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018-2009-62-000
Wsco Safety Department of Commerce Safety - an County tl Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 633993 State Plan ID No Personal information you provide may be used for secondary purposes [Pnvecy Laws 16 Oa 11 VmQ Permit Holder's Name City Village Township Parcel Tax No Daniel Grebowski TOWN OF HAMMOND 018-2009-62-000 CST BM Elev finish BM Elev IBM Deso„nnnn TANK INFORMATION TYPE MANUFAC UR CAPACITY Septic t f�11 Dosing IV A H TIdng TANK SETBACK INFORMATION I ,v d r, ti 11.. , TANK TO P/L N WELL BL G Vent to air In ke ROAD Septic 7 t Dosing Aeration Holding rullorfalrl'IVIN IN Head SOIL A[i50KH I ION SYSTEM 04.29.17.1046 ELEVATION DATA �'Y7= {I`- M. --MM --M ,J Sd'ZA Ilnrel- BEDRRENCH DIMENSIONS Width 3 ) Length GI/V// No Of Trend PIT DIMENSIONS No Of Pits Inside Dia Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL f LAKE/STREAM LEACHING Man to r INFORMATION CHAMBER OR Type Of System I UNIT Mod umber UIa I RIDU 11V1Y a T a I CR/l ' Header Manifoltl ID,str,but on Size x Hole Sp Vent to make {( Pip Length CJ Dia Length Dia Spacing 5UIL COVER ir Pressure Svstams Ori TT Mnno etr_—ne c—.— nnh, Depth Over i Bed/Trench Cent / �' -✓ Depth Over Bed,Trench Edges ry � t, xx th of To so p ; xx Seedetlo xxtied ,Yes ,_ Nc_ Yes No COMMENTS: (Include code discrepencies, persons present, etc ) Location: 1782 111TH AVE 1) Alt BM Description=-YII±{/ro✓t� 2) Bldg sewer length = y01 - amount of cover =! i Inspection #1 Inspection #2 —h%d �14 ll5�� �+o ✓� !l4 Sj'k_�y�aw„ py� 1#oQd��rd/IGeI tbr; �0✓evlFc'so<(si/i, Plan revision Required? Yes 2 No 10 Use other side for additional information SBD-6710 tR 31971 Date Insepctcr s Signature Cart No IFA S 1. 2. S19n)-aua 1- Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7152 Madison, WI 53707-7162 County �/• 2e�vF'""R^'crr Sanitary PermitNumber (lobe filled in by Cc) ACT 33g9 3 15 2021 ermit A.pplicat- Croix � W.e,.cd te Transaction Number St. �;a*�ry In ae da dpr*' de, submissicu of this form to the ap4POAXTS ilect Address (if diffrnen[ than trading address) p� Peace) H is requ ore .4pphcatton Corms Cor state-owned the Department of Safety and Professions Servtes Perscmal informanou you provid ay be used for se ndary purposes in accordance with the Privacy Law, s 15 04(1 JLm), Sots 1. Application Information — please Print AJI Information ' Property Owne c -� re, 0 - a 9- P-0 a Property Owner s Mailing Address 7 Property Location Z S � Go t j Number ty, rate Zip Code Phone l y, Section co T`�N, R E rW U. ype of Building (check all that apply) Lot q Subdry ion Faintly Dwclhng—Number of Bcoroortt Block 6 ❑ PubltdCommercial — Describe Use ❑ City of CSM ❑ State Owned - Describe Use _ ❑ V it of Number Bf. Type of Permit: (Check only one box on line A. Complete line B if applicable) A S stem ❑ Replacement System ElTreannent/Holdmg Tank Replacement Only ❑ Other Modificiuion to Existing System (explain) 1 B. ElPeimd Renewal 11 Permit Revtsion ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Dale Issued Before Expiration Dim" 1V. e of POWTS S stem/Coin onent/Device: (Check all that apply) Nan-Pressunzed In-Grountl ❑ Pressur and In-(nound ❑ At -Grade ❑ Momid 124 in of suitable sod ❑ Mound <24 en. of smr°ble sod D'Iloklung Tank ❑ thher Dispersal Component (explain) / ❑ Pretreatment Device explain)_ I,-_ V. Dis ersai/Treatment Area Information: Design Flow (gpd) Design Soil Application R st) Dispersal Aces