revised plan. 6. Regarding Condition #5, the Board has never allowed any burning of job- related materials on the applicants' sites. Staff does not support the burning of any job - related materials on the site as it could cause a potential fire hazard and nuisance to neighboring property owners. The County does not regulate general residential /recreational burning, which is under the jurisdiction of the affected town through the issuance of burning permits. At the hearing on March 27, 2008, the applicant testified that he wants to burn wood and brush on the site that is intermixed with concrete, fence posts, wire, and other materials not suitable for grinding. The Board finds that smoke from such materials poses a human health hazard and that commercial burning is not appropriate. 7. Regarding Condition #12, the Board has consistently required that lighting for any non - residential use in or adjacent to residential areas be located no higher than the lowest eaves to minimize glare. The applicant constructed his pole shed with two lights located four feet above the lowest eaves, but below the peak of the roof. The Board finds that this is acceptable provided low - intensity bulbs are used and any future lighting is placed no higher than the lowest eaves. 8. With the revisions outlined in Findings 94 - #6 above, this request would meet the spirit and intent of the St. Croix County Zoning Ordinance and would not negatively affect the residential character of the area. 9. With the revisions outlined in Findings #4 - #6 above, this request would not be contrary to the public health, safety, and general welfare of the public, or be substantially adverse to property values in the neighborhood affected. 2 10. With the revisions outlined in Findings #4 - #6 above, this request would not constitute a nuisance by reason of noise, dust, smoke, odor, or similar factor. 11. The Town of Richmond Town Board is still strongly in favor of the applicant's use of the property as a contractor's storage yard, but with the conditions in question removed. According to the Town Clerk, the Town Board feels that the cost for the applicant to comply with the conditions would be prohibitive, and that the applicant has taken good care of his property and is now being punished for it. DECISION Based on the Findings of Fact, Conclusions of Law, and the record herein, the Board of Adjustment approved the applicant's request for reconsideration of Conditions #3, 4, 5 and 12 of the after - the -fact special exception permit approved on January 3, 2008 as follows (the applicant shall strictly adhere to all other conditions of the Board's January 3, 2008 decision as worded): Condition #3: Within 30 days of the decision for reconsideration, the applicant shall submit to and have approved by the Zoning Administrator a landscaping plan to enhance and extend the existing vegetative buffer along the northeast, southwest, and rear property lines extending from the pole shed east to a distance sufficient to encompass all outdoor storage areas and wood and brush piles. The buffer shall be at least 10 feet in width and include native trees and shrubs at least four feet in height at the time of planting to screen the employee parking lot and loading area, and all outdoor storage areas from adjacent properties and County Highway A. The trees and shrubs shall include a mix of native coniferous and deciduous species and may be supplemented with native fortis and grasses. All vegetation comprising the buffer may be spaced and planted in a manner that provides a natural look. The buffer shall attain at least 80% opacity and an average height of at least eight feet at maturity. The plan must include the species, size, and location of all native vegetation to be planted on the site, as well as a timeline for the plantings and a maintenance agreement to ensure that all vegetation establishes successfully and is maintained long -term. The applicant shall be responsible for ensuring that all storage and loading areas are fully screened from adjoining properties and the highway at all times. All approved vegetation shall be planted no later than August 31, 2010, at which time it will be reviewed to ensure proper screening per Condition #15. Condition #4: Brush and logs on the site shall be limited to three piles of the following dimensions: 150' x 20' x 8' (L x W x H). The piles shall be located at the rear of the property in the location indicated on the approved site plan for the site. The applicant shall bring the property into compliance with this condition by moving the existing pile to the designated areas, or burning it, hauling it off -site, and/or grinding it no later than June 1, 2008. At no time shall any wood or brush pile on the site exceed eight feet in height. All wood and brush stored on the site shall be removed at least annually. Condition #5: No job- related wood or brush shall be burned outdoors on the site after June 1, 2008. Condition #12: All fixture lighting on the building and associated with the employee parking lot and outdoor storage areas shall be located no higher than the lowest eaves and illuminated downward and shielded away from neighboring properties to prevent glare. Existing lighting on the building that is currently located above the highest eaves shall be fitted with low- intensity bulbs at all times to minimize glare. The following vote was taken to approve: Chairperson Malick, yes; McAllister, yes; Luckey, no; Nelson yes. Struemke was not present. Motion carried. 3 APPEAL RIGHTS Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30 days after the filing date shown below, pursuant to §59.694(10), Wisconsin Statutes. St. Croix County assumes no responsibility for action taken in reliance on this decision prior to the expiration of the appeal period. St. Croix County does not certify that the identity of all persons legally entitled to notice of the Board of Adjustment proceedings, which resulted in this decision, was provided to the County. If an appeal is taken of this decision, it is the responsibility of the appellant to submit at his/her expense a transcript of the Board of Adjustment proceedings to the circuit court. The Planning and Zoning Department can be contacted for information on how to obtain a transcript. It is the responsibility of the Board of Adjustment to submit its record (file) of this matter to the circuit court. ZONING BOARD OF ADJUSTMENT Signed: Clarence W. Malick, Chairpers Date Filed: 03/31/2008 4 CO ST CROIX AA I UN R PLANNING & ZONING January 7, 2008 I =ile Ref: SH)15U Greg Bonnes 1461 County Highway A New Richmond, WI 54017 Re: St. Croix County