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HomeMy WebLinkAbout030-2011-10-100 (2) V epartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix uilding Division INSPECTION REPORT Sanitary Permit No: 515067 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: En elhart Family Trust, James P. & Jaculin En I St. Joseph, Town of 030 - 2011 -10 -100 CST BM Elev: Insp. BM Elev: BM Description' : //�� Section/Town /Range /Map No: l� G YY� `_ ' 35.30.19.388B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER L / CAPACITY STATION BS HI I FS ELEV. Septic / j" "S Benchmark Dosing P6 1 , ( Alt. BIVJ� Aeration U Bldg. Sewer ' y. L5 . G Holding St/Ht Inlet 1 1 r I TANK SETBACK INFORMATION St/Ht Outlet II.�9 •� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic /Z10 A , / 1 Dt Bottom Dosing Header /Man. 12 -71 T1 1 Aeration Dist. Pipe Z' % 6 - Holding Bot. System 3. U 0. "' a o PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cove GPM Gay Model Number - n�� / � o /O�' �f� TDH Friction Loss System TDH F Force Len th Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No. Of Tre PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Gif 1 r � SETBACK SYSTEM TO F+ P/L 1BLbG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR .LrL�t Type f System: t . Q , � / 3 _ L ` / A� UNIT Model Number: J' � `r u ey DISTRIBUTION SYSTEM Header /Manifold / / Distribution ` x Hole Size x Hole Spacing Vent to Air I t ke 9 Pipes) ` ` 3 e Len th Dia Spacing Length D a�_ g p 9 _ SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mul ed Bed/Trench Center Bed/Trench Edges Topsoil,. Yes Ej No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 1286 80th St. Huds n, WI 540016 (NE 1/4 NE 1/4 35 T30N R)9 metes & bounds Lot Parcel No: 35.30 1.) Alt BM Description = F n Jr 9 2.) Bldg sewer length = I 1 I / E � rra �dJ � -- A w o, 4 ., - amount of cover = Go�'^�' I 7 0 C J Vinature ` '�"o G 1 +�t. a - — Plan revision Required? Yes No 04 U (II A��75 se other side for additional information. _ — _ Date r sepctor' Cert. No. SBD -6710 (R.3/97) eommereemi.gov Safety and Buildings Division County 201 W. Washington Ave. O. x 1 2 5. Ce0 / X ' sco n s i n Madison, W 714 i Sanitary Permit Number (to be filled in by Co.) Depar t of Comnwres 5 5 0 49 Sanitary Permit Application Sta T' ' umber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate ! - governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned Project Address (if different than mailing address) POWTS are submitted to the Department of Comnnerce. Personal information you provide may be used for secondary in accordance with the Privacy Law, s. 15.04 1 m , ts. I. A lication Information - Please Print All Information Ur Property Owner's Name Parcel �! 7 7 mg 8200 030-Z0/ /4 /0O Property Owner's Mailing Address ,, f Property Location � �J Q� Z Q 96 TN 57 - 3n N g ZONING O�f10E Govt. Lot (' '✓ City, State Zip Code Phone Number Al E yA, � %, Section Ai d So iv W 17 1 57 /- /(q/(0 (circle one) H. Type of Building (check all that apply) Lot # T t7 N; R 1 E or W IX 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # ❑ Public /Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of 0 6 &t t!!) <& � 6L 6rin, i ® Town of III. Type of Permit: (Check odly one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Trealn=WHolding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS S m/Com nent/Device: (Check all that apply) Nm Pressurized In- Ground ❑ Pressurized In-Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component. (explain) ❑ Ptetreatmern Device (explain) V. Dispersal/Trea0ment Area Information: Design Flo (gpd) Design Soil Application Ra t) Dispersal Area ReWired A ( Dispersal rea y stem Elevation 7 07 641 j v.0 VI . Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units W t �QcY� 0 �' U New Taub Existing Taub a Septic or Holding Tank 000 /000 VJ Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibifity for hrstaDation of the POWTS dawn on the attached phens. Plumber's Name (Print) Plumber's Sigua MP/MPRS Number Business Phone Number T ©rt►V vcNvn(rr a.237&0 7/5 y4 -6 6J I Plumber's Address (Street, City, State, Zip Code) vm. Co one went Use Onl Approved ❑ pprov Permit Fee l l Issuing Signature ❑ 1ven Reas� o l $ / 75 • 2 ' 5 / 01 IX. Conditions of ApprovaUReasons for Disapproval a� SYSTEM OWNER: 3) oil W f, Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. AN setback requirements must be maintained Attach to enmphte 31 4 the system and submit to the County doily on paper not leas than 8 1a x 11 inches In size I NaQrli :_ ►��o . crLT`l 1-1 N.= To __' G Pip A! 44T. 014 _ /O oZS ` Q o7 o l= S1a ■ ao Qc /-� S .yD i I { _ �Xispw� u -jK u (o QCkores : i i w Lo _ I _ _ Jr �a 14 S t LT_� . C - - 3 1q 19 I?lvc- WAY r , cG Ch< 5 /44 SC7D TT & SONS EXCA MATING INC 586 VALLEY VIEW TRAIL SOMERSET, WI 54025 IN-GROLIND SOIL ABSORBTIONSYSTEM FOR ENGEM4RT FAMff Y TRUST ADDRFSS 1286 BOTH STREET, HUDSON, WI 54016 LEGAL NE % NE % S35, 730N, R19W TOWNSHIP ST. JOSEPH COUNTY ST. CROIX CONTENTS Page 1 Plot Plan Page 2 System Cross - Section Page 3 Management Plan Page 4 Maintenance Agreement Attachment 1 Soil Evaluation Report In- Ground Soil Componentt Manual (immersion 2.0) SBD -10705 P (N. 01/01) By: jc MFRS: 223760 Date: May 28, 2009 s i • _ 8►!� _._ ID�.Do -roP o�" Z ` PVc p t = y ©" I �XisTi�1J¢ - _♦ _ - � - _._ C�u1K W - reek flits _ I000 GAC ous S r Ex�siw1 SL / To.B� �M -63 -- -- -- - _ 3 T 1 0 L cG/faeT Cl�lca2 Als 7 �4Kt! Soly w r c ,eS�7 '/� 0/1, r- Quik 4 Cross Section • J 4 "PVC,Inspection + Vent Pipe Tv Approximate Grade F� E1.= 97 0 I —�, i lii �J- II I El. L > 3' ArWoge Open A/f0 WOO A" . AreO WiOM POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FUR WFORMATION SYSTEM SPECIRCATiONS En elhart Chi ldrens Trust Septic Tank Capacity 1000 gal ❑ NA PG=k Septic Tank Manufacturer Week's• C.P. 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer Pol lok ❑ NA Number of Bedrooms 3 0 NA Effluent Filter Model 525 0 NA Number of Public Facility Units Ift NA Pump Tank Capacity a l v NA Estimated flow (average) al /da Pump Tank Manufacturer ■ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ■ NA f3oV Application Rata gal/day Pump Model 0 NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit 0 NA Fats, 011 &•Grease (FOG) S30 mg /L 0 Sand /Gravel Filter O Peat Filter Biochemical Oxygen Demand (SOD 5220 mg /L 0 NA 0 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L 0 Disinfection 0 Other: pretreated Effluent Quality Monthly average Dispersal Collis) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L o In- Ground (gravity) 'O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ■ NA ❑ At -Grade 17 Mound Fecal Coliform (geometric mean) S10' cfu / O Other: 100ml 0 Drip -Una Maximum Effluent Particle Size Y. in dia. r O NA Other: ❑ NA Other: 0 NA Other. ❑ NA ' * m hews typical for domestic wastewater and septic tank off Want. Other. ❑ i'A MAINTENANCE SCHEDULE Service Event Service Frequency 0 monthls) (Maxlnwm 3 years) ❑ NA Inspect condition of tarik(s) At least once every: 1 0 ear a) pump out contents of tanks) When combined sludge and scum equals one -third (Ys) of tank volume ❑ NA 0 month(3) ( Maximum 3 Years) ❑ to dispersal cells) At least once every: 1 ® ear(s) ❑ month(s) ❑;NA Clean effluent fliter At least once every: 1 !