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HomeMy WebLinkAbout018-2021-10-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s 15.04 (1)(m)] Oeverinci Homes TANK INFORMATION TOWN OF HAMMOND TYPE MANUFACTURER � 5 CAPACITY Septic 14 OuT / tM v KJ OL Dosing Aeratic Pfaldinlg _ r TANK SETBACK INFORMATION M�Mm® •' • PUMPISIPHON INFORMATION M If cturer Demand GPM Model Number TDH Lift Friction Loss ,_-- Lem Head TDH Ft Forcemain Dia. Dist. to Well SOIL ABSORPTION SYSTEM L3—FZ3 ELEVATION DATA STATION BS HI FS ELEV. Benchmark l%% I / 00 Alt. BM Bldg. Sewer ,z J laq,� SVHt inlet S S#Ht Outlet t9 ✓R, D J O0 r� Dt Inlet Dt B Header/Man. $m N A Q7 S. Dist. Pipe Bet. System 'j 11. Final Grade 6.0 / 9lGe+0ar— b v-c_^ z.� 7 BEDrrRENCH DIMENSIONS Width N 3 Length No Or Trenches Z PIT DIMENSIONS No. Of Pits Ins' Dia. Liquid Depth SETBACK SYSTEM TO P/L (.t% BLDG WELL LAK ST EA H E CHI ManufactureC-� /' p INFORMATION HA iE R NI -L ✓t Of eak?I, .ystarrl' b r1156 1451156 \ ` , Model Number: ` DISTRIBUTION SYSTEM Header/Manifold / Distdbu 'on Pipe(s) z H Si a Spacing Vent to Air Intake Length Die / Lengt Dia S ng SOIL COVER x Pressure Systems —Only xx Mound Or At -Grade Systems Only Ke/\ r iv M kc- Depth Over BedrFrench Center ^�Si IDepth Over Bed/Trench Edges �7 y 9 7 >x Depth of T 1roc SeededlSodded [4es ® No xx Mulched Yes 0 Na COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:,y/ Inspection #2: Location: 1647 102ND AVE V VAS 1.) Alt BM Description 2.) Bldg sewer length -amount of cover= Plan revision Required? [*Yes No 3 5 l S ! 11 20 5 Use other side for additional information. L__. _ SBD-6710 (R.3197) Date Insepcto s Si ature Cart. No. Fr =oT _9F 'nl S)'Yv-aoaa -d 39 Industry Services Division Cowry C Ia FEB 2 5 2020 1400 E Washington Ave P.O. Box 7162 r Sanitary Permit Number (to be filled in by Co.) \{ Madison, 07-7162 (l 1933 qt C,L)X.__., , Commu0 n ni jj it Applicati rusTransection Number In accordance with SPS 383.21(2), W is. Adm. Code, submission of this form to the appropn wit _— is required prior to obtaining a sanitary permit. Note: Application fortes for state-owned POWTS,,, OW TS are su to Project Address (if different than mailing address) 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. 1 m Stars /Dso? L Application Information — Please Print All Inform Property Owner's Name Parcel a ( Property Owner's Mailing Add IProperty Location Q $, R 1 43 CQ S , Lot yyh Section O ]ty. State Zip Code Phone Number eul �r� w �- �� �'-hgc le on T N; R L1 E W 11. Type of Building (check all that apply) rt/ Lot s / a Subdivis' Name or2 Family Dwelling —Number of Bed=ot 5 Block tt`T� ` p ❑ Public/Commerciai — Describe Use ❑ City of ❑ State Owned— Describe Use CSM Cl Village of dJ Number wn of III. Ty of Permit: (Check only one box online A. Complete line B if applicable) yfvl ` . System ❑ Replacement System ❑ Treument/Holdirig Tank Replacement Only ❑Other odifcatioto Existing yAem (explan) B• ❑Permit RerKwal ❑Perini[ Revision ❑ Chrtge of %umber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Fxpimtion Owner Type of POWTS S stenllCom nenliDevice: Check all that a on•Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound> 24 in. of suitable sod ❑ Mound <24 in. of suitable soil Holding Tank ❑ Other Dispersal Component (tx lain) ❑ Pret en Deuce (explain V. Dispersalinfreatuatut Area Information: 64 X Des] Flow (gpd) Design Soil Application Rat si) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System -3 Elevat �v ' � �v VI. Tank Info Capacity in Gallons Total Gailttns r of Units ufactureir W/j�as� = tL �1 ejS e V 8 9 g s _ New Turks Existing Tanks S.V N�i N riV a Septic or Holding Tank Dosing Chamber VII. Responsibility Stateme , the undersigned, sisjOWnesponsibility for installations of the