HomeMy WebLinkAbout030-2131-33-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Qivision ?
INSPECTION REPORT Sanitary Permit No:
430543 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:
Dan Lang Homes I St. Joseph Township
CST BM Elev: Insp. BM Elev: BM Description: S ction/Town /Rang ap No: 3
l bo . !3 s� B S c 23.30.20. D
TANK INFORMATION ELEVATION DA A
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic Benchmark
20 0 `! o 16q, o /00 , o
Dosing Alt. BM
Aeration Bldg. Sewer
Holding SVHt Inlet
TANK SETBACK INFORMATION brJwko SVHt Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Iq Dt Bottom
Dosing 5 Header /Man.
�• 3V 91.30
Aeration Dist. Pipe
T of 5 1.30 q 2 / .3 6k-
Holding Bot. System • 30 / w 3 a
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer ^ Demand St Cover .2 ma4,&, k6 - seph'c,
✓i F CX GPM 3 ' bn (,) c 2•l� �UZ •!'ri
Model Number
TDH Lift riction Lo System Head t
Forcemain Length Dia. Dist. to I
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches ZZ f�kl� PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 b /
SETBACK SYSTEM TO { P/L JBLDG WELL LAKE /STREA LEACHING Manufacturer:
INFORMATION Type Of System: t1u UNIT Model Number:
.J . CHAMBER OR •-1- n
` - � _ n / �/ �
DISTRIBUTION SYSTEM U�•cex, 10 5k- e � "7
HeaderlManifold Distri x Size x acing Air Intake
/ I( Pipe(.)
Lengt Dia_ Length is Spacin
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded es No xx Mulched
Bed/Trench Center ! Bed/Trench Edges `, Topsoil
s 7,N
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1_
:f� //E
Location: 1415 Thelen Farm Trail Hudson, WI 54016 (SE 1/4 SW 1/4 23 T30N R20W) Settler's Glen Lot 33 Parcel No: 23.30.20. �. eef�""
1.) Alt BM Description = "' 7J4Y� CG.wkj LOL�iI so � T eS� dd- i � I A,""a 2.) Bldg sewer lengt sySlLUr
amount of cover = $ km "'VA J Veit," er 4 / OIL Sa c aQ—
° �'`� C X ,
Plan revision Required? _ Yes No
Use other side for additionainformation.
I V �! � d��
SBD - 6710 (R.3/97) Date Insepctor's Signature Cart. No.
PA �, i Safety and Buildings Division County 4 ty n
r0 1
P V 201 W. Washington Ave., P.O. Box 7162
M adison on, WI 53707 - -` "'' " "P t Number (to be filled to by Co.)
(608) 266-3 1 RF_GEi o
Department of Commerce State elan L Number
Sanitary Permit Application Nw 1 'ZOU ____ - ----�
In accord with Comm 83.21, Wis. Adm. Code, personal information you vide Pr . eci (if different than mailing address)
sos
may be used for secondary ptapo Pnvacy Law, sl5.04(1 xm) t) o l�t 1'
ix T N
1. Application Information - Please Print All lnformatioo �ONINC' ►4 l L
Propen Owner's Name Parcel k Lot k Block N
Wopert
33 .�-
Property Owner's Mailing Address y Location
�LZ1 ITT tr( arL4 ST'A"T
r., v., Section
City, State Zip Code Phone Number
(circle one)
(PSI t �4� Sd R
(P 8 439 3 T 'jD N; 20 E ol&
11. Type of Building (check all that apply) Subdivision Name CSM Number
Y, or 2 Family Dwelling - Number of Bedrooms S
S �
❑ Pub5c/Commercial - Describe Use �!
