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HomeMy WebLinkAbout030-2137-09-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488190 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: Schuelke, David and Debra I St. Joseph, Town of 030 - 2137 -09 -000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town /Range /Map No 1 04, 30 ' ) 30 1 '� 4 4 4 e = C,ST i`. �IM1 - 05.29.19.3 TANK INFORMATION f ELEVATION DATA TYPE ' ANUFACIRER CAPACITY STATION BS HI FS ELEV. Se tic V Benchmark p cw ( & S t -. Z S IS• 3s ii9.�s o V Dosing Alt. BM Aeration Bldg. Sewer S~ ZZ 21 H olding St /Ht Inlet `, 9 � IIZ -4� TANK SETBACK INFORMATION St/H Outlet '�S' / / ` / TANK TO P/L WELL BLDG. V ent o it Intake ROAD Dt In ep is '> � t > 15 ' o om J osr ng Header/Man CJ era ion Dist. PAe rr it E .� • 1 9.t,2 ���•fl3' o Ing B o . ys Fe m zs F inal Urade PUMP /SIPHON INFORMATION M anufacturer Demana St Cover / GPM .D( IIS6'� m odel u er I UN IL Fricr i System ea r-o rc;7h I Lencin in. 1,131 Lu Mull MMU jL111yL11— I I el ILI M3 a 111U, V1 riLb 111blut: uld. DIM S ` Q0 . 4• Z) INFORMATION l CHAMBER OR ype 01 UNIT T i J v L MSTKI13UT ION SYSTEM -fv f,2,o -ca t,l • �� Pipe(s) Length �� Dia ll Length Dia Spacing 50 '- x Pressure Systems Only xx Mound Or At - Grade Systems Only Qeededtftdded Bed/Trench Center Bedrrrench Edges Topsoil F Yes [ ] No Yes ;I No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection #2: -- i Location: 454 Bluebird Or Hudson, WI 54016 (NW 1/4 NE 1/4 5 R19W) Bluebird Bluffs Lot 9 Parcel No: 05.29.19. sad¢_ 1.) Alt BM Description = S• T I 0 �&O -_kfc ,. 4tAr 2.) Bldg sewer length = X5. - amount of cover = If - r"�"`� C'�� , / 3) $� IAAA� . slag eu�o�•� ►e_ �� , 8 3. S Y"�a�... t0 (per �� fe I ; � -T 04 Pla}t'ti'evision egwr , / Use other side for additional information. ��l c .Z2�'jl�o --- "' ---sss V�n sSig�tur SBD -6710 (R.3/97) Safety and Buildings Division County ` 201 W. Washington Ave. P.O. Box 71¢Z = Voris n Ma is , 5 707 —R$2 x ,ti' germ it N pater (t e� d in by Co.) (608} 3151 Vo 5v � Qe 8rtmeflt Of Commerce D.Number Sanitary Per cation MAY 1 In accord with Comm 83.21, Wis. Adm. Code, personal info y i provide may be used for secondary purposes Privacy Law, s15.04(I)( ) ST. �,;.�, -.. (;C?,ress (if different titan mailingaddress) I. Application Information — Please Print All Information °` g, r a lJ 14 Parcel # Lot # Block # Property Owner's Name Property Owner's Mailing Address Properrt�y�Location I ,_W /.,' / Section City, State Zip Code Phone Number circle � �° 5 S T r �� N; R�E o Wr II. Type of Building (check all that apply) . � S '"^� Subdivision Name CSM Number iV iQ 'lor 2 Family Dwelling — Number of Bedrooms 5 •'` ❑ Public/Commercial — Describe Use r ❑City_❑village�Township of ❑ State Own Use 42 8 vJ III. Type o erm - (Check only one box on fin A. Co etc line B if applicable) A. ( Ne System ❑ Replacement System ❑ TreatmentlHolding Tank Replacement Only ❑ Other Modification to Existing System 1 List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of :1 []Pe:rrn:iit T ransfer to New Before Expiration Plumber Ownr IV. T ype of POWTS S stem: Check all that a pply) 0 Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At-Grade ❑Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Melia Filter ❑ Leaching Chamber ❑ Drip Line G rave l -less Pipe ❑ Other (explain) V. Dis ersaVfreatment Area Information: Desi Flownr ( (g�gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Pro (sf) System Elevation Prefab Site Steel Fiber Plastic VI. Tank Info Capacity in Total Number Manufacturer Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks optic Hokling Tank + A 1 QS Aerobic Trentment Unit Dosing Chamber VII. Responsibility Statement - L the undersigned, assn responsibility for i of the POWTS shown on the attached plans. tuber's ) PI bets Sign atu RS umber Business Phone Number v � ��s d .SI3S Plumber's Address (Street, City, State, Zip Code) V III. Coun !De nt Sig artment Use Oal Sanitary Permit Fee (i clud Groundwater Date Issued 1 uing natu (No Stamps) Approved Disapproved Surcharge Fee) w� :f -� u eason f :,., IX. Conditions p e�PP !►1 3 \ � � � _. 4 SYSTEM OWNER: l ' 1 I 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach Complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) S- , I IS QQ- -_7 #..�_Y?