Required (sf) Dispersal Area Pro sed (sf) Syst,=Elcsliiaoo j 33.2 VI. Tank Info Capacity in rots Gallons Gallons k Of Units Manufacra I/ ♦ . II ., _ ° a �'$ o ivewT Fxisang Teaks i U Septic or Holding Tank Dears Chamber VIL Responsibility StaternentA the undersigned, a in responsiM1iliry for installatuo oC the POWTS shown on the attached plans. p , Name (Print) C PI _ tgiatme MP/Ivf}'RS)ahuber Business 7'hone N er =oZ� > > Plumber's edfrelfs (Street City, Stare, Zip Co J VIU. County/Department Use Only _ Approved ❑ Dis ve permitFeel Dale issued lssumg A enl slwa[ure ❑ O ben Reason for Demal S 52 ✓' IX. Conditions Approv 31 TEM OWNER //\ eptiC tank, effluent filter and / P�� iy plplliG� S ^ ispersal cell must be serviced_/ maintained / ,I presided by plumber. y4f r�16T1�'1 ffj s per management plan All setha k re raments mist he. maintained as per applicable codelor41S41*k&mpi`i`plans for the :y:"maydsubmnt enptnauEµ/Ax]imc nsve p SBD-6398 (R 11/11) 5 Jl A System PLOT PLAN PROJECT Daniel Grebowski ADDRESS SE 114 SE 1/4S 4 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 96.0/95.6 4.5' Below grade DATE 10/15/21 BEDROOM 3 CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 934 # of chambers 46 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE q WELL *H.R.P. same as benchmark C y Vent roperty Line B.M.* 99.5' 111' 155' 4% Slope a. 90 10, 25' 5' >6» Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 6.6ftA2/pair of end caps 4' Long 12 Grade at System Elevation 100.5' Vents B-3 2-3' X 94' cells with >3' spacing B-4 Pro 3 Bedroom House 20' 30' T B- B-5>> 111th Ave Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 8/25/21 Owner:Daniel Grebowksi Location: SE1/4 SE1/4 S 4 T29 N,R 17W 1782 111th Ave Hammond Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross SPncy 4-6. Maintance and Plan 7. Filter Cross Se Signatu License nuaiVr #226900 System PLOT PLAN PROJECT Daniel Grebowski ADDRESS SE 1/4 SE 1/4s 4 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 96.0/95.6 4.5' Below grade 10/15/21 BEDROOM 3 DATE CONVENTIONAL XXX CONVENTIONAL. LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 934 # of chambers 46 , BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Line el I 155, 4% Slope 3' = 90 10, 25' 1 15' 185' Vent >6" of Cover 4' Lone 12 99.5' 100.5' Vents 1 Quick4 Standard Leaching Chamber with 20.0 ft2 of Area \6.6ftA2/pair of end caps .LGrade at System Elevation B=3 2-3' X 94' cells with >3' spacing B-4 Pro 3 Bedroom House 20' 30' W c -r B-5 IIIthAve Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 6.6ft^2 pair of end plates / Typical Installation Grade ,A/30/34 Septic Tank 5' Long Spacing 5' System elevations: 5' at System Elevation E To be >1' above grade Finish grade elevation 100.5 ,Vent 1" at System Elevation 2-3' X 94' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell POWTS OWNER'S MANUAL. & MANAGEMENT PLAN Page _of! FILE INFORMATION Owner -"-- - Permit # I - hESIGN PARAMETERS Number of Bedrooms _.._. ❑ NA Number of Public Facility Units? Nq i Estimated flow (average) —' al/dav I Design flow (peak), (Estimated x 1.5) i Soil Application Rate allda e Standard InfluenUEffluent Quality Monthly average' Fats, Oil & Grease (FOG) S30 mg/L Biochemical Oxygen Demand (BODe) 5220 mg/L D NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) S30 mg/L S30 mg/L 7414, Fecal Colifonn (geometric mean) 5104 cfu/10om1 Maximum Effluent Particle Size ya in d'a. ❑ NA (Other: ANTI 'Values typical