After -the -Fact Special Exception Permit CodeAdministratr Parcel #: 20.30.18.298D, Town of Richmond 715 -386 -4680 fit; x; Dear Mr. Borines: Land Information dr Y Planning 715 386 - 467 4 4 � The St. Croix County Board of Adjustment (Board) has reviewed your application for an ` after - the -fact special exception pen for a contractor's storage yard in the Ag Residential Real P District in the Town of Richmond. After the hearing on January 3, 2008, the Board voted to 715 -4677 approve your request with conditions. The enclosed document is the fonnal decision regarding the application. R - cling 5- 386 -4675 you must obtain any other required local, state, and federal permits and approvals. Please feel free to contact me with any questions. Sincerely, Jennifer Shillcox Land Use Specialist/ Zoning Administrator Eric: Decision . Cc: Clerk, Town of Riclunond Pam Quinn, St. Croix County Plamling and Zoning Department Jeff Durkee, St. Croix County Highway Department �t ' <r K... <SC.'ai1�'Yh.: FV'` .taa -1eM ST. CROIX COUNTY GOVERNMENT CENTER 1101 CARMICHAEL ROAD, HUDSON, W/ 54016 715386.4686 FAX PZC�CO.SAlNT CRO /X. WI. US W WW. CO.SAI NT- CROIX. WI. US FINDINGS CONCLUSIONS, DECISION OF THE ZONING BOARD OF ADJUSTMENT ST. CROIX COUNTY, WISCONSIN File: SE0150 Applicant: Greg Bonnes, New Richmond Tree Service, LLC Parcel #: 20.30.18.298D Complete Application Received: November 5, 2007 Hearing Notice Publication: Weeks of December 17 and 24, 2007 Hearing Date: January 3, 2008 FINDINGS OF FACT AND CONCLUSIONS OF LAW Having heard all the testimony, considered the entire record herein, and reviewed the site, the St. Croix County Board of Adjustment makes the following findings of fact and conclusions of law: 1. The applicant is Greg Bonnes, property owner and owner of New Richmond Tree Service, LLC. 2. The site is located at 1461 County Highway A in the SW '/4 of the NE' /4 of Section 20, T3 ON, R18W, Town of Richmond, St. Croix County, Wisconsin. 3. The applicant filed an application with the Board of Adjustment for an after - the -fact special exception permit for a contractor's storage yard pursuant to Section 17.15(6)(d) of the St. Croix County Zoning Ordinance. The applicant requests to continue storing vehicles, trailers, and equipment used for his business, New Richmond Tree Service, LLC, in an existing pole shed, as well as a trailer, rough lumber, firewood, woodchips, and brush and wood piles in outdoor storage areas on the site. The applicant has been operating the business on the site since 1997 and was notified by County staff that he would need a special exception permit when he applied for a sanitary permit for the pole shed in 2007. 4. This request would not violate the spirit and intent of the St. Croix County Zoning Ordinance in that a contractor's storage yard is an allowed use in the Ag Residential District, which the property is currently zoned. The site features an existing single- family dwelling that serves as the applicant's residence, a large pole shed, gravel employee parking lot, and outdoor storage areas for materials. Access to the site is from a single navel driveway access from County Highway A. According to the applicant, the primary use of the site will remain residential and the appearance of the site will be consistent with existing development in the surrounding area. The applicant's 3.5 -acre lot is not within a major subdivision, and the closest existing residence is located approximately 550 feet to the southwest. 5. The gravel employee parking area is currently partially screened by evergreen trees and existing buildings as vi ewed from the highway and adjoining properties to the northeast and southwest. The outdoor storage area for woodchips, lumber, firewood, and brush and woodpiles is currently not screened. With conditions for continuing to maintain the property in a neat and orderly manner, ensuring that all outside storage areas are fully screened from adjacent properties and the highway at all times, limiting the amount of wood stored on the site, prohibiting the storage of brush on the site, and limiting business activities on the site to only the storage of equipment and materials, this request would preserve the rural character of the area and would not be substantially adverse to property values in the surrounding neighborhood. 6. According to the applicant, no fuel or hazardous materials, other than oil for the vehicles, will be stored or used on the site. With conditions for restricting access to the site to the existing driveway only, prohibiting burning on the site, and requiring vehicle maintenance to be done on an impervious and contained surface, this request would not negatively impact the health, safety, or general welfare of the public. Traffic to the site is anticipated to be minimal. 7. According to the applicant, no work or services will occur on site, only the storage of vehicles and equipment and other work- related materials, and the stockpiling of brush and wood materials. The brush and wood used to be burned on the site until 2006, but are now hauled away by Ever41reen Encrgv upon re(�lucs( by the applicant. With conditions for limiting the noise and hours of operation during which business - related equipment and materials on the site are accessed, prohibiting burning on the site, and limiting the amount of wood and brush stored on the site, this request would not constitute a nuisance by reason of noise, dust, smoke, odor or other similar factors. 8. There are no complaints on record at the St. Croix County Planning and Zoning Department for the site since the applicant started operating his business there in 1997. 9. The existing buildings and gravel parking area meet all applicable setbacks. According to the applicant, the pole shed is 19' 11" and meets the height requirements for accessory structures. 10. The Town of Richmond Town Board strongly recommends approval of this request. 11. The St. Croix County Highway Department has reviewed the special exception application and has informed staff that the applicant will need to apply for and receive a commercial access permit from the Highway Department for his current residential driveway, which may require that the throat of the driveway be improved to commercial standards. DECISION On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board approved the applicant's after - the -fact special exception request, with the following conditions: 1. This after - the -fact special exception permit allows the applicant to store vehicles, trailers, equipment and materials for New Richmond Tree Service, LLC in an existing pole shed, as well as a trailer, rough lumber, firewood, woodchips, and wood piles in outdoor storage areas on the site as indicated in the plans submitted, and as provided in the conditions below. All vehicles, trailers, equipment, and materials shall be kept in the designated storage areas at all times when on the site, except while being loaded or unloaded. This approval does not include any additional structures, services, business activities, operations, or the storage of items other than those listed above. 