HomeMy WebLinkAbout026-1306-00-045San Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix
Safetyfety and Budding Division
INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERMIT 617817
GENERAL INFORMATION � State Plan ID No
Personal information you provide may be used for secondary purposes (Privacy Law, s 15,04 (11(m)]
Permit Holder's NameCity Village Township Parcel Tax No.
Shaun Bird TOWN OF RICHMOND 026-1306-00-045
CST BM Elev Insp BM Elev BM Description SectioniTown/Range/Map No
18.30.18.1652
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer Demand
GPM
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia Dist to Well
b1i Ab5bli i IUN SYSTEM
STATION
BS
HI
FS
ELEV,
Benchmark
Alt. BM
Bldg Sewer
SUHt Inlet
St/Ht Outlet
Dt Inlet
Ot Bottom
Header/Man.
Dist. Pipe
Bot. System
Final Grade
St Cover
BED/TRENCH
DIMENSIONS
Width
Length
No. Of Trenches
PIT DIMENSIONS
No. Of Pits
Inside Dia
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
JBLDG
IWELL LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer
Type Of System
Model Number
1v r�i u�l �� 1lL lCrl nl�yP11
Header/Mandold
Distribution
x Hole Size
x Hole Spacing
Vent to Air Intake
Pipe(s)
Length Dia
Length Dia Spacing
QW1" l WYCR n-1- -.., u....� ^_ ♦•
Depth Over
Depth Over
xx Depth of
xx Seeded/Sodded
xx Mulched
Bed/Trench Center
Bedrrrench Edges
To
Yes No
Yes 0 No
COMMENTS: (Include code discrepencies, persons present, etc ) Inspection #1:
Location: 1529 96TH ST
1.) Alt BM Description =
2 ) Bldg sewer length =
- amount of cover =
Plan revision Required? [Yes ] No
Use other side for additional information.
SBD-6710 (R 3197) Date Insepctor's Signature
Inspection #2.
Cent. No
5�A) — P 00?0 _0a 1
/
Industry ServicVs Division
C unty C1
1400 E Wasfiington Ave
(}I
N 29 2020
P.O. 716
NAldison, 70
Sanitary Permit Number (to be filled in by Co.)
>�
s�
C-olx ` V. v Permit Applif � 10
Ccrr,;ur;l[. Da���yJl Y
State Transaction Number
d
�
In acco-idance wtt SPS3837ijZ), Wi& Code, submission of this fo to the appropriate governmental unit
Project Address (if different than mailing address)
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats.
L
'nt
1. Application Information - PleaseAirinformation
Property Owner's,Name
PPance14L
/
!
^ l %
V V — _Q
Property Owner's Mailing Address
Property Location /qf
J U
Govt. Lot
,t,J y� /., Section
Ct , state'
Zip Cod Phone
/
Number
�
T N; R or W
1I. pe of Building (check a at apply) Lot
4 _
2 Family Dwelling -Number of Bedroom
Subdivision Name( � / / )
❑ Public/Commercial - Describe Use
❑ City of
❑ State Owned - Describe Use CSM
❑ V' lage of
Number
Town of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
New S ste y
❑Replacement System
❑ Treatment/Holding Tank Replacement Only
❑Other Modification to Existing System (explain)
B.
ElPermit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer tc New
List Previous Permit Number and Date Issued
Before Expiration
Owner
TV,
S stem/Com onent/Device: Check all that apply)
Non -Pressurized In-Groun ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 inof suitable soil ❑ Mound <24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. DispersaLVIrreat nt Area Information K P
Design Flow (gpd) Design Soil Application R dsf)
Dispersal Area Required (sf)
Dispersal Area Pro osed (sf)
System Eleev7atio
�G�
�J
s
c�
•C/ �g
VI. Tank Info
Capacity in
Total
4 of
Manufacturer
Gallons
Gallons
Units
%t 1
c
u
y
n
New Tanks
Existing Tanks
JU
n ;n
n
U
a
Septic or Holding Tank
Dosing Chamber
VII. Responsibility Statement- Iyft undersigned, responsibility for installation of the POWTS shown on the attached plans.