❑ State Owned - Describe Use
2� k S ❑City_❑VJlage*wnship of
111. Type of Permit: (Check only one box on line A. Complete line B If applicable)
A. tNew System ❑ Replacement System ❑ 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
1V. 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 C3 Holding Tank ❑ Peat FJter [I Aerobic Treatment Unit C1 Recirculating Sand Filter ❑
Recirculating S thetic Media Filter ❑ ❑ Dri Line ❑ Gravel- P' lain) M
V. Dig ersal/Treatment Area information:
Design Flow (gpd) Design Soil Application Rate(g Dispersal Area Required (sf) Dispersal Area posed (sf) yttem Elevation
_ f�pp g 57 8 9 G• 3
ic
t iv Total Number Manufacturer Prefab Site Steel Fiber Plastic
Vl. Tank Info Capacity
Gallons Gallons of Units Concrete Constructed Glass
New Exining
Terra Tura
Septic 0P4 .�.
Aerobic Tma[mcra Unit
Dusing Chambcr
VII. Responslbili Statement - 1, the unde ned, s usibili for installation of the PON'i'S shown on the attached Tans.
Plu 's Name (Print)
PI MP/MPRS Number' g ,ci ice Phone Number
AAD G 7!'NL �� /3g'!�w
Plumber's Address (Street, City, State, Zip )
"56o a Ei✓o�OWIC 6 VA
* =7 /Department Use Onl
Sanitary Permit Fee (' eludes Groundwater Date lssuod Issuing gent Signature ( Stamps)
❑Disapproved Surcharge Fee) A �- /, (
❑ Owner Given Reason for Denial Qn 7
1X. Conditions of Approval/Reasons for Disapproval 3� S�tJC mil _ C&,A
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained
as per management plan provided by plumber. p
2. All setback requirements must be maintained ��r c nne�- S t , A41LA.iL
CS
as per applicable code /ordinances. `S at..tZC-
Attaeb complete plans (to the County only) for the system an paper o than S112 r. 11V�WCJ.1a alxa
SBD -6398 (R. 01/03)
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Wisconsin Department of Commerce SOIL ION R POR Page I of 3
Division of Safety and Buildings in accordance with :e. mm �srt8lisr �b Certified Soil Testing
t[Gl� Co my
Attach complete site plan on paper not less than 8% x 11 inches in si Plan must 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 di ance to t rdpdo 1003 Pa el I.D.
Please rint all information. Re ie d By A Date
Personal information you provide a M4MW
be used for secondary purposes (Priv y Law,�T5.1 O Y FFICE / /vW t4 - UD 3
Property Owner rope y -cation
Lang, Dan Govt. Lot SE 1/4 SW 1/4 S 23 T 30 N R 20 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
221 East Myrtle Street 33 Settler's Glen
City State Zip Code Phone Number City � Village 0 Town Nearest Road
Stillwater I MN 1 55082 651 439 - 3430 St.Joseph I Thelen Farm Trail
Vi New Construction Use: 16 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial - Describe
Parent material loess over sandy outwash Flood plain elevation, if applicable NA
General comments
and recommendations: install trench system w/ 0.7 gpd /sq ft loading @ system elevation 45 below surface contours as trench
center lines
Boring # __j Boring
Pit Ground Surface elev. 100.8 ft. > 100 in. Soil Application Rate
Depth to limiting factor pp'
Horizon Depth Dominant Color Redox Description Texture Structure 7 dsh sistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 -6 10YR 3/2 - 1 2 f gr mvfr cs 1m .5 .8
2 6 -21 10YR 4/4 - 1 2 f sbk gs 1m .5 .8
3 21 -40 7.5YR 4/4 - sill 2 m sbk dh cs 1m .5 .8
4 40 -100 7.5YR 3/4 - s 0 sg dl - - .7 1.2
ai R4 . g
"/ CI O
occasional gy si coats on peds in horizon 3; occasional gr /cob /st in horizon 4
Boring # l Boring
Pit Ground Surface elev. 100.0 ft. Depth to limiting factor > 100 in. Soil Application Rate
Horizon I Depth Dominant Color I Redox Description Texture Structure 7 dsh sistence Boundary Roots GPD/ft-
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
1 0 -6 10YR 3/2 - 1 2 f gr ds cs 1 m .5 .8
2 6 -23 10YR 4/4 - 1 2 f sbk cs 1m .5 .8