2. The applicant shall be responsible for obtaining and adhering to all other required local. state, and tederal permits and approvals, including but not limited to obtaining a commercial access permit as required by the St. Croix County Highway Department. 3. Within 30 days of this approval, the applicant shall submit to and have approved by the Zoning Administrator a landscaping plan to enhance and extend the existing vegetative buffer along the northeast, southwest, and rear property lines extending from the pole shed east to the rear of the lot. The buffer shall be at least 10 feet in width and include native evergreens at least six feet in height at the time of planting to screen the employee parking lot and loading area, and all outdoor storage areas from adjacent properties and County Highway A. The buffer shall attain at least 80% opacity at maturity. The plan must include the species, size, and location of all evergreens to be planted on tine site, as well as a timeline for the plantings and a maintenance agreement to ensure that all vegetation establishes successfully and is maintained. The applicant shall be responsible for ensuring that all storage and loading areas are fully screened from adjoining properties and the highway at all times. All approved vegetation shall be planted no later than May 31, 2008. 4. Wood may be stored on the site not to exceed the height of the top of the shortest evergreen at any iven time. At no time shall the woodpile exceed eight feet in height. No brush shall be stored on the site. 5. No wood shall be burned outdoors on the site. 6. Any vehicle maintenance involving fluids shall be done on an impervious and properly contained surface. 2 7. Access to the site shall be limited to the existing driveway only. 8. No onsite retail sales, services, business activities, or operations other than what is provided in the conditions shall be allowed. The wood shop on the site shall be used for personal purposes only. 9. General hours of operation during which business - related equipment is accessed on the site shall not extend beyond 6:30 AM to 5:00 PM. 10. Upon complaints of regularly occurring, excessively loud noise at any time, the applicant shall work with the Zoning Administrator to abate the noise problem. In the event that the matter cannot be resolved administratively, the applicant shall take the matter before the Board of Adjustment at a public hearing. 11. No fuel or hazardous materials other than that associated with maintenance and use of the business equipment shall be used on the site. Any oil and /or hazardous materials stored on the site shall be stored in proper containers and conditions and disposed of in accordance with applicable state and federal standards. 12. All lighting on the buildings and associated with the employee parking lot and outdoor storage areas shall be located no higher than the lowest eaves and illuminated downward and shielded away from neighboring properties to prevent glare. 13. No signs or additional lighting are approved as part of this permit. 14. The property shall be maintained in a neat and orderly manner. 15. The applicant shall contact the Zoning Administrator to review this special exception permit in two years from the approval date (January 2010) for compliance with the conditions of this approval. These conditions may be amended or additional conditions may be added if unanticipated circumstances arise that would affect the health and /or safety of citizens or degrade the natural resources of St. Croix County. Conditions will not be amended or added without notice to the applicant and an opportunity for a hearing. 16. Any change in ownership of the property or change in project details — including but not limited to expansion, signage, lighting, landscaping, or access changes — shall require prior review and approval by the Zoning Administrator and in some circumstances through the special exception approval process as stated in the Ordinance. IT Failure to comply with the conditions of this approval within the timeframes and provisions stipulated shall be grounds for expiration or revocation. If the special exception permit expires or is revoked, the applicant will be required to secure a new special exception permit to continue using the site as a contractor's storage yard. Prior to expiration and /or revocation, the applicant may request extensions of up to six months fi the Zoning Administrator, not to exceed a total time of one year. 18. Accepting this decision means that the applicant has read, understands, and agrees to al conditions of this decision. The following vote was taken to approve: Chairperson Malick, yes; McAllister, yes; Luckey, yes; Struemke, yes. Nelson was not present. Motion carried. 3 IC I APPEAL RIGHTS Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30 days after the filing date shown below, pursuant to §59.694(10), Wisconsin Statutes. St. Croix County assumes no responsibility for action taken in reliance on this decision prior to the expiration of the appeal period. St. Croix County does not certify that the identity of al I persons legally entitled to notice of the Board of Adjustment proceedings, which resulted in this decision, was provided to the County. If an appeal is taken of this decision, it is the responsibility of the appellant to submit at his /her expense a transcript of the Board of Adjustment proceedings to the circuit court. The Planning and Zoning Department can be contacted for information on how to obtain a transcript. It is the responsibility of the Board of Adjustment to submit its record (file) of this matter to the circuit court. ZONING BOARD OF ADJUSTMENT Signed: Clarence W. Malick hairperson Date Filed: 01/07/2008 4 'Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Satety and Building Division INSPECTION REPORT Sanitary Permit No: 506377 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: Bonnes, Gregory D. & Patricia I Richmond, Town of 026- 1060 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /1)6 { YY� 1 7_ 20.30.18.298D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 47 CAPACITY STATION BS HI FS ELEV. I Septic -jr- • S