POWTS sbown on the attached plans. Flu is Name ( Plu igneture MPIMPRS Number Business Phone N bar Q�i G ' _— Plumber's Address (Stred, Ciry, ute, Zip C , d Court /De rtment use Only Pproved 1 ❑ Disapproved Permit Fte Date Issued 2/'ter I u] Agent Signature /1 ❑ Owner Given Reason for Denial Jvo /2D10 IX. ConditionsTM OWNER:Approvat'Reasons for Disapproval P . j Y SYSTEM OWNER: 3 e, r �" S tear 1. Septic tank, effluent filter andJ. dispersal cell must be serviced I main airs AI as per management plan provided by plumber. l/'I All sethas;k r as per applicaN'VI&tZ 78p , e°WiWg theeystein ind submit W the Counry only on paper not less the.8 rr a 11 inch. In ,.0 SBD-6398 (R. 08/14) z i SN System PLOT PLAN PROJECT Overino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 6 /T 29 NIB 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.4/99.0 4.5' below grade DATE 2/22/20 BEDROOM 3 CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46 BENCHMARK V.R.P. Top Of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 445' property line N 4c ps, 2-3' X 94' cells wiO >3' 50' B-1 104' Vents ll Ci1.1YArl Ki a Pro 3 Bedroom House 102' ---T— B-3 25' 137' Property Line Scale is 1" = 40' unless otherwise 20 noted B-2 D- >6,.uick4 Standard of Coveraching Chamber h 20.0 ft2 of Area ftA2/pair of end caps 4' Lon Grade at System Elevation A ll piping shall be ASTM SDR 30/34, within \� (�0 PY 10' of tank, piping shall be ASTM F891 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 2/22/20 Owner:Oevering Homes Location: SE1/4 SW 1/4 S8 T29 N,R17W 1647 102nd Ave Hammond Manuals Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintance d Contigency Plan 7. Filter Cros a tion Signature License nkfrdber #226900 System PLOT PLAN PROJECT Overina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 6 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.4/99.0 4.5' below grade 2/22/20 BEDROOM 3 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46 ,� BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 102nd Ave Pro 3 Bedroom House 445' property line 1 2-3' X 94' cells with >3' spacing 50' B-1-1 104' —'(1s= Vents a 5% Slope 102' IMuA 137' Property Line B-3 25' All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Scale is 1" = 40' unless otherwise noted -2 Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^::::,2/pair of end caps 4' Long 12 Grade at System Elevation 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 5.6f A2 pair of end plates Typical Installation Vent Grade f;-�30/34 Septic Tank 5' Lone1 1 5' Grade at System Elevation Spacing 5' 5' To be >1' above grade Finish grade elevation 103.9' Went 1" at System Elevation 2-3' X 94' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A 99.4' I _- Owner/Buyer Mailing Address Property Address City/State ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM (Verification required LEGAL DESCRIPTION 7 Property Location �.'/e , 1-✓ '/a Subdivision Certified Survey Map # Planning & Zoning Departent for new Parcel Identification Number O % g 62 0 °1 1 8 , T Z� N R_aW, Town of , do,�_aj Volume , Page # Warranty Deed # S� 2, ( b Voltune r_ , Page # Spec house) an Lot lines identifiah ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # / /] Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumpmg out the septic tank every three years m 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 responsillwities are specified in §Conan. 