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HomeMy WebLinkAbout042-1020-60-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 552348 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: Jacobs, Elen R. Warren, Town of 042-1021-60-200 CST BM Elev: Insp. BM Elev: BM Description: Sectionlrown/Range/Map No: ,ILCA_ 08.29.18.1256 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER Ny CAPACITY STATION BS HI FS ELEV. Septic Benchmark 2 Dosing Alt. BM Aeration 1 Bldg. Sewer V Holding St/Ht Inlet / B $z 7S sL St/Ht Outlet I • Z7 7 TANK SETBACK INFORMATION I W. 07 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Dt Bottom Septic $5 ~ 70 Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade _ PUMP/SIPHON INFORMATION Manufacturer De and St Cover GPM 11 Model Number 'S 76 1Z - 31 TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO /t BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: J v A- UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Le Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade S my Depth Over Depth Over xx Depth of xx Seeded/Sodde xx Mulched I Bed/Trench Center h Ed es 0 Yes ❑ No ❑ Yes :5 d No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1036 110th Street Roberts, WI 54023 (NE 1/4 SE 1/4 8 T29N R1 8W) NA Lot 6 Parcel No: 08.29.18.125B 1.) Alt BM Description = C~G, ; /O 4, d 1', (*t" L.O✓-e , 2.) Bldg sewer length 61A j ` -amount of cover ~T'f d✓fL.1L- L Plan revision Required? ❑ Yes o C g 12- other side for additional information. Use Date Insep is Sign re Cert. No. SD-6710 (R.3/97) r' - County Safety and Buildings Division 1 t , u 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) SP Madison, WI 53707-7162 ( F It Application State Transaction Number In accordance wit1S dm. Code, submission of this form to the appropriate governme 120 sanitary permit. Note: Applforms for state-owned POWTS are submitted to ~j is required prior to bb ication ect Add e s (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1)(m), Slats. o 1. Application Information - Please P ' ll Information Property Owner's Name Tyeb~ / Parcel # EMI) a a 099-IWJ 1 L12 -ad6 Property //O~~wner'>>s ailing/A/ddress Property Location / I V~© ~C! i~ S-( Govt. Lot L' City, Staaatte Zip Code Phone Number ~h V. y<, Section 0 J" bu S ~n f 'rcleone II. Type of Building (check all that apply) ✓ Lot # T u N; R ` E orV I or 2 Family Dwelling - Number of Bedrooms Subdivision Name f lock El Public/Commercial`-Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number D ! Town illage of 0 ✓ of III. Type of Permit: (Check only one box on line A. Co ete line B if applicable) A. ❑ New System El Replacement System Treatment/Holding Tank Replacement Only Other Modification g Sy to Eristin stem ( explain) fctrLo ~;,1° t"e fax List Previous Permit tuber and Date Issue B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber FEermit Transfer to New Before Expiration / 2U ✓vZ IV. e of POWTS S stem/Com onent/Device: Check all that apply) Xon-Press ed In-Grou d El Pressurized In-Ground 11 At-Grade [I Mound > 24 in. of suitable soil El Mound < ~4 in. of suitable soil ,G,~~- nD.sp., ❑ Holding 7%dithl Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area nformation: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (so System Elevation S/ d4 VI. Tank Info apacity in Total # of Manufacturer Gallons Gallons Units 6 o New Tanks Existing Tanks c ) - M CZ P. UO cn y ~5 iz. 3 Li. Septic or Holding Tank / Od V DUv / SrPrJ~ X Dosing Chamber VII. Responsibility Statement- I, the undersigned, ssume responsibility for installation of the POWTS shown on the attached plans. Plumber s Name (Print) in is Signature MP/MPRS Number Business Phone Number )N_ Plumber's Address (Street City, Stat, Zip Code) Ln &t VIII. unt /De artment Use Onl Approved Permit Fee Date /sued Issuin gent Signat e $'756. 5 7/jZ, teen Reason or Denial IX. Condi*V,8T AAmvq"gN;Reasons for Disapproval rat, Y aJG 1. Septic tank, effluent finer and 2 dispersal cell must all be services /maintained as per management plan provided plumber. 