for domestic wastewater and septic tank effluent MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity Allroal ❑ NA Septic Tank Manufacturer O NA Effluent Filter Manufacturer ❑ NA Effluent Filer Model ❑ NA Pump Tank Capacity Pump Tank Manufacturer Pump Manufacturer 1103 Pump Model Pretreatment Unit ❑ Sand/Gravel Filter ❑ Peat Filte ❑ Mechanical Aeration ❑ Wetland f ❑ Disinfection ❑ Other. Dispersal Cell(s) Cl NA ound (gravity) ❑ In -Ground (pressurized) ❑ At -Grade ❑ Mound ❑ Drip -Line ❑ Other. Other ❑ NA Other. ❑ NA Other ❑ NA Service Event Service Frequency nspect condition of tank(s) At least once every. 6 monts)s) (Maximum 3 years) ❑ NA J 'Pump out contents of tank(s) When combined sludge and scum equals one-third ('h) of tank volume ❑ NA Brspect dispersal cell s) At least once every: ❑ month(s) ear(s) (Maximum 3 years) ❑ NA 'Olean effluent filter At least once every: / ❑ onth(s) (( ear(s) ❑ NA nspect pump, pump controls & alarm _ At least once every: ❑ month(s) ❑ NA :lush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) ❑ NA Other ___ At least once eve �' _ ❑ month(s) CI years) El NA __ D NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individur.l carrying one of the following licenses or certifications: Masts,,r '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 I'ardware, identify any cracks or leaks, measure the volume of ombined sludge and scum and to check for any back up or pending of efflueni on the ground surface. The dispersal cells) shall be Wisually inspected to check the effluent levels in the observation piper and to check for any pending of effluent on the ground surface. 'The ponding of effluent on the ground surface may inrlicata a fading conditjo,' and requires the immediate notification of the local Iegulatory authority. When the combined accumulation of sludge and scum in any tank equals une-th�;d (X) or more of the tank volume, the entire contents of !.he tank shall be removed by a Septage Servicing Operator and disposed of !n accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of e,4luent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be "'erfoin-,e.d by a certified POk•1TS Maintainer. A service report shall be provided to the local regulatory author it; ,NL l 10 days of completion of any service event Page — of _; START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thr t may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thb 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 (a) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of efttuerd. To avoid to the effluent pummp ois r conactuation ave the a Plumber ornts of the pump POWTS sin ainer to assist in nk removed by operating thege Servicing por pHor to restoring controls o restore ormal levels within the pump tank. Do not drive or park Yehldes 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 life of the POArr$' antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants: fat foundation dra[n (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produces; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the fallowing steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm a3.33, Wisconsin Administrative Code; • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pia shall be removed and properly disposed of by a Sepage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS ails and cannot be repaired the following measures have been, or must be taken, to provide a code compli8nt