Benchmark is3. s /LA=. Alt. BM 1 7 4 ? • E Aeration Bldg. Sewer Holding St/Ht Inlet 7. f - l 33 (Q TANK SETBACK INFORMATION ! St /Ht Outlet . - 951, 7$ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 Septic 7Z_ / �D - 7 Le) Dt Bottom -� Dosing _ ✓ Header /Man. g m Aeration ` Dist. Pipe Z L ,J 2, J Holding Bo. System 9 P9 > - tzt-3z. e� PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover qG �. � GPM Model Number i TDH Lift Friction Loss stern -K6ad TDH Ft Forcemain Length Dia Dist. to We ff - SOIL ABSORPTION SYSTEM BED /TRENCH Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 -56 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: J /- INFORMATION Type Of System: CHAMBER OR Model Number: h '5 �4� I56 l�N DISTRIBUTION SYSTEM tk, I b Header /Manifold ,/ Distribution x Hole Size x Hole cin ag V Intake T ' Pipes) �1 „� Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched ”, Bed/Trench Center / , Z J Bed/Trench Edges �� Topsoil \� R Yes F] No es f _l No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:/_ / Inspection #2: / / Location: 1461 Cty. Rd. A New Richmond, W 1 54017 (SW 1/4 NE 1/4 20 T30N R18W) metes & bounds Lot Parcel No: 20.30.18.298D 1.) Alt BM Description = , ' I tom.. C ✓ 2.) Bldg sewer length amount of cover = Z Plan revision Required? ! Yes '< No 75 Z. h6 07 Use other side for additional information. Date Insep or's Sig re Cart. No. SBD -6710 (R.3/97) t 7qL i Safety Butl � 201 W. W n Ave PP .O. Box 7162 � Madt ' OFT I 12 0 0 7 Sanitary s i� ( 7 -7 mbyCo) State Transaction Number �� Sanitary Permit Appli ' ORT. CROIX COUNTY '/'(� In accordance with s. Comm. 83.21(2), %is. Adm. Coda, submission of this to the appropriate governmcatal Project Addners (ddiffueru than mailing addreaa) unit is required price to obtaining a sanitary permit Note. Application submitted to the Department of Commerce. Personal information you provide may be used for spry Purposes in accordance with the Privacy Law, a 15.04(l m Stats. L a Iaiformttt�a - Please Print AN Worma6lon Pared # Property s Name y o �r �asi S Q ✓A U 00 0 —10 (00 - 7 0 — O b r) s Mailing Property Location Govt Lot t C' ,State Zip Code Phone Number n y., N E _'Y., Section t S k Q1 rl � a S � I T REor II. Type of B ' (check all that apply) Lot # ' t or2 Family -Dwetling- NumberofBedrooms - -- _ ._. ' -- - - j ` _ SubdtwsionName ��(� Block # �PublielCommercial - Describe Use 4 rte " ' / ❑ City of ❑ Village of — St§ie t - bc Usc � Town of it �O A !� C S t , nB. ype of . (Check a box on A. Complete line B if ag ble) New System ❑ Replacement Systcan` U Trgantt *Holding Tank Replacement Only ❑ other Modification to Existing System (explain) )❑, Permit Renewal ❑ Permit Revision ❑ Change of Phmdxr ❑ Permit Transfer to New List Previous Permit Number and Data Issued Before Expiration Ow'nc� IV. Type of POWTS team! aent/Devi¢e: Check all that a Non- Pte"uri ed In- Ground ❑ Pressmwd In-Gramd ❑ At -Grade ❑ Mound 24 in, of witable sorb ❑ Moi�ind < Z4 is of suimb� sa! � Holding Tank ❑ Other Dispersal Component (explain —� , wt's - ❑ Pieuaat cat Device (explain V. D' reatment Area Lsformations Design Flow W4 Design Soil Application Rate(Wdst) Dispersal Ar- Ra9uired (so Dispersal Area Proposed (so system Elevation a'?7 s� Syr y VL Capacity in Total # of Manufacturer B Gallons Gallons Units n a V New Tanks Existing Tanks tG U v w P+ Sepi Hokr g Tank 0 G ' p G C L ' ,Q -DoxingDwsnb- -1 � c VII. ResponsibEfty Statement b the n ed, assume sespoasibMty for hastallation of the POWTS the attached plans. Plumber's Nam c Phtmbea's Si Business Phone Number Phmtbees Address (Strut, City, State, Zip Code) 7/ 5 - 7,k/ ' '5 15 f S VIII. un !De ent Use Onl Approved ❑Disapproval ssued issuing Agent Si Permit Fee Date � � MI5 ❑ Owner Given Reason for Denial - • ' L /� C DL Conditions of Approval/Reasons for Disappro SYSTEM OWNER) l IA)) 0 1 Septic tank, effluent filter and � dispersal cell must all be serviced / maintained as per management plan provided by pi umber. SMaCk req u l r l x"pW4j*wnfttr" aad to the caaety oaty ea pa et leer tmm rrz s I t In size as per applicable code /ordinances G- SBD-, 98 .01/07} Valid tiro 01/09 C at - `Near its ��rno►1 � �r � V - - - o'►� - ° — S vet rts' /c f 1 -- a - -Vo - - _ _ _� m £i tom► i3e o S � 1 'N %S3 Co ►1 c� - - - i lot, s" - - 1 2 ,9.AcRe rc, 7 -- -' = ABSe�y/trEow IP-GS -- - - - - - - C?Y r ob G�2[1 Y'wc _ � i 1 i r Q t . 1 s , } --- C7 , Safety and Buildings 4 COULEE RD commerceml.gov LA CROSSE WI 5460 3 TDD #: (608) 264 -8777 www. commerce. wi. g ovisb/ isconsin www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary October 05, 2007 CUST ID No. 220537 ATTN: POWTS Inspector CALVIN W POWERS ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/05/2009 Identification Numbers Transaction ID No. 1469828 SITE: Site ID No. 731125 Greg Bonnes / New Richmond Tree Service Please refer to both identification numbers, 1461 County Hwy A above, in all correspondence with the -agency. Town of Richmond St Croix County SWIM, NEIA, S20, T30N, R18W FOR: Description: Non - pressurized In- ground POWTS / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1155785 Maintenance required; 194 GPD Flow rate; 96 in Soil minimum depth to limiting factor from original grade; System(s): Conventional POWTS Component Manual, SBD- 10567 -P (8.6/99); Commercial System 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 private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.02. This approval covers only the domestic wastewater directed into the POWTS. The Department of Natural Resources must be contacted regarding the treatment and disposal of non - domestic wastewater, including those mixed with domestic wastewater. • 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. Note: The changes made to these plans were acknowledged and approved by the system designer. Condit' I Tonally l DEPAR7MFUr CALVIN W POWERS JR Page 2 1015!2007 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. • 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 the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 • Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART?code: 7633 jerry.swim@wiscons*m.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. t r TITLE SHEET DATE D— —Q PAGE _LOF CONVENTIONAL SYSTEM FOR A GARAGE AND OFFICE THIS PLAN HAS BEEN PREPARED IN ACCORDANCE WITH THE CONVENTIONAL SOLL ABSORPTION COMPONENT MANUAL SBD 10567 P(R.6/99). LO D IN HE S47 /a OF THE V. OF SECTION` '-hN,R�W,TOWN OF ST. CROIX COUNTY, WISCONSIN. INDEX PAGE 1 OF 4 TITLE SHEET PAGE 2 OF 4 PLOT PLAN PAGE 3 OF 4 CROSS SECTION OF E Z FLOW PAGE 4 OF 4 SYSTEM MANAGEMENT PLAN PREPARED FOR RECEIVED fle n �ti� % v�a1 �► �r.