2. Ap setbeck requirements must be maintained " n pet appic" cods / W&Wices. { t~l "`j M • j"- f 5 r lit[.. Attach to complete plans for the system and submit to the Countymy on paper not less than 8 t/z x 1 inches in size SBD-6398 (R. 11/11) v n N 04 f `Y _..wwis, cl - - U' I ` ry - ST. CROIX COUNTY SEPTIC TANK. MAINTENANCE AGREEMENT AND J OWNERSHIP CERTIFICATION FORM Owner/Buyer l ~I G~ .c r~-~- u L✓ n~-~ Mailing Address j Property Address m3u (Verifications required from Planning & Zoning Department for new constriction.) City/State e) Parcel Identification Number LEGAL DESCRIPTION Property Location jF 1/4 , I/4 , Sec. , T e ~9 N R_y~? W, Town of . Subdivision , Lot 4 Certified Survey Map # Volume , Page # Warranty Deed # Volume Page Spec house yes no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. Uwe, 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 Departmenf 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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. Number of bedrooms /I/2 SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application 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. (REV. 08/05) 838112)0 /I REGISTER H. DEWALSH EDS State Bar of Wisconsin Form 1-2003 ST. CROIX CO., MI WARRANTY DEED RECEIVED FOR RECORD 11/03/2006 02:20PM Document Number Document Name WARRANTY DEED EXERT # THIS DEED, made between REC FEE: 11.00 Mark Renstrom and Mary Renstrom, husband and wife TRANS FEE: 975,00 COPY FEE: ("Grantor," whether one or more), CC FEE: and Elen R. Jacobs, a single person and PAGES: 1 Annette Jacobs, a single person as joint tenants ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in r~-~~ St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return ~ Address 5H needed, please attach addendum): Wisconsin Assured Title, LLC Lot 6 of Certified Survey Map filed June 5, 2002 in Volume 1810 Cre View Drive, #1B Huds I 54016 16, Page 4317, as Document No. 682639, being a part of the c m sw S'-q 3 Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/4), 042-1021-60-200 Section Eight (8), Township Twenty-Nine (29) North, Parcel Identification Number (PIN) Range Eighteen (18) West, Town of Warren; St. Croix This is homestead property. Countv. Wisconsin. (is)(isnot) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, Restrictions, and Rights of Way of Record ~I Dated October 31,_2006 I (zi GOY'7 (SEAL ' (SEAL) *.Mark Renstrom *Mary enstom (SEAL) (SEAL) 'y-mot AUTHENTI4q4►Tjf ACKNOWLEDGMENT Signature(s) " TATE OF WISCONSIN ) ) ss. authenticated on It. Croix COUNTY ) Personally came before me on this 31" Day of October, 2006 , S the above-named TITLE: MEMBER STATE BAR OF VJ) ~ Mark Renstrom and Mary Renstrom, husband and wife (If not, to me known to be the person(s) who executed the foregoing authorized b . Wis. Stat. § 706.06) instant and ac owle the same. THIS INSTRUMENT DRAFTED BY: * Richard K.Y. Lau - Redmon Law Chartered MerileeJ. Bune 2217 Vine St. Ste. 204 Hudson WI 54016 Notary Public, State of Wisconsin My Commission (is permanent) (expires: November 8 2009 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED O 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. 1 of 1 Apr, 30,E 21) 1 Z' , 27PM ERA Muske (;oruany Real Estate No, 0568'; P, 17 CERTIFIED SURVEY MAP Thomas and Nona Sullwold Lowated in Ixart of the Northeast of the Southeast ~ls of Section 8, Township 29 North, Range 18 West, Tmvn of Warren, St. Croix C'ount)~ Wisconsin. 'S ADDRESS 1229 100TH AVENUE: ROBERTS, WI 54923 N i , 6EARMaS ARE REFERENCED fi THE EASTLNE OF THE 50U1N6118T1/~OFSECf10NA, f TMN,Rfrfir,ASSUMAs Naors'rrw. i SCALENFFEr 1, 100' UNPL4 TED LANDS ! i ' 'r ' d 160 7~rr C7~ CENTER},E1fE f10THSTWT i N 89°44`48" E 384.95' - R 5D►G 33 ro l ALR181~RlM AI rip t.. ~rF S , F - - - - - pt1A wG LOT 6 1"n CONTAIIV5111,467 Sp. FT. 0112. 