HomeMy WebLinkAbout030-2103-95-000 Wisconsin Department Department a Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Bolding Division
INSPECTION REPORT Sanitary Permit No: 453351 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:
Durnin , Jim I St. Joseph Township 030 - 2103 -95 -000
CST BM Elev: Insp. BM Elev: BM Description: Sectionfrown /Range /Map No:
P c• 00 g• - - a t 36.30.19.841 B
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
•V �GC� • r.0
Dosing Alt. BM
Aeration Bldg. Sewers
Holding 7 St/Ht Inlet c5;
TANK SETBACK INFORMATION St/Ht Outlet � 98 35
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic � 5G �) � �� _ Dt Bottom
t
Dosing Header /Man. Z 5
Aeration Dist. Pipe
9�.c3
Holding Bot. System w . C7 ''
4 .X -h_ Y.
Final Grade h
PUMP /SIPHON INFORMATION 4F
Manufacturer Demand St Cover
GPM t. ('��ie
Model Number �-5 (1
TD Aft rnet1 on Loss System Head T Ft
Forcemain Length Dia. Dist. to Well
N
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 2
J l r „
SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: k
INFORMATION CHAMBER OR 13 z C c
Type Of System: � T UNIT Model Number:
DISTRIBUTION SYSTEM `
Header /Manifold IDistribution I x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s) 1 1-ength t G Dia L 4 LL Length Dia Spacing
SOIL COVER x Pressure Systems On ly xx Mound Or At - Grade Systems Only
Depth Over t Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center L4 �� Bed/Trench Edges Topsoil �- 9 Yes E No [] Yes C No
�_+ 1
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 / 1_3 / �`� Inspection #2: / /
Location: 1301 89th Street New Richmond, WI 54017 (NE 1/4 NE 1/4 36 T30N R19W) Dunning & Le is Lot 9 Parcel No: * � s 3 ` 1 '
6
ec. t (
1.) Alt BM Description = 40 V S/ . C-cv ✓� c..n �b�� cb��t n � �� o f c�
2.) Bldg sewer length = ? �lf.r d b, - "3c' ° Fc �, ►� (c, �.- �f v , Slic t ti ri 3�d c ps,�t xf
amount of cover = ��f i r� rz u-✓ Cs —�
Plan revision Required? i Yes ?, No
Use other side for additional informs on.
SBD -6710 (R.3/97) Date Insepctors Signature Cert. No.
Its W3 -3
Safety and Buildings Division County
Aw 201 W. Washington Ave., P.O. Box 7162 5� C
wi
scon51 Madison, WI 53707 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce (608) 266-3151 (n aml 3
Sanitary Permit Application- State Plan I N her
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide / K
may be used for secondary purposes Pt Project Add ess (if different ailing address)
I. Application Information — Please Print All Inforry ation
136 1 T1 7n m s7
Property Owner's Name Parcel # 6 30 — - 1 I 6*, ( lock #
.� 1M tR]Ji 6_b -ZI03- 45,61040 L0 1 9 /
Property Owner's Mailing Address �( i N I N G OFFICE_ S PrtY Location g /
1 Z91 8? TH ST ecnor
City, State Zip C,,++ode Phone Number / 1 1 S
/1ti =ov eto-AM 008 tiVI �`16 I� - 71S - Z-46 - 5 Z11 (circle
I'I. Type of Building (check all that apply) T �® N; R �q E oV
C6 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number
❑ iIAT &F jr_ kM 6 4- Public/Commercial - .Describe Use 31x&,7 �s�.�� -}� �� �
❑State Owned - Describe Use DISrc I / ❑City_❑Vivageii�,Townshipof S 10S EP
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. XNew System ❑ Replacement System g p y g y
❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System
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 System: Check all that appl
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 Cl Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter Xeaching Chamber ❑ Drip Line ❑ Gravel -less
V.Dis ersalrfreatmentArea rmation: 91; W' /O z 7 u_w'?S
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s a evation
VI. Tank Info_ Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plu her Si re MP/ RS umber Business Phone Number
Plumber's Address (Street, City, State, Zip Code)
OX SOX `z_R S EXESSICK W 610 D `1
VIII oun /De artment Use Onl
Ift /Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued suing Age Signa re ps)
Surcharge Fee)
❑ Owner Given Reason for Denial �� V Z �'1 Q rll/zl
IX. Conditions of Approval/Reasons for Disapproval
SyGTFnn nWN€R� U
C9 Septic tank, effluent filter and !
dispersal cell must all be servi e / maint fined ( /�Je //�6 3( '
as per management plan pr oyltlAd
2. " setback requirements must be maintained � ��yyu��
as per applicable code /ordinances.
