The URL can be used to link to this page

Home My WebLink About032-2117-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CCOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: 395146 0 ATTACH TO PERMIT) GENERAL INFORMATION ( State Plan ID N 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: Tetzlaff, Mike I Somerset Township 032 - 2117 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: C'ST gfdt I D4. ?'O p p X01. TANK INFORMATION U1 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �y Benchmark o 110,10 Dosing Alt. BM Aeration Bldg. Sewer O6 . r 4 Holding 1SIJHt Inlet �— f J ►l7 �u TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1 1 ' _ _ 22, 1 Dt Bottom Dosing Header /Man. �p i Aeration Dist. Pipe t o2 -8S Holding Bot. System -Zd , l ot- S -0 Final Grade 1 PUMP /SIPHON INFORMATION Manufa urer Demand St Cover M Model Nu r TDH Lift tion Loss System Head TDH t Force Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM Io REN Width t Length I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMEN ONS -7S (0 2 . 3 e SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING M yujactmrer INFORMATION Type Of System: t , CHA BET OR l v M 1 I tm eLNu r: N w DISTRIBUTION SYSTEM �- Header/Manifold Spacin Distribution x Hole Size x Hole g Vent to Air Intake to Pipe .2, (00, Length_ Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over " D Over xx Depth of xx SeededlSodded I epth x Mulched Bed/Trench Center �v Bed/Trench Edges Topsoil D Yes jj No [j Yes [] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 01 / OS_ Inspection Location: 2199 59th Street Somerset, 54025 ( 1/4 NE 1/415 T31N R19W) Shadow Pines Lot Parcel No: 15.31 T 1.) Alt BM Description =F C (N�� Cvsyuv". 7� S . 2.) Bldg sewer length - Z.,?,dd Cc :7,4! ZD - amount of cover = 2 " +0.i � Czv- � D 1•0 C.. w- � -SS �t • Zo 3� I,�,..�,�•,• /u� Plan revision Required? Fw16j Yes VNo i oS Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) 3 — \ Safety and Buildings Division County ST e e-ov f 201 W. Washington Ave., P.O. Box 7162 viSconsin Madison, WI 53707 - 7162 Site Address Department of Commerce 4ft verl .S �f- Sanitary Permit Appliea Sanitary Permit Numb 39G5 � In accord with Comm 83 21, Wis. Adm. Code, personal i o �f R may be used for sec purpose Privac st 1 ( �' ❑Check if evisfon I. Application Information - Please Print All Informatio Cam,'` State Plan I.D. Number ��r� w ;;rte -- Property Owner's Name ,* " �;� Parcel Number 1S, 3 l , / - /O" M1K� d RE1.9t rt ET2LAt F a� Jt1 1 9, b3Z - 2111 - ,gh -oDD Property Location Property Owner's Mailing Address app rty Z) C11., gti r N J11/C � .�,.,� IY E 'A ME : S 15 T 31 N , R 19 E City, State Zip Code ;. Lot Number 1 Block Number c�,l rte. OM, L A W S`IOZp _y 9H Subdivision Name CSM Number SWAWW II. Type of Building (check all that apply) u ❑City &I or 2 Family Dwelling - Number of Bedrooms 1 []Village ❑ Public /Commercial - Describe Use pl'ownship nONNEKSE r ❑ State Owned r Nearest Road CT`r R D T. 4 -r,7 T44 III. Type of Permit: (Check only one box online A (numbering scheme for internal use). Complete line B if applicable) A. 1 kNew 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use System Tank Only Existing System B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply) (numbering scheme is for internal use) 44 O-Non - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dis ersal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal 4oil Application Percolation Rate System Elevation Final Grade