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Home My WebLink About032-2117-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420544 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: Olson, David I Somerset Township 032 - 2117 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ( ELEV. Septic � � � ) � � � Benchmark � 4 . 9 /03 • � c 1 �7 . UG Dosing 2 , / A -10 Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet 7.40 TANK SETBACK INFORMATION St/Ht Outlet G5 c, 2-7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic - ; - Dt Bottom Dosing Header /Man. _ S,.0! q5• Ej Aeration Dist. Pipe 4 4- 8G7 q y Eag 3 e 8 3'. Holding ' got. SystemEQS+ n Iv ti a a sc c. PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM TC",k_S Model Num r 1 r i s S TDH Lift 1 rictio n Loss System Head TDH Forcer Length I QZ. � Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth O DIMENSIONS z . - SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: 1 UNIT L �V Zr1 G ►� 1 7 Model Number: DISTRIBUTION SYSTEM v L• ; p� -� �-- HeadedManifold Distribution x Hole Size x Hol acing n a e Length Dia Length Dia Spacing 7 V SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodde xx No Mulched Bed/Trench Center 7 �., cv Bed/Trench Edges L- -- Topsoil �] Yes o n Yes j COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: is / ZZ / 03 Inspection #2: Location: 2164 59th Street Somerset, WI 54025 (SW 1/4 NE 1/4 15 T31N R19W) Shadow Pines Lot 15 7 Parcel No: 15.31.19.1072 1.) Alt BM Description = S. Ti . cc- "' V/ d �I t �° 2.) Bldg sewer length = !Q c e C, r 1 ) - amount of cover J Plan revision Required? wiq Yes No U3 � - X / � f - Use other side for additional informat n. J J SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. zxe4 5ci ea- Safety A Buildings Division 201 W. Washington Ave. ` Sanitary Permit Application PO Box 7302 \*sC�ns jry In accord with Comm $3.2 1, Win. Adm. Code Madison, WI 33707 -7302 Department or Commeroe Personal information you provide may be used for secondary purposes (Submit completed form to county if not 3I,.- (Privacy Law, s. 15.04(I)(m)) 7 stale owned. Attach com lets plans to the cou copy only) for the system, on paper not fess than 8 -1 /2 x I I inches in size. Count QC } State Sa Zry� i Number ❑ Check if revision to previous glication Stale Plan I. D. Number t O I. Application Information - Please Print all Information Location: Property Owner Name - -— Properly Location q 1 O1 __ _ _ ' S(14 l/4�1/4 S1ST ) N E or Property wnW Mailing Address Lot Number Block Number (06 ) ;4 Kv� S alb s S City. State Zip Code P tone Number u iv ' S bd iston Nome or CSM Number Me 1�1C�l�Ot+� 1 V 43 �; �1�10U61 ri N{1" Ii Type of Building: (check one) ac q,.(, S ❑ City O 1 or'2 Family Dwelling - No. of Bedrooms O Village O Public/Commercial (describe use):_ — ❑ 'Town of O State - owned Jom -q III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road S/ p, }� A) 1. t New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Numg J System 'Tank Only l Existing System _ 0 o�' 01 I� o b - 0d U 13 B) Permit Number _ Dale Issued A Sanity Permit was previously issued IV. Type of POWT System: (Check all that apply) CkNon pressurized In- ground ❑ Mound ❑ Sand Filler ❑ Constructed Weiland ❑ Pressurized In- ground ❑ 1lolding'Fattk ❑ Single Pass ❑ Drip line ❑ At -grade t t 4"" ❑ A obic' •realm nt Unit O Recirculating ❑ Other: 3 &Z-m a& 3n V Dia ersallTreatment Area Information: _ 1. Design Flow low) 2. DispersalAres 3. Dispersal Area 4. Soil Application S. Percolation Rate 6. System Elevation 7. Final Grade Required ` � Pioposed Rale(Gals. /day /sq. ft.) (Min. /inch) Elev ton 8 S 4' ` 3 � . b'00 �7.oc� VI Tank Capacity in Total N of Manufacturer Prefab Site Steel Fiber- Plastic j Information Gallons Gallons 'Tanks Con- Con- glass New Existing crele strucled Tanks Tanks VII Responsibility Statement I the undersigned, assume responsibility for installation of the POWTS sho on the attache plans.