11 8 AC. f11,629 ( . I=r. as 2.5s3 Ac.'CGUDINO r!, TOWN ROAD RIGHT OF WAY) 1 z ` S 1 i "2''17" 1± 443,90 C1 33,8 3.54' S 89°44'48" W 477.54' j~'''•- 0 Orr UNPLArml) t ANpS W W 47.49 4 DA CP sadS ,S+~c~ru V 2MA LLEGEND 3 '•1,AttR~N~~ 14 a INtHGAYES T'q,p. fs"}f217N Muwp►+ a PIPE SET IAftN. WT. -1. f9l.B,R..P.} Ar ~ s a ~ # A INDICATES P IRON IRON PfPE f'OWD q z FALLS, a SOIL BORINGS (PRtOPOSEO SEPTIC SYSIEA}J f o b i4 c SEG770 CdRNER MONUMENT (AS NOMD) 4sconsin Department of Cgrnm~rce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building b"roision INSPECTION REPORT Sanitary Permit No: 429968 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: Duhme, Fred Warren Township 042-1020-60-200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: l C: t~ • It too-a' C vr vs ( -,-rLyt P (r 08.29.18.1/(, TANK INFORMATION EL VATIO DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W ~5~ Z SQ Benchmark • q~ ` OZ.93 o>D,D 9S Dosing Alt. BM -3- -Ae V-4 3 Aeration Bldg. t&" 150~ ~ Holding St/Ht Inlet .OS / e-r 9115-. TANK SETBACK INFORMATION St/Ht Outlet / / Z ~S• O TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , Z~ ` Q Dt Bottom Dosing J C, Header/Man. Aeration Z=- I T O r -mss 9~f• Holding Bot. Syst m Gt, ~ • P P/SIPHON INFORMATION Final Grade M nufa turer c Demand St Cover GPM Model Numbe TDH Lift Fr' Loss System Head H Ft loo Forcemain ength Dia. Dist. to Well SOIL ABSORPTION SYSTEM J= CH Width t Length No. f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI p.,%Qat • 2,) 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING M fa INFORMATION CHAMBER OR Type Of Syst m: 1 UNIT Model Number: if 15D 5~ DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size Ix Hole Spacing Vent to Air Intake Pipe(s) Length Dia Leng Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil U Yes F=j No ~ Yes No XS4 I l~de . dis 'gyp cie persons present, etc.) Inspection Inspection #2: e;T...W at ion: 1056 110th St Hudson, WI `54 16 114 NE 114 8 T29N R18W) NA Lot 4 Parcel No: 08.29.18. 1.) Alt BM Description = i • 2.) Bldg sewer length 19 - X - amount of cover = -2f f Plan revision Required? / S No ©T ZZ S'- Use other side for additional i r ' IseQ ~ or,s Signature ♦ 1 i ~S1B`6710 R.3/97) G~~ ✓ ~ /t //1, / 3 A .4 sap., a zcw ~ - Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 lSG~J~f~ Personal information you provide may be used for secondary purposes Madison, WI 53707-7302 Department of Commerce [Privacy Law, s. 15.04(I)(m)} (Submit completed form to county if not state owned. Attach complete plans to the coup co only) for the stem, on paper not less than 8-1/2 x I 1 inches in size. County State Sanitary P ' Number C cation State Plan 1. D. Number 5~ • G'Oi c 1. Application Information - Please Print all Information Location: M S-40 f Property Owner Name MAY 0 7 2003 Property Location SC 1/4 f76114, S F T.2p,N, W Property Owner's Mailing Address ST. CROIX CO(JNT`-/ Lot Number Block Number /r O~f7~ ZONING OFFICE City, State Zip Code Phone Number Subdivision Name or CSM Number AU_Q(&,)10 L..:)/. i 3y,-51"O 0501 doh /a 33Vy II.1,ype of Building: (check one) l a❑ Village 'lop II~~ 1 or 2 Family Dwelling - No. of Bedrooms ❑ Public/Commercial (describe use)._ _ m+I'own of ) ❑ State-Owned Nearest Road W u-~►`• Parcel TaxNumber(s)Q Z_~020-(o0-Z III. T e of Per it: Check only one box on line A. Check box on line B if applicable) A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Yype of POWT System: (Check all that apply) on-pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis ersal/Treatment Area Information:.V $ S ' Z. S . r it s )70J: A. .5.~, 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. -Percolation Rate 6. Syste levation, 7. Fi Grade Required Proposed Rate (Gals/day/sq. ft.) (Min/inch) Elevation 600 68S7/S X 70, POs . 0. 