� ��''� �. OCT p 4 200 ! Wt� ey`r A 7 c�n r>��., SAFETY & BUILDINGS PREP v #220 37 I POWERS EXCAVATING INC. 1969 185 AVE. NEW RICHMOND, WISONSIN 54017 PHONE 715 -246 -5135 FAX; 715 - 246 -5135 CELL; 715- 781 -5154. UIVisiui. of 64E) Y ANU BUILDINGS S�1= CGRkE r ONDENCE o-i- -' _OOs�tr vS b �iCYiY�no.t1 d r•¢a S•Qr cv . +_. C J W 1 E S _) 'N l 0- ro - MOO . ^� fO _ Vi 3'7 ` V re ST �d►os, CA ACg p - , Gell � -off _ Y - : , y 1 t � i i a : _ 1 : I X- IN- GROUND WORKSHEET IN- GROUND WORKSHEET A. SITE CONDITIONS Evaluate the site and soils report for the following: • Surface water movement: • Measure elevations and distances on the site so that slo areas can be determined. pe, contours and available • Description of several soil profiles where the system will be rotated: Determine the limiting conditions such as bedrock, hi Permeability, and setbacks, groundwater level, sail Slope - Occupancy: One- or Two - family Dwelling, # of bedrooms - Public Facility Depth to limiting factor -,>1 inches In situ. soil application rate used - L j gal/Wjday B.. DESIGN WASTEWATER FL W One- or Two Dwell' DWF = 150 g Ibedraom x #•of bedrooms = 150 g day/be om x # of bedrooms gal/da Public Facilities. DWF = Sum of each wastewater flow per source r da y x I �� — - -`_ gal/day x 1.5 .5 = 14____ 3, _ g al/day q5P= 20 of 28 r I C. WIDTH AND LENGTH OF THE DISTRIBUTION CELL. I. Determine the design loading rate (DLR) for the site. From Table 83.44 -1 or -2, Wis. Adrn Code, select the effluent application rate for the most restrictive sail horizon in contact with the distribution cell that matches the soil cmnditioms. The effluent application rate selected from Table 83.44 -1 or -2, Wis. Adm. Code, is the design loading rate (DLR) for the site. DLR == , 7 gpd/ ftz 2. Determine the distribution cell area. Calculate the distribution cell area by dividing by the design loading rate (DLR)_ the daily design wastewater flow (DWF) Distribution'cell area = DWF _ DLR Distribution cell area = I gpd _ ,) gpd/fj Distribution cell area = J"7 7 fl' 3. Select a width (A) for the distribution cell. The width of the distribution cell can not exceed 6 feet. A =,3_ft 4_ Determine the distribution cell length. Calculate the distribution cell Iength (B) by dividing the required distributi distribution cell width (A�)- area by the B _ Distribution © — gAj a 03 B - �?7 fe 7ft ; � -5 Svc P�� °"3 &Z B ft - ,y a 7, f Ia n3 j 5 o� 21 of 28 e44 `ell EZ1203H - rlvo ` e�1c "rscs T"YP rC4L- of oT14M FIAJAL R4� .L ?, :s ,:..�.. ° f... • 1TP179p t t "" V•�. O e «.:y7• �. ni �•�f" :.•. w. 7:44 to vlpv Q /� • ri - '� is i Y1, • .: �' �` �; Y.,q v r P { V ! 7PP S ove _ • `� T 4.62Stt PPP ♦ ~r 7PP vas PvT- P O.P" "PPP vvp p •,' vv 1 ++ 1/2 Circ. = 18.84" v p TvP PPP I wd7,4p 'p 7v,PVVPV, TOT ''Tv„_ PT rP T, PPP 7 9v0" ►v P, vvvvvv T' y��• ♦ ♦ ♦vP49P9 v7P vvv♦1P" T.vTT9.OT v ,P P,7, O9P7, - v %rwv Ov "9 Y'P P' 4 to 3 12 -1/2" DIA. O yp.} Soil tst`rfae_ Arm j32g s j_t Void C4etticient fa Aggo gate gh= at 57.4%. O.D. Of 4" Sidewal3 (2 Sidmwisj 18.84in Pipe 2s 12in = 3,14 Void volume per linear R 7 3.14. I f 23125 m ' . t>~t t 12inlifil lift a 4.1 i7 R' Bottom 2.00 O.D. afcmtercyli dcr =12.5 inches Total Soft Interface Area /// Void vol tmu :saaggreogateof center cylinder 5. }4 $Q.FT = 3.14 • 6 33tZ5o, " l29n ft j 3 14 I k 12 in R `.374 =..422 Ra O.D. of outside cylinders- 12 inches Projected Trench Area Void volume in outside cytindcr3 = 2'3,1q� bat l tt,in /ftJ .574 =.901 ft Sidewall Height= I2:in. 0 2 a 2.00Sq.Ft, Void volume at bottom between c Bottom = 36 in. = 3.00 Sq.R. ylindeM ¢ 24ai . -61 }_( l .( din �= t2in r r4 ]Zin f ft f 'N l l W IJ } ' 0213 ft- Projected Trench Area ` 5.00 Sq.Ft. Void volume at outside bottom comers (112 of void volume between cylinders) 0.215 / 2 =.0.108 ft' Total void volume - 0.117 + 0.422 + 0.901 + 0,215 +0.108 m 1.763 cubic ft I ft- Gallons Per ft = 1.763 X 7.48 - t3.; earlons I, r u o S A EPS Aggregate Trench System EZ7 203H , t Ring -Industrial Group 65 In.dustrial Park Rd. SCt1l E fltt !` QI203H--vSi S►lEEr: t m t t t -z7 -o� Water tight cap 4" min, dia. O O o 0 o perforations o 0 6" min. o 0 0 0 0 0 0 o System elevation _ o o Water Closet Collar Bar (3/8" min. dia.) Figure 5 - Observation pipes Observation pipes are installed in the distribution cells or on each leaching chamber row and extend to at least finish grade and terminate with a waterproof cap. Observation pipes within aggregate distribution cells extend to the bottom of the cell. The portion of the observation pipe below the distribution pipe is perforated while the portion above the distribution pipe is non ` perforated. See figure 5. Observation pipes used on leaching chambers are attached to the chambers in accordance with the chamber manufacturer's printed instructions. Observation pipes on leaching chambers are non perforated pipe. All observation piping has a nominal inside diameter of 4 inches. . i I Wisdonsin Department of Commerce SOIL EVALUATION REPORT Page / of ' Division of Safety and Buildings acoo Comm 85, Wis. Adm. Code Attach complete site plan on paper not less ttna x 11 inches in size. Plan must County _ST C �^ o X Include, but not limited to: vertical and horizontal ref point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V Z --/0 - )0-- LCD Please print all infonnation. Reviowed bYT Date Persona, inforrr,atim you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ' // 0 -7 P Owner Property Location Mt 0 1 R O T\ r� P- % `j°�.eu, Govt. Lot S cJ 1/4 NE 1/4 S a T 3 0 N R IS *Or) W Property owners Mailing Address RECEIVED t # Block # Subd % N cZs I ,' A / A r h�41 '3. (H City State Zip Code hone Number City ❑ Village M Town Nearest Road vl _ (; T 1 1 2007 � q K I' ❑ New Construction Use: ❑ Residential / u 6�9 Code derived design flow rate GP ❑ Replacement G - G`Yhk Parent material _ a 'Z' p &.*;( Flood Plain elevation if applicable General comments W and recommendations: S cc.� ��' I. E� Gc a�' C? y y / Ong # ❑ �tt Boring ��� IG�I Pit Ground surface elev. Depth to limiting factor in. SoU Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Efy# �a d D ,. 