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040-1304-19-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Permit Holder's Name: Reggie & Erika Estrella City Village Township TOWN OF TROY CST BM Elev: Insp, BM Elev: BM Description: TANK INFORMATION 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 For cemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 617872 State Plan ID No: Parcel Tax No: 040-1304-1MOO Section/Town/Range/Map No: 0832801921825 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet SUHt Outlet Dt Inlet Dt 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 BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: Type Of System: _ Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 Bed/Trench Edges Topsoil 0 Yes COMMENTS: (Include code discrepencies, persons present, etc.) Location: 448 SUNRISE CIR 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Inspection #1: Inspection #2: Plan revision Required? 0 Yes � No Use other side for additional information. L_____�_�_1 �—___ Date Insepctor's Signature Cert. I S P�t� -2o2t� -� 01� §����������'aa�. Safety and Buildings Division County y • S L 2-®f x Sanitary Permit Number (to be filled in by Co.) 8 . ,�, ;'� 201 W. Washington Ave., P.O: Box 7162 , �. '�c .;{F, � Madison, WI 5 �D /^ � ���—�� :�. •,� :� .. � D KJ �`kr)r,Ct3rot,A�S� Sanitary Permit Applica ion pp�� �, ?tl?0 fate Transaction Number � ' �' In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form't the appr�lidt8 governmental unit is to obtaining a sanitary permit. Note: Application forms for sta e-otirned POWTS ���� eject Address (if different than mailing address) required prior the Departmenfof Safety and Professional Servies. Personal information.you ovide m�}k.b�tt�� ev��� the Privac :Law, s. 15.04 1 m • unity �(j., � �' u � � f/� L'1� �ZCL• osesinaccordance wifh ,Slats. (, ( 7 I. A 'ligation Information —Please Print All Information Pazcel # Prope wner's Name - Prope Owner's Mailing Address _ �N � Property Location O m ' �� �C�� IOC v O Go,vtr1. Lot ''� � /�+ � /, �� %, Section City, State Zip Code Phone Number • .. �rcle one T Z �N; R � E or� II. Type of Building (check all that apply) Lot # . ,/ : � Subdivision Name �1 or 2 Family Dwelling -Number of Bedroom �� r .. 11 I / J � N �'� V �L � C` Block # � S�2 ❑ Public/Commercial -Describe Use �—� ❑City of ❑ State Owned -Describe Use ❑Village of (,Town of � 0 � � CSM Number �'-�' III. Type of Permit: (Check only one 6tix on line A. Completeaine:B if applicable) �'' � w System ❑Replacement System ❑ Treatment/Holding Tank Replacement Only . ❑Other Modification to Existing System (explain) B, ❑ Permit Renewal ❑Permit Revision g ❑Permit Transfer to New ❑Chan e of Plumber List Previous Permit Number and Date Issued Before Expiration Owner �� T e of POWTS S stem/Com onent/Device: Check all that a 1 . on -Pressurized In -Ground ❑Pressurized In -Ground ❑ Af-Grade ❑Mound > 24 in, of suitable soil ❑Mound <24 in. of suitable soil Holding.Tank ❑ Otherbispersal Component .explain) ❑ Pretreatme t Device (explain) . V. Dis ersalfTreatment Area Information � u- DesigrrFlow (gpd) Design.Soil Application to sf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) st� Elevption �/ s, VI. Tank Info Capacify in Total # of Manufacturer y Gallons Crallons Units D � '° ,� y New Tanks Existing Tanks � �q ;? i p � � �, l.J �n � i:, c7 a Septic or Holding Tank �7 y-�) Gam..! V '�� /�f' /L, Dosing:Chamber . VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. ' Plumber's 1•�ap�e (Print) Plumber's Signature MP/Ni�Ri3'Number Business Phone Ntunber . D e GL a.