7 96. VII. Tank Capaci in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks i 2S 2S~ Gt~j~ $Grr ~n~. VIII. Responsibility Statement 1, flee undersigned, assume responsibility for installation of the POI S shown on the attached plans. Plumbers Name (print) Plumber's Signa (nos s): MP/MPRS No. Business Phone Nu^ bee -old .1 aaso3~O ~~s 3~- ~'~pa I c,~b/►~ Plumbers Address (Street, City, State, Zip Code) 0 O der ~iatU~ S . Sy0/6 IX. County/Department Use Onl C3 Disapproved Sanitary Perrnit F (Includes Groundwater Date ued uing Agc t Signature stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee)( 1 Determination / . Cgriditions of Approval /ReasonA for Disapproval- P/" G'Q~1• ~ 3 : 3y~e /ham. . 3 l~lQ-®' vh 9'343-1 nddty 45601 ,n Safety and Buildings Division County n ` 1*isco' 201 W . Washington Ave., P.O. Box 7162 J~ t ao 1 Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266-3151 De artment of Commerce Sanitary Permit Application State flan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal ' vide may be used for secondary purposes Privacy Law, 15.04( ~,~CD Project Address (iftiifferent than mailing address) 1. Application Information - Please Print All Information C C S, r•, Property Owner's Name Parcel # Lot # Block # F-1-id v-kmQ. sr. CROIX 0r12-1d20-(00-240 f of Prop/erty(O~wnejr'ss Mailing Address ING OFFICE, Property Location `-I C~ !'1 Cwra 5 E '1A Section City, State / Zip Code Phone Number p/ ~)q~1 c e c~5 Sy Ql t0 C ~sj " sd /f✓ trcle one .3 0 6 ) tf'~ T _g.-VA N; R~~C-W 11. Type of Building (check all that apply) 2 Family Dwelling - Number of Bedrooms l SubdivisionN/azneQ CSM Number ❑ Public/Commercial - Describe Use cs v U o~ 33 ❑ State Owned- Describe Use ❑City_❑Village ownship of Z0Lt-/Y'ei'1 Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal tsarit Revision ❑ Change of ❑ Permit Transfer to New Ust Previous Pennit Number and Date Issued Before Expiration Plumber Owner 5~Z / 7 a /,,2 zea3 1V. T of POWTS System: Check all that apply) Non -Pressurized In-Ground ❑ Mound? 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculattrig Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information:' 5Eu.. wc) I I" $ 3/. f s 1E E, x: 5.4 r = .2.S, /1, Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area roposed (sf) System Eleva n G 00 q d 0.7c%,454 857. 16-5.r S~ ~0. Flo yet 9 3.74 Vl. Tank ififo Capacity in otal (Number Manufacturer Pref Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Hoiding Tank 2.5.0 `O c..r Aerobic Ttcatmcnt Unit J 1 Dcsing Chamber V11. Responsibility Statement- 1, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) c PI ber's tune Mf'/MPRS Number Business Phone Number irlc/ 2250 30 (?/S)3 ?6 - K9z Plumber's Address Street City, State, Zi ode) _ ~I /D 70 G/ j 6G~ SG 500 VIII County /De art ment Use Onl ❑ Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval Attach complete plans (to the County only) for the system on paper not less than 81/2.% 11 inches In size SBD-6398 (R. 01/03) A w 0 S6$1T, D `f f ZtR~3 WfisconsinDepartment ofCommerce SOIL EVALUATION REPORT p 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code 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. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 042-1020-M200 Please print all infonnation. By,. Date Personal irrformabon you p vvWe may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Fred Duhme Govt. Lot SE 1M NE 1/4 S 8 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Nam or CSM# 418 Bantara Dr. 4 na CSM Vol. 12, Pg. 3344 City State Zip Code Phone Number City I Village &A Town Nearest Road Hudson WI 54016 715-386-5890 Warren 110Th Street M' New Construction Use: to Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD rI Replacement Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recomrnendati Addend to original Soil Evaluation report completed to verify depth of soil suitability at greater system epth. Boring # J Boring >136" in. Soil Rate iY Pit Ground Surface elev. 100.68 ft. Depth to limiting factor Application 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 10ye3/2 none sl 2fsbk mvfr as 2f,lm 0.5 0.9 2 13-21 7.5yr4/6 none scl 2msbk mfr CW 2fm 0.4 0.6 3 21-28 7.5yr4/6 none Is 0 sg ml Cw - 0.7 1.2 4 28-136 10yr5/6 none s 0 sg ml - - 0.7 1.2 .d iq. =~=L= Boring 2 Boring # I Pit