3 23 -40 7.5YR 4/4 - sil 2 m sbk dh cs 1m .5 .8
4 40 -100 7.5YR 3/4 - s 0 sg dl - - .7 1.2
y -5 Y
occasional gr /cob /st in horizon 4
` Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' effluent #2 = BOD < 30 mg /L and TSS < 30 mgL
CST Name (Please Print) Signat r : � CST Number
Henry F. Grote 222774
Address Certified Soil Testing Date Evaluation Conducted Telephone Number
E. 4366 353rd Ave., Menomonie, WI 54751 11/7/2003 715- 233 -0398
Property Owner Lang, Dan Parcel ID # Page 2 of 3
F3 ]Boring # jj Boring
Pit Ground Surface elev. 100.0 ft. Depth to limiting factor > 100 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPDjft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2
1 0 -6 10YR 3/2 - 1 2 f gr ds cs 1 m .5 .8
2 6 -14 10YR 4/4 - 1 2 f sbk mvfr cs 1M .5 .8
3 14 -26 10YR 4/4 - 1 2 m sbk dsh cs 1M .5 .8
4 26 -39 7.5YR 4/4 - sil 2 m sbk dh cs 1m .5 .8
5 39 -100 7.5YR 3/4 - s 0 sg dl - 7 1.2
yY y s C. <
occasional gr & cob in horizon 5 p
Boring # Boring
— 'j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
Boring # I Boring
W } Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD 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 - 264 -8777.
SBD -8330 (R.07 /00)
Certified Soil Testing
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POWTS OWNER'S MANUAL at MANAULMtr4l rtAN "fic
/FILE INFORMATION SYSTEM SPECIFICATIONS
Owner j� f Septic Tank Capacity 0 a g al ❑ NA
Permit # 4 5-�3 Septic Tank Manufacturer wj!' ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA, Effluent Filter Model .•1QQ ❑ NA
al e'NA
Number of Commercial Units NA Pump Tank Capacity g ,
Estimated flow (average) gal /day Pump Tank Manufacturer �^A
Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer Ja'NA
Soil Application Rate gal /day /ft' Pump Model
Influent/Effluent Quality Monthly average* Pretreatment Unit �A
❑ Sand /Gravel Filter ❑ Peat Filter
Fats, Oil 8z Grease (FOG) 530 mg/L ❑ Mechanical Aeration ❑ Wetland
Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Disinfection ❑ Other:
Total Suspended Solids ( TSS) 5150 mg /L Manufacturer
Pretreated Effluent Quality ' ❑ NA Monthly average ** Dispersal Cell(s)
Biochemical Oxygen Demand (BODs) :530 mg/L In- ground (gravity) ❑ In- ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ At -grade ❑ Mound
Fecal Coliform (geometric mean) :510 cfu /100m1 1 ❑ Drip -line ❑ Other:
Maximum Effluent Ta_r�ticie Size A inch diameter * Values typical for domestic (non - commercial) wastewater and septic
tank effluent.
* * Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event. Service Frequency
At least once every Z. ❑ months year(s) (Maximum 3 yrs.)
Inspect condition of tank(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume
Inspect dispersal cell(s) At least once every 2 ❑ months $ year(s) (Maximum 3 yrs. )
Clean effluent filter At least once every ❑ months ,6 year(s) �„t
Inspect pump, pump controls ez.alarm At least once every ❑ months ❑ year(s) gNA
Flush laterals and pressure test At least once every ❑ months ❑ year(s) 2 NA
Other: At least once every ❑ months ❑ year(s) 7NA
Other: At least once every ❑ months ❑ year(s) Z NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made b aeCn POWTS Maintainer, Septage Septage Servicing n Oprator. Tank inspect or
Plumber; Master Plumber Restricted Sewer; POWTS p
must include a visual inspection of the tank(s) to identify n missing � ponding of effluent on the ground surface. e The t1
e dispersal
volume of combined sludge and scum and to check any
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 (Ys) 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 ch. NR 113, Wiscon!
Administrative Code.
The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other
maintenance or monitoring at intervals of 12 months or less shall be performed by a ce0fled POWTS Maintainer.