� � z �1.��1 �`� . Plumber's dress (Street, City, State, Zip Code) _.. L% lid. c�tJ a �! •� Ff - Q % VIII. Coun /De artment Use Onl Approved ❑ Disappioved.. Permit Fee $ Dat Issue Iss ng Ap�ent Si fur ;;p Owner Given Reason for Denial �� l 7 �S �� - S�Sgti�EM r��prtivaUReasons for Disapproval 3,�(,vi�SQ�tI UP 5'�'. I r-.-�[ c�c ie.Q �Y�s+� 1. SelptticMtaUUnk, e�LfflKKuent filter and Csra''`� �' ��- Z1'�� dispersal be �� � cell must sgrviced /.maintained �-G?.w���a- • ��i�Q., as per management plan provided by plumber. u'°'Q— � . 2. All setback requirements rnust be maintained �4f flo'i ri>jil@f6.plans for the system ands met t e County my on p er not less than 8 T/2 11 in es in SBD-6398 (R. 11/11) I'LOf PLAN Iq tiv AlC�'s R L/ -?M D / � 4m pipe _ ®-WL BODY W! DAC1M NO COMM B3 5MIa t'MXW 1. &Oq AtFT�s r''j' � Il ,w CONVENTIONAL COMPONENT DESIGN - Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: Legal Description; Township: ��d y County: �� G%Z-o/u s Subdivision Name: �L.C,?%,,�"L�-�- U/�--c��y Lot Number: Parcel ID Number: C�'�(� �—%,`��f� � g' .�0�� Page 1 Index and title �� Page 2 Plot Plan �� Page 3 System Sizing & Cross -Section Page 4 Filter Specs Page 5 Maintenanceflnformation Page 5 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed �� Page 9 CSM or Plat Attachments:Soil Test &House Plans Designer/Plumber: ® ��� �L_�'�>�/ License Number: � Z ���.i/ Date: Phone Number "�/�--- Z%��5�� Signature Designed pursuant to the in -Ground Soil.Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01), Page 1 I 1� Ul KAN PWPWYOWL Tr4koy ST. C MSX 1 S �y,uey X Ro. - or 2- Family Dwelling I li] Gaily. Wastewater Flow (DWF) i �� # of bedrooms x 150 gal/day/bedroom = �� � ga,l/day d ft� er SPS Table 383.44r-1, 2, or �) Design Loading Rate (DLR) or Soil Application Rate = � Ygp / (p (��() ��� ftz Required�distribution cell area = DWF--�=—=—gal/day � DLR_ �� gpd/ftZ = _ # Chambers =Required Distribution cell area _--�=" fts Chamber Manufacturer and Model Actual Distribution cell area =Required cell area �� ft� ecfion �1�n-ground Soil 4" Schedule 40 PVC � f � vent pipe with vent cap �-� _�(,�_ ft2/unit EISA = _—_�L�Chambers + � , Z- ft2/unit EISA End Cap Pair = �r �ftz 12 inches minimum 12 inches minimum �1�1 I I� �b Inches Soil Cover Trench 1 Sys- J� i tem Elevation inch Chamber Height �� �ft � ft Trench 2 System I. _ - � _. � � Elevation ft Trench Separation Leaching Chamber Width - P Plan View I l�J leaching Chambers praw Q for a Vent and for Observation Pipe above. ft with end camps They will be located Trench 1 Veht pipes shall be Schedule 40 PVC and extend at least 12 Inches above finished grade. Observation pipes that extend above finished grade must also be 41nch Schedule 40 PVC. �� to limiting factor Modify header/ design as needed. 4 inch Header Sch.� __ ft from the end of the cell. .. y `. -. Irt-ground Gr��'r�Y I�a�na��rnen. Plan �- fI�DP-� tam shall;be res�tons'ible�for its perpetual operatron arttl rnarntenart4e pursuant is The. Qwner of t�iis in-graundgravifij sy�. 