Ground Surface elev. 100.71 ft. Depth to limiting factor > 133" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/3 none sl 2fsbk mvfr as 2f,1m 0.5 0.9 2 13-22 10yr4/3 none Is 1msbk mvfr Cw 1fm 0.7 1.2 3 22-26 7.5yr4/6 none Is 0 sg ml CW - 0.7 1.2 4 26-133 10yr5ro none s 0 sg ml - - 0.7 1.2 l• * Effluent #1 = BOO 30 < 220 mg/L an~ TSS >30 < 150 L * Effl #2 = BOD < 30 mg/L and TSS <_3O mg/L CST Name (Please Print) Signature/ CST Number -"'t < - James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations ithite Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceol , 154020 8272003 715-248-7767 i I ♦ Eledat~o~ 5 cult : I ~ {fro pcse.d q b c d~~m lG S r d ~'1 CQ, 11L St~ect" I ■ ai u~ a: 11 i S/off ■ $L ~O/.0' s 970" 99.0' 4 - i i /1,11 e- 1629 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accor Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on inches i size. Plan must County St. Croix include, but not limited to' reference point ( direction and percent slope, scale or di emsion , h arrow, and locatil and tance to nearest road. Parcel I. D. 3 042-1020-60-200 PI a print~, a~~(( #►~D"29A. Revie B Date Personal information you provi may Ja§ for secondary rooae~ (Priv taw, s. 15.04 (1) (m)). ` , OF Property Location Property Owner SA GR C Fred Duhme -z Govt. Lot SE 19 NE 19 S 8 T 29 NR 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 418 Bantara Dr. 4 na CSM Vol. 12, Pg. 3344 City State Zip Code Phone Number City _J Village 0 Town Nearest Road Hudson WI 54016 715-386-5890 Warren 110Th Street t> New Construction Use: 1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments Z d &00 ~p and recommendations: Install two trenches at elev. = 96.00' using 21 leaching chambers. a M Boring # J Boring fI Pit Ground Surface elev. 100.68 ft. Depth to limiting factor >106" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-13 10ye3/2 none sl 2fsbk mvfr as 2f,1m 0.5 0.9 2 13-21 7.5yr4/6 none scl 2msbk mfr cW 2fm 0.4 0.6 3 21-28 7.5yr4/6 none Is 0 sg ml cW - 0.7 1.2 4 28-106 10yr5/6 none s 0 sg ml - - 0.7 1.2 a Boring # Boring Pit Ground Surface elev. 100.71 ft. Depth to limiting factor >107" 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 0-13 10yr3/3 none sl 2fsbk mvfr as 2f,1 m 0.5 0.9 2 13-22 10yr4/3 none Is 1 msbk mvfr cW 1fm 0.7 1.2 3 22-26 7.5yr4/6 none Is 0 sg ml cW - 0.7 1.2 4 6-107 10yr5/6 none s 0 sg ml - - 0. 1.2 5~O • Z` 2 Effluent #1 = BOD 30 < 220 mg/L and TSS > < 150 mg/L ' E nt #2 = D < 30 mg/L and TSS <-30 mg/L CST Name (Please Print) Signal CST Number James K. Thompson a 3602 Address A.C.E. Soil & Site Evaluations Data Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, Wl 54020 5/32003 715-248-7767 Property Owner Fred Duhme Parcel ID # 042-1020-60-200 Page 2 of 3 3 ] Boring # J Boring f Pit Ground Surface elev. 97.37 ft. Depth to limiting factor > 102" 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#l *Eff#2 1 0-17 10yr3/2 none sl 2fsbk mvfr as 2f,1m 0.5 0.9 2 17-31 10yr4/4 none sl 2msbk mfr 9W 1fm 0.5 0.9- 3 3143 7.5yr4/6 none sl 2msbk mfr cvr 1fm 0.5 0.9 4 43-51 7.5yr4/6 none Is 0 sg ml cvv - 0.7 1.2 5 51-102 10yr5/6 none s 0 sg ml - - 0.7 1.2 F4 ] Boring # 01 B it Ground Surface elev. 98.95 ft. Depth to limiting factor >72" 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 0-12 10yr3/3 none sl na na na na na na 2 12-24 10yr4/3 none Is na na na na na na 3 24-30 7.5yr4/6 none Is na na na na na na 4 30-72 10yr5/6 none s na na na na na na Hand auger boring evaluated to verify soil texture at system elevation. F 5-1 1 Ong # Boring Pit Ground Surface elev. 98.83 ft. Depth to limiting factor >72" 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#l *Eff#2 1 0-12 10yr3/3 none sl na na na na na na 2 12-20 10yr4/3 none Is na na na na na na 3 20-28 7.5yr4/6 none Is na na na na na na 4 28-72 10yr5/6 none s na na na na na na Hand auger boring evaluated to verify soil texture at system elevation. ' Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 S_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. I~ 