(i earls) ❑ month(s)q: Inspect pump, pump•contro13 & alarm At least once every: O year(s) ' ❑ months) O tlA; Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) p.NA At least once every: ❑ ear(s) Other: ❑ NA: & AWTENANCE INSTRUCTIONS Inspections of tanks and dispersal calls shall be made by an individual carrying one of the following Ucenses or certi(Icatlons: Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Sepiags 'Servicing .Operator. ,:Tank inspectIorts must include a viwai inspection of the tank(s) to Identify any missing or brok en hardware, ldentlfy any. cracks or: leaks ... rneasute the volume of combined sludge and scum and to check for any back up or ponding of' nt on the groundsurfaqe. The dispersal cells) shall be visually Inspected to chock the effluent levels In the observation pipes and to check for any,..podin of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immedlate 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 a rti contents of 'the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NN 1, Y hw4nsln Administrative Code. ' All other services, Including but not limited to the servicing of effluent filters; mechanical or pressurized components, pretreatment units, and any servicing at Intervals -of 512 shall be performed by a certified POWTS Maintalner. A service report shall be provided to the focal regulatory authority withln 10 days of completion of-any service event. START UP ANQ OPERATION For now construction, prior to usa of the POWTS check treatment tanks) for the presence of painting products or other chemicals that May impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tanks) removed by a soptage servicing operator prior tp use. system start ujshall not occur whin sou 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 disohorgod to the dispersal carts) in•one largo dose, overloading the cells) 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. F. Do not drive or park vehicles over tanks and dispersal cells. Do-not drive or park over, or otherwise disturb or compact, area wiJM - 15 feet down slope of any mound or at -grads sou absorption area. Reduction or *WTdnatlon 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 draln (sump pump)' water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; panting products; pesticides; sanitary napkins; tampons; and water softener brine. , 'ABANDONMENT Whm the POWTS falls 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: e All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. e The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator, •r e 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. r j CONTINGENCY . PLAN W*.Sho POWTS falls and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant aiaa ment system: O A suitable replacement ores 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 1 required setbacks from existing �snd proposed structure, lot lines and wells. Failure to protect the replacement. area will result In the need for s now sou and site evaluation to establish a suitable replacement area. Replacement systems must comply with the w.lo; In affect at that time. 0 A suitable replacement`area4s, not available due to'setback and /or soil limitations. Barring advances In POWTS' f technology a holding tank may be installed as a last resort to replace the failed POWTS. ), The site has not been evaluated to Identify a su)tabli replacement area. Upon failure of the POWTS .a soil and site I evaluation must be performed to locate a suitable replacement area. If no replacement area )s 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. 3: «wARNING>> SEPTIC, 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 POWYS INSTALLER POWTS MAINTAINER Name Jo h n . Schrrri tt Name John Schmitt (715) 549-6621 F Phone - Phone (715) 760 -0486 .Y SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name a "' Name St Croix Ct Zoning� Rhone Phone 715 386 -4680 } This document was dratted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. { ter-- -- ••- - -..