1lViss. Admin Code, this system shalt requirements of SP5� 3s�-384, tNiso. Admin Code �urauant tops 38a �z {2)' roved:mat�a emenf plan: be considered a human health :hazard if not me�� hall bye p�erf pied by. a registered P�1IV'�'S R�atntainer in Furthemtore; all inspe�tiorn and rriaintenanre a accordance with �S.PS' 383;52 (3), Wisc. Admin. Code. DNlaximu is rs r A o�.. ........ j���,�} BOpa 5 220 mgL"'; tS3 5 950 mgL''; F©t3 � 30 m�G"' ®eeign Flow= —JCS...= � gpd' Ina�ection.CheckDi�t IiVSPIE�GT`RY 3 YEARS o type,of use: .� . o age.of systein la�nts, atc. a nuisance facCors (i:e. odors; user corrlp ) o rneechanit�l irtatfuncbgn (ie � :pumps, valves, shritches, floats„ afc.) �� o. material fatigue (i.e:, leaks, breaks, corrosron, efc ) o solids volume rn anaei'otitc tre mina design taps b!eS, ptoh. r'bd� activitiQs, 8of �) �., distribution. /drop boxes) o neglect or iinpmper use (ts , ex g o extent of p�ndrr�g in distribution calf prior to dosing o dosing. irhegularities d applrcatile (� e., pump �::cycling, float switch semngs, etc,) elG:)' o electrical components - if applicable (i;e., wrong; connectrons, switches, controls, timers;: alarms, o distribution lateral :or iater�i orifice plugging (measure Isteral distal pressure —compare to design.specfication) o surface discharge of effluent or<sewage back-up' into structure served All�atn� enahce:Checktist NiIAfNTA1N D.�/�EtY 3 YEADZ3 (oc whet► neces�a .ry.) a Septic and deae tankEs� shalt be pum. � by.a,c�rtfied septage servicing operator licensed under s: 281.48 ems. �t2�ts when: iP9e rroiurne:�of se►iid3 ire tOse tams} eXcserOs ane-tD�i�:(1/,3j 4f�e Diquid voDis�a ®i its €�ro�(s} cr as required by�local ordinance: Dispbsal'Of c�rtents shall be•pursuant to tVR 't 13,`1Nisc. Admin. Code. o �fflusnt fiit�sl shall be.inspeGfed eue � �$ sp�itlonse A se a'itig penad�witl�aiways reate than '12 accumulaferi sairds r3ccording to man .. .months. System maintenance reports shall be;gubmitted tO f11b ti ai�re�ttta�unciion � nit in a�ccardance with SAS 383.�5 Wis�.:R►dmin. Code. Report any:co['nponen �g `` <..r j � � �c ,Nt /� phone: _, � i S- Z:7' a #-t4'� y� A \ �- L f � �.y�.-,TM Name of individual or company �/,� � � �� � �/6 �'� lc�l govemmenf unit:... S''�� Gl�:�lX 7�%Ut,�9 ,Phone: Local goVemmenf urnt address Vifisc Ad .min. Arty defective part.of thissystem5hall: be repaired,.r`eRre�� or remc�V,ed putsuant #o: SP5 3$3 5 NY�sc. Admin. Code: Code. Repair or replacement ofi falted'or malfunctioning,cgmponents• shall c�tpty w�fh SP5 3$3, No product for cfternical nr physical restoration of the i�OWTS rnaY be used unless approved -by fhe_department in accordance wfth SF'S 384; Wisc: Adt:�in. Code. Gontin�eney Plan to the event thatanyfailed treatment companeritof this"i�t3WTS cannot t�e.repaireri, it shalt be replaeed pursuanYto a plarrsubmitted to the appropriate agency�for review atid; approval: A fatted in -ground dispersal campanent may be abandoned and replaced by a code-compiYing d'isper�ai c�rnponent in �a pre-deterinine¢;ar'�ea of suitable soils. SYs� ndoilmen� . - If use of this PQVV"FS isdiscontinued; it shad be abandoned to accordance with SPS`383.33, Wse. Admin. Code. Authentisign ID:1BD14302-7B7A-4BOB-9DED-B041EEOBE93b ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Reggie ot Erika Estrella / Klemm & Calvin Cloutier Mailing