5 / a tY C I , to ' 9 p A I Ell Boring # 0 Boring tg Pit Ground surface elev. 98, 4 ft. Depth to limiting factor W o in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fts In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 r o - /o r- z i' ►�K C w It'll 3 3 9 6 s — S M s hA I — 17 /, * Effluent #1 = BOD > 30 < 220 mWL and TSS >30 < 150 mg/L Efflue #2 = BOD < 30 mg/L and TSS _< 30 mg/L T Nacre ( Print) Signature CST Number �W -1�rs S3 Address Date Evaluation Conducted Telephone Number Igo we l b, s of 9 -ds- o 15 a si3s - Property owner r 90 �n i\ Q S Parcel ID # Pagea of —3 D ��# Pit g ® Ground surface elev. q ft. Depth to limiting factor �� in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Strucaure Consistence Boundary Roots GPD/ftz In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff;" •Efl#2 eC4 am b/ M C La 6 , ,3 oW 9b a r S 0 M s ib 1 /, C ty1 d S -5 S / r „ W c� Sa `cF , �,► ►v F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to iirniting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNF In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'E01 'Etf42 Boring F # ❑ Bwft ❑ Pit Ground surface elev. ft. Depth Bmitin9 saw In. Soil Application Rate Hlortzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Efl#1 *Efl#2 Effluent #r1 BC% > 30 < 220 mg/L and TSS >30 < 150 rng1L ' Effluent #2 = SOD, < 30 nVR 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. seassW (L6" r a" `Ty, � S s�� N04saoT3 LJ M'u2,w R�c.� rvt orct�l ►"� 5szr��ce ��c]nvvx o o �o M t I i C A 7 . Q Q .; r 0 p' y ck anti POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page —1— of FILE INFORMATION SYSTEM SPECIFICATIONS Owner i1 rt•Q,s Septic Tank Capacity poo al ❑ NA Permit ir SD 3 Septic Tank Manufacturer S Q `s ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model j ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ A Estimated flow (average) 7 g al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) -- <�-- -- g al/day Pump. Manufacturer NA Soil Application Rate y al /da /ft2 Pump Model NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Grave) Filter ❑ Peat Filter Biochemical Oxygen Demand iBOD,,) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 51 SO mg /L ❑ Disinfection ❑ Other: Pretreated- Efflue ' _ - -- - __- a kt�__ otbiy�suerage ���id`� Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ in- Ground ( essurizedd) Total Suspended Solids (TSS) 530 mg /L X NA 13 At Grade O Mound (� kv a Fecal Coliform (geometric mean) u /100m ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other. ❑ NA Other. ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ears) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Clean effluent filter Z ' At least once every: ❑ year(s) 1 (s) 13 NA > �s Inspect pump, pump controls & alarm At least once every: months) ❑ NA 13 year(s) Flush laterals and pressure test At least once every: ❑ m E3 NA E3 yeaar(sr(s ) ) Other. At least once every: 13 month(s) ❑ NA ❑ ye ar(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspection must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal celi(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Pegs � Q f START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dram (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance_ with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, ail tanks and pits shag be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: $� A suitable replacement area has been evaluated aid may be utilized for the location of a replacement soil absorption J system. The replacement area mould be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot Ines and wells. Failure to pratect the replacement area win result In the need for a new soil and site evaluation to establish a suitable replacement am. Replacermernt system must comply with the rules in effect at that tune. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failnue of the POWTS a soil and site evakration must be performed to orate a suitable replacement area. If no replacement area is available a holding tank may be Maned as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may to reconstructed in place following removal of the biomat at the infiltrative surface. Reconstruct of s uch systems must c with the rules in effect at that time. WARNING > > - — — SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TPE. WEn _ PERSON FROM THE Ir < . :: •�_ « - =- ---• - - - -- -- . - _ _ _ _ _ _ _ ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Phone -A 13_ Phone 7 Name Name S� © °.� c «..w jot:tl "wail was dranad in E;i3iF"t�"iWW'sGo wan c ul'PYs f lit. SS�3ji 6i.tijec ;Yj cttu C'y.J r;it, iGi � Sal. �r Y+�s �rwiii r�i«ikat« «r�i - ` - ••_�_ aarvv vvuea. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIRCATIONN FORM Owner/Buyer Gr 9 �s ` ! r �+� ►w Mailing Address 1 ( N © f Property Address (Verification required from Planning & Zoning Department for new construction.) i City /State Parcel Identification Number LEGAL DESCRIPTION I� i 1 0 ` Property Location SCE /2 , �� Sec. at, T �N R �� W, Town of �, [ YlQ C) trlC Subdivision , Lot # Certified Survey Map # /l'Z4 -eS 3. Volume , Page # Warranty Deed # S C o 0 D �7 , Volume /A q a , Page # S Spec house yes Lot lines identifiable (�) no SYSTEM MAINTENANCE AND OWNER CERTITiCATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper mannteuaace consists of purnpirrg out the septic tank every three yeses or sooner, if needed, by a licensed pumper. What you p ut into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner mamttenauce responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordfimm. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form signed by the owner and by a rester 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. Uwe, 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 roust be completed and returned to the SL Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe amlare the owner(s) of the property described above, by virtue of a warranty deed recorded' Register of Deeds Office. Number of retirMnns -A. /§ IGKATURE OF APPLICANTS) DATE ** *Any information that is mistepsented may result= the sanitary permit being revoked by the Planning & Zoning Depattment "• 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) Parcel #: 026- 1060 -70 -000 10/15/2007 07:42 AM PAGE 1 OF 1 Alt. Parcel #: 20.30.18.298D 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BONNES, GREGORY D & PATRICIA M GREGORY D & PATRICIA M BONNES 1461 CTY RD A NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description 1461 CTY RD A SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 3.500 Plat: N/A -NOT AVAILABLE SEC 20 T30N R18W PT SW NE COM S 1/4 COR Block/Condo Bldg: N 1852.4' TO NW R/W N37DEG W 1285.2' TO POB N37DEG W 774.6' TO CL HWY A N52DEG E Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 201' S37DEG E 722.4' SW 207.7' TO POB 20- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1242/574 WD 07/23/1997 1127/561 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.500 47,300 106,500 153,800 NO Totals for 2007: General Property 3.500 47,300 106,500 153,800 Woodland 0.000 0 0 Totals for 2006: General Property 3.500 47,300 106,500 153,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 221 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 `_ _ ItAR (11 WISCClSJti1N PORlvl 2 — I')82 - s�iU2 () VVA UN A pr V3L ?A AM STUT C,*,- Joel w. Cade a single person, _ __.._. __ . __ -- .