-.' , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM S Omer/Buyer 4 1 4/ 142 1 - 1- ad Mailing Address , ��� P3 property Addre - S� P (Verification required from Planning Department for new construction) City /State Q Parcel Identification Number �. C7 `Z d 1 (1 00 LEGAL DESCRIPTION t 0 el W, Town of �• .J property Location '/4, %•, Sec. TN -R� Lot # ';Subdivision ��( e # � Certified Survey Map # , Volume Page Warranty Deed # Volume _, Page # Spec house ❑ yes 0 no Lot lines identifiable ❑ yes Cf no SYSTEM MAIl�ITENANCE 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 sffect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St, Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. , Uwe, the undersigned have read the above qquirem eats 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 -C Ocat'o stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning ce within 30 days of the three ear expiratio _ DATE SI TURE OF APPLICANT OWNER CERTIFICATION the owne r(s) of I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the property desc abo utue of a warranty deed recorded in Register of Deeds Office. lL.� D SI TURE OF APPLICANT ' DATE . « + «•« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * « «* * «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy f the certified survey map if reference is made in the warranty deed v p ' Isco sin SOIL EVALUATION REPORT ith #1 609 'Mparlment of Commerce in accordance w Comm 85, Wis. Mm. Cods Pape of 4 Divialoa d Safety and Buildings Schmitt Boll l Testing, Inc. County AftWh complete oft plan on paper not was than 814 x 11 inches in size. Plan must St. Croix but not limited to verticstl and hofixontal �arencepoinrt (BM), direction and Parcel I.D. stops, scale or dimensions, north w w, and location and distance to nearest road. 030- 2011 - 10-100 Please print ag kdbrinatfon. ReAemd By Ddte Personal information You provide may be used for secondary purposes (Prl rp 1,PW. s.10.04 (1) (rhW- ; Property Owner f� Location Engelhart Children Trust Govt. Lot NE1 /4, NE1 /4, S35, T30N, R19W Property Owner's Melling Address Lot a Block a Subd. Name or CSbfli 1286 80th St na CSM V 2851 P 047 CRY State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Hudson I WI I 54016t StJoseph I 80Th St W New Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement ❑ Public or Wmmercbl Describe: PataM Outwash Sand (Antlgo Setfes) Flood plain elevation, If applicable na ft. General corrar** and Replacement area is suitable for a conventional system with a 0.7 gpd/sgft rate. System elevation may range between 93.48 and 90.18'. Slope of area Is 8 %. ❑.gyp # ❑ Bodw, . 0 pit Ground surface slew. 97.60 R Depth to limiting factor +125 in. Sob Application Rata FTexture Depth Dominant Color Radox Description Stu*" Boundary Roots GPD/ft' es In. Mor Qu. Sz. Cont. Color Gr. Sz. Sh. -IMI -082 0-10. 1X}yr3/3 none sl 2mgr mfr as 2f .6 1.0 10-16 6 none grsl 2msbk mfr gw 2m,2f .4 .6 3 16-23 10yr5/6 none Is ic;bk mvfr gw 2f .7 1.6 4 23-84 10yr6 /4 none s Osg ml gw ----- .7 1.6 5 84125. 