�`1 Tr # { r f ` i i # JPK C�A } } t _ ff{ 1 I t i } tf � {(` a-- , - { -� l - -�-- -� - f --- tit { I , x l IR 77 � - - -� - i LJ l j } i 7 f • � F F -RDt S JQkLL -O�T,e Nw SS �Ql� `�, /g .S'eAp vs fps a eke 1 (00 , ` y1 4 /}Ct tb C ��cJz task t to 3 - 1 g a r � L , �ell 3 I - � ,t E . O tt x• ' 7 1 , M481 d' �nM SQ! EV ki# T1C�fit:R FC T in VAM W VAL Adw Caft C " na x in dial�a PMsr prMt M by c 4h a � � Q 6aN. 4M JU uD in Ajr a T M R � E pU ttt4ekf a" low CONNI #' IT l 1" Wear tbWfARadowadi xrdbndroomc L Code dolboddwAr Saw nta ��aotaaaladd FioodPlobxMrxMeMapplaott AIIA R oaf aaaaoads aM� S �I �0 7i X a BwF t_:.,J � � so , Pit Show ZZL 7 d, 011pok In �e1o► 9 7 it ad on I EbI1 1 o0l�la�s OL Q. ft t9k 'Fi1 'EIS -3 S/ Ylr1 �b ht r rs ► oir Q c a.�. .o..a�► _ /�� ,�a�t�aror //S �. i, Nadten ° °a"�Mw�l' . �IadeR Dwo�Atw Trdnm abeam oa r to tlanaa� Oi. ttt oaat Qifor Qr. 8xw 8h �� ►. 2, s i a rY. S m J r J' ► S� -IUv\ 5lK o rri V r — ► 7 . �- �o 03 •t z ( 2 t'JlMneit +� s gyp!= 106 ow T" tea_ — • E #cwt @ _ �D anpd. and T88 < ao alt. t ri' r C6TlWrat Adam � Oft TUhplaa► gS u � yoc� • M��� on i l a� � / 7' oZ� �V 1�@ 4� cv; p .x Oo , ° \ �` d 14 � s � ,f � °¢ e - 5— .10 R S- r o Prof ' � t w L _' t � t �' %.� i , � s � • f �� ;, F+ £,. i+ � - i e . ;_ � -. _ - _ r J. '__ ,*'�. — L_ 1 I F 11 , s � _ , { t ►_ [ E r-_► - I i�i _ _ { l f .- -J -_-f_ ?__ %_ ► �_ I � ! i FF EZ1203H vvvvvvv vvvvvvv °�'. `i.' •� vvvvvvv vvvvvvv vv r °n••::• +•,h'', •vvvvvvv vvvvvvv •,`.•' " i' veo vv vvvvv t1 vvv vvv a '• _ 12 vV .. v 24" vvv i :T`•. vvv voe a" vvv vvv vvv 4.625" V V VWV vvv v v v IF V oe v vv V j" 1/2 Circ. = 18.84" eve ov v odv vvv vve000v� v e v VVVe'vvv a vvv ve VVeev v vvvvvv evvv eevvvevvvv VVVVVVV vvvvvvv: vvveveeevvvvvvv ♦evvvvv 24 B Bottom 36 12 -1/2" DIA. (typ.) Void Vnlume ,oil Interface Area IQ EL 5R L Void Coefficient in Aggregate given at 57.4%. Sidewall (2 Sidewalls) � 18.84in — — O.D. of 4" pipe = 4.625 inches l2in 3.14 } Void volume per linear ft. = 3.14 • ( 2.3125nt )' • Ift = 0.117 ft Ift ' Bottom 12in ! ft 2.00 O.D. of center cylinder =1'2.5 inches Total Soil Interface Area 5.14 SQ.FT Void volume in aggregate of center cylinder — 3,14 • (( 6.25in 3.14 • 3125in l ( `12in7ft) ( 2 /ft) I =.422 ft O.D. of outside cylinders = 12 inches J Projected Trench Area Void volume in outside cylinders - 213.1 J but Y 574-.901 ft' Sidewall Height = 12 in. "2 = 2.00 Sq.Ft. 112in/ft� •• Bottom = 36 in. = 3.00 Sq.Ft. Void volume at bottom between c •linders — f 24m 6,n 6m } `12utift 2 inttt,�( 3 ' 1 �12inifl) ]]'0.215 ft' Projected Trench Area 5.00 Sq.Ft. Void volume at outside bottom corners (1/2 of void volume between cylinders) 0.21 2 — 0.108 ft' Total void volume - 0.1 17 + 0.422 + 0.901 + 0.215 + 0.108 - 1.763 cubic ft 1 ft Gallons per ft - 1.763 X 7.48 - 13.2 nallons per linear ft 1/ E regate S 5 to m Y CZ.low Ring - Industrial Group 65 Industrial Park Rd. Oakland, TM .18060 scree nu: 1•u1.re: EZI203h,I t of 1 11 -27 -01 I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa L ot Z FILE INFORI ATION SYSTEM SPECIFICATIONS Owner k-j Permit # S Septic Tank Capacity gal 13 NA Septic Tank Manufactur E3 NA S DESIGN PARAMETERS Effluent Filter Manufa ctu rer � 103 NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity g al ❑ NA Estimated flow (average) 0 gal/day Pank Manu El NA Design flow (peak), (Estimated x 1.5) 0 al /da Q NA Soil Application Rate r Pump Mode) al /da /ft ❑ NA Standard Influent/Effluent Quality Monthly average Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (SOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids ITSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Gell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L 96 In- Ground (gravity) ❑ In -Ground (pressurized) Total Suspended Solids ITSS) S30 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /i00ml ❑ Drip - Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other 13 NA Other: NA Other: ❑ r. ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ N A MAINTENANCE SCHEDULE Service Event Service Fretuency Inspect condition of tank(s) At least once every: ❑ months) (i1llaxhrnrm 3 vows) ❑ NA earls) Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) IMax<nwm 3 years} ❑ NA year(s) Clean effluent filter At least once every; month(s) ❑ NA yearlsl Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ year(s) ❑ NA Flush laterals and pressure test At Ieast once every: ❑ month(s) other. NA ❑ year(s) r. E3 monthis) At least once every: Other: ❑ yesrls) d ❑ 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 inspections must include a visual inspection of the tanks) 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 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 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 fitters, 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. � 1 STAiT uP AND OPERATION Pag e . of For ew construction, prior to use of the POWTS check treatment tanks) for the presence of painting products ather chemicals that may impede the treatment process and /or damage the dispersal coo(s). If high concentrations are detected have the contents of the tank(sl removed by a Septage servicing operator prior to use. System start up shall not occur when soli 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 drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; moat 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 properly 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, all tanks and pits shall 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 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 required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the tailed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation 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. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SO'TIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Nam me, Phone 71-S 5135 Phone SEPTAGE SERVICING OPERATOR 4PIBNPER) LOCAL REGULATORY AUTHORITY Name Name ; `Y\ Phone Phone `y �' This document was drafted in compliance with chapter Comm 83.22(2)(b)(10M(f) and 83.64(1), (2) & (3). Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 6 A� 1 4 t D 4up DzObaA S( L4 e: L_W_% Mailing Address eD (`2z `tl©G 0 Ot N14 Property Address (Verification required from Planning & Zoning Department for new construction.) City /State t4 u it SO E-tt 1 Parcel Identification Number LEGAL DESCRIPTION Property Location �LW '/4 , % , Sec. , T 21 N R 19 W, Town of \ )Gs 1 1 t4 Subdivision I:JC-ut< Vbt (N 6k.A — t' S Lot # 1 Certified Survey Map # , Volume , Page # Warranty Deed # $%5 A SCA 1 , Volume ' S , Page # Spec house yes 19 Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83,52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. 1 /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your ieptic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of warranty deed recorded in Register of Deeds Office. Number edroo SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * *'� Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey reap if reference is made in the warranty deed. (REV. 08105) r - - ti� ?P 356 Document Number WARRANTYDEED THIS DEED made between Brushy Mound Partners, LLP, a 8 liZ 4 �, 9 Wisconsin Limited Liability Partnership ( "Grantor ") and David Schuelke and Debra K. S chuelke , husband and wife, as survivorship KATHLEEN H. WALSH marital property, ( "Grantee "), REGISTER OF DEEDS WITNESSETH, that the said Grantor, for valuable consideration ST. CROIX Co., WI conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: RECEIVED FOR RECORD 08/26/2005 10 :30AN Recording Area of Nine 9 Plat of Bluebird Bluffs in the Township of St. Joseph Name and RelumT I Y VEED St. Croix County, Wisconsin"' EXEMPT Brushy Mound Partners PO Box 445 REC FEE: ®0 New RichmondTyAJW1FEE: 268-50 COPY FEE: CC FEE: PAGES: Part of 030 - 1018 -50 -000 and 030 - 1017 -80 -000 (Parcel Identification Number) This is not homestead property. Grantor, Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership, is an affiliate of Derrick Homes, LLC, a Wisconsin Limited Liability Corporation. Grantor develops land and Derrick Homes, LLC is a home construction contractor. Grantor agrees to sell this lot to Grantee on the condition that Derrick Homes, LLC will be the builder of the home for Grantee. If Grantee does not commence construction with Derrick Homes, LLC as the contractor /builder Within two (2) years of the date of sale of this lot to Grantee, Grantee gives Grantor the irrevocable right to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. If Grantee desires to sell the lot to another purchaser before constructing a home upon this lot, Grantee gives Grantor the right of first