___ Plumber's Name nt) P e� a o stamps): MP/MPRS No. [lu Ines Phone Number M ouM�� w )a'Dw � �� -7U- * u er't Ad ress (Street, City, Slate, Zip Cod -- ---- - - - - -- - - - - -- 1 10 Oikv - 3� N VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) I� Approved O Owner Given Initial Adverse Surcharge Fee Determination � Z2 ' IX. Conditions of Approval /Reasons for Disap rovalt 5, a e- LL) i nu e rs TL rio le-d s�u �_1 L �uum�..e��er'..... NA Gp2� S - tt�IJ 1)��p N61�S • Da i 13 -TM N IL ® f33 I r i cs Q- I F I� {R NA 3 l G AIZ� S ite�J U�Cp �aI�S � Qa g 13 - To w , .V.,., s to � • 3��a.s� f33 o 139 � p ► 9 9. Ou e� . �' )a' PVC I�; 4 ►�V = G0. D 1582 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 2 Division of,Safety and Buildings iO 7with Comm 85, Wis. Adm. 1 Code -.0 Z_ A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croon include, but not limited to: vertical and horizontal reference point (BM), direction and p I.D. percent slope, scale or dimensions, north arrow, and bcation and distance to nearest road. 032 - 2 117 -20 -000 Please print all information. g y D e Personal information you provide may be Tor secondary purposes (Privacy l ayr s. 15.84 (1) (m)). I I Z Property Owner Property Location Dave & Heidi Olson - . Lot SW 1/4 N 1/4 S 15 T 31 N R 19 W Property Owner's Mailing Adds Lot Block # Subd. Name or CSM# res 109 192nd Ave. 5 �Shado Pines City State Zip ode Phone Number N ; - City _j Village #6 Town Nit Road New Richmond WI 54 " -- 715- 248 -7149 Somerset 2164 59Th Street 01 New Construction Use: Residential / Number of bedrooms 4 _— Code derived design flow rate 600 GPD J Replacerrrent I Public or commercial -Describe: —_- — Parent material Glacial outwash _ Flood plain elevation, if applicable na General comments and recommendations: Soil evaluation completed to expand area evaluated by Gary Steel 10/05/99. Install three trenches at 93.00' using 30 leaching chambers. Boring # I Boring f+ Pit Ground Surface elev. 98.02 ft. Depth to limiting factor > 106" in. Soh Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 - Eff#2 1 04 10yr4/2 none Is 1 fc mvfr cs 2fm,1 c 0.7 1.2 2 4 -23 10yr3 /4 none Is 1 m mvfr cw 2fmc 0.7 1.2 3 23 -38 10yr4 /6 none Is 1 msbk mvfr aw 2fm,1 c 0.7 1.2 4 3848 7.5yr4/6 none Ifs 2msbk dsh aw 1 f 0.5 0.9 5 48 -106 10yr5/6 none s 0 sg dl - - 0.7 1.2 -E ° ►3 • D _ 2] Borin # Boring — Pit Ground Surface elev. 96.88 ft. Depth to limiting factor __ > 102" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Eff#2 1 0 -11 10yr4 /2 n one Is 1f mvfr cs 2fm,1c 0.7 1.2 2 11 -34 10yr4 /4 none sl 2msbk mfr cw 2fmc 3 34-47 10yr4/6 none Is 1msbk mvfr aw 2fm,lc 0.7 1.2 4 47-63 10yr4/6 none s 0 sg ml aw 1 f 0.7 1.2 5 63 -102 10yr516 none s 0 sg dl - - 0.7 1.2 5 S2, S * Effluent #1 = BOD s' 30 < 220 mg/L and TSS 30 < 150 mg/L * Effl BOD < 30 mg/L and TSS <30 mg1L CST Name (Please Print) Sign re: CST Number James K. Thompson s. 3602 Address A.C.E. Soil & Site Evaluations D e Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 9/4/02 715- 248 -7767 p pppppp, ' � Soll e ✓alcca -bcv� Gary Stee-C �o /os /ff / I ca/e: / c 1!0 �S7 Gib' /tz',O , C. a. / in /B QQt "o,;oe. ASsc.tm a lc% = /d0. oo; r-- E/ee - 3 �r,%n 5 - -- -- 97"o 980 y `� y, � 99.40' /owesf .L'lo�i e le✓; be = 98•yS ,'. w 99.o'co.,to V Pr po su.d • iao.,to' y 6 cd eao.n yes duce o a3 Staxle 1 Wisconsin Department of Industry SOIL AND SITE EVALUATION -11 E P O R T Page 1 of 3 Lhbor and Human Relations DiYision of;afety &Buildings in accord with ILHR 83.05, Wai§.,Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Flan must inclu'd; 6LA St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope,rscale or i;' PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 32 — - - APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R VIEWED BY DATE �� PROPERTY OWNER: PROPEN ' 'LQCA ION Rob Jennings GOVT. LOT 9' ^ LANE 4,S15 T 31 N,R 19 2E (or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SU AD NAME OR CSM # 563 Washington St. ppCC ppEE } NN M 15a -- - �Yiadow Pines CITY 12i ATE Falls, WI . ZI 548ZZ P 715 E 425 6443 ❑CITY [:]VILLAGE KFOWN NEAREST ROAD ( ) 220th. aVe. ? ] New Construction Use [x] Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd /ft • trench, gpd /ft Absorption area required 858 bed, ft2 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft2 . 8 trench, gpd /ft Recommended infiltration surface elevation(s) 98.00 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem MS ❑U ®S ❑U U S ❑U K] S El Q S El 1 ❑S 91 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed JTW& .................. ................. 1 0 -13 10yr3 /3 none sl 2mgr mfr gw lc .5 1.6 2 13 -31 10yr4 /4 none is Osg mvfr gw lc .7 .8 Ground 3 31 -99 10yr4 /6 none ms Osg ml na na .7 .8 elev. 10 ft. Depth to limiting factor Remarks: Boring # 1 0 -5 10yr4 /3 none sl 2mgr mvfr gw 2c .5 .6 2 5 -21 10yr4 /4 none is Osg mvfr gw lc 3 21 - 10yr4 /4 none is Osg ml gw if .7 .8 Ground elev. 4 444 10yr4 /6 none ms Osg ml na na .7 .8 1 03. Qt. Depth to limiting o Q factor +144" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av ° Few Richmond W 4017 Signature: Date: 1 -5 -99 CST Number: m02298 Rob Jennings PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2 � of 3 PARCEL I.D. # 032 - 2117 -20 -000 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft ................. in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .................. ................. 1 0 -10 10yr4 /3 none sl 2mgr mvfr gw 2c .5 .6 ''' :::3:::':`' 2 10 -22 10yr4 /4 none is Osg mvfr gw lc .7 .8 Ground 3 221 7.5yr4/4 none ms Osg ml na na .7 .8 elev. 1 Depth to limiting factor qz +120" Remarks: Boring # 1 0 -10 10yr3 /3 none sl 2mgr mvfr gw 2c .............. . 5 .6 ................. 4 '> 2 10 -20 10yr4 /4 none is Osg my fr gw lc .7 .8 3 20 -96 10yr4 /6 none ms Osg ml na na .7 .8 Ground elev. 100.9ft. — Depth to - limiting g3-a factor +96" Remarks: Boring # 1 0 -10 10yr3 /3 none sl 2mgr mvfr gw 2c .5 .6 5 2 10 -35 10yr4 /4 none is Osg mvfr gw lc .7 .8 3 35 -14 10yr4 /6 none ms Osg mvfr na na .7 .8 Ground elev. 1 02 . 7 ft. Depth to limiting factor + Remarks: Boring # Ground elev. i ft. Depth to limiting factor Remarks: S13D- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Rob Jennings 1554 200th Ave. CSTM2298 SW4NE4 S15- T31N -R19W New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #15- Shadow Pines ✓N ✓1 " =40' = top of 1 pvc pipe @ el. 100.00' 'vit BM.= top of 1" pvc pipe C el. 103.30' '' t kt , , c � r ) C O � j 4 o ' c Gary L. Steel 10 -5 -99 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 4 Number of Bedrooms Design Flow - Peak (gpd) (,0() Estimated Flow - Average (gpd) 3O Septic Tank Capacity (gal) 1 a 6 Soil Absorption Component Size (ft 5 Ty Wastewater e of Wastew er mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak 3 9 (9P) d %3 � � Maximum Influent Particle Size (in) $ 1/8 !