Attach complete plans (to the County only) for the system on paper not less th 812 x 11 inches in si
+ sv 6 d s ecv%,�
S -6398 (R. 01/03)
N
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Q SOIL BbrRI UL.S
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3 BEAR MI
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Q \ /000 dAL WE-MS T A0
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99
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12 9) A Cl T N sT 16PS FA TWS P
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SA01 ti
® 0900A1AM - t) - MF b>= '/Z S — ► ��c, Pi pf-- a~='
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S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER /BUYER
ADDRESS FIRE NUMBER
CITY /STATE Nc' -�;: ,'L % f`�IG;C Lv'� ZIP 7
PROPERTY LOCATION : 4:'-, � 1/4, SECTION
TOWN OF -ST St. Croix County, a
SUBDIVISION 12 0. 4 �i Lf'�t), �i ��T ;�� LOT NUMBER _I_
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 septic tank pumper. What
you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 60% of the cost of replacement of a failing
system, which was in operation prior to July 1, 1978. St. Croix
County accepted this program in August of 1980, with the
requirement that owners of all new systems agree to keep their
system properly maintained.
The property owner agrees to submit to St. Croix Zoning a
certification 'form, signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or a licensed pumper
verifying that (1). the on -site wastewater disposal system is in
proper operating condition and (2) after inspection and pumping (if
necessary), the septic tank is less than 1/3 full of sludge and
SCUM.
I /14e, the undersigned have read the above requirements and
agree to maintain the private sewage disposal system in accordance
with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be
completed and returned to the St. Croix Co. Zoning Officer within
30 days of the three year expiration date.
SIGNED:
DATE:
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
02/26/2003 10; 42 7162473038 BELI SLE EXCAVATING I PAGE 01
ST C ROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATIO;V FORM
Owner/Buyer -7//A At , - (J o eo/ o
Mailing Address ) Z9 1 97 TH IT IUFW ptdtthin UD 1N S � bl`7
Properly Address I 3o 1 O
(Verification required from Planning QtParnnent for new construction)
City/Stair: Parcel Identifications Number WO - Z ti d3- '? -M0
LEGAL DESCRiP`I•IO1V 0 30 - 0 2 60 3-10 -Wd
sE sc 2S /� 3Q ) q ' Y� wn l � f $
Property Location s �/, ")� �j,, S r N -IZ W. To o V J6es ,4 ,
Subdivision IMLI Q1, 4 L.CwiS AOOIT00 ,Lot # �
Ctrtilied Survey map # Volume , Page #
Warranty Deed ## 7 , i R el 6 �� �.
�. ,Page # -1
Spec hou n se [:J yes no Lot lutes identifiable yes 0 no
STEM 111 wm—
Improper use and maintenanceof your septic sy31em could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if nceded by a licensed purrtper. What you put into the system
can affect the function of the attic 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 ttte owner and by a
masrer, plumber, journeyman plumber, restricted plumber Ora licensed pumper vcrifYing that (1) the on•site wastewaterdispotai systeas
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than l!3 6x11 of sludge.