replacement system; 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 requhIed setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the ni Jed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rulerl In effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barng advances in POWTS technology a holding tank may be installed as a last resort to replace the ailed POWTS. ❑ The site has not been evaluated to Identify a suitable replacement 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. ❑ Mound and at -grade soil absorption systems may be reconstructed in pace following removal of the biomat at the infiltra'11ve 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 BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS _— POWTS INSTALLER Name ate. Phone j i POWTS MAINTAINER Name w Phone 7.1--v4� h SEPTAGE SERVICING OPERATOR PU PER LOCAL REGULATORY AUTHORITY Noma �ik.L� QZ Phone This document was drafted in compliance with chapter SPS 3a3.22(2)(b)(%d)&(f) and 383,54(1), (2) & (3), Wisconsin Administrative Code. 2� 1 4C048A 3 1921 ST CRo LINTY SANITARY SYSTEM File#: �i.+roirvn Office Use Only OWNERSHIP/ADDRESS FORM Created 2,12021 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNFR/RIIVFR INFORMATION Owner/Buyer Mailing Address 1 City/State/Zip Phone Number (re Email Address (req ParcelldentificationNumberQ%—rJ�r hot_i (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location5� '/n , ::'/a , S c. � T &N Fa W, Town of4 �wti' � Subdivision Plat: �r Lot # T' Certified Survey Map # Volume Page # Warranty Deed If (before 2006)Volume Page # Number of bedrooms ---S Spec house ❑ no Lot lines identifiabj/e<yes ❑ no / R OFFICE USE ONky / l New Property Address P� G� l (Venfication of new address required from Community Development Departmen for new constru ion ) /0 R 2 (Staff Initials) (Da ) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form 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. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.00v v 12 VI — 9 N — 6p a CCRNER9 - LEFT ELEVATION I/8 I-0 VERIFY ALL �L— GRADELINES RIGHT ELEVATION I/8 I-0 WOW. GRIDS 6 T FRONT ONLY MILGARD �~ 12 tT .PT rs"qx<nlub WINDOWS 'Y— �6 a efiecce-rs �Yrl— c56 LP VL.uaoo I] —c�c� VINYL SIDING I] �B ^� ALL SIDES i L_ B TRIM FRONT ONLY - 13 F O.T rnl IH. DFTdlL B. I 6 V/ Lu B� .r. °T.1 — a O UILU Ul min ��N� POPcw > Iklr -- 0 V W V be Ltm w..r.iaar.ea+erowm,muvesnae <v Imrv°crv,�a r„4.u�pomm wu�—r- �q FRONT ELEVATION I/4 =—r—rr -0 mow. N.e��oam�d.e.ra�, 2 FLR I,O:B SO Fr. -ALTO DOOR .nOR WINDOW BuTEDEixs 9' CEILING o FIRST FLOOR TO FLR. IOIB so FT. ma�l�2xa°wwn u,.wro To ee Bp.F. a OR aprTox 8' POURED FOUNDATION TOTAL 2,c43 sa Fr. J © Planco MN, Inc. 2021 L/ 2 PLATE 21-015 sMA I I � I �u I u o FUT FAMILY ROOM I I ¢ m 1 I n cro,sw- I a w"r»"rl1— :c - t" etc �covc v<G ct in au twsu t o � n ` zav I I d 3 0 l maa I �___________ _-__ ___ I a o I urt.in,i rn u rc w UNE+'CdVATED r I n 9 z I I �Ence I I I I m UNEXOA`/ATED � I �------------JI I I,`LL BASEMENT PLAN 1/4 . -O B'POURED FOUNDATION W; 2 PLATE © Planco MN, Inc. 2021 eLK — s1v •21-018 sMA MV IT T o- vmae eu aovnz, w j �D�ce�rli II b ITOHEN b °w D " 9 Do FAMILY ROOM o DINING ¢ o tuaR[t v II I { � v' as aooa � II II m ♦ 9wvutnv "fi __ __--------- __ _ I� p 6DiC0 16 R A V of L�i G o 9 o WALL y 5 FOYER mt'E unu WIC % O¢I cF ROOH v ] I I I GARAGE I deb 11 IT � A. WAusO� _ J _ r GONG PORCH _____yas-eaw O cArvi U E 3 5t0(R COLY�x� ]euObCe - m r]' IT I we �xio D FIRST FLOOR PLAN 1/4-O i Op ,D w 1,025 SQ. FT. S' CEILING 6 FIRST FLOOR 3 ©Planco MN, Inc. 2021 •21 ova $HG 8 NAIL ALL INSIDE 4 i OUTSIDE INTERIOR CORNERS SECOND FLOOR PLAN 1/4 11 0 1,015 50, FT. © Plano MN, Inc. 2021 •21-Ol5 SMA ' 61 B.M. ELEVA-nON = 1079.5 I , j [ 61 s �� Ln 67753 S.F, 63 56 Ac. 65457 S.F. co, 1.50 Ac.