1 50;1 ¢✓a/ccG.t~+or~ bvr>%~9 ♦ E/e ✓-16'017 5 cr~le 4P-z-:i 16.29 Pro p0se.d y 6 cdro,o.n 8encf► h'jarA': Ycp p V C, res;d" m p e, ss ccA7cQr e I eta = ia~ ~o3.IB stre~r ai I 747. `I Ark. Qk! trarncl`r,cc Posh c lave io7.S8' 4Yat't 5 /O~ 8 2 col. a' 97.0" 99.0' ~w t~j. 3 a,3 i j d I, A E/e✓4or1 j Lcz F7 Propose,d 25-0Y4, S.T.' kc/''~ r6z9 f.'ltcryE,S.T. owt~~' ~ l o(Y~i~ 51o Qropased PJC..:nta of q 6 ~a S, cx~.n as dnre i rcs,dence ~~x-hMo~~: Top oP/"P,✓.C. 103.18 ;,ot. 5SCAInEd e1tJ: r0aw a..r-p~oposcar ,..7ccr i St/FCT tfic ;tee vs 'E"`~ Two (z~ t~e~rc%e s of 3 :r 87So' u s~ store 'F'~S/t3io r0.'F,/use~- C-~o.•~,(.c~s p~+' trcrr~ 83 ■ 43 Fd , a ~ ra3:o co~t»ur V A/E.CSM.; Ylwl ~n d~~• i 82- Y70' i 99. o i copy So u - ✓u. to 9 ru,~/~C d Pi - - .3 r - - i ♦ E/e✓at,'on C/ f ScWe~/''=~oProposRd 1, zSOyof. 5 T.- ka 16Z9 I f.'ltera•t s.7. o,,,~lQ.t. atof ScaQ yo Qro pose d I~oc.r (y) i,7 ;nt y 6c.d~oo,„.► c os~ clr~~e~.vay rc5,-ct ev, Pr P --i-t-- lnc.~►tr~~: Top old /"p,d.C. ss(A •nede)w`=/Ooa proposed ,Jei! Str~cr Y A. 5.T i►G 3 o3q p. c. ~ FF l ~cor ~ ae i I Qom---- ijz' B f I vs'.4-~ 7wo (z~ fi e,~el~e s of 3 X 8 Z So u s, e? More dr.-rS/lgio~,iS~s~'C-/~a..►~~5~0~+''f1'~c''~• 83 ■ ~ I ~d /03 o C.0 n60 ccr v d ? I Air. Q i , h ~ CArntr ' PaS~, L s/oa 82- I 340 97.0 99.0' ~ I I i i Sou - i~aEe yj cc c4 dries ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerlftWw- Frei b" mi?, Mailing Address 4y na ff s g h LD1 Property Address /OS 'y ro- (Verification required from Planning Department for new construction) City/State Parcel Identification Number 0 S - /Da0 -4,0 LEGAL DESCRIPTION Property Location 56' 1/a, r 1/a, Sec. T_,LtN-R / W, Town of 60-ar en Subdivision , Lot # Certified Survey Map # 54,4/ 7 2 7 . Volume /o? , Page # 33 Y9 Warranty Deed # 56 ooX76 , Volume 49 76 , Page # por Spec house ❑ yes 2 no Lot lines identifiable Ryes ❑ 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. Uwe, 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 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. ,moo w e 444-e, 5' /c31o3 SIGNATURE 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. 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 Conventional Septic System Management Plan -L12 q Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10567-P (8.6/99). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank The operating condition of the septic tank and outlet filter shall be agsseisW.at least once every two ears b inspection. The septic tank cant s ffi-MM-te en e s udge and scum in the tank exceed 1 /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation The filter cartrid e should not be removed unless provisions are made to retam son m e tank that may slough off the filter when frome o ns equipped with an a arm, a er a service n the aalarm ns activated. Septic tank manholes 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 individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October- February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to installing plumber, Jim Boumeester at (715) 386-9020, or the St. Croix County Zoning Department. I FILED leor AV' CC £ SEP 0 3 1997 ► ~dY3 ~.i ! Z KARegisterJof De ds H ® O oZ60 /~G st. Croix Co., W1 Q yZ /Q aZ N C ER T -T F I ED S UR V E Y MA P Located in the Northeast quarter of the Northeast quarter and the Southeast quarter of the Northeast quarter of Section 8, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Owned by: John & Anne.Kurkowski x 1,059 110th i •-indicates a 1" iron Roberts, Wisconsin 54023 - LOT 2 x pipe found. ' I I C_S. M. VOL. 8i: PG. 2382 6 6'1 I LOT - S 88'00'41"E 885.21' 1 f 1 852.1'7' } I 33.041) 1 Bearings referenced lL ®1T- 3 I 1 to the East-West 1 /4 Section line, 488, 363 Sq, ft. (11 .211 acres) rl I assumed N89 3314011W a;1 I Including right-of-way, x(nn 1, I 470,567 Sq.ft. (10.803 acres) C.S.M. CU Escluding right-of-way. 31m _VOL._I PG. 244 xn - - - - - 61 ZI I S Q' I 1 -o° S 89'33'40"E 889.19' a 856.18' ; } (7~ t\ (U 33.01'1 to I U_ ® T 4 I ~ o ~ 893,264 Sq,ft. (20.507 acres) Including right-of-way. CU .r) ~ N 0 860,257 Sq.ft. (19,749 acres) 01 O Excluding right -of -way. aril _ I x o: cn I w Z ' / ^ z. 3l o u? p NI /l _ W o SJ o Z I a w. 0 0 Jx o m: I xn I o~ `0N15 co~NN•.,,~ of I SCP 0 2 '97 w, 'i of I 21 1 I C) Q1 RVEY ~i. ~ W I '~"b#'~s?.'