Required Propa ed1� te(Gals./Days /Sq.Ft.) (Min./Inch) Elevation �(6 eaP. 1,6L. 2 _ - ' nl r L R X i VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks �,/ Septic or Holding Tank I Z<o 0 1 Z bo V! L�F I Dosing Chamber VII. Responsibility Statement- I, the undersigned assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Pi is nature 1 M RS N ber Business Phone Number A 1 «� � ZZ ZyZ 715 -�9`/- 31`11 Plumber's Address (Street, City, State, Zip Code) &Y- ZC) S- �R�ss�12, yJr S400ci VIII. Count /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse . ZZS �- 3 ` Determination �(� n IX. Conditions of Approval/Reasons for Disappr9val �J us ;l Q A. Q Qr1 n►�,� �-na e�n� -l$., s ys, .�..� �� "� 'fT D ou�c g 3 1 e,,� g `� S �wQ - 5 , �ta-�t �v.s1 �J� A bA-- a l YV -n _�� `` '' __ complete plans (to the Co ty nl) a system on pap SBD- 639 (R; Q % v T cj � a H � r Q 3 ae J Q q � D � G J o � N T ale • 4L f� Q v N a 3 r l CIO t D ILI aJ 0 tAj �! f-Y.) -� i' b 2 � 2 i 6s � w o V � N �1 V� 7 X —pt Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 —of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. C r oix Attach complete site plan on paper not less than 8 1 /2.x'1 inches in stze:•Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north ar rid location and distance to nearest road. 032 Please print a \ mafio �� , evi ed by Date PV Personal information you provide may be used fo dary ptbsb>rj Privacy Laws. 15.04 bt (m)). 3 { p 1 _q Property Owner ,� c; rope _ ocation Mike & Brenda Tetzlaf t�� X Govt. tot NE 114NE 1/4 S 15 T31 N R 19 2 (or) W Property Owner's Mailing Address w; C p►> �� of # • Block # Subd. Name or CSM# 2196 84th. Ave. G na Shadow Pines City State Zip Code Ph r _ ;' ity ❑ Village (X) Town Nearest Road Osceola I WI 1 540201(715 Somerset Ct . RD. "I" �] New Construction Use: (2 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material - W -Gregh Flood Plain elevation if applicable ft. Fla General comments and recommendations: trenches @ el. 102.10', spaced to code 4.00' below grade Boring # Boring [� Pit Ground surface elev. 10 6 . 10 ft. Depth to limiting factor 9 6 in. Soil A lication 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 '092 1 0 -12 10yr3/3 none sil 2msbk nfr gw 2f .5 .8 2 12 -2 10yr5/4 none gil 2msbk nfr qw if .5 -8 3 28-96 7.5r 4 6 none 1.2 r a Boring # Boring 2 pit Ground surface elev. 1 0 6 . 3 5 ft. Depth to limiting factor 1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fiz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 1 0 -10 10 r3/3 none sil 2msbk infr Cs 2 10 -2 10yr5/4 none sil 2msbk infr gw f .5 .8 3 23-1007.5yr4/6 none Ins Osq ml na na 7 1 Effluent #1 = BOD > 30 220 mg/L and TSS >30 5 150 mg /L ffluent #2 = 92D < 30 /L and TSS a 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel Z. 02298 Address Date aluation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 7 -13 -2001 715 -246 -6200 v Property Owner Mike Tetzlaf Parcel 10# 032 - 2117 -80 -000 Page 2 of 3 ❑ Boring # ❑ Boring 9 6 3 Ground surface elev. 10 4 .4 �. Depth to limiting factor in. ® Pit 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. *Eff#1 *Eff#2 1 0 -13 10 r3/3 none sil 2msbk mfr Mq 2f ,5 ,8 2 13 -3 10 r5/4 none sil 3 0 -96 7.5 r4 none 4 Boring # ❑ Boring 4 g] pit Ground surface elev. 1 . 