Address69 Tribute Ave. Hudson, WI / 120 Meadow Dr. N Hudson, WI Property Address City/State 448 Sunrise Circle REC IVED APR 14 2020 St. Croix county Community Development (Verification required from Planning &Zoning Department for new construction.) Hudson, WI 54016 Parcel Identification Number 040-1304-19-000 LEGAL DESCRIPTION Property Location IVr'/4 , S W 1/4, Sec. g , T Zg N RjW, Town of % jQ 0 Y Subdivision Plat: SUNSET VALLEY Certified Survey Map # �— Warranty Deed # / �SIS� Spec house DyesOno Volume (before 2007)Volume Lot lines identifiable ❑yesOno 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 §SPS. 383.52(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 1/3 full of sludge. I/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 Safety And Professional Services and the Department of Natural Resow•ces, 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 three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. The Sellers, Estrellas, give permission t tk6nu e,r�s�hnCloutier14/112020 419n&pply for sanit����obuilding permits. Number of bedrooms 9iJLeCC� btwffll Authm/412020 7:32:14 PM E Authenfis: 7:07:23 PM EDT re«1 � elll' �l , l l SIGNATURE OF _ e ce an per PM CDT 3/31/202012:47:24 PM CDT 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. (R1JV. 04/12) STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number � WARRANTY DEED THIS DEED, made between Gary W. Feyereisen and Rondi A. Feyereisen, husband and wife, Grantor, and Reggie R. Estrella and Erika J. Estrella, husband and wife, Grantee. Grantor for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, Wisconsin: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this April 17, 2014 Rondi A. F 995151 BETH PABST REGISTER OF DEED ST. CROIX CO., WI RECEIVED FOR RECORD 04/25/2014 08:00 AM EXEMPT # NA REC FEE: 30.00 TRANS FEE: 225.00 PAGES: 3 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address: Edina Realty Title, Inc. 400 South Second Street, Suite 115 Hudson, WI 54016 1120269 040-1304-19-000 Parcel Identification Number (PIN) This is �j (1'� homestead property. WARRANTY DEED St. Croix County 995151 Page 1 of 3 STATE BAR OF WISCONSIN 3�7:i�ri�R7f�b � � P AUTHENTICATION Signatures) authenticated this April 17, 2014 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Martin D. Henschel 6800 France Avenue South, Suite 410 Edina, MN 55435 (Signatures may be authenticated or acknowledged, Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature. ACKNOWLEDGMENT STATE OF r COUNTY OF Personally came before me this the above Gary W. Feyereisen and Ro di A. Feyereisen, husband and wife to me known to be the person or persons who executed the foregoing instrument and acknowledged the same. �nerl �srown Notary Public, State of Wisconsin My commission is permanent. (If not, state the expiration date: 03/01/2015) WARRANTY DEED STATE BAR OF WISCONSIN St. Croix County 995151 Page 2 of 3 ii FORM No. 2.2000 `il Exhibit A Legal Description Lot 19, Plat of Sunset Valley in the Town of Troy, St. Croix County, Wisconsin. WARRANTY DEED STATE BAR OF WISCONSIN St. Croix County 995151 Page 3 of 3 FORM No, 2-2000 �G�IC,U T ` 9CJ 4 � 1,' 14" E_, 1; s-�R SI ENTIAL 11, 910.E N� �,' 1 AST-�HE'ST �' AN L l E 913.3 22 � _ .., (A � X - LOT` �' 19 604' ACRE a,875 S.F. '°4 � 4� � � _ \ \ � `� \o L 1 \15 0 E 6 ,3 6 S. . rn` � � � \ ' � \ � 71. 