Plumber Name (Pninl)
Plum gnature
MPP/MMPRS Number
Business Phone Nurpber ,
Z7 4
�� J
Plumber's ddr ss (Sfffit, City, State, ip Code) ,
VIII. County/Department Use Onl
pproved
❑ Disapproved
Permit Fee
$
�/'J�_�
Date Issued
Issu g ent Sgrrature
Owner Given Reason for Denial
W�
p
Z• I 'i.�t0
i
IX. CoSYS 1 t!Mf An tpl/Reasons for Disapproval 3 / ` � S� n,� t
Qr'Q❑
1. Septic tank, effluent filter and
dispersal cell must be_serviced _/ maintained �) �G`A
as per management plan provided by plumber. Oe .�r �p�t�-A
2. All setback requirements must be maintained
as per appllcaDttf VLUW6bXWbp §W1br the system and submit to the County only on paper not less Ihan 8112 x 11 inches in sin
SBD-6398 (R- 08/14)
M
System PLOT PLAN
PROJECT Shaun Bird ADDRESS 1432 120th St. New Richmond Wi 54017
NW 1/4 SE 1/4S 18 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 95.0/94.8 4' below grade DATE 1 /28/20 BEDROOM 3
CONVENTIONAL X00( CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑BOREHOLE O WELL *H.R.P. same as benchmark
Scale = 1 /4" = 1 0' Property Line
B.M.*1 B-2 -
[INVA
100
Vents 55'
1 % Slope
2-3' X 66' cells with >3' spacing
B-3
STV
25' r 1
3
Vent
B-1 20'
>6" Quick4 Standard
of Cover Leaching Chamber
witIt 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long
12"
Grade at System Elevation
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
96th St.
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates
Typical Installation
Vent � Grade
4" 3'
�/30/34 Septic Tank
5' Long; 1 „ 5'
36" Grade at System Elevation
Spacing 5'
System elevations:
A_95.0'
B 94.8'
To be >1' above grade
Finish grade elevation
99.0'
Vent
1 "
at System Elevation
2-3' X 66' Cells
Same on other end Observation tubeNent
At end of cell
A
16 chambers per cell B
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
Owner/Buyer
Mailing Ad&
Property Address t 5 i
(Ve
City/State
C-
required from Planning & Zoning Department for new canatrnetian.)
Parcel Identification Number 0 cL " j 3 D 0 I j
LEGAL DESCRIPTION
Property Locations✓tk) 1/< , �C—_ V4 , Sec. R_LLW, Town of %
'L�� rjo
Subdivision /_ -- /� / t ,t/ , Lot #
Certified. Survey Map # ` Volume , Page #
Warranty Deed # L (] ,'! i (1/ Vo lume -f , Page # ^�
Spec house no Lot line- identifiable 6;) no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, it needed, by a licensed pumrper. what you pat into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner mamtcriaooe
responsibilities are specified in §Cotrmt 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance_
The property owner agrees to submit to St Croix County Planning & Zoning Department a certification form, signal by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system ism proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than M full of sludge.
Ilwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standAids set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St Croix County Planning &
Zoning Department within 30 days of the timee year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/am the ownar(s) of the
property desctihe4Bove, by virtue of a warranty deed recorded in Register of Deeds Office.
Humber of ms >
SIGNATURE OF APPLICANT(S)
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. '*'
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page `of —
K
FILE INFORMATION
Owner 3
Permit #
DESIGN PARAMETERS
Number of Bedrooms
=,
D NA
Number of Public Facility Units
NA
Estimated flow {average}
L
aUda
Design flow (peak), (Estimated x 1.5)
�J L�
allda
Soil Application Rate
f
aUda /ftz
Standard Influent/Effkuerd Quality
Monthly average
Fats, Oil & Grease (FOG)
53o mg/L
Biochemical Oxygen Demand (BODs)
5220 mg1L
0 NA
Total Suspended Solids (TSS)
15150 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BODs)
<_30 mg/L
Total Suspended Solids (TSS)
s30 mgtL
NA
Fecal Coliform (geometric mean)
510O cftUi ooml
+Maximum Effluent Particle Size
;k in dia.
0 NA
Other.
NA
"Values typical for domestic wastewater and septic tank effluent.
MAINTENANCE SCHEDULE
SYSTEM SPECIFICATIONS
Septic Tank Capacity
al D NA
Septic Tank Manufacturer
❑ NA
Effluent Filter Manufacturer
0 NA
Effluent Filter Model
❑ NA
Pump Tank Capacity
al T NA
Pump Tank Manufacturer
NA
Pump Manufacturer
NA
Pump Model
NA
Pretreatment Unit
❑ NA
D Sand/Gravel Fitter
D Peat Filter
11 Mechanical Aeration
D Wetland
i
0 Disinfection
D Other.