5 O ft Depth to limiting factor 90 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. *Eff#1 *Eff#2 1 _ sil 2 9 -29 1 2msbk mfr 3 29-3E 7,5 7,5yrA 4 nane r, 3 2 w if 9 4 36-9C 7,5 r4 6 none ml na Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F El pit Soil A lication 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 *Eff#2 * Effluent #1 = BOD > 30 220 mg1L and TSS >30 150 mg/L ` Effluent #2 = BOD < 30 mg /L and TSS 5 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.6100) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. MIke Tetzlaf New Richmond, WI 54017 MPRSW 3254 NE ' 4 S1 5 -T31 N -r1 9W (715) 246 -6200 town of Somerset lot #21- Shadow Pines ✓N - " =40' AM.= top of SW lot stake @ el. 100.00' /Alt. BM.= top of elec. transformer @ el. 104.70' ` Iz l ,� � to U- 1 QV r �+ l n f P Gary L. Steel 7 -13 -2001 f 05/01A1 TUB 10 :39 FAX 71 � ZIu0'2 Priva Onsite Wi stowraf:er Treatment System Management Plan A Septic Tank And ter:, ;r � A � i n -Ground ,.►oif Absorptian Component Pursuant to Comm 8' `/!t?s. Palm. Code eacf; Private Onsite Wastewater Treatment System (POWTS) shall incli::Ja irroiTnation and procedures for maintaining the system within the parameters of Comm 8�� and 3 and 1ha conditions of approval by the department, agent, or governmental unit. The approycd 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 (8.6/99). Ta 1: S ystem Design Specifications Sanitary Perrrit f.t:r-b r Number of Be - ro:�c i _ 1 4 Design Flow - Peak (gpl) 1 Estimated Flow - Average (gpd) W H610 Septic Tank Capacity (gal) ) ZLIO Soil Absorption Componeni S (ft Sob 3o Ibtl CAP. S11)EW►Nth F ttiF IL. Type of Wastewater Domestic Table 2: Soil Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Co onent Design Flow - Peakk rg pdJ) d A '- MaAmum Influent Particle S i22 2 :" r , ' j 1/8 Maximum SOD, (mg /L) 220 Maximum TSS (m /L) 150 Tab;o 3: Maintenance Sc hedule 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 t -- i 4 $ontic 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 se + an outlet filter shall be assessed at least once every 3 years by inspection. 7 e cu'IPt fii r shall be cleaned as necesaani to ensure =per op eratio n. The filter s::�r{r fir: , not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the 05 -01 -00 10:34 RECEIVED FROM:715 386 4686 P•02 5 /U1: U1 TUE 10:37 F J: 713 Nc; Q (13 tan otic Tank ,rid Soil Absorpt is activated continuously• _ Management f c„ a 5z. The tl�e filter shalt be serviced if the a pm co nt in' ala. , e t3�NS or an impending alar a in the tank fitter is equipped with an titer's', volume of scum and sludge 1„{ecmittent filter alarms may indicate sur9 half have its Contc;r�t; removed when the caner lation t of when the next se Bice e k s tank. if the contents se of theete are not removed at n el ptic u yrsorinel shall advise a accum the exceeds 113 the liquid ximu l0m�me� ance P' mam scum and slud9 time of an assess needs to be performed to :maintain less then htness and tank. ins p e cted for water b watertight upon access risers and covers should be insp ect to failure must Manhole risers, -s used for service and assessment st It Qes sealed cured by soundness. Access opesunc� Arvin, deemed unsound+ completion of s ervice. An, ° f " , than S- inches in diameter shall e e the comp osed arce idental cr unauthorized ent s openings be re placed. Fxp g device - prevent accry into ink for an effective locking ent or holding t tic or other treatm OSHA standards for No one should enter a se n full compliance with s or other any reason without being ' atmosphere within the P a confined space. The ases, and rescue of a entering task may contain lethal g impossible. treatment of holding be difficult or imp person from the inferior of the tank may Comm 83 . 