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 neceasary), the septic tank is less than 1/3 full of shmdge. Itwe, 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 you septic system has been maintained must be completed and retuned to the St. Croix County Planning At Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the beat of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms /-cpEr IGNA OF APPLICANTS) 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 map if reference is made in the warranty deed. (REV. ems) e11 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_ FILE INFORMATION Owner oe n Permit a 833 Of DESIGN PARAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units NA Estimated flow (averege) aUda I Design flow (peak), (Estimated x 1.5) /SO pal/day Soil Application Rate S— aUda tfe Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODa) 5220 mg/L ❑ NA Total Suspended Solids (rSS) s150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) 530 mg/L S10 mg/L � NA Fecal Coifom (geometric mean) 510° cfu/100 ml \ �MUcimurr Effluent Particle Size )l; in dia. zJNA ❑ Other 'Values typical for dwiestic wastewater and septic tank elfluant NI INTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity al ❑ NA Septic Tank Manufacturer NA Effluent Filter Manufacturer ❑ NA Effluent Filter Model ❑ NA Pump Tank Capacity I 0 NA Pump Tank Manufacturer Pump Manufacturer Pump Model 4NA Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other. Dispersal Cell(s) AQ:Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ In -Ground (pressurized) ❑ Mound ❑ Other: p NA Other. ❑ NA Other Other EE=101 Service Event Service Frequency 9nspect condition of tank(s) At least once eve every: ❑ mo (s) (Maximum 3 years) ❑ NA ea s Pump out contents of tank(s) When combined sludge and scum equals one-third ()y) of tank volume ❑ NA Inspect dispersal calls) At least once eve every: � month(s) Ks) (Maximum 3 yeah) O NA Clean effluent filter Al least once every: month(s) r(s)0 NA nspect pump, pump controls & alarm At least once every: 0 year(s) month(s) ❑ NA I -lush laterals and pressure test At least once every' ❑ ❑ month(s) years)0 NA Otter At least once every: Q month(s) ❑ year(s) O NA JMer: ❑ NP., 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 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 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 hegulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (%) or more of the tank volume, the entire contents of the tank shd 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, land arty servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. IN service report shall be provided to the local regulatory authority Mthir. 10 days of completion of any service event. Page __ of _, START UP AND OPERATION For new construction, Prior to use of the POWTS check treatment tank(s) for the presents of painting products or other chemicals the 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 pourer is restored the excess wastewater will be discharged to the dispersal cea(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 conterte of the pump tank removed by a Septage Servicing Operator prior to restoring power to title 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 teas' 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 fife of the P n drai antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; denial tkus; diapers; disarfedenta: fat foundation drain (wimp 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 propelly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • Ail 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 property 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 falls and cannot be repaired the folowing measures have been, or must be taken, to provide a code compfent replaceerent system: / suitable replacement area has been evaluated and may be utilized for the location of a replacement � absorptionsoll y �. / The replacement area should be protected from disturbance and compaction and should notupon in the need by requi0ed setbacks from existing and proposed