�S Maximum BOD (mg /L) U 220 Maximum TSS (mg /L) S O 150 Table 3: Mainten Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the seubcAaak and outlet filter shall be assessed at least once every 3 years by inspectiorS a outlet filter hall be cleaned as necessary to ensure pro o p e ra ion. The filter cartridge a removed unless provisions are made to re am' 1-solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. When system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386 -4680 Boumeester & Sons Excavating 386 -9020 Tri- County Sanitation 386 -2130 I 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer IA y O D A 4 1 0 IS bN 11 Mailing Address Property Address �» (Verification required from Planning Department for new construction City/State Parcel Identification Number LEGAL DESCRIPTION Property Location W %,, N P- %,, Sec. �S , T 3 N -R 9 W, Town of 50► K . Subdivision 5 �I ►.V I , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # W3 i U Volu ne I s s 1 , Page # Spec house ❑ yes-® no Lot lines identifiable 4L yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. 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, restrictedplumberor a licensed pumper verifying that (1) the on -site wastewaterdisposal "stem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above px lutremu nts and agree to maintain the private sewage disposal sysh" with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 . days of the three year expiration date. a S NATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. U 00 0 SIGNATURE 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 of the certified survey map if reference is made in the warranty deed io V111.1557F 236 6331 SO KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 -2000 ST. CROIX CO., WI WARRANTY HEED RECEIVED FOR RECORD Document Number This Deed, trade between Robert A. Jennings and LeeAnne M I1 -07 -2000 10:00 AM Jennings, husband and wife Grantor, and David M. Olson and Heidi J. Olson WARRANTY DEED h usband and wife Grantee. EXEMPT Y Grantor, for a valuable consideration, conveys and wan-ants to Grantee the CERT COPY FEE: COPY FEE: following described real estate in St. Croix County. Stale of Wisconsin (if more TRANSFER FEE: 165.00 space is needed. please attach addendum): RECORDING FEE: 10.00 GAGES: 1 Lot , Shadow Pines in the 'Town of Somerset. St, Croix County, I Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Recording Area i DAVID J. ESTREEN 304 LOCUST ST. HUDSON, WI 54016 032- 2117 -20-W Parcel Identification Number (PIN) This is not homestead property. Date this 2 y of tober, 2000. ob" A_Jena * LeeAnne M. Jennings AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) _ authenticated this _ day of ) ss St. Croix County ) Personally came before me this 26th day of October 2000, * _ the above named Robert A. Jennines and LeeAnne M Jctutings TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person s who executed the foregoing (If not, __- authorized by § 706.06, Wis. Slats.) instrument and acknowledged the same. THIS I;NSTRU�MEN'I WAS DRAFTED BY Robert A. Jennings JULIE C DODGE 5 G3 Wash_gton St Rive Public/State of Wisconsin Notary Public, State of Wisconsin WI 54022 My Commission is permanent. (If not, state expiration data i, (Si talure may be authrnticated or acknowledge Both are not necessary.) •Nun es of pernons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 -2000 s H I I 37 MATCH LINE (SEE SHEET 1) S89'25'09 "E 456.61 MATCH I * (SEE SHEE I I � I 12' UTILITY EASEMENT - I � II i 1 i 1 I i i \ I 1 I 1 I -- I 11 1 1 I( EAST 1 b� 1 5 II 1 1 71.03' 1 I `� 131,170 SQ. FT. 28.0 EAST -e N I 1: }' l i I I I I 3.01 ACRES � I I PONd EASE 1 EASEMENT II 25 YR H.W.L. ;t 925,47 • 0 od I 1 N POND cv N 25 YR H.W.L. POND. r.. . I 2 YR z N� . 