I regulatory authority within 10 days of completion of any service event.
A service report shall be provided to the loca
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or ocher chemu
that,may =impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the concer
„f rka rarsk(s) rpmoupd !.y z - senwe servidng operator prior to use.
System scary up shall not occur when soil conditions are frozen at the infiltrative surface. Page
During power outages pump tanks may fill above normal hlghwater levels. When power Is rtstortd the excess wastewater will tie
discharged to the dispersal cell(s) In one large dose overioading the ceil(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 POWT5 Maintainer to assist In manually operating the pump control3 to
restore ncrmal levels within the pump tank.
Do not drlve or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise dlswrb or compact, the area
within 15 feet down slope of any mound or at-trade soil absorption area.
Reductlon or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swats; degreasers; dental floss; dtapers; disinfectants; fat;
foundation draln (sump pump) water; fruit and vegetable peelings; gasolne; grease; herbicides; meat scraps; medications; oil;
PalntlnK products: Pesticides; sanitary nookins: tampons; and water softener brine.
ASANDONEMENT >
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 ch. Comm 83.33, Wisconsin Administrative Codes
• All piping to tanks and plts shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and plts shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all Links and pits shall be excavated and removed or their covers removed and the void space fllied with
soil, gravel or another Inert solid materlal.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A sultable 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 strucwre, lot (Ines and wells. Failure to protect the replacement area will
result In the need for a new soil and site evaluatlon cc establish a sulwMe replacement area. Replacement systems rnust
comply with the rules In effect at that ume.
0 A suitable replacement area Is not available due W setback and /or soil IlmluWns. barring advances In POWTS technology
a holding tank may be Installed as a last resort to replace the failed POWTS.
0 The site has not been evaluated to Identify a sultabte repfacemer t area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may
be Installed as a last resort to replace the failed POWTS.
O Mound and at-grade soil absorption systems may be reconstruRed in place following removal of the biomat at the
Inflltradve surface. Rrconswalons 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 TH`9 INTERIOR OF A TANK MAY BE DIFFICULT OR
IMpMM1141 F
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name L A/Z A- Af Na me — N E- �tlL
Phone — Phone S
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Agency GI v
/M
Phone hen �_
Oct 09 03 08:48a P.1
10/09/2003 09 :32 FAX 7152352592 T L SIN2 P1.044I& JAP 49 002
ST CROIX COUNTY
SEPTIC TANK MAINTENANCL' AO"EM31
AND
OWNLRSRIP C1?RTMCATION FORM
oaotnr/$uyer
_ +-1-e� S
Mailing Address r
proporty Address
T�R, P, `mot
&A , 4 rvl (Vcnf,cst i io d required ftom Planning DePaMcw for new coostruttion)
City /state t Parcel Identification Nturtber
L F . 1I aSC — B- 'r'70N
a 5 T 30 N �b W. Town of 2( I
Propctty Location 't•. �` /•. sec. _._.,,
Subdivision
Lot # 3 .
Volume Page t!
Certified survey Map � _ G
warranty Deed # _ ` (� �OM Volume t Page # �
Spec beusc 0 yes 0 no Lot lines identifiable O yes El no
cv * M dTt11'I'FrfANCE WV ��y to t� . �Pcr mainteaanu
�' S• o use and =6 of your M;pfkC slrst= eoWd Malt is to PMM
t Pu c thti a or sooner, if aesdad by a tioensed pumper. V T yen put iota the
ao system
e�sists of ptttnpia$ oat 6 septio tsalt +*ery gene
can aHcet t1k function of tits septic tank as a matment stage in the waste disposal system
�t a ee rdfmtioa form. signed by the owner nod by a
The Pt p�m' ow= srtecs to attbttui to St Croix 2' r Deport- v«ityiog (f� the oo - cite w w :watetdisposal nvs =
Qus o er plumDor. i° utuaY��PlaodYar. tesYtietadpla�mbeta �is lemd'An 1A fall ofdudge-
is in psop,r operat m eoodirioa andlor (2) after inspection and pumping (if treo�ssaty), ow acp
rfwa the uadeecigned bave read the above tcquiremeaa and agrx tc sasidain die pavate jewsp disposal system with the madards
sat Earth, beteies asset by the Deparmont or caum tt:e and the bepgMcut O f 14,100a Rewuncs State of WimanshL Cerdflation
stag tbat your m e NY bas been mait ujucd toast ba completed aadzetumod t° the St Qroix County offi within 30
da of rte dutc y expiration date. V 1 el 61
pwTE
SL 'k OF Apps tcAN'r
QVV �A CL�'RTr1*ICJt►�QM Laomlcdgc. I (we) am {are) me oaner(s) of
I (we) Certify tbat aLL statenscnts ou this fame arc true to the best of my cur
ZSj A 'M___ ._.00'F pety dn above, by virtue of a worranry decd recorded W Register or Deeds Orrice.