D€s ersal Cell(s)
❑ NA
round (gravity)
D In -Ground (pressurized)
D At -Grade
D Mound
• Drip -Line
❑ Other:
Other.
D NA
Other:
D NA
Other:
D NA
Service Event
Service Frequency
€nspect condition of tank(s)
At least once every:
tD month{s}
S ea s (Maximum 3 years)
DNA
Pump out contents of tank(s)
When combined sludge and scum equals one-third N of tank volume
D NA
inspect dispersal oell(s)
At least once every:
'�y month(s) (Ma)imum 3 years)
ear(s)
D NA
Clean effluent fitter
At least once every:
❑ month(s)
�� ( r(s)
CjNA
! nspect pump, pump controls & alarm
At least once every:
D month(s)
D year(s)
D NA
I=lush laterals and pressure test
At least once every:
D month($)
ID year(s)
DNA
Other.
At least once every:
D month(s) ❑
year(s)
D A
i7ther:
MAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: ster
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
ccmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(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 indicaie a failing condition and requires the immediate notiftcabon of the local
regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (36) or more of the tank volume, the entire contents of
the tank shag be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
14dministrative Code.
NI other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer.
A service report shag be provided to the local regulatory authootp ,within 10 days of completion of any service event.
Page _ of _.,
START up AND OPERATION or other chemicals that
For new construction, prior to use of the POWTS check trm±atmettt tank(s) for the presence of painting ti detroducected have the contents of the
ts
may impede the treatment prods andlor damage the dispersal cell(s). If high
tank(e) removed by a septage servicing operator prior to use.
System start up shall not occur when sot conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above norr ai highwater levels. When power is restored the excess wastewater will by
discharged to the dispersal eels) in one large dose, overloading the call(e) and may result in the backup or surfacedischarge of
power effluenL
to the
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator Pry to resWng
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 IbIWA g from the wastewater stream may improve the performance and prolong the We of the POWT$:
antibiotics; baby wipes: d0arette butts; condoms; cotton swabs: degn�sers dental fkhss; diapers; disinfectarhts; fat; foundation drain
(sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides meat scraps: meddcstiorls; oil; Painting product;
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 propeliy
and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandonari pipe operengs sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servkang Operator.
After pumping. all tanks and pits shall be excavated and removed or their covers removed and the void space filled with smil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or muss be taken, to provide a code cartpli*
rep system:
A suitable replacerrmertt area has been evaluated and may be utilized for the location of a replacement soil absorption system•
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requided
setbacks from existing and proposed structure, tot lines and welts. Failure to protect the replacement area will result in the nged
for a new soil and aite evaluation to establish a suitable replacement area. Replacement systems must compty with the rtded in
effect at that time.
0 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.
O The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a sal and site evakut*on
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
O Mound and at -grade soil absorption systems may be reed in place fotlowing removal of the biomat at the infi trove
surface. Reconstructions of such systems must comply with the rules in effect at that time.
ccWARNiNG»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O� A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS _
PewTA INSTA,IFR ih
Name
Phone
► -_ aE - �'l H
SEPTAGE SERVICING OPERATOR (PUMPF%k
Name
E�
('
Phone
— '/ -// z d
POINTS MAINTAINER
Name '
phone 1 21 -� � d //' — y-') —/ h? j
n�+e� ocr_in Arnnov ArrrUMfTY
----Neale
kf - -- / A /
-717
Phone
This doasnot area draAed in compliance wth chapter SPS 383.22(2)(b)(1)(d)&(1) and 383.Ki), (2) & (3), Wisconsin Adminstrative Code.
2 0 1 4 0 0 4 8 A
X0
9,E
.01 Gap between Case and $erpen#ine
SECTION A -A
1921
NO
IN
UIR
16 �• t LOT 4
9s 3 e _ !
r pr
`
t a 001W S
� t
io TWO,
N78285t WE - 227.97
1
Oy ,45 ao !` 1 i
N •s07 f. R
ORAINACE
�HJ£AS£MENT ! H17 N1B
x..- --
_HN73'35'21*E 387.65
''
.-�►�
T '44
t
', t
1*5255
66.420 ��ES
�41
t
B� F
95.28' t
n
HJi sr�7o
Hrs S�zzog
N;,xj;:
SEA sim.,
Lor 49
Asconsin
Department of Commerce
Division of Safety and Buildinas
SOIL EVALUATION REPORT
in accordance with Comm 85, Wis. Adm. Code
#1494
Page= of 3
Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
County
St. Croix
area''
45
Revi By Date
co /� O
Property Owner
Sienna Corporation RECEIVED
Property Location
4ovi. Lot W1/4, J114,4, T30N, R18W
Property Owner's Mailing Address
4940 Viking Drive Suite 608unn
of #
45
M(x* #
Subd. Name or CSM#
The Glens Of Willow River
City State fip Code Phone u r
Minneapolis MN I 5543$T CROIX COUNTY
r City Village X Town Nearest Road
Richmond I 95Th St.