10yr6 /4 none nos Osg ml — ---- -- .7 1.6 AIZI . c ❑ ° Boring 2 8 Pit Ground surface elev. 96.40 ft. Depth to limiting factor +120 in. Soft Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G D/ft= In. Munsel s, Qu. Sz. Cont. Color Gr. Sz. Sh. - Efitsl 'Ef{i2 1 0-12 10yr3/2 none sl 2mgr mvfr as 2m,2f .6 1.0 2 12 - 23 10yr4 /4 none grsl 2msbk mfr gw 2m,21F .6 1.0 3 23-32 7.5yr5/6 none Is icsbk mvfr gw if .7 1.6 4 32 -59 10yr5 /4 none Ors Osg ml Cs ---- -- .7 1.6 5 59-92 10yr6 /4 none s Osg mi Cs ---- .7 1.6 6 92 -120 10yr5 /4 nbne. Cos Osg ml — --- .7 1.6 • Eftlupnt it = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent $2 a SOD 5 s.30 mglL and TSS <-0 MOIL CST Name (Pleats Print) Signature CST Number Thomas J. Schmitt 227429 Address Schmitt Sol Testing, Inc. Data Evaluation Conducted Telephone Number 150572nd Street New EMZ2Md, WI 54017 51122009 715- 247 -2941 r `rl{� ty t/YYlltll YnrAI IIII�vN1Y1MN IIW1. ParcNIL) rage L Or Y • "" " ® Pit Ground surface elev. 96.4 R Depth to ImRing factor +122 in. Soli Application Rate Horimn Depth Dominant Color Redox Descriptlon Tsodure structure. Consistenoe Boundary Roots WON In. Muuwel Qu. Sz. Cont. Color Gr. Sz Sh. 'EB#t 'EMi2 1 0-15 10yr3/3 none 2mgr mfr as 2m,2f .6 1.0 2 15-2 on 3 10yr4/4 none SI 2msbk mfr gw 2f .6 1.0 3 23-28 7.5yr5/4 none is Oeg ml gw if .7 1.6 4 28.61 7.5yr5/6 rune Cos Osg ml gw if .7 1.6 5 61-83 10yr6 /4 none s OSg ml gw ---- .7 1.6 6 83 -122 10yr5 /6 none Cos OSg ml — ---- .7 1.6 a o ❑ PR Ground surface elev. ft. Depth to UmbV factor lo• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsed Qu. Sz Cont. Color Gr. Sz. Sh. •Etrt1 'Em ❑ P Ground surface elev. R Depth to limiting factor In. Sod Applica Ra te Horan Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Muusell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efts! 'Eff#2 • Effluent#t = BODe 30 <_220 mglL and TSS >30 <J50 mg/L '-Effluent #2 = BOD mg/L and TSS <30 myL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material m an alternate format, please contact the deparbnent at 608- 266 -3151 or TTY 608-264-8777. , s • •,� • wuuwa.cu rur. Scbmitt Soil Testing Inc. Name: Engelhart Childrens Trust Thomas J. Schmitt, CST 227429 Address: 1286 80th St. 1595 72nd St. City, State, Zip: Hudson, WI 54016 New Richmond, WI. 54017 Phone: 715 - 247 -2941 Subd.Name: CSM V 2851, P 047 sewn Lot No.: NA Deft � 'tTU 9 Legal Description: NE114 NE1 /4 S35 T30N R19WSt. Backhoe pit Township, County: St. Joseph, St. Croix county ♦ Bench Mark El. 100.00' Top of 2" pvc pipe ;27— b' A Alternate Bench Mark EL 103.25', Bottom of siding on house Slope= 8% Scale 1" = 40' Akd 4 G. 07 y 2 41 Ajee Piszveezz Oe 541 r � � r / i / 14 l 78 J 90 3 3' > .. 3d - t V i sconsin EVALUATI A f arce ON REPORT #1609 Department of Commerce P with Comm 85, Wis. Adm. Code Page 1 of 4 Division of Safety and Buildings Schmitt Soil Testing, Inc. Attach complete site Ian on r not less than 8% x 11 inches in size. Plan must County PI P Pape St. Croix 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. 030-201,11-10-100 Please print all information. Reviewed Date Personal information you provide may be used for cy Law, s. 15.04 (1) (m)). Property Owner Property Location Engelhart Childrens Trust Govt. Lot NE1 /4, N 1/4, S35, T30N, R19W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# 1286 80th St. f GKCi�� ����' Y na CSM V 2851 P 047 City State Zip CalckANN um r ❑ City ❑ Village ® Town Nearest Road Hudson I WI 1 54016 1 St.Joseph 1 80Th St. ❑ New Constriction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial - Describe: Parent material Outwash Sand (Antigo Series) Flood plain elevation, if applicable na ft. General comments and recommendations: Replacement area is suitable for a conventional system with a 0.7 gpd/sqft rate. System elevation may range between 93.48' and 90.18'. Slope of area is 8 %. F Bonng # ❑ Bonnq ® Pit Ground surface elev. 97.60 ft. Depth to limiting factor +125 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0 -10 10yr3 /3 none sl 2mgr mfr as 2f .6 1.0 2 10 -16 7.5yr4/6 none grsl 2msbk mfr gw 2m,2f .4 .6 3 16 -23 10yr5 /6 none Is icsbk mvfr gw 2f .7 1.6 4 23-84 10yr6/4 none s OS9 ml gw - - - -- .7 1.6 5 84125 10yr6 /4 none Cos Osg ml - - -- - - ---- .7 1.6 F 2 ] II Boring # ❑ Boring ® Pit Ground surface elev. 96.40 ft. Depth to limiting factor +120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 "Eff#2 1 0 -12 10yr3/2 none sl 2mgr mvfr as 2m,2f .6 1.0 2 12 -23 10yr4 /4 none grsl 2msbk mfr gw 2m,2f .6 1.0 3 23 -32 7.5yr5/6 none Is icsbk mvfr gw if .7 1.6 4 32 -59 10yr5 /4 none grs Osg ml Cs - - - - -- .7 1.6 5 59-92 10yr6/4 none s Osg ml Cs - -- .7 1.6 6 92 -120 10yr5/4 none I Cos Osg ml - - -- - - - -- .7 1.6 ' Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 50 mg/L ' Effluent #2 = BOD mg/L and TSS < -0 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 15% 72nd Street New Richmond, WI 54017 5/122009 715- 247 -2941 t Property Owner Engelhart Children Trust Parcel ID # 030 - 2011 -10 -100 Page 2 of 4 3] Boring # � Boring ® Pit Ground surface elev. 96.4 ft. Depth to limiting factor +122 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Eff91 *Eff#2 1 0 -15 10yr3 /3 none sl 2mgr mfr as 2m,2f .6 1.0 2 15 -23 10yr4/4 none sl 2msbk mfr gw 2f .6 1.0 3 23 -28 7.5yr5/4 none Is Osg ml gw if .7 1.6 4 28 -61 7.5yr5/6 none Cos Osg ml gw if .7 1.6 5 61-83 10yr6 /4 none s Osg ml gw - - - - -- .7 1.6 6 83 -122 10yr5/6 none Cos Osg ml - - -- - - - - -- .7 1.6 i F—IBoring # Boring (Q� IVI 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/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Efr#2 ❑ Boring # Boring ❑ 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/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 I 'Eff#2 * Effluent #1 = BOD 5 > 30 <220 mg/L and TSS >30 < j 50 mg/L * Effluent #2 = BOD <-30 mg/L and TSS <-0 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. - - - - - _Page -3_of 4 - - 1 Conducted by; Con ducted For: - - - - - - Schmitt Soil Testing Inc. Name: Engelhart Children Trust Thomas J. Schmitt, CST 227429 Address: 1286 80th St. 1595 72nd St. City, State, Zip: Hudson, WI 54016 New Richmond, WI. 54017 Phone: 715 -247 -2941 - Subd.Nam,e: CSM V"2951, P 047 sip A — Lot No.: - NA - _ - � Legal Description: NEI4NE114 S35 T30MR1 WSt. - Backhoe- pit - - _ - Township, County: St. Joseph, St: county_ - -- - -_ - - -L Bench Mark EL4W.00` --T-op of2 " -pvc -pipe -- -__ �, -L1 Alternate - Bench -Mark E1.103.25%, Bottom-of siding on- house - - - -- - - - -- - _ _ Slope= 8% - Scale l" = 40' - - - - - - - - - - ArcIMS Viewer Page./ off a 'x `Lt � w. 1 g http: / /www.landinfo.co. saint- croix.wi.ust website /LRportal/ARCIMS/MapFrame.asp ?PIN= 5/15/2009 �) X851 P Oy? a�1414 KATHLEEN H. WALSH State Bar of Wisconsin Form 11 -2003 REGISTER OF DEEDS ST. CROIK CO., NI LAND CONTRACT (TO BE USED FOR NON - CONSUMER ACT TRANSACTIONS) RECEIVED FOR RECORD Document Number Document Name 07/26/2005 10:00AK LAND CONTRACT EXEMPT t CONTRACT, by and between Lester W. Langness and Heather M. REC FEE: 19.00 Alderman - Langness, husband and wife, survivorship marital property, TRANS FEE: 3000.00 COPY FEE: ( "Vendor," whether one or more), and Engelhart Family Irrevocable Trust, CC FEE: ( "Purchaser," whether one or more). PAGES: 5 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together with the rents, profits, fixtures and other appurtenant interests ( "Property "), in St. Croix County State of Wisconsin: Recording Area The North 800 feet of the NE 114 of NE 114 of Section 35- 30 -19. AND All Estreen & Qgland that part of SW 1/4 of SW 1/4 Section 25 -30 -19 lying Wly of Highway; all � 004 Locust Street ( that part of Government Lot "1" of Section 26 -30 -19 lying East of a line 1v Hudgon, WI 54016 1132 feet West and parallel with East line of said Section 26; Except the following: Parts to Margaret G. Engelhart in Vol. 11 598 ", page 