DATE
APPLICA
DG �tcnL ••••■•
Ayy informstiou that u s:tis•repraseotnd MAY result in the sanitary permit being revoked by the Zoning P'
•• Include w11b this agplicatioa a copy of the ocr$ W God survey W3P if o et"oe Ls Mae in the wasfaury deed
I
r -
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all in : r Reviewed n Reviewed by Date
Personal information you provide may be used for an purposes (N-0a " s. 154 (1) (m)).
Property Owner PropIrty Location
t " `i ti 8 2 0 0 Govt Lot 1 /4 W 1 /4 S T O N R U E (or)gG
r r�� 0brvice S i Z 3 3 z
Property Owner's Mailing Address ail ty Block # Subd. Name or CSM#
( - p - 1 2 - 0 5 11 \ vJO,�e City State Zip Code Phone Number ❑ Village STown earest Road
MN 1 55 C5 Z 104 5 - � h w 3s -
New Construction Use: Residential / Number of bedrooms _ Code derived design flow rate �1 �G ,Z 0 O GPD
0 Replacement ❑ Public or commercial - Describe:
� L" _ Flood Plain elevation if applicable �f / / ft
Parent material 0 U 1
General comments S y v, 9 Y 0
and recommendations:
' E] Boring
Oct
Boring # / ft. Depth to limiti factor In.
® pit Ground surface elev. g 1 30 Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color I Gr. Sz. Sh. 'Eff#1 'Eff#2
0-1Z 311 r I 2 Is m L S I v� -5 -9
Z 1 -49 jb1 ' r qjcj S c I I Zrn k i c - 'q , (D
CoS OS ml
Boring # ❑ Boring
® pit Ground surface elev. 99 ft Depth to limiting factor 3q in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2
3H 5' 2.n-bk nor S I vV 5 g
mr C5 { (�
3
1 5Z -V% C " O ' Os m
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name ( Please Print ) Signa a CST Number
ACla)r c h rn er 25336
Address Date Evaluation Conducted Telephone Number
2-113 �o�� Sa . Socre e } , UJ l 5'4 02 S ( ) 24 7 - `4 0102
1
Property Owner �Lr ( GCS e. 1 Parcel ID 0 '
Boring
Page o f ,3
a Boring #. 11 : . .
&Pit Ground surface.elev. 0 ft. Depth to limiting factor _ I� In.
Heron Depth Dominant Color Redox Description Texture Soil Application Ra
Structure Consistence Boundary Roots GPD/fl=
In. Munsell Qu. SY. ConL Cobr - -
Gr. Sz. Sh. 'Eft #1 •Eff112
2r, cS I v 5 g
-Lis I y
r � I cl ZmSbk m -�- cs • � . �
3 `+$-13 / 2
7
F-1 Boring # ❑ Boring
❑ Pit . Ground surface elev. ft. Depth to fimiting factor In.
Horizon Depth Dominant Color Redox Descripio Soil Application Rai
n..... Texture Structure Consistence Boundary Roots GPD /f1
In. Munsell Qu. Sz Cont. Color Gr. Sz. Sh. •Eff #1 'Eff#2
Boring # ❑ Boring
El pit Ground surface elev. ft. Depth to limiting factor In.