Uwe, the undersigned have read the above requirements and agree so rnaiatain e vale sewage a dis o
act forth, herein, as set by the Department of Commerce and De B disp osal systen with tba standards
statirxg that your septic system has been rrrainta' �° partment of Natural Resources, State of Wisconsin. Certification
med must
oe comp 1
days of the,. three year expiration date, eted and returned to the St. Croix County Zoning Office within 30
SIG T[JRE OF APPLI(q>�
/ B o
DATE
S?VVNER RTIFICATICN
• 1 (we) certify that all statements on this form are true to the best of my (our) knowledge, 1 (we) am (are) the awner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds office,
Si ATURE OF APPLICA r /
DATE
ti4 * * Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
•r.sa•
*� Include with this application: a sta
mpt:d warranty deed from the Re ' `t
ra or of A copy Of the certified survey map if ref- -rcnce is Made i in the warranty deed
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of 7i
FILE. INFORMATION SYSTEM. - SPECIFICATIONS
Ouvner �®
'T1 Iln, Septic Teak Capacity ga l ❑ NA
Permit #
Septic Tank Manufacturer Wl ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Ntitnber of Bedrooms .3 ❑ NA Effluent Filter Model (� 13 NA
)dumber of Public Facility Units J& NA Pump Tank Capacity
gal R
Esiiiarsated flow (average) g nO gal /day Pump Tank Manufacturer NA
Design flow (peak), (Estimated x 1.5) q :50 gal /day Pump Manufacturer KNA
Soil Application Rate gal /day /ft' Pump Model Ild NA
Standard_Influent/Effluent Quality Monthly. average* Pretreatment Unit VNq
Fats, Oil & Grease . (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter VV
NA
Oxygen Demand (SODS) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (.TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality. Monthly average Dispersal Cells) ❑ yq
Biochemical Oxygen Demand (BOD 530 mg /L Kin- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L WNA ❑ At- Grade. ❑ Mound
Fecal. Coliform (geometric mean) 510` cfu /100m1 ❑Drip -Line ❑: Other:
...
Maximum Effluent Particle Size Y in dia. ❑ NA Other. ❑ NA
Other: Other:
❑ NA ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA
MAINTENANCE SCHEDULE
.Service Event Service Frequency
Inspect condition of tank(s) At least once eve 11 month(s)
ry' 3 Q year(s) (Maximum 3 years) O. NA
Pump out contents of tank(s) When combined sludge -and scum equals one -third (y) of tank volume ❑ NA
Inspect dispersal cell(s) At least once eve ❑ month(s)
ry ' 3 3 year(s) (Maximum 3 years) ❑ NA
Clean effluent filter —At least once every: / ❑ month(s) > (Z yyypy�yjs ❑ NA
rl year(s)
inspect um ❑ month(s)
p pump, pump controls &alarm At least once every: ❑ year(s) Vkl" NA
Flush laterals and pressure test At least once every: ❑ mo ye ar(s) ❑ year(s) s) NA
Other: At least once every: ❑ month(s) V NA
❑ year(s)
Other: "A
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 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 filters, 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.
GMVV (4/01)
Page �of
or�n AND OPERATION
ew construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals
that may impede the treatment process 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 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 fife 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; 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
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 drovers 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 failed POWTS.
The site ha not been. evaluat identify a suits cement area. Upon failure of the POWTS a soil and site
alu io mu be perform io to e a suita replacernen rea. If no re nt area is avail of fn ak—
77/ may. nstailed a la wort to rept 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> >
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 DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name 1=6 x Name
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name n^ /� �,�/
Name ' N.3 ,{ olv�
Phone Phone
This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.540). (2)'& (3). Wisconsin Administrative Code.
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF SAINT JOSEPH
COMPUTER NUMBER 030 - 2103 -95 -000 Parcel Number 36.30.19.841 B
OWNER NAME: First JAMES J & SANDRA J Last DURNING
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
1291 89TH ST
SECTION 36 TOWN 30N RANGE 19W '/4160 NE 1 /440 NE
Line Description Line Description
TOTAL ACREAGE 0.000 PLAT DURNING & LEWIS ADDITION LOTPT9 BLK
01 SECS 36 T30N R19W NE NE 15
02 _PT LOT 9 DURNING & LEWIS 16
03 AQDN (THIS PART IN HUDSON 17
04 SCHOOL DISTRICT) 18
05 19
06 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF SAINT JOSEPH
COMPUTER NUMBER 030 - 2103 -90 -000 Parcel Number 25.30.19.841A
OWNER NAME: First JAMES J & SANDRA J Last DURNING
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
1292 89TH ST
SECTION 25 TOWN 30N RANGE 19W %160 SE 1 /440 SE
Line Description Line Description
TOTAL ACREAGE 0.000 PLAT DURNING & LEWIS ADDITION LOTPT9 BLK
01 SECS 25 T30N RI 9W SE SE 15
02 PT LOT 9 DURNING & LEWIS 16
03 ADDN (THIS PART IN NEW 17
04 RICHMOND SCHOOL DISTRICT) 18
05 19
06 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, 178- History, F10 -Exit
U. 2 5 6 6 P 6 1 76 1 4B 94
STATE BAR OF WISCONSIN FORM I - 1999 KATHLEEN H. WALSH
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIK CO.. KI
This Deed, made between James J. Durning_ and Sandra J.