33, WI Adm. Code when the Tank abando i WTS componen� wit tank used as a pp is no longer u Soil t bsa l ion C rn one Th soil absorption Component serving this structure is designed to accept domestic The limits of operation of this component are shown in wastewater from a residential faciiay. Table 2. The longevity of a sal absorptim component depends greatly on proper and t nWY 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 foftres 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 ce of oxygen into improve. and dispersal cdell mpaction ll, which lead to component will more intense, and earlier, organic clogging of the soil. C 2 j 65 01 - 06" 10:32 RECEIVED FROM:715 386 4686 P.93 i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FO Owner/Buyer Mailing Address r 0/ Property Address A `.ICJ (Verification requir from Planning Department for new construct 1� City /State Parcel Identification Number W 0 ^ c� 0 ~ � LEGAL DESCRIPTION )5 T Property Location '�4, %., Sec. N -R ftnW, T own of Subdivision _ Lot #. Certified Survey Map # � a 7q , Volume Page # �8 Warranty Deed # & / 0 04f . Volume f (70 , Page # Spec house ❑ yes 9 no Lot lines identifiable 0 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, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system 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 requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f the thre 'yea xpirat• n t . rr NATURE OF APPLICANT j DATE T pert CERTIFICATION e) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of desc bed ve, y v' ie f a wa my deed recorded in Register of Deeds Office. 114 1 / 1 8/ o 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 STATE BAR OF WISCONSIN FORM - 2 1998 649684 WARRANTY DEED KATHLEEN H. WALSH Document Number Vn(. .�6 (OPAG£2O REGISTER OF DEEDS 1 ST. CROIX Co., WI This Deed, made between RECEIVED FOR RECORD _ — RICHARD 0-STOUT au AiIT 06 -28 -2001 9:30 AH ___ --- - - - - -- WARRANTY DEED Grantor, EXEMPT W and MTrHAFT M TF 7T AFF anr3 RREXD K TFT7 CERT COPY FEE: nusnan ti an wife T•AFFi COPY FEE: TRANSFER FEE: 140.70 RECORDING FEE: 10.00 Grantee, PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in County, State of Wisconsin: Z 'riselt, Plat of Shadow Pine Town of St. Croix County, Wisconsin Name and Return Address f'1Le Lot 0 32- 2117 -80 -000 ', Parcel Idenflfication Number (PIN) This i S nn} homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this __1 4th day of _ .Tune �nn1 R� S (SEAL) (SEAL) Richard O-- Stout Janet P S ou -- -- - - -- (SEAL) -- ,- _ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, St, Cro County. J authenticated this day of Personally came before me this 1 4th day of Tune - , 2 n n T , the above named GtQUt � � TITLE: MEMBER STATE BAR OF WISCONSIN j — to (If not, me known to b�i l n 3 w G the foregoing authorized by §706.06, Wis. Slats.) instrument and s ON J. BAST Janet K THIS INSTRUMENT WAS DRAFTED BY Janet P, Stout '— _ 1353 Awatukee Tr. Hudson, WI 54016 Notar ublic, State of W nsin My omrnis ion is per neat. (if not, state expi uon date: (Signatures may be authenticated or acknowledged. Both are not Names of perso s signing in any capacity must be typed or primed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN Co wiscoosm Legal eianr. ., me FORM No. 2 - 1998 kuwaukee. WIs. Wiscosin Dr' - in of Commerce SOIL AND SITE EVALUATION Division and Buildings Page 1 of3 Bureau br ated Services in accordance with