��o N 89&17'00" W 394.84'� � `��;� 0 N 4 T2 6' 59" E C6— �f 4 68868 S.F. of ? 1.58 Ac. S 89`31'461�E� / - ` 26.19_. S— - S co Tip h Q A ;71'L';jam r� 4 2 2 6 . I p �._. `.' N 89'51'46" W 60 64 i JC) f Erb H WE 1 C"ji 74627 S,F. t f t 1.71 Ac. ! 0 N 87*c)l'ncig' w 9 s f !^i hf i i 2 Wisconsin Department of Commerce Division of Safety and Buildipgs ._ Attach complete site plan on paper include, but not limited to: vertical, percent slope, scale or dimemsion Please F 1542 SOIL EVALUATION REPORT Page I of 3 in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc. County St. Croix t r I Broad. Parcel I.D. �a y Personal information you pmoe w It)(m)) �yr� 1 Z /S 6e Property Owner oerty Location d Cutting Edge Four, LLC e f,. n �, . Lot n/a SE 1/4 14 S 4 T 29 N R 17 W Prerty owner's Mailing Address t a.oticw+i r • # _ Block # Subd. Name or C opSM# E976 170 TH Street fAoX 62 _ n/a _ Hillside Heights City State Zip Code Phone Number J City J Village a Town Nearest Road Hammond WI 54015. 715-796-2793 Hammond I CtyRd"T- N New Construction Use. ✓ Residential / Number of bedrooms _ _ 4 _ Code derived design Flow rate _ 600 GPD _J Replacement J Public or commercial -Describe wa _ Parent material Ground and end moraines, to.lted glaica�l drift Flood plain elevation, if applicable n/a General comments �r tL' l 0 Z lLTC�(ni� and recommendations: Conventional system, system elevation 96.95 Trenches spaced and depth to code 3.75 ft below grade. Boring # _I Bonng 1e Pit Ground Surface elev. 98.90 _. _ ft Depth to limiting factor 110 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz Cont Color Texture Structure Gr Sz. Sh. I Consistence Boundary Roots _ GPDdt' -Eff#1 I 'Eff#2 1 2 3 0-10 10yr3/1 10-29 10yr4/4 none sit 2msbk none sicl 2msbk m none s osg mfr mfr cs cs 1f .6 .8 n/a 4 6 29-110 7.5yr4/4 ml n/a n/a 7 1.6 ✓J Pit Ground Surface elev 99.90 ft. Depth to limdmg factor 100 in. Soil Application Rate IT]Boring # _j Boring -- Horizon Depth in. Dominant Color Redox Descnpbon MunseA Cu Sz Cont. Color Texture Structure Gr Sz. Sh. Consistence Boundary Roots GPD& 'Eff#1 'Eff#2 1 2 3 4 0-12 12-26 10yr3/1 none 1Oyr4/4 none 5 r4/4 none y 7.5yr4/4 none sit sicl sl 2msbk mfr cs 1f 2msbk mfr cs n/a 2msbk mfr g w n/a 9 i osg mvfr n/a n/a .6 .4 .8 .6 26-41 6 r .7 1.0 41-100 cos 1.6 ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 601)5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - CST Number David J. Steel 248956 Address Steel's Soil Service, Inc Date Evaluation Conducted Telephone Number 994200th St., Baldwin, WI 54002 9/10/2004 715-684-5680 Property Owner Cutting Edge Four, LLC Parcel ID# pending _ Page 2 of 3 3] Boring # J Boring ld Pit Ground Surface elev. 99.60 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 'Eff#1 `Eff#2 1 0-11 10yr3/1 none sit 2msbk mfr IDS 1f 2 11-16 10yr4/4 none sicl 2msbk mfr CS 1vf 3 16-26 7.5yr4/4 none scl 2msbk mfr Cs n/a 4 6 4 26-110 7.5yr4/4 no SIBS 2msbk mfr n/a n/a .6 1.0 Boring # J Boring 'A Pit Ground Surface elev. ft. Depth to limiting factor [L in. Sol Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cunt Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots -Ef1#1 