RECEIVED FOR RECORD
Durning, husband and wife Grantor, and James J. Durning and Sandra J. 05/07/2004 10: @0AN
Durning as trustees or the successor trustees of the Durning Revocable WARRANTY DEED
Trust dated December 16, 2003, as amended or restated Grantee. EXEMPT # 16
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00
TRANS FEE:
TAdition. y") (if more space is needed, phase attach addendum): COPY FEE:
Lots 0 Durning & Lewis Additio and 1.9t 11 Durning &Le wis CC FEE:
First
PAGES: 1
Recording Area
Name and Return Address
Ann E. Brose r
Estreen & Ogland
304 Locust Street
Hudson, WI 54016
Together with all appurtenant rights, title and interests. 030210395000, 030210390 -000 & 030211910000
Parcel Identification Number (PIN)
This is homestead property
(is)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions and reservations, of record, if any.
�/ � , tom
Dated thi day of , 2004
4A 0
— -- — - - --
* e s J. Du rning * Sandra J. Durning
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) — — _ _ — — _ _ _ _ —_ _ STATE OF )
ss.
County )
authenticated this day of O
Persopal a before me this day of
fix 2004 the above named
James J. Durning a Sa ndra J. Durning husband and wife
*
TITLE: MEMBER STATE BAR OF WISCONSIN _ (If not, o to bet pets n(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) ckn wled ed the same.
THIS INSTRUMENT WAS DRAFTED BY
Ann E. Brose, Estreen & O glan d
304 Locust Street, Hudson, WI 5_4016 Notary Public, State of
My Commission is permanent. (If not, st a expiration date:
(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. Information Professionals Co., Fond du Lac, w1
STATE BAR OF WISCONSIN 800- 655 -2021
WARRANTY DEED FORM No. 1 -1999
I
s .
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 81/2 x 11 inches in size. t county S
include, but not limited to: vertical and horizontal reference point (BM), di coon p ID
percent slope, scale or dimensions, north arrow, and location and distan road.
Please print viewed b Date
Personal information you provide may be used r se.Rfi c Law. 15.04 (1) (m)). r Z O
Property Owner roperty Location
5 SE d5
t N JUN 1 � vL Lot N E 1/4 NE 114 S T 30 N R/ E (or
Property Owner's Mailing Address of Block # Subd. Name or CSM#
�i I . Ci�UIX CUJIV i / a o F Du r ; n ♦ Le ";5 i oAj
City State Zip Code Rhi; &M ❑City ❑Village ®Town earest Roa
New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Vrt L. Gt.S Flood Plain elevation if applicable ft.
General comments -= 50
and recommendations: SS 4. 7 )l Fo ✓' C! �t.C_ (^ 5 -` "E` E i.
-r. (94..97'� - r.3
T.*4 4S. Do
F I Boring # Boring p b
Pit Ground surface elev. 7 , ft. Depth to limiting factor � 0 a in.
Soil ' Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.. •Ef#1 I 'Eff#2
I D-10 n '
o -a L Sy�, -- _....._ SG L Am5 1R Cw I r • I r (�
- `i5 ,51 P- /v ._w s 0 -6 A wt L L w I v F j ),4o
Y5 -jPo1-7,s4V5T%1- I La
p zr- Gk V
Boring
Boring # r
Pit Ground surface elev. /O h'11. ft. Depth to limiting factor I DS in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2