Soil Application Rats
Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD /h=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 •Eff #2
• S
' Effluent #1 = BODS > 30 < 220 rrxt/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/l and TSS < 30 mg /I.
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 -266 -3.151 or TTY 608 - 264_8777.
SB69770 (R07/00)
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NAME C rr � 'ac � TOT# .35 LFC,AL DESCRIPTIONS � ,S Z 5 T 3U N R. ZU E(or
SCALE: T"= 7
BM I ELEVATION /D Q 0
BM I DESCRIPTION &n 0-f Du
BM 2 ELEVATION
BM 2 DESCRIPTION 1 D_ P ✓c e� Dom_ _
SYSTEM ELEVATION vy �U
SYSTEM TYPE 4-
CON'T'OUR ELEVATION q `, 5y 4 9$ od
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SIGNATURE DATE
ORIGINAL'
1929
Wisconsin Department of Commerce SOIL A EP RT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing
ounty
Attach complete site plan on paper not less than 8% x 11 inches i size. F1� E � � E Q St. Croix
include, but not limited to: vertical and horizontal reference point ( M), dir t
percent slope, scale or dimensions, north arrow, and location and istance to nearest road. arcel I.D.
Please print all information. NOV 1 O Z003 eviewed By Date
Personal information you provide may be used for secondary purposes ( ivacy Law, s. 15.04 (1) (m)).
Property Owner Z on
Lang, Dan 1/4 SW 1/4 S 23 T 30 N R 20 W
Property Owner's Mailing Address Lot # Block # ubd. Name or CSM#
221 East Myrtle Street 33 Settler's Glen
City State Zip Code Phone Number City Village kjf Town Nearest Road
Stillwater MN 1 55082 1 651 439 - 3430 St.Joseph I Thelen Farm Trail
New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial - Describe
Parent material loess over till Flood plain elevation, if applicable NA
General comments
and recommendations: install 5' x 124' rock cell mound on 100.0 contour as upslope edge of rock w/ 1.0' sand fill
FTI Boring # Boring
Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 30 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 -4 7.5YR 3/1 - 1 2 m gr ds cs 1 m .5 .8
2 4 -14 7.5YR 3/3 - 1 2 f sbk ds gs 1M .5 .8
3 14 -30 7.5YR 4/4 - fsl 2 m sbk ds cs 1m .5 .9
4 30 -34 7,5YR 4/4 f2d 7.5YR 4/6 fsl 2 m sbk ds as 1m .5 .9
5 34 -44 5YR 4/4 f2f 7.5YR 5/3 sl 0 m mfr cs 1m .3 .5
6 44 -54 7.5YR 4/4 c SYR 3
7. 5YR 5//3 scl 0 m mvfr - 0 0
7.
a Boring # �j Boring
kJ Pit Ground Surface elev. 99.5 ft. Depth to limiting factor 35 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 - 7.5YR 3/1 - 1 2 m gr ds cs 1m .5 .8
2 7 -14 7.5YR 3/3 - 1 2 f sbk ds gs 1 m .5 .8
3 14 -26 7.5YR 4/4 - fsl 2 m sbk ds gs 1M .5 .9
4 26 -35 7.5YR 4/4 - fsl 2 f -m sbk ds cs 1M .5 .9
35 -42 7.5YR 4/4 f 7 / ds
5 f2 7.5YR 5 3 fsl 2 m sbk as 1m 5 .9
6 42 -50 7.5YR 3/4 f2d 7.5YR 5/8,5/3
7.5YR 5/3 sl 0 m mfr - - .3 .5
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' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BO D < 30 mg /L and TSS < 30 mgr
- I CST Name (Please Print) Signatur : CST Nurpou.