5' S 9 °C 895�\�\ \/� �� o� ��p A 39�,� �12� 00" ��,, � p � 910.8 OT 2 1NJ� 1• AC I_ 165,4 S.F. m '913.3 a � - --, > `p�, � \ �6''� � . it _ _ / ! 150 I 17 �- �B—P21 "' ° „ 87 043 w � x � � i G�, � ' ^ 90s. 1 c � / '� , O J� �� 903.0 00 I � 7Si � � , . r V ' I � s �• 1.570 ACRES r w L= _ S.F. � 50' t. o 0 o Q •°�° .2 o � � a9s.s 2 0 0 '0� _ 1 05' Z � N °00' 00' W 57 9 UT OT 1 ` - .62 CRE M �� 2 ,206 S.F.,.�. �O¢�ACR � 8 '7 iS F 890.9 �0� o (LBO=888.0 oo\1.506 ACR S %� 65,624 S.F. !�� 893.0 N�, �� cr_ rn� ,� ZX � / °�. '� �� . .! I� E. " +•.'. a z D rn a z c -,� n 0 O m --� O X n rn 0 I N J c z �o 0 O \ _� rn 52�" 41" s` I�; —I O 84" t'� �' �o c -i �• c N D�� IV Nc z z n � c �i' � m az � .�L z Doz v � � CW�mx�nO�czn z� cn a Z�� G) nc� c") O�Z D'Z ��r�zmDr1* -{�Z m� � 07 v=� m D�D D �pp T`D'O �o�.z�, �,,SIOz;UO ,n � � m rya N r'-i� o �zo !�cnc '-'zroo •r �N r � \ C F� '�� nS•• _� NZ� � � oo�r,ANNI��iVJ\ O o m SO fir' gyp. D. � DD� Co�*1ifT-1100�� -pN � p �' Z pp D Rl W —I (n (n � O \ s c� oz � o � m-mim cnw oov z z � 4*f o• D i v � �'- Z �� o � cm-x � v � .cam W z ��o Wo vDi � N� D D .--i. o� O A -1 -I O c> � A z � .o � -mi o N m r m c� z � r c r�* o ra- � � � .m rn � .� __-� ,. WLP1250-MR lU�EgER C�IICAETE SCALE:, 4" _ �' DRAWN BY:SWT SEPTIC MANUAL W3716 US�Hwr10. MAIDEN ROCK, WI 54750 DATE: JANUARY 2008 REV. JAN, 2008 � 800-325-8456 FILE: WLP1250-MR N REV N0. DATE: n jo 3Dv .. O rt �� CIl (C m c p �� � 373 � o f. O : e n } t} 9f trfr! ............. �}:F}:is It F}:F} is Is is 01 It };F4.F};FF;F};F} t t t t t L' i o0 F}:F}:F}:F};F}:F} of Oil i t t t i t l 4.F}.F}.E}.Ft.Ft.F4 4;F};F} `F}.F}:F}:F4 Is }.F}.F}:F}:F4 I40 s /' is 4 4 M I t f 4 }};F};F4:FIs rt60 :F}:F};F4 so Oso El El F};F};F};F};F}so '4 t f 4 ! O� 19.9 so so so 4 4 t t 1of F}go :F};f}:F}:F} (0 4rtF! } m '4 Z m44❑ 0 at as so 00000 ge - �� ®®�®� 0HUM 00000 is If at L ! I t Y s s go as is rvA h , B ct m so Be so so so It �` i 0 itj fill :�; tt e 'E CU BUILDERS € llaJJ 445 SUNRISE CIRCLE `$ g \ 2/ n \& � <2 2\ � ;R � CD {� o §�� | 44a sUNR 6E CIRCLE % A § ` �| In In Ec� 4'd' .W d' ........... ti€ 4 w. ye = i e K qK} I' 'I ............ ;! 6 ° €4S EaC 0 IJU d o ' 4'd• ' d; 9 1 (4 � � 6'-0 -0• 3'- '-a' 7•�4' 4 R s 3 P 4= o b 4€ P b 5.-g. -0' iY-0' P• IY-9' � sr-0• � 6�: 6 E S 4 6 e gg h� S t a �•➢P q ed; € � o CBU BUILDERS m" 440 SUNRISE CIRCLE 4� m I I :c 6 Q. P b Ru s p" s R • A p � Y Y-ID'L L yy d Mgt < N�pJg S_pt a3 �myZ �� UXp° TA Roo = I fill FMiss E� 440 SUNRISE CIRCLE M R a € .g��e84 N1�=43 JU mtu F At IJ ERICA f N W41` 14" E _7fl' 1310AW JUI ]1UN t -CST 114 j5FCFfCW L 1W T ' 9 LOT 20 ACRE i 1IZ02 ACRES = r 65,44E S.F. F ... �� %'Am 4 LOT 18 Cb ti 1.} ACRES r W� J M354 SF.:, •44? ' f�� 03 FIR 11 2020 Al A (JATION EPo r Wisconsin Dapathment of Comrrif Q C ;; 2 }'At Division of Safety and Buildings 1 Q�h� in t r riardan Nim Wis. Adm. Code ST.CR�iX b`+441 Yinity Developrrt�T 01 Attach complete site plan on pa not �s PI m - include, but not limited to: very ! n� fatcet `E.d. Ffe $s percent stope, scale or dimensi ( s, nort an d rt arest i�"IE�S� �3P'Ftt@all 9lE�:�Ya21aPlOfi. tzGv cu "'' ...,. Porsonal lnformatlon you provlds maybe used for secondary purposes (Privocy L=nv, s. 15.04 (1) (m)). .ay ( VI,/ a�Ut 4 �• _ ?fty Oyynef Property Location I r; ARTI M & MARIYLN FEYEREISEN