s. ILH_R 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 incheq- th'size. Plan must `�` County include, but not limited to: vertical and horizontal reference point' 9W"directiord St . Croix percent slope, scale or dimensions, north arrow, and location id dystancea(eatad. ;parcel I.D. # APPLICANT INFORMATION - Please print all i f i!naA�t � � eviewed by Date Personal information you provide may be used for secondary purposes�Priviicy law, Property Owner -' t oc Richard Stout 60vt. Lot r 1/4 1 /4,S T N,R E /(orr)) Na N is 21 19 Property Owner's Mailing Address f' "CI , y I # Subd. / rw � r�Stvl# 1353 Awatukee Trail ( R Shadow Pines City State Zip Code Phone Number ❑ City ❑ Village )M Town Nearest Road Hudson wi 54016 ( 715)549 -6731 Somerset New Construction Use: Residential / Number of bedrooms 4 Addition to existing building ❑ Replacement S Public or commercial - Describe: Code derived daily flow 6 0 0 gpd Recommended design loading rate 7 _ bed, gpd/ft 8— trench, gpd/ft Absorption area required 858 bed, ft 7 5 0 trench, ft Maximum design loading rate . 7 bed, gpdfil . 8 trench, gpd /ft Recommended infiltration surface elevation(s) See plot z nl n n 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 S U S U S U ❑S U U Unsuitable for system Q S El U 12 � � � � � ❑ S � U SOIL DESCRIPTION REPORT Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0-3E 10 r2/1 -- sil 2 1I A 8K mfr 2 36-48 10yr3/2 -- sil 2.m4f3X mfr Cs -- .5 .6 Ground 3 1 48-9 6 10yr4/6 -- ms osq ml Cs -- .7 .8 elev. 9 1. 6 Ott. j Depth to limiting factor 9 6 in. Remarks: Boring # 1 0 -24 10 r2/1 1 2 MAtb 2 2 24 -84 10yr4/6 ms osg ml Cs -- .7 .8 Ground elev. 9 L -B-Ot. Depth to limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. : /l, a 'W 5�:1'�'> /rev GJ, � 1,15-37d �l�( Address Date CST Number 4 -•, 4 ? l t �'�':t , �� J.J � � - �. � � 'mod Richard Sto SOIL DESCRIPTION REPORT PROPERTY OWNER car — Page f3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 -2 10 r2/1 -- is 2 mvfr C 1f .7 '.8 ...:::....................:::: 2 20-38 10yr3/6 MS osg ml cs -- .7'.8 Ground 3 38 -110 10yr4/6 MS 0sq ml cs -- .7 .8 elev. 92 .8.a. Depth to limiting factor 1 1 in. Remarks: Boring # 1 -18 10 r2 -- - an A 4 2 18 -8 10yr4/6 ns osg ml cs -- .7 8 Ground elev. 92. ft. Depth to limiting factor 81 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 # 1 -24 1 0 r2 1 Bil M 2 P4-44 10yr3/6 -- s 2 Yn4-bK mvfr c -- .7 ;.8 Uj 8 3 4 -9 10yr4/6 ns osg ml cs -- .7 ,.8 Ground elev. 9 2 .10—ft. Depth to limiting factor g_g__ Remarks: Boring # i3 Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) r -- 5' T� T 6 T 3� X30' o f 9g, Sd �J ti 0• U ,44 % r O n� 4 Y'7 h7 II Wisconsin Department of Commerce SOIL AND SITE EVALUATION Divi, d of Safety and Buildings Page —Z of j Bureau of Integrated Services ,t°'d with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper notOsslhan' 8 1/2 x 1 inches l Plan must County include, but not limited to: vertical and"hoYzontal r �i�b �it (BM), drpction and St. Croix percent slope, scale or dimensions, north arrow, a d �ddat d distance'to nearest road. parcel I.D. # APPLICANT INFORMATION,- Paease t all i� 1 /J t RQt � ation1 Review by Date Personal information you provide may be used tdr seconda (Privacy Ida N s (1) (m)). Property Owner �, ICE , ;,, ^:;" Property Location ` Govt. Lot 114, ,1�'1/4,S /5' TS/ ,N,R l el E (or) W Richard Stout Property Owner's Mailing Address a;. . Lot # Block# Subd. Name or CSM# 1353 Awatukee Trail & City State Zip Code