1 0- 010J SL - w C2 YY1 L !r o
$ -1617.SYAYIY L Rri86 ynfr C w ►�
7151 Ry ly 0 ML C r !.
% O
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 1 30 mg/L
CST Name (Please Print) Signature CST Number
Address Date Evaluation Condu ed Telephone Number
a"'o T�: r; e- -6 - 7 'S- 3
r ,
3 .�
Property Owner V V 4 N . h !S, Parcel ID # Page of
11 Boring # ❑Boring
pit Ground surface elev.- ft. Depth to limiting factor I bO in. Soi Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. TIM 'Eff#2
Q o-1 P)A SL ar5bVc Mf r a,w OM 1. b
7 - 540 h Sc. L M S K- M F ,- I G w 1►'►'1 ,
3 X43 .S1R1 d -5 L w IJF 1 11400
ID v
Q k 4
P—il Boring # ❑ Boring 1
Pit Ground surface elev. � bb� � � ft. Depth to limiting factor / Q 5 in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Ito .5 `t ' , ---- -- t - L— A rN b K M r
--3 to .5'10 ^--S L C Ivy 1,
34 — -
0
F-1 Boring # E] Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EffQ
I
Effluent #1 = SOD, > 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
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 2648777.
sBD -8330 (IL07/00)
SE1�j e-
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Wissconsii% Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Lator and Human Relations
nivision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 030- 2013 -10
APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
James Durn GOVT. LOT NE 1/4 NE 1/4 T 29 N,R 19 :k (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
7217 Courtly Rd. na Durnin
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY [ DgTOWN NEAREST ROAD
Woodbury, MN 5 125 (612) 739 -5208 St. Joseph Ct . Rd. "A"
[�] New Construction Use [ x] Residential /Number of bedrooms 3 [ J Addition to existing building
[ ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gp d Recommended design loading rate • 7 bed, gpd /ft - 8 trench, gpd /ft
Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd/ft
Recommended infiltration surface elevation(s) 96.87 ft (as referred to site plan benchmark)
Additional design / site considerations alt site sy� el.= 96.301 & 95,69
Parent material outwash Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem E3 S [I U [2 S ❑ U [RS ❑ U fr7 S El EIS ❑ U ❑ S F] U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
..................
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
.................
..................
.................
..................
;.,,,.,1,.. "_ _ 1 2msbk mfr lm .5 .6
2 11 -33 10yr4 /4 none sil lcsbk mfr gw if .2 .3
Ground 3 33 -88 7.5yr4/6 none cos osg ml na na .7 .8
elev.
1 01.2 ft.
Depth to
limiting
factor
Remarks:
Boring #
1 0 -8 10 r3 3 none 1 lmsbk mfr gw lm .2 .3
2 2 8 -22 10 r4 4 none sil 2msbk mfr 9W if .5 .6
Emma
Ground 3 22 -84 7.5y r4 4 none cos osq ml na na .7 .8
elev. _
10 ft. -' s
Depth to
limiting
factor M
+84"
MA
Remarks: �, sr C X
CST Name: -- Please Print Gary L. Steel Phone: 715 -246-6200 z �ft
Address: 1554 200t New 5ichQAn W 4017
Signature: Date: 5 -13 -97
PROPERTYOWNER ,Tamar TMrnin' SOIL DESCRIPTION REPORT Page-2
PARCEL I.D. # 030- 2013 -10
Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft
Boring # Horizon in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0-
Ground _ 7.5vr4 none MR nqrf MI na nal .7, .8
elev.
10 ft.
Depth to
limiting
factor
Remarks:
Boring #
.6
2 11 -31 10 r4 4 none sil lcsbk mfr qw if .2 .3
Ground 31-82 7.5vr4/6 none Cos osa M1 na na .7 .8
elev.
98 ft.
Depth to
limiting
factor
+82"
Remarks:
Boring #
1 0 -10 10 r3 3 none 1 2msbk mfr gw 2f .5 .6
2 10 -26 10 r4/4 none sil lcsbk mfr
gw if .2 .3
Ground 3 26 -80 7.5 r4 4 none cos 0SQ ml na na .7 .8
elev.
9 9.2 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
w
* r
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 James Durning New Richmond, WI 54017
MPRSW 3254 NE4NE4 S36- T29N -R19w (715) 246 -6200
town of St. Joseph
p
lot #9- Durning & Lewis Addn.
N
1 =40'
BM.= top of2" pvc pipe C el. 100'
Alt. BM.= nail in pine tree C el. 98.70'
f
r�
' b
°
67 0
V
W
0
n n
Gary L. Steel
5 -13 -97
06/09/2004 13;46 7152483568 SUPERICR AUT043TIUE PAGE 04
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