'Eff#2 'Ar`- (- l I� i ❑ Boring # J Boring - — J Pit Ground Surface elev. ft. Depth to limiting factor in. Soi Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu, Sz. Coot Color TbAure Structure Gr Sz. Sh. Consistence Boundary Roofs GPDM 'Eff#1 'Eff#2 Effluent #1 = BOD s> 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOOS < 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200"' St. CST-POWTSM Cutting Edge Four, LLC Baldwin, WI 54002 Lie. #248956 SEl/4,SEl/4,S4,T29N Rl7W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 62 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend 1" = 40' ♦ = Benchmark Ele. 100.00Ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.20Ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations Bl = 98.90Ft B2 = 99.10Ft B3 = 100.30Ft ua = i nn ?nFt y N i p %6�2�''/ _„±tom \\\ < \\ �\\ N.B. \\6 \\ \ \ate 6a\ \ 67753 S.F, \ \ . �5457 S.F. Q1 \156 'Ac\ \ / 1� O A N.B� �753 S.'r-. \ \ \ i I I N.B. 1.56 Ac. W.-Et' 60530 S.F. \ N--&947' r N.B. 1.39 Ac.� —1 0' TEMPORARY UL—DE—SAC ASEMENT. TO O E REMOVED Z \ \ 68868 S.F'` \\ I UPON RLY \ 1.58 Ac. XTFNSION F _ \ AD AY. N18. 68868 S.F. / \ tJ.B. 1.58 Ac. / Q1 6 61 45��n�4 N 89*51 " W n / /V CD 99R 19 co N 89'51' 45 '� 1 l / L ' B-3-. J4 / — 74627 S.F. j L�J i 1.71 Ace—' // // / I � N.B. ' I N/B/ 1.60 Ac. Q —Rol 87'01'n IAA\ //3 65 - l� 66828 S.F. 45599 S �I 1.53 Ac. O I N.B. 66828 S.F. \00 I(d ( / LBO jam' / N.B. 1.53 Ac. 8 W,14 5 —N- 87-!G�" `"W d52:32' 1 ( A 66 � , ����a3 FBI z1 65341 S. ♦ isco sin SOIL EVALUATION REPORT Department of Commerce in accordance with Comm 85, Wis Adm Code Division of Safety and Buildings Attach complete site plan on paper not less than 8% z 11 inches in size Plan must County 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 1 Please pri tall CCtt�� Reviewed B Personal information you provide may be sed for secondary dxanvacy aw, s 15 04 (1) (m)) Property Owner MAR 2 Property Location #1542 Page 1 of 3 Steel's Soil Service St. Croix Date /y ��.I 1.ryJ iti �� Cutting Edge Four, LLC s 2007 Govt Lot n/a SE1/4, SE1/4, S4, T29N, R17W Property Owner's Mailing Address ST Lot # Block # I Subd Name or CSM# E976 170 TH Street CROIX COUNTY _ 62 n/a Hillside Heights City State Zip Coe tuber City Village Town Nearest Road Hammond WI 54015 715-796-2793 Hammond Cty Rd " 7 New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe n/a Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable n/a _ ft General comments Conventional system, system elevation 95.35 ft Trenches spaced and depth to code 4.25 ft below grade and recommendations based on boring #2 elevation and depth of 7 sand at time of Installation. " T M1 Boring # 99.40 44.. Ground surface elev ft Depth to limiting factor 110 . Soil Application Oster 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 10yr3/1 none sit 2msbk I mfr Cs if .6 .8 2 10-29 10yr4/4 none sicl 2msbk mfr �ml cs n/a .44 .6 3 29-110 7.5yr4/4 none ms osg n/a Y n/a 7 1.6 ❑ Boring # 100.40 Ground surface elev ft Depth to limiting factor 100 in ISoil Application Rate' Horizon Depth Dominant Color Redox Description Texture Structure i Consistence Boundary Roots G_ PD/ft' in Munsell Qu Sz Cent Color I Gr Sz Sh 'Eff#t 'Eff#2 1 0-12 10y-3/1 none sil 2msbk mfr ce if .6 8 2 12-26 10yr4/4 none Sid 2msbk mfr Cs n/a .4 .6 3 26-41 5yr4/4 none sl 2msbk mfr gw n/a .6 1.0 4 41-100 7.5yr4/4 none cosy osg mvfr n/a 1 4- 7-1 fl D r Effluent #1 = BOD? 30 < 220 mg! and TSS >30 < 150 mg/L ` Effluent #2 = BODs < 30 1 and TSS < 30 mg/L CST Name (Please Print) - Signature CST Number David J. Steel ,.