structure, lot lines and wells. Failure to Protect the replacement area coal for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule:t 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 �yhold rig tank may be installed as a last resort to replace the failed POWTS. �l-e site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation 4� mIltust 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 recautrvcted in place following removal of the bicmat at the infittrative surface. Reconstructions of such systems must comply 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 TREATMENT TAN 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 Phone a— — Phone — J SEPTAGE SERVKV4OPERATOR(PUMPER) LOCAL REGULATORY AUTHORITY Name Name l L Phone/�— ' �( Phone This doament was drafted in compliance with chapter SPS 3e3.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3). Wlscon Administrative Code. 20140048A E SECTION A -A r" • :'iI�I�Y�.iv EW&D .n (715)243-3010 -------- 1 i 1 ui e • i _—_—_—_—_-1 i _—_—_—_—_ ElNpIICEI 5 1 �ro,rc:Loixn� , 1 -- � � i wrwlowwoxro so.n i 1 1 i 1 i MUSS • i 9 1t ON EDWMlLINE 9 ! ETR O PPNLS EL ®...ETA......» �tln9 IIIB$ MO MAINLEVEL 1183 SG. ff. MAW LEVEL M+xr. e a A3 ., 1 I I I I i c o x —p-- 1 x x t (LY x 1 0 t �1 � , I I I I I� 1 I I I I I I ii i�5 16 i I I , r i 1 ; I,w•) 1 1; 1 I • I ! -1,-. ,,,• I • ------------ x f ' . i ' I 1 ' � • I I'I In, , I P A I- 1 ------------------ 1 it O . I I ' „•,fie 11 _ ' i � I I 1 1 I I I . I State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number 11 Document Name THIS DEED, made between Bruce J. Moll and Thomas S. Aaby ("Grantor," whether one or more), and Oevedng Homes Investments LLC a Wisconsin Limited Liability Company ("Grantee," whether one or more). Grantor for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ('Property") (if more space is needed, please attach addendum): Pan of the Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 114), the Southwest Quarter of the Southeast Quarter (SW 114 of SE 114), the Northeast Quarter of the Southwest Quarter (NE 1/4 of SW 1A), and the Southeast Quarter of the Southwest Quarter ISE 114 of SW 114) of Section Eight (8), Township Twenty-nine (29) North, Range Seventeen (171 West, Town of Hammond, St- Croix County, Wisconsin, more particularly described as follows: ✓ Lots 1, 3.19, 21, 23, 26 and 28, County Plat of Hammond Hills Estates in the Town of Hammond. '0184021-01-000, 018-1021-01-000, 018-1021-04-000, 018-1021-05-000, 018-1021-06-000, 018.1021-07-000, 018.2021-08-000, 019-2021-09-000, 018-2021.10-000, 018.2021.11-000, 018-2021-12-000, 018-2021.13400, 018-2021.14-M, 018.2021.15-000, 018-2021.18A00, 018.2021-17-000, 018-2021.18-000, 018.2021-19-000, 018-2021-21-000, 018-2021-23-000, 018-2021-25-000, 018-2021.28-000 Exceptions to warranties: Easements and restrictions of record. Dated P10 ey4ty /$) 016 Tx:4294534 1025296 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 02/24/2016 3:41 PM EXEMPT#: N/A REC FEE: 30.00 TRANS FEE: 1155.00 PAGES: 1 Recording Area Name and Return Address homas A. McCormack O Box 2120 ;aldwin WI 54002 see below" Parcel Identification Number (I This is not homestead property. (is) (is not) L) Q /� (SEAL) L) ���� (SEAL) * Thomas AUTHENTICATION ACKNOWLEDGMENT Signature(s) of Thomas S. Aaby STATE OF WISCONSIN ) ) ss. authenticat Februa 2016 ST. CROIX COUNTY) Personally came before me on ar V Fb, * Thomas A. McCormack the above -named Bruce J. Moll . ,A61' TITLE: MEMBER STATE BAR F WISCONSIN '3vaW (If not, to me known be the person(s) wYi1C�' "afi t� /^ authorized by Wis. Stat. § 706.06) instrument a knowled d the sai r„ n^ THIS INSTRUMENT DRAFTED BY: Thomas A. McCormack Notary Public, State of Wisconsin I_ Baldwin WI 54002 My commission (is permanent) (expires:N, 4 j (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY WARRANTY DEED 02003 STATE BAR OF WISCONSIN *Type name below signatures. J FORM NO.2-2003 INFO-PRO"'w JnfoprIXatnu min St. Croix County 1025296 Page 1 of 1 ryv OD ,29.92' O .00'- 92.90' - -- - - -- __ QD : 392.90' - - rn N 60 V 392.90' co 175.000- - - 42.90 =- C7\ --- gg6 a LOT 1(, -- - — — — ---- — - - - IQ 75560 S.F. �N1.73 Ac. � 4 - 82• z 1> g o LOT LOT 11 ti so� E g8° 12 O 71533 S.F. N 76 g�, .