Govt. Let -- RE4 114 SW 114 S 8 T 28 N R 19 E (or) W >2rty Ovmer's Whiling Address Lot # Block Subd. Nauss or CSUt►1 420 Tovmsvaltey Road 19 — Sunset Valley — State Zip Code Pherse Nsaelher ity Village m Town Nearest Road Hudson, t W1 t 54016 1 t 715) 3861.2122 Tsni� Townsvaliey Road NawCattstnfcttan Use Resid�tstiai / Nurtts,er of bedrooms 4 Code d8mred design tiav rate otns GPD Rep',acontent ®Pub9e or cammetriai - Dsscxibe: Patent matefial outwash/sandstone Rood Plain elevation if app?icab',a General com=--nts Conventional 1n-ground trenches - to be designed by installer and reations: a � �4 0.7 oading tc� °t` �Z� o j{wwwr- A o F ®Boring P13- Boring 0IG'�•`%7 r >112 Apit Ground surface elelr. � ft. Depth to EimiUag factor in S�— �P p„t,tirnitan Rate Hofizrrn f}apth t'iominant Colal Redox Description Terfttsz; Structure Consistence Boundary Roots GPDffF in. Mansell Qu. Sz. cont Color Gr. Sz Stt. 'Efft3 4E1'(02 1 0-5 10YR2/2 - I 3f4sbk mvfr ab 3vf-m 0.6 O.8 2 549 (OYI'.2/2 - 1 2f-mabk mfr ci 2vf-m 0.6 0.8 3 ) 9-27 1OYR3/4 - I 2f=mabk mfx cs 2vf- m 0.6 0.8 4 27-33 IOYR3/f s 2f-msbk dsh aw 2vf m 1 0.6 1A 5 33-50 1OYR3/6 -, s Osg di ab 24-m 0.7 1.6 6 SQ-GO 1QYR3/6 t2fts)YR4/G s Osg ml as -- 0.5 }.0 7 - 12 10YR4/4_ s Osg m1 — — 0.7 3.6 R�Boring � t3onryg # E Pit Ground suriao elev. _ft. >113 Depth to limitingfactor „r,Statsaa Ra4e Horizon Effluent Depth Dominant Color Redox `'hsctipiion feature Stsudure Coflsisterroe Boundary Roots GPDJW In. t,liunsoil Clu. Sz. CGont. Color Gr. Sz. Sh. `Eft#i `Eff!!;2 } 0-3 10YR2/2 - si 3fabk ds eb 3vf-m 0.6 I.0 2 3%_9 10YR3/2 ^ _ Sl 2fa&sbk ds ci 2vf-m 0.6 I.0 3 9 28 1pyR3/6 is lmsbk ds cvr 2vf-m 0.7 1.6 4 28 113 1QYR5/4 Osg tnl -- -- -0.7 l.6 r(Horizons 3 & 4 have some gr.) fo 30 #1 = BODS > 30 _< 220 ntgfL and TSS >30 < 150 mg/L Effiuoll9 2 = BODS < 30 nuyL and T5S < 30 myL CST Nast>z (Please Pont) Signaiura /' i { CST NumberE�ary 3o tlollistcr %,v�'` 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, Wl 54022 01 - 13 & 07 - 09 - 04 (715) 426 - 1775 Property (>aw FEYERBISEN, Arthor (Lot 19) Parcel ID ( ) Page of 2 3 QBoring V 8oring 14? .4ei w'a i Pit Ground surface aw. ft. Depth to limiting factor i07 in. So Horizon Depth Dominant Color Redox Descriptirt Ication Rate.on Texhrre Stmefure Consistence Boundary Roots GPD/fe in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Ef&l "E02 1 0A 90YR2/1 — I 3fsbk ds cb 3vf4n 0.6 0.8 2 4 17 10YR2/1 - i U--inabk ds ci 2vf rn 0.6 0.8 3_ 17-25 i0YIz3/2 I 2fsbk ds ci 2vf-m_ 0.6 0.8 4 25-31 10YR3/4 I 2fabk mfr cs m 2vf-0.6 008 5 31-43 IOYR3/6 Is if-msbk mvfr cs 2vf-m 0.7 106 6 43-107 10YR3/6 - Osg ml -- 0.7 1.6 (Horizon 6 has some gr.) L .J Boring fi ! t3oring if u Pit Ground surface elev. _ _ Q. Deolh to limitinn faHnr Horizon Depth in. Dominant Color Mansell Redox I]escripGcn Qu, Sz, Cont Color Te>rture Stnrcture Consistence Gr, Sz. Sh. boundary Roots Soit lica6an Rate GPD/ff °Eff#1 'Ef#f2 Boring tF L--1 t3onng M Pit Ground surface etov. Depth to limiting factor Horizon Depth —in. Dominant Color Mansell Redox E;:saitrtion Quo Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Soil lication Rate Roots GPD/fe °EfftRt `E02 L•ffluen; fJODt _JO mg/l and TSS < 30 m !L ncLti Inrllt:fiai in an atiCflSiSlC tUr711;iL pi�.tjc ciTiti:LiY iiN: FIF �:ii is � i+il�i-i4-��-•-.- .. ... . ��ffj�i7jl I m