185; and Vol. "598 ", page 186; parts to Edna G. Smith in Vol. 11 598 ", page 187 and Vol 030- 2011 -10 -100, 030 - 1068 -20 -000 and 11 598 ", page 188; part to Margaret G. Engelhart in Vol. "598 ", page 190 030 - 1066 -50 -000 Parcel Identification Number (PIN) St. Croix County, Wi.wmsin This is not homestead property. This is a purchase money mortgage. Purchaser agrees to purchase the Property and to pay to Vendor at location directed by Vendor the sum of $1,000,000.00 in the following manner: (a) $600,000.00 at the execution of this Contract; and (b) the balance of $400,000.00, together with interest from the date hereof on the balance outstanding from time to time at the rate of 6.00% per annum until paid in full as follows: Annual payments in the amount of $41,185.11 commencing on July 15, 2006 and continuing on the fifteenth day of July each year thereafter. A balloon payment is due July 15, 2013. The Purchaser shall be entitled to receive a Warranty Deed in partial satisfaction of this Land Contract upon additional payments of principal in the amount of $18,000.00 per acre of the total acres so released. These payments are in addition to the regularly scheduled annual payments and shall not relieve the Purchaser's obligation to make all of the regularly scheduled payments. The Purchaser is not entitled to the release of any property if he is in default under the terms of this Land Contract. The Purchaser shall pay all costs associated with any partial satisfaction of this Land Contract, including deed preparation. State Bar Form 1 1 -Page 1 © 2003 STATE BAR OF WISCONSIN ArcIMS Viewer Pagel oft Bws Zake u, x 0 x http: / /www.landinfo.co. saint- croix.wi.us/ website /LRPortal /ARCIMS /MapFrame.asp ?PIN= 5/29/2009 '� St. Croix County Final Property Report Page 1 of 1 Croix r oil em to . _ 2008 P ' e l Report Generated: 5/28/2009 6:07:20 AM Data Updated: 5/28/2009 1:00:00 AM PARCEL COMPUTER NUMBER: 030 - 2011 -10 -100 PARCEL MAP NUMBER: 35.30.19.3888 *2008 <- Click on the year to select the annual record. Property Description Billing Information Municipality: 030 - TOWN OF SAINT JOSEPH Name / Attn.: ENGELHART FAMILY TR Document Number: 801414 Address: 13651 OAKWOOD CURVE Volume & Page: V 2851, P 047 Public Land Survey: SECTION 35 T30N R19W City, State, Zip: BURNSVILLE, MN 55306 Quarter: NE Country: USA QQ / Tract: NE Ownershi Plat: NOT AVAILABLE primary Owner: ENGELHART FAMILY TR Description: SEC 35 T30N R19W PT NE NE THEN Secondary Owner. 800' OF THE NE NE Total Acres: 24.24 ACRES Assessed Value Other Valuation Date 4/24/2008 Fair Market Value: 201,200 Assessment Type Acres Lard Improved Total Assessment Ratio: 0.8597 Value Value Value Net Assess. Val. Rate: 0.015454205 G4 - AGRICULTURAL 19.55 3,300 0 3,300 School District: 3962 -NEW RICHMOND G5 - UNDEVELOPED .69 100 0 100 G7 -OTHER 4.00 39,100 130,500 169,600 Totals - -> 24.24 42,500 130,500 173,000 Tax Installment Dates 7 Tax Detail Tax Balance Category Amounts Paid Due Period Pay To: Date Due Amount Real Estate Tax Due 2,638.82 1 County 1/31/2009 1,319.41 2 County 7/31/2009 1,319.41 Net Property Tax 2,638.82 1,319.41 1,319.41 Total Taxes - -> 2,638.82 Special Assessments 0.00 0.00 0.00 Tax Payment Histo Special Charges 0.00 0.00 0.00 Date Paid Receipt Number Amount Delinquent Charges 0.00 0.00 0.00 2/2/2009 30737 1,319.41 Private Forest Crop 0.00 0.00 0.00 Paid By: ENGELHART Woodland Tax Law 0.00 0.00 0.00 Total Payments - -> 1,319.41 Managed Forest Lands 0.00 0.00 0.00 Specials 7 Penalties 0.00 0.00 Category Amount Interest 0.00 0.00 NONE Totals - -> 0.00 1,319.41 0.00 Notes http: / /www.landinfo.co. saint - croix. wi. us /website/LRPortal /total_process.asp ?IDValue =030 - 2011 -... 5/28/2009