(\9 (oo 1.64 Ac. Q0 {1r 77700 S-F- CTD g 1.78 Ac. J a O 0 .(9 (:LOT::,0 OD '80 o° HWE-1027.39 N 1.93 Ac. a �� LBO=1029.39 O HWE=1027.39 40 LBO=1029.39 Z 4v (36 C"15 p LOT 9 _ C� 79920 S.F. `P���F. 45.36'r..!' �� N 1-83 Ac. �P 175.00' 75.57' v' LOT 8 5.57'--- 41.48'"`"' '" O? 79920 S.F. '36 ti� 1.83 Ac. O 19• o I z aM / 8 �J LOT6 N "6os g96°00, 123993 S.F. C 2.85 Ac. N10 HWE=1025.0 L80=1029.0 W LOT 7 .0 0' ' � 3' 85362 S.F. Cps ' JD - 1.96 Ac. ti C 10.29' --- a CO S_89'34'18' E 206.48' s� w 101ST AVENUE w — s-6 N 89'34'18" W 206.48' w r'a D � 6 '----126.6T- - 79.81' 6� � Q O \ J, •. N f Wsconsih Department of commerce O visim of Safetyand Buildings P-A- Il SOIL EVALUATION REPORT page—/ of� vi auzvkadwn vnm ..kwrtm k>,, vvku. rwm. a.oua Couay •� 5. Attach complete site plan on paper not tess than 81/2 z 11 inches in size. an must Pl p` Panel I.D. n,� include. btA not Inked to: verfical and horimmal reference percent slope, scale or dimensions, north arrow, and location and distance nearest road. Please print all information. Re ' by Vereel rr oklamveon you provld•may M used be (m)). Z;Lpate Property Owner OCatldn Det)P/� •/1 p 7 SG 1/0(,V 114 S T Z J N R E( W Owrners Adores%s # Block # . Name ar r O G M� qI/ city D Code NkrrMer city ❑Village Town Nearest Road New Construction U,0)0 Residential / Number of bedrooms _ Code derived design flow rate GPD ❑ Replacement ❑ PL c or commercial - Describe: ( Parent material 7 e-Ou2�c�a-0 Flood Plain elevation it applicable General oem"wku and recommendations: n / /-� System Type ClO %'�V� r�(Cr.Q.d .stem Elevation/'• /// /• C/ i a,,L� MUM MFM%/JM MA . mil. « M�JM", ©M� �M � / � LP,�® rr • >� r romp MI PM ram_ � ©= i• fu„ i ft. ���� MLS/ala7vm � W E141erd #t - SOD > 3D < 220 mg4 and TSS >30 < 1544joL EfAuera #2 - BOO, 130 rnglL and TSS < 30 nglL CST Name P IAM P*O CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5 17 ,_ � 7 715-246-4516 /7 Property Owner Parcel ID # Page —of Boring # BoringLj O �. 2 I L- L) Pit Ground surface elev. _ ft. Depth to limiting factor �n Soil w. Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'Eff#1 'Efl#2 -t L 3 f es a 3 Lb ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ___ fl. Depth to limiting factor in. Sell Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Cola Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD#F `Etf#1 'Eff#2 Boring # ❑ng — ❑ pit Ground surface elev. ft. Depth to limiting factor in. Snip Rate Horizon '*pth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont- Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDtfF 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 rnglL and TSS >30 < 150 mglL ' Effluent #2 = BODE < 30 mglL and TSS < 30 mglL 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. sewrw(asm) Soil Test Plot Projedt Name Oevering Homes LLC Address P.O. Box 179 New Richmond Wi 54017 Lot 10 Subdivision SE 1/4 S W 1/4S 8 T 29 Hammond Hills Estates Dat_ N/R17 W Township Hammond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 99.4/99.0 *HRpSameasBenchmark 445' property line 1 102nd Ave Scale is 1" = 40' unless otherwise noted mom 104' �'—'�\ 80 5% Slope 102' B-3 25' 137' Property Line Please note: survey was not complete at the time of testing, installer must check all setbacks prior to installation. --r—B-2 11