-- - - - - -- - - -- ;, r a ?. GROIX Ci`(., Wl t, -- 1997 altd .•anants to 8:30 A. Ail I� i1Z j Convey 1� i - nd_ andswi� f, -._mss sL� yiv orsl�Zp mar!.Lal -_ !' k +t c• %���« — _BQ11i1QS s _hL 1wetste. Of orio o — ------ —_ __. —__ —_ __ ,. ... _ ii MIS, SPACE 11FSEnVF0 1'0R nFCCiRG! L A-1 Ar:D RE,Un1 A1)nRESS First National Bank of New Richman the foltowil,g described real cslate in wt.�r— oi- x - -_--. ----- - - - - -- ' PO Box C Statc of Wisconsin. it New Richmond, wI 54017 nA110E1. tDFN1tFICATION NUM9ER (t I� parr, of sVII; of NE; v£ Sectior, 20, Township 30 North, ' 1R West, St. ii ii Croix Coui Wisconsin described as ro)•low,: Commencir. at the S3; corner 1 of said Section 20; Chence Nartli along said 1/4 line, 1652.4 feet to the tt{tly right of way of the Ct znd Norti,waste) Railroad Propezty; thence l) N37 °-3ng s. -Ai.cl right of way 1?fi "2 feet to the Poir]t of beg:l.nning; 7'E along li thence N37 °29'W '729.6 feet to the SEI-Y right of way of: Co1u]ty Truzilc highway J, 11A` +; thsance 1437 °29'17 45.0 fecL t- t1{e cG'nt -r of County TrurLk Highway 1111- � Chenc P152 °3 z' k along t:he Cent:eY of County Tx']�nY. 7Iigllway "�\" 201.0 Leek; !, t S37 45.0 feet to the SEly right of= way of County TrunY- Highway '! 1 +IA.I+ tl)cnc.e 537°29'F. 677.4 fetlt ti;- the NWly.right of: way of said Railroad; 1 I thc'rce 537 207.7 Ceet to the point of teginning. 1 t This i (i.') 1.f X any. i f L•accl,til,n i warranties: Easements, rCStriCl.:i.vi'iS ailC� ri.ghtS -of -way Of record, ti V 29 day tat —_�_ X_._.____ -- __.__�___.___. A.D.. 19a7_ ! Dated this _ I rl j (SEAL) 1 (SitAL) oe `17. Cad, — _ — I (SEAL) _ (SEAL) ACKNOWLEDGMENT +i AUTHENTICATION �i State of Wisconsin, l tl S C roix I t CJU nl 4 i authcta h ticatcd this day of — 19__— rersnnally came brfclre i:,c this _ Z th day of 19 _. the above named } +' TITLE R1CAfil[R STAVE DAR OP "`ISC M. Gullixson �c "f"t' — - -- - c _me'l the (.•ict;. authrri_i d by §:OC i76. \ \ +is Slats) J t�IGtary Public Ir1c vil? I to be 11'w ;o ht•rroll State of W ISCOf1Sin in ;tru cn� a hn/ the can THIS. INSMUMEN) WA�i t:rtAV'1 - By .,.G% / 7�1. F, — _. At 1 nrnr? 1SLlstitl� QglancL _ _. _ _ .__ _. Connie M GuL L> xson 11t i` t ry 1`llhl SC C qlx , lt}: ' S Hudson, _tdL __..5401 _ _ ._ _ :..t rtt lai. ex :111:. d.1.:• n1 a. krl.n. i lard 1'x.tb �1.- n. C.1, ..Io1 t. .:..: t...i.. {`illrrrt ur + :n a'; hi :x1t h.•n1 n'au•.I .�^ 1� {) 9.7.. 1 • ArcIMS Viewer Page 1 of 1 AL u ; � -M E Jal �`. O 1 ` j� e `47x LOT J � f • I '1 3 V 9.9: http:,,'72. 21230. 178 / website /LRPortal /ARCIMS /MapFrame.asp' ?PIN= 10/15/2007 D Midwest Directories Inc 2000 Midwest Directories Inc - 'ir` k ..� 221 ON TREAt S Trees Are Our l 1AVEL SERVICE �y �`� Business CRUISES' MLT * TGV `r Jeff ;r$ TTY -- BARB (715) 778 -5634 e., Dresser No... 755 -2510 since Teas ..........................294 -2661 Jerry TO serve you better" ( 778 -5984 ` , . < Q awles Ave ...............246 -6922 Fully Insured *Residential* Commercial *Pruning of deciduous, conifers, &shrubbery sy Ad This Page) : 3 Planters Available • Insurance Claims /Appraisals • Cabling for protection Storm Damage of structural Weakness • No Travel Charges • Removal of dead or undesirable trees i0l Some Trees Available • Climbing hard to reach trees No Job too BIG or too small! - •Turf friendly Stump Grinding - ,Free Estimates - •Wood chips delivery th ................ .......246 -3434 SPRING VALLEY, Wisconsin • Brush Chipping ...................294 -3979 River Junction Tree Service Prescott N6357 1323rd St ...... .......................262 -5475 Hudson No ........ ............................................ 386 -2214 Randy Iten Chevrolet H ST CROIX TREE SERVICE Je Planting Of Roberts 943120th St .................... ............ 749 -3475 CHEVY TRUCKS :VERGREENS River Falls No .................... .......................425 - 2006 _° 1 i Nursery St Croix Valley Trees Somerset 458 Rice Lake Rd .... .......................247 -5500 Like A ROCK Sunrise Grove Tree S adin J .. .......................684 -2613 P 9 e New Richmond 2076170th .... .......................246 -3692 w1 7 15 - 386 -2341 Inc Tuynman Northern Tree Service K ................. . .............. 386 -6265 Luck 1182 240th Ave .............. ....................... 472 -8740 1 -800- 515 -9121 Wilson Hill Tree Farm. Min 651- 436 -5231 L ...772 - 4704 Sales Hours: " " " " " " " """""" REE SALES Wilson 1140 US Hwy 12 .... ......................... ... - Thurs. 8:00 - 9:00, Fri. & Sat. 8:00 - 6 :00) tANSPLANTING Trenchin Servi See Us On The Internet At WWW.RandyltenChev.Com M TRADE 6 - 25 Ft. Also see Excavating Contractors HUDSON, WI 54016 IRED * Hel eson Electric Inc FAY AUT COMPANY N 755 -2809 Amery 1101 Cornwall Ave .........................26$ -7676 son E 793 240th .................................. .. .... 684 -2402 — town No ..................825 -3115 T r op h ies FORD TRUCKS 0 e Service. GLENWOOD CITY FORD INC Rd A .......................246 -4437 Also see Plaques Glenwood City, 133 W. Oak St.......................... 265 -7077 P Greg's Trophies & Awards ....... .......................386 -5238 Baldwin 108010th Ave ........... .......................684 -2544 GMC TRUCKS Q TROPHIES 8t MORE E New Richmond 335 N 4th St .....................246 -9333 I - C uttin g THE STRENGTH OF EXPERIENCE R • Stump Removal • : SALES • SERVICE - PARTS ured pp D C Topper to In Our Work" r Sales S 684 - 3638 Amery 798115th/Cty Rd C ..... .......................268 - 7110 " WHERE TO CALL ......................... �. CE Truck Deale STILLWATER .....................778 -5634 ROUTSON MOTORS, INC. U Pa ge ) AMERY FORD Hwy. 36 & Osgood Ave ... ,, Ad On Pa a 221 - CURY INC ........... ......:.. 800 - 747 -1047 Amery 320 Keller Ave S ...... .......................268 -7127 HUDSON -RIVER FALLS CHRYSLER M Rd A .......................246 -2183 River Falls 1282 N Main St .........425 -$228 V r . .............. Ad On page 221) ERNARD'S NORTHTOWN Iten Randy Chevrolet &Winnebago DODGE TRUCKS - SALES & SERVICE Hudson 1 -94 At Exit 2 ............... NEW RICHMOND, ............................. 800-515-9121 W s Trl 1 51ODeere0r. LEASING .....................715 - 246 -2236 (See Our Display Ad This Page) ......... .......................549 -5784 (See Our Ads At Automobile Dealers JOHNSON MOTOR SALES INC & Renting & Leasing X New Richmond 620 Deere Dr ....................246 -2261 f " " " " " " " " " " "' ......247 -4205 CIFALDI MOTORS INC Moody's Chevrolet Buick Pontiac Oldsmobile Ford & Dodge River Falls 590 S Wasson Ln .......... ............... 