Henry F. Grote ` 5EEt 4 Z 222774 "
-4- :
Address Certified Soil Testing Date Evaluation Conducted Telephone Number
E. 4366 353rd Ave., Menomonie, WI 54751 10/27/2003 715- 233 -0398
Property Owner Lang, Dan Parcel ID # Page 2 of 3 Y
F3]Boring # Boring
In Pit Ground Surface elev. 98.4 ft. Depth to limiting factor 24 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -4 7.5YR 3/2 - 1 2 m gr ds gs if .5 .8
2 4 -10 7.5YR 3/2 - 1 2 f sbk ds cs 1M .5 .8
3 10 -24 7.5YR 4/4 - fsl 1 m sbk ds cs 1 m .4 .6
4 24 -30 7.5YR 4/4 f2d 7.5YR 5/3 fsl 1 m sbk ds as 1 m .4 .6
5 30 -36 7.5YR 4/4 c2d l OYR 6/2 sl 0 m mfr - 3 5
7.5YR 5/8
a Boring # . j Boring
j�- Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 24 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -5 7.5YR 3/2 _ 1 2 m gr ds gs 1f /m .5 .8
2 5 -12 7.5YR 3/2 _ 1 2 f sbk ds cw 1M .5 .8
3 12 -24 7.5YR 4/4 - fsl 1 m sbk ds cs 1 m .4 .6
4 24 -28 7.5YR 4/4 f2d 7.5YR 5/8 fsl 1 m sbk ds as 1 m .4 .6
5 28 -34 7.5YR 4/4 f2d l sl 0 m mfr - - .3 .5
5 /8 8 5
7.5YR
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F 1 Boring # _j 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 =
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
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' Effluent #1 = BOO 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg /L and TSS < 30 mg /L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 -8777.
SBD -8330 (R.07 /00) Certified Soil Testing
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U 2 4 2 9 P 14 8 KATHLEEN H. WAISH
f STATE BAR OF WISCONSIN FORM l - 1998 REGI5TER OF DEEDS
ST. CROIX CO.. YI
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t�umen Number t WAILRAt�TTXDEED RECEIVED FOR RECORD
030 - 2043 -10 -000 030 - 2032 -10-M 030 -2032- 20/06/2003 12r05PH
70 -000 030 - 2033 - 40-000 030 - 2033 -20 -000 WARRANTY DEED
030 - 2032 - 5000 -000 EIEW, f
Pared tdmtiEcation Number (FtN1
REC FEE: 13.00
Tim DEED, made between St. I evelopment Corporation, s COPYSFEE: 268.90
Minnesota corporation, Gramtar, and an Lang Home,, Ltd. a Mm=0'a CC FEE
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Corporation Grantee- PA
Grantor, for a valuable consideration, conveys to Grantee the following
described real estate in St. Croat County. State of Wisconsin (the
"Property"):
SEE ATTACHED EXHIBIT A Recerdiaa Ann
N,arnc and Rcrum Address
This is not homestead property. Land Tide Inc n
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Together with ail appurtenant rights, title and interests- Icw Silver Lake Read Suitc 200 `✓},'
\cw Iirighltxt 4fn 551 12
Grantor warrants that the tide to the Property is goad, indefeasible in #
fee simple and free and clear of encumbrances except
Dated this 3rd day of 0cwber 2003.
St. 302c Devclopmment Corporation
lfd!fi %r (SEAL) (SEAL)
* Kellei St. Martin, Vice President `
(SEAL) (SEAL)
AUTUENTICAITON ACK-NO AILEDGAfENT
Signature(s) STATE OF Mum esoa
WASHINGTON COUNTY.
authenticated this 3rd day of October, 2003 Personally came before me this 3rd day of October. 20D3,
the above named Kellei St. Martin, Vice President of SL
- - Joseph Development Corporation, a Minnesota corporation to
y me ]mown to be the p who executed the foregoing
instrument and acknowledge the same.
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Scats.)
TIJIS INSTRUMENT WAS DRAT -'I ED BY
Greg Booth Attorney 1900 Silver Lake Road Suite 200
New Brighton Mn 55112
Notary Public, Slat of Minnesota
(Signatures may be authenticated or acknowledged. Both are My commission is permanent. (If not, stars expiration date:
not "ccessary.) 134% _
•Naum of pawn signing in any capacity must be typed or pixttal below their
signtwte.
NANCY J LENTZ
u air � NOTARY PU6U0- A1NN_cSOTA .
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