refusal to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. Dated this 22nd day of August, 2005. Derrick ' P11"il R. Stfens AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this 22nd day of Auoust 2045, authenticated this _day of 20_ the above named Michael R. Stevens and Ronald L. D c , 4 partners of Brus Mound Partners, LLP, a isconsin Limited Lia artn hip-to me known to be signature the persons ho exe a the fo egoing instrument and type or print name acknowl get a sam TITLE: MEMBER STATE BAR OF WISCONSIN signature (If not, type or print name f PAJMEU, J. R E authorized by' 706.06, Wis. StatsJ Notary Public St. Croix County, Wiscons I $ire A vVisconWn THIS INSTRUMENT WAS DRAFTED BY My Commission Expires: July 27. 2008 Brushy Mound Partners *Names of persons signing in any capacity should be typed or PO Box 445 printed below their signatures. New Richmond, WI 54017 LBO =936t .;V.vw ay. r 1. v1• - -- - w»tl 3.00 ACRES KAZ. aVpo f 5 `�,' LOT ff ., sA9Y++'SRi Q +`�% •,�Y'�� -�'�� i 130,688 SQ. FT. • . 3.00 ACRES �• r ' o.'Tr S89'48 58 "E `�` 254.73'. 1 •;s.• t • ,, may ,' �,� �d;� �L� U + J T�� mss•.. Y ..� v E-- �i 1 T 300 ACRES '� �•, x . Q.•s..' HBO- 9.,6 H L4T9 vi I� vr►o noQ. �: 130.685 SQ. 9 7. +y / n r� si o t � 3.00 ACRES •'ti '�� / .4► • I . ~ ` f '.Mh �� �� gam~ "1�' LO / 130.742 3 tee.0550' � 3.00 At -� z _ .s ►a 9'56 7' J g 21.13' •. .•• 214.13 ' 130.685 SQ. FT. 3.00 ACRES Hal -- --N89'S6'17 "E--- ----- 5-' �, ,s - tB0�9.7RO' I �/ 3a l��" � l �S �d � �� I 2 ,,� �� A, 1076 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Crob( include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. pending Please print all information. R y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / O3 Property Owner Property Location Derrick Construction Inc. Govt. Lot NW 1/4 NE 1/4 S 5 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1505 Hwy. 65 9 na Bluebird Bluffs City State Zip Code Phone Number City Village a Town Nearest Road New Richmond WI 54017 715 - 246 -2320 St.Joseph Rolling Hills Trail ev New Construction Use M Residential / Number of bedrooms a derived design flow rate 600 GPD Replacement Public or commercial - Describe: rased `E C E f derived I Parent material Pitted outwash plains Flood plain a ion, if applicable na , General comments AU 0 2 I 20 b ` and recommendations: Mound design, system elevation 103.95ft n contour ne .45 . CROI.X CUUN�y a Boring # Boring Pit Ground Surface elev. 102.85 ft. Depth to limiting factor 46 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 I *Eff#2 1 0 -12 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 12 -25 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 25-46 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 4 46 -72 10y� sandstone residuum na na na na na .0 .0 Boring # Boring Im Pit Ground Surface elev. 102.85 ft. Depth to limiting factor 18 in. Sod( Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ t *Eff#1 *Eff#2 1 0 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 6 -18 10yr4/4 none scl 2msbk mfr cs na .4 .6 3 18 -50 10yr7/6 sandstone residuu na na na na na .0 * Effluent #1 = BOD ? 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel � t `� 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 8/20/2002 715- 246 -5085 Property Owner Derrick Construction Inc. Parcel ID # pending Page 2 of 3 ❑ $ Boring # Boring Pit Ground Surface elev. 99.45 ft. Depth to limiting factor 72 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W *Ef1#1 "Eff#2 1 0 -7 10yr3/3 none SO 2msbk mfr cs 1 f .5 .8 2 7 -34 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 34 -72 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 F -1 Boring # Boring Lj Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftx *Eff#1 *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM *Ef1#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/L and TSS <_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Page 3 of 3 STEEL'S SOIL SERVICE David I Steel 1564 Cty Rd GG CST - POWTSM Derrick Construction, Inc New Richmond, W154017 Lic. # 248956 NWi /4,NE1 /4,S 5,T29,R19W (715) 246 -6200 Town of St. Joseph, St Croix Co. (715) 246 -5085 Bluebird Bluffs lot # 9 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for N your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. 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