.';a., r•tart~,>F'~:,~ _J1 JOHfl►SON 1 i 2or'rr; if r;,, S- - yBgQ y +1vo'-> coq I71 I W SON e t = ( _I 4 1 et ON nxwded < r I I Z wftn 30 days of tdti ~ I awrrvat oaw 0' O ~SU I 1 AWOV& and know • yyybyyy NOO°19'48"W P08 33.15' 66.01' 859.95' N 89'33'40"W 893.10' E1 /4 Corner W1/4 Corner N89°33'40"W 5222.09'- - Section 8 Section 8, found County UNPLATTED LANDS found County Mon- monument. o - indicates a 1"X24" Iron pipe ument. weighing 1.68 pounds per lin. foot set. This instrument drafted by: 497-2570 Vol.12 Page 3344 'Nib .g.g.: ~_-..qll. ee~..o.+-*-.-.,..........................w..:.•.w..~N:.VmrM.w.+AYR+w..l~e _ DOCUMENT NO. WARRANTY D YOL 1?76 PA008 REGISTER'S OFF lCE T. OIX CO.- W1 Rac'd for Record THIS DEED, made between John A. Kurkowski and Anne T. Kurkowski, husband and wife, Grantor, and Frederick E. Dub_me and N o V 10 1997 JE At---DIrzbeth S. ahmer 9:30 / husband and wife, Grantee, WTTNESSETH, That the said Grantor, for a valuable consideration of one dollar and other valuable consideration conveys to Grantee the following R , ister of Deeds described real estate in St. Croix County, State of Wisconsin: Lot 4 of Certified Survey Map recorded in Volume 12 on page 3344 as RECORDING INMRMATION Document No. 564787, being a part of the East 1/2 of the Northeast 1/4 of • • • • • • • • • • • • • • • • • • • • • • • . • • • . • . Section 8, Township 29 North, Range 18 West, Town of Warren. NAME AND RETURN ADDRESS Bakke Norman, S.C. 1200 Heritage Drive New Richmond, WI 54017 -f18 ~ d"Z' TRANSFER ~w Dlwl re 2 O FEE 042-1020-60-200 (Parcel Identification Number) This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; and Grantor warrants that the title is good, feasible in fee simple and free and clear of encumbrances except: ents, highways,~t{tility rights and reservations of record, and will warrant and defend the same. r Dated this X1,6 3 j --t day of October (SEAL) (SEAL) * . Kurkowski (SEAL) (SEAL) * Anne T. Kurkowski AUTHENTICATION ACKNOWLEDGEMENT Signature(s) of John A. Kurkowski and Anne T. Kurkowski STATE OF WISCONSIN } } ss. ST. CROIX COUNTY } authenticated thisWday of October , 1997 Personally came before me this day of 19 97, the above named * i Cott TITLE MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the persons who executed authorized by §.706.06, Wis. Stats.) the foregoing instrument and acknowledged the same. THIS INS 1 RTjWN 1 WAS DRAT 'ED BY: Timothy J. Scott BAKKE NORMAN, S.C. NEW RICEMOND, WISCONSIN Notary Public, County, Wisconsin W.- of no.•annq q:nn:na in gnar rgngnit{, ghnlllil ho t{MPit n. nnnt^A h^Wv the;~ My Commission is permanent. (If not, state expiration date: it i Jane Hansen Subject: McDoonnell/Duhme/ 429968 Location: Warren Start: Wed 08/27/2003 12:00 PM End: Wed 08/27/2003 1:00 PM Recurrence: (none) G1 ~ ~l b ~ C~ ' V r I I to i 1 Parcel 042-1020-60-200 07/11/2005 04:23 PM PAGE 1 OF 1 Alt. Parcel 08.29.18.116C 042 - TOWN OF WARREN Current X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner FREDERICK E &ELIZABETH S DUHME ` DUHME, FREDERICK E &ELIZABETH S 418 BAN TARA DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description " 1056 110TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 20.507 Plat: 0577-CSM 12/3344 SEC 8 T29N R18W SE NE BEING LOT 4 CSM Block/Condo Bldg: LOT 4 12/3344 Tract(s): Sec-Twn-Rn 40 1/4 160 1/4) 08-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 09/25/2003 741256 2419/175 EZ-U 11/10/1997 568270 1276/008 WD 1050/610 WD 862/203 more 2004 SUMMARY Bill Fair Market Value: Assessed with: 37938 Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.507 46,000 90,000 136,000 NO AGRICULTURAL G4 16.000 2,500 0 