Phone Number ❑City Village own ear Hudson WI 54016 (715)549 -673 �" New Construction Use: Residential 1 Number of bedrooms 4 Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow _0_ gpd Recommended design loading rate 7 _ bed, gpd /ft trench, gpd /ft Absorption area required $ 5 $ bed, ft 7 5 d trench, ft Maximum design loading rate :_ bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) See:_] Cwt plan an ft (as referred to site plan benchmark) Additional design /site considerations Parent material Cnc2 Flood plain elevation, if applicable ft S Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank Unsuitable for system I 1] S❑ U [� S U WS ❑ U I OS ❑ U ❑ S [Z U ❑ S ] U SOIL DESCRIPTIO REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 .:............. in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. Bed Trench 1 0 -6 1 0 r3 3 Sil 2L bhk mfr 2 6-3d 10 r4 4 Sl i>tahk m Ground 3 30-S6 10 r4 6 Ms 0sq I -- -- elev. Depth to limiting factor _ 6 in. Remarks: Boring # mfr 2 2 14/18 10 r4 4 S1 r 3 38/S6 10 r4 6 Ms - -- Ground lev 4,S#t. Depth to limiting factor _46- in. Remarks: CST Name (Please Print) Signature Telephone No. William Schumaker (715)386 -3121 Address Date CST Number 1070 Scott Rd Hudson WI 54016 2 . - Z - 7 il ly 10� PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT i Page a of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 1 0 -1 10 r3" 3 Sil mabk mfr cs 2F .5 '.6 2 114/28 10 r4 4 S1 mabk mfr Cs 11F .5 ,.6 Ground 3 138/S6 10 r4 6 Ms Ogg ml .7 '.8 elev. -- -- q�ft. Depth to limiting factor —CL6_ Ll I I Remarks: Boring # 1 Sil mabk mfr MR 2F -5 -6 4 Ground elev. y�n25 ft. Depth to limiting factor 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 # 1 0/14 1 0 r3/3 Sil mabk mfr Cs 2F .5' .6 5 2 14/38 10 r4 4 S1 mabk mfr Cs 1F .5 ,.6 3 38/96 10 r4 6 Ms 0sq ml -- -- .7 .8 Ground elev. �575 Depth to limiting factor .gL-- Remarks: Boring # .......................... ........................... Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) f �7? � /�•c e � C /d 7 '_ 4 5' � ' `PUG i,J � � 7'�t�u - �!t 5YS,'e T - t v Tl 7s , s 7'2 A lY.2P T T/ ?3,3 Tod 9 ;2 S/ d M �o 0 �1 �; ®?� 22 { i +�3iGifiWa) ......, ... '..:.ty..r.. :'t „• ul:e.•. uuAt3l � 1 ,££ I I - - - - - -J j L------------------- r--” ----- CO — — — — — — — — - - - - - - -- w 0) M l8'LS6 ",�Hmv ZgZ 30 dd 0 o NOW •06L81Z5 o°' d or" dW .13n2�(1S i I w h y \ 11N: ££ I Z 10 Me 39 Vd { +; ° o o 3 z �� Z I Z+� �6 ,,20,bb.00S =�1 A -:m&ns 03/36 + m o rn I C 3„ l 1,LO.00S ,09 00 o w 1 > c 5' / a 3 a o o I a .,� �F, Noy b Q) En a . 2-0. q I U /��°' �4� ti L o ° d M a� >, h I o, 96 49 5°c . p c M o ° �° 3 y I o ^I M„ l 1,L0.00N x CO a — , v w 7 I— O o c c .? v I ►� \ i� ao W U co o rn Q O C3 N a� ° C ., a I I M . l 1,L0.00N r cn C- to c Q) lfj �,, 0 v� x o ; \ 1 N `` ,st's� `Asa cq e C4 CC •- i v v y c _0 I � �F O ci o U) 3 cn o �° Q) m' (D T3Q wl P w t w p I ,? �= C14 M 3 M _Z -C k j � o��' I \I of CN m ' ` sue ..�N M I .8 6 �� E N t• I O ZZF9 00 rn I N Z L" a, O co ol .s8'6£ Q� U �� ,M„ L U-0-00N � 1 W I W ~ c • � \ � � � � �sy� �i�i z I (0 8£Z O 1 00.09 r: L •S2 ;� \ .96 i I o N ,09 ,09 I I I I I , I I au - Q) 0 a)E a�i -r o� 1 °J � �n •c 0, Q — 00 C) 0 d oa,�a� y L 0 c 0 CD 0 a I z a o o QI I 3 , C ` I N D (n1 a v m tC I I C0 CO . o_ t >, Q I =I C\1 c0 =Y N i i O O N C - I °? rn z C) a Q) pi Yi I f� /l 3N 3H1 30 */l 3N 3H1 I I o y i a o 1— nzt�c� Q� � rn= 0 0� c -J I QI M c :5 0 V) QI I I �V- o „ f-1 N f� /1 3N 3141 J0 A/l MN 3KL .jO 31V/-I rn �,