-"-- - 248956 Address Steel's Soil Service Dale Evaluation Conducted Telephone Number 1396 141st St New Richmond, Wl 54017 3/20/2007 715-760-0347 Sun-9:;o I n nnr ( , 0 Property Owner Cutting Edge Four, LLC Parcel ID# Pending Page 2 of 3 Boring # 100.80 ft Depth to limiting factor Ground surface elev _. 96 in Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in Munsell Qu. Sz Cant Color Gr Sz Sh. 'Eff#t -Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 10-32 10yr4/4 none Sid 2msbk mfr cs n/a .4 .6 3 32-96 7.5yr4/4 none Is ml mvfr n/a n/a .7 1.6 01+ (-q o Boring # 101.20 ft Depth to limiting factor Ground surface elev 96 in Soil Application Rate Horizon, Depth, Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in Munsell Qu Sz Cant Color Gr Sz Sh 'Eff#1 *Eff#2 1 0-17 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 17-36 10yr4/4 none slcl 2msbk mfr cs n/a .4 .6 3 36-96 7.5yr4/4 none cos osg mil i n/a n/a .7 1.6 Boring # 101.20 Depth to limiting factor Ground surface elev ft 144 in Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in Munsell Qu Sz Cant Color Gr. Sz Sh 'Eff#1 'Eff#2 1 0-28 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 28-42 10yr4/4 none Sid 2msbk mfr Cs n/a .4 .6 3 42-144 7.5yr4/4 none cos osg ml n/a n/a .7 1.6 Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD_ < 30 mg/L and TSS <_30 mg/L I he Depanment of Commerce is an equal opponunn\ sen ice prof ider and emploNer. If Nou need assistance to access sere mes or need material in an alternate format. please contact the department at 608-266-3151 or TTY 608-264-8777. 4Ea)K3; IR b7 tlt, ste 55Nse'Ke Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200"' St. CST-POWTSM Cutting Edge Four, LLC Baldwin, Wl 54002 Lic. #248956 SEl/4,sEl/4,S4,T29N,Rl7W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 62 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. r/ ILY /60'1vF- /�ik r l 16,9 � '55r 73' i Co 7" A �e Legend 1" = 40' ♦ —Benchmark Ele. I00.00Ft 'Fop of 3/4" pvc pipe • — Alt Benchmark Ele. I00,70Ft Top of 3/4" pvc pipe f_I = Borings Boring Elevations BI =9 VOR B2 =f' B3 = 00$O009'Ft B4 = 10/ .7OFt &;f /O/,-7 N cl NA �� I I •3 \61 \ \ ' 67T53 S.F \\ \ 1 � t 457 S.F. Q1 ',1.56 �Ac. IffI / 1\�O Ac. N.B\67753 S.�\ N:B� 60530 SF. W N.B. 11.5 \Ac'N-8q-1-7- 'i �X lL / O � i N.B. 1.39 a ,o ` 394.84`- \ x �— fUA TEMPORARY LDESACCDSEMEN TTO REMOVED Z68868 S-F`UPON STERLY \�1.58 Ac. Cj \ I D AY. F N\B. 68868 S.F. \ N.B. 1.58 Ac. / �64 61 45�� N 89'51 W n 1 o ` N 89-51'skG —W r7/ �7 8 4S / - VU 74627 S.F. I IUN I 1.71 Ac N.B. 69,760 S.F. NIR./ 1.60 Ac. � / Q � ---87-e1n9 ' ii�--- � ;I� // 3 1 —342.1 f5'-- —� \ �194C� i I — 65 f \ \ J 66828 S.F. 45599 S 0) 1.53 Ac. ON.B. 66828 S.F. 00 1 ; LBO i 40; N.B. 1.53 Ac. 8 5 —N 87°81'89„ -w_ „L258-.tB' 2 66 ��r, F / �I << 1 65341 S. 1500E C 3 W-ee 00couN NO. 633993 STAT&SANI'�R� PERMIT 1 �82 ✓E L PREVIOUS NO. OWNER PLUMBE B lot TOWN OF IHWVD SEC__,T Z7 N, R. AND/OR LOT GZ t S%L L SUBDIVISION CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. to, Changed regulations will not impair the validity of a sanitary permit. (c) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 e. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. ,iww. U RIZE ISSUING OFFICER -DATE f4 r r PERMIT EXPIRES NLESS RENEWED BEFORE POST IN PLAIN VIEW THAT DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)