New Construction Use: Residential /Number 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe:
Parent material Oulwash Flood plain elevation, if applicable _na
General comments
and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sqft rating. Possible system elevation for Area
1 �o
1 is 95.6'. � e
Boring # Boring
® Pit Ground surface elev. 99.56 ft. Depth to limiting factor 115+ in. Soil Application Rate
Horizon
j Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure Consistence
Gr. Sz. Sh.
Boundary
Roots
GPD/ftz
•Eff#1
•Efr#2
none
sit
2fsbk
mfr
as
1vf
.6
.8
10yr3/4
none
sid
2msbk
Osg
n*
cs
1vf
.4
.6
10yr5/4
none
grcos
ml
ml
cs
as
.7
.7
1.6
1.6
E10yr3/1
10yr5/6
none
Cos
Osg
Osg
10yr6/4
none
s
ml
,f ml
cs
--
.7
.7
1.6
1.6
10yr5/6
none
grtos
r Osg
rr �3
F21Boring
# Boring
Pit Ground surface elev. 98.86 ft. Depth to limiting factor 112+ in. [Soil Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
ConsistenceBoundary
Roots
GPD/ft'
•Eff#1
•Eff#2
1
0-8
10yr3/2
none
sl
2fsbk
mfr
as
2vF
.6
1.0
2
B-17
10yr4/4
none
sl
2msbk
mfr
cs
ivF
.6
1.0
3
17-60
10yr5/4
none
grcos
Osg
mi
gs
.7
1.6
4
60-112
10yr5/6
none
Cos
Osg
ml
----
--
.7
1.6
rr
1
3�•jz
' Effluent #1 = BOD 5> 30 < 220 mg/1- and TSS >30 < 150 mg/L ' Effluent #2 = BODS <30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: s CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond, WI 54017 9/18/2006 715-247-2941
SB0.8330 (R.07100)
Property Owner Sienna Corporation Parcel ID #
Page 2 of 3
Boring # � Boring
j Pit Ground surface elev. 98.61 ft. Depth to limiting factor 115+ in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/W
' M
•Eff#2
1
0-9
10yr3/3
none
sil
2fsbk
ITrrfr
as
2vf
.6
.8
2
9-14
10yr4/6
none
grsl
2msbk
mvfr
cs
1vf
.6
1.0
3
14-51
10yr5/6
none
grcos
Osg
MI
as
.7
1.6
4
51-115
10yr6/4
none
s
Osg
ml
—
--
.7
1.6
I
b
❑ Boring # ❑ Boring
Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft'
'Eff#1
•Eff#2
❑ Boring # Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/W
•Eff#1
•Eff#2
Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 � 150 mg/L . Effluent #2 = BOD5 < 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.
SBD4330 (R.mroo)
SdxNU Sol TestMp, Inc.
Conducted by:
.Jch-tt Soil 7Cstin
Thomas J. Sc � Inc,
1595 72nd St Ott, CS7 �27429
Newh c
Ri
Phone: r ond, WI 54017
247-2941
si2rahlr
Date.
Conducted For.
Name:
Address:
City, State, Zip:
if i l--- Subd,1raine: 43S
Benshoe pit — La t No.: Thus °f Willow River
Alternate BNlarE1. 100.00' To P Of2 Togal Description, f
Slope= / ejch Mack El. �` vc pipe nslvp, County:co4 SEI14 S18 T30N
nto nd St. Croix R18W
0
iu Line Ep of
_l. Nl�
Scale 1„ _ 40, t�(, Contour Line Length jy�
1S7'
a
-11
L,�- yq
Page=� of
Sienna Corporation
4940 Vi ;ng Drive Suite 608
Minneapolis, MN 55
This Soi(and Site Evaluation was complEyed to firlfill a zoni ng It maY or rnaY not be is a location suitable for o
Y u use.
k