425 -2472 Y Ave Amery No ........268 -6890 Cumberland Jct Hwys 63 S & 48 W .... : ..... 822 - 4931 Z A n ■ s n c 2 § g f § . 2 k . 0 o I/ 0 g I% G @ k § } k \ E Sr §_ & E- �� 0) � E\ £ L R a a : s : ® w § 8 n / : ¥ E e «\ ° ; oQo ■ Q \' [ / / ± % R f 3 k / t§f CD C4 7 § { 0 k �\ § E . $ 0 7 r. . z o 0 0 0; .. . / 2 § § § § 2 J 7 J 7 9 90 � ® [ � # & / co 0 / @ J Er � _ _ @ CD 2 = CD CD w % / _ 2 3 ƒ CO) C ■ a Q. + z R � ƒ .. @ � w § ° ' E § z o F : z 2 . N z (D G) )0 CL CD CD } § � + X % cr � CD /kCD � — &CD k� oE « -4 (m ; __, a \/ &® ` ax t g§ l �_ CD D 2 co � / ; ■ 0 � $ CL : 2 Parcel #: 026- 1060 -70 -000 06/26/2006 12:30 PM PAGE 1 OF 1 Alt. Parcel #: 20.30.18.298D 026 - TOWN OF RICHMOND Current K ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner GREGORY D & PATRICIA M BONNES O - BONNES, GREGORY D & PATRICIA M 1461 CTY RD A NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1461 CTY RD A SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 3.500 Plat: N/A -NOT AVAILABLE SEC 20 T30N R18W PT SW NE COM S 1/4 COR Block/Condo Bldg: N 1852.4' TO NW R/W N37DEG W 1285.2' TO POB N37DEG W 774.6' TO CL HWY A N52DEG E Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 201' S37DEG E 722.4' SW 207. TO POB 20- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 2427ff4 WD 07/23/1997 11 27/561 , WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.500 47,300 106,500 153,800 NO Totals for 2006: General Property 3.500 47,300 106,500 153,800 Woodland 0.000 0 0 Totals for 2005: General Property 3.500 47,300 106,500 153,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 221 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT 1IER � , TOWNSHIP� T C' Y R Lf V DRESS ! >.0. AD ST. CROIX COUNTY, WISCONSIN. :BDIVISION , LOT LOT SIZE ' PLAN VIEW -Distances dimensions to meet requirements of H52.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM L r 3 k I dicate No thi Arrotta j ;i S CAL I f: ,tQTIC TAN,(S)� j MFGR. j�� „�� �� �, ;,ti l.�W CONCRETE X STEEL NO. of rings on cover_ Depth C.. , DRY WELL ? NC � HES NQ. of width length area no. of lines width f -),, length `-j' L area �G?tEGATE ,depth to top of pipe _/ l RATE 2 - i 1 AREA REQUIRED 4.. /_ AREA AS BUIL itsCiaimer: The inspection of this system by St. Croix Coun does not imply complete oopliance with State Administrative Codes. There are other areas that it is not possible a t inspect at this point of construction. St. Croix County assumes no liability for Istem operation. However, if failure is noted the County will make every effort to itermine cause of failure. 1 4ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. `'INSPECTOR DATED _ PLL-MBER ON JOB LICENSE NUMBER _ J REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM San.itaxy Pexm.i.t / State SQp.ti NAME Town6hip "' 'CQ%L'G Caoix County Location 6 . 10L :Sect.ion _ SEPTIC TANK Size gatton6. Numbers ob CompaAtment6 j Distanee'FAOm: Wet 12% on gxeaten. 6tope it Bu.itd.ing _ it. Wextand6 N.ighwaten it. DISPOSAL SYSTEM t D.i6tanee Fxom: Wett it. .12% oA gxeaten 6.�ope �" jt. Bu.i.td.i,ng a it. Wettand6 F t. • N.ighwateA 6t. FIELD DIMENSIONS: wi dth o xnench it. Depth o A ock betow tit n. � 1- tength of each tine 5t. Depth o6 Aock oven tite 2 .in. NumbeA o6 tin e6 _ Depth o6 t.ite below gxade 2 .i.n. T otat. .length o 4 t ine6 4t. Stope of tteneh in pen 100 it. D.i6 tanee between tines 4C st. Depth to b edxo ck Totat ab6oAbt.ion axea Z !rt2 Depth to gAoundwateA ��• . Requ.ixed area it Type o6 Covet: Papex ox Stxaw PIT DIMENSIONS: Numb eA o j pits GAav e.E' axound pith ye6 no Outside d.iame.teA it. Depth betow ,intet 2 Totat ab6 oAb.tion axea it A Axea xequkxed bt2 rm INSPECTED BY TITLE APPROVED ,DATE — 197 — . REJECTED , DATE 197_. I EH 115 Rev.9 /f8 a z 3 721, ` V � REPORT ON SOIL BORINGS AND PERCOLATION TESTS � 3 Z �, 677q r ° WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES p� 2 7 P.O. BOX 309, MADISON, WISCONSIN 53701 bd� 5JW pG =3 GC � a� LOCATION ' /a,�' /a, Sectior>Z T_30_N,R (or) W Township or Municipality Lot No. , Block No. County .S T C� A4 / ,'� Subdivision Name Owner's/Buyers Name: � y Mailing Address: I '' C'^�m i TYPE OF OCCUPANCY: Residence No. of Bedrooms j COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW L— REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 6 &) - 7 ' PERCOLATION TESTS 5 SOIL MAP SHEET NAME OF SOIL MAP UNIT S4 SAW4E PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTEF INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- 1 // P — ' [ i t ► i P— ? ' y r AbUd P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- B- = 2 B- a B- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the 11cation and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy - .Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. _ s.= i -A It _ _n e 3 a a } e f m ...,,..,<... Q .- _..,,.. _ ` ` I } 3 1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) Certification No. S'5 Address Name of installer if known Copy A —Local Authority CST Signature hL __ p State and County State Permit # Permit Application County Permi • for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY /► Mailing Address: MIA ez J2R¢ zk � 1 �.zk: jf's�� rJi.% 24JL B. LOCATION: _ % '/4, Section .?�L, T N, R_j& g (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Towns t ►,�ie,_a C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY r (Q0X , ;i Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete ured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Si amber Total gallons Prefab concrete Poured -in -Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rat Total Absorb Area sq. ft. New�Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth "" (�t ° No. of Trenches Seepage Bed:_ _Length t,,.. Wid � th _Depth 2' Tile depth (top of Line Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land ,t ; Distance from critical slope WATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑ O name as lis on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Cer �fied Soil ester, NAME C.S.T. # S S 1 and other information obtained from lU . (owner /builder). Plumber's Signatur MP /MPRSW# /.�G: -3 Phone Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. i , e F ; F ,.m.m _. -� mP _. ,6 _ -_ _ , . �__- w _.. i �_. __ . . . E , k = a , , i j 1 .._ .. w_ e e a a E eP , i Do Not Write in Space Below OR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application -- Fee Paid: State unt r ��. Q O Da 7 Permit Issued /" (date) Issuing Agent Name Inspection Yes No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/7$, l _ �