92730 H.% V) i S 52.w 583'35' 02" W 459.1 i I 925.47 I I 0 1 z.Ml JI I rte• ° ^ N I i I LLI ac 8� 3 9r\ al EAST 162.62'• WEST-/- I - - - - -- 1 I I 28.73' ., r` 1.11 I p �r�l j��CX} 25 YR H.W.L. Ip� 30.19 _ 00 Z POND 628.68 �/ 1 , o — _WEST 97.59 _ O L_ j " 1 4 WEST , 62 - 62� ^ o I 131,237 SO. FT. n 3.01 ACRES — N coo) / 3 JOIN? } ILI 414.79' WAY 00 Z 00 p p 584'27'21 �N DRIVE , Z t •► o 0 00 ° o f i `. 1 I � z I ' 1 t 13 I v � ~ N Z �— z 131,124 SQ. FT. I i �, W 3.02 ACRES . y r Y .. , N.�, _ _ . .. �. .:.. .. � .. r wcflgsinepanment of commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page 1 of 3 Bureau of Integrated Services in accordance with s. ILHR $a,09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in siz . Nr tl'ust aNnty include, but not limited to: vertical and horizontal reference point (BM) ;FoneaXd on � St . Cr olX percent slope, scale or dimensions, north arrow, and location and dis nA;64t}f.111 Parcel D. # mss, APPLICANT INFORMATION - Please print all inforIgn ? �f'P 3 Reviewdd by Date Personal information you provide maybe used for secondary purposes (Privacy Law; �. 15.04 (1�tn� Property Owner �' °,, _Q(Rf Richard Stout ' . - Govt. Lot SW,,' '1iX NE 1 /4,S 15 T3 1 N,R1 9 E (or) W Property Owner's Mailing Address # r Po6 5ubd. Name or CSM# 1353 Awatukee Trail 15 Shadow_�Pin s 23 12 City State Zip Code Phone Number City E] [:1 V Town Barest Road Hudson j Wi 1 54016 (715)549 -6731 Somerset 60th Street New Construction Use: n$ Residential / Number of bedrooms 4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpdfft2 • - 8 trench, gpd/ft Absorption area required 8 5 8 bed, ft2 750 trench, ft 2 Maximum design loading rate ' 7 bed, gpd /ft • 8 trench, gpd/ft Recommended infiltration surface elevation(s) See . ltd Ot plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material CoC2 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system I s ❑ U CRS ❑ U [Y s ❑ u [� s ❑ u ❑ s ®u ❑ S KI U SOIL DESCRIPTION REPORT Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 0 -8 10yr2/1 -- sil 2 , e�aiK mfr cs 1f .5;.6 2 8 -2 10yr4/3 -- is 1 MA-6K mfr cs -- .7 .8 Ground 3 20-E 4 10yr4/6 -- ms osg ml cs -- .7 .8 elev. 96 ft. Depth to limiting , factor 84 in. Remarks: Boring # 1 0 -6 1 0 r2/ 1 sil 2 FM 4� mfr cs 1 f .5 .6 2 2 6 -8 10yr4/6 -- ms osg ml cs -- .7;.8 Ground elev. 97 ft. Depth to limiting factor - Remarks: CST Name (Please Print) Signature Telephone No. Address / J Date CST Number PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT 2 f ,� ' — Page o PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench 3 1 0 -5 1 Oyr2 /1 -- sil 2 m A -C2 mfr cs 1 f .5 :.6 2 5-1E 10 r4 3 -- is 1fiAP, Ground 3 18-El 10yr4/6 -- ms osg ml cs -- .7 .8 elev. 9 6 ,Q_ ft. Depth to limiting factor $m in. Remarks: Boring # 1 -4 10yr2/1 3il 2mp, mfr cs if .5 4 2 20 1 Oyr4 /3 Ls 1 P)P-hj,, mfr cs -- .7 8 3 20-83 10yr4/6 ns 0sq ml C .7 - Ground elev. 94 ft. Depth to limiting factor 8 3 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # -- 5 2 -81 10yr4/6 Ins osg ml cs -- .7 ;.8 Ground elev. 96 ft. Depth to limiting factor 81 in. Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) S'a'm k' r s. a T / S p y 3 o F 3 It Oa,& 146.0 I Am Aj led r.' S' A T Y�. Y Fo7 rS I i f� i 1 J H I I I i I