2,500 NO Totals for 2004: General Property 20.507 48,500 90,000 138,500 Woodland 0.000 0 0 Totals for 2003: General Property 20.507 48,500 0 48,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 Wisconsin Department of Industry, S011- AND SITE EVALUATION REPORT Page I of 3 Labor "and`Human Relations Qivtsion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 in zo. Plan must include, but ~ST' cf-oI not limited to vertical and horizontal reference point (BM Y.10 slope, scale or PARCEL LD. # d yL-/OZO -/O dimensioned, north arrow, and location and distance roa /O 20 - 4,0 R EWED BY GATE APPLICANT INFORMATION-PLEASE PRIN INFR~i 40 PROPERTY OWNER: CC PRO LOCATION NE JSC)M 4' AMAX, KLI.RjZV~5<1 AU3 1 SE 1/4 A,JE 1/4,S g T ~1-9 N,R /g W W PROPERTY OWNER':S MAILING ADDRESS ST CF1Ot?( LOT BLOCK # SUED. NAME OR CSM # [~5 c( 1104" A \I;:- COUNTY CITY, STATE ZIP CODE PH t fCE ❑VILLAGE OWN NEAREST ROA f~0 EIcT6 55F023 rJf - b7 En{ 118'x' New Construction Use K Residential / Number of be r [ I Addition to existing building j ] Replacement [ I Public or commercial describe Code derived daily flow 446C> gpd Recommended design loading rate 0,,'7 bed, gpd/ft2 0A trench, gpd/ft2 Absorption area required 6g14-5bed, ft2 5(63 trench, ft2 Maximum design loading rate_ 61 bed, gpd/ft2 03 trench, gpd/ft2 Recommended infiltration surface elevation(s) To _.I_TETS< JF l~ , referred to site plan bench k) Additional design / site considerations Parent material -56AC -A AI Flood plain elevation, if applicable AM ft rU =Suitable for system C,ggNVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN R L HOLDING TANK = Unsuitable for s ste XSI S O S❑ U S❑ U S❑ U C] S U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft_ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tme & 6L S 0.5 0. Z - _lD_ye314_ S1~ +r Cs O.s 0.10 Ground -3_ elev. _ _ 8,75t. 30 1~ 3 S ,-n - Depth to J15, 495 1D yl S m 1 - 0~-? ' p, g limiting - Zor , Remarks: Boring # 6-1Z_ )o Z/Z 1 Z dsh a 6 o,~ o. 1 -7 AD yk, f)(Ifr C5 Ground Cr _ 01 elev. .q3 77 5 p , $ ft. - Depth to limiting factor - ,~a3 Remarks: CSMName. Ple s0 Pr, iPt Phone: C IS 1426- 12 7,5 vas 22-0 30 tCrl" Act) p ~zz Signature' JG F,~ Date: 1997 CST NumberM03?07 PROPERTY OWNER wK Kb t k 6 K a O i L D E S C R IP i w N REPORT Page Z- of 3 PARCEL I.D. # V t--1020 --/d 0 y2-1020 - 60 Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends I D-11 1QYK j ► z o~ 6.(0 3 .<n 7- 11-31 lb%fKqlq. - '511 2 rr4 -F CS - o.s o•6 Ground 3 31-q~ I 3 $1 Yn - 0.44 0.5 elev. 95Nt ft. yfo 5 7, 5~ ~ s rn I ~ 0 ,7:0,8 R Depth to 5 ~ 7 SYA4~i6 S , limiting fact .t I Remarks: Boring # I 0-9 I'D yf h I as - 0-5 0.1 Z, q-t~7 0 ~y - 5'• 1 K rw& as - 0,5-10,10j 3 171.5 10 \lr 3 rnJ CS - ,`f 0.~ Ground _ elev. '4 25- Z 7.540e jq S m GS 0.7 ' o g _ l qj~L ft, .S 32-9 7.5YKyAO Depth to limiting factor5 ~r Remarks: C~r2 t'V t-to(~7-0~U 3 Boring # i 10-)0 0 211 - 2 msbx dsh ab J.. Z 10-I I0 y j - 5 1 2- sb v^ C-S - ,S 0, e Ground 3 m sb I'Y1 i O L5 ©.22 iQ eleV q 25- 6 ICy - S 1 0,4 ' x,31 ft. y _ s rn I - - - J 0 0 5 Depth to limiting factorO Y Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: S80-8330(R.05/92) Page of -3 PLOT PLAN Property Owner_KMAK8 W6K) SOm OMF Legend: Legal Description f(- PAtZcp(- "e rrc--o BM . ® #I crtjAA)D sv.RFACS ik-r llv TItE -AiEA € 5EX bF LiE yeA~.SEG_ TZ.9~, ►2 ~8~, lrotOJ OF W,4KREN, f$~ Z C."Wav SLIVUodW-E A-T' meom [~R wo ba ST, CMK ca WI C3 = soil 13 Ify" ~L 13.0 ? 5~ C]g3 Ow, IAJN'~~ / oD. D~ Cps No-r ID%STUje6) EL 95~y1 ' q8. 0q N t E> A WAS V) o D13q ~L 97.5 ? 3 °'D SLe o- J 3 8s o B o 9L. 910.3 7 ' EL 48. T QC AL~--,LFA- P1 1.D S Signed CST MD3707 Date AUCoUST g, 19Q~ ~i~jVlru Post-It- brand fax transmittal memo 7671 4 or pages . TDA 4K , F' ,Rvcy J C C4. -1 Co. UIPL Phone 10 5~ l U -gOz3 3 - Fax # Fax A! I 61l-32/-oKo 7rS 3~6J161 l S 88' 00 * .41 "t. 885.21- 852. 17' j ' I 1 j 1 LCJT 3 I 1 J 1.Z 1 J~C . ~NCL R14NY OF i..1►5~I tnl . I lp.~CO Ac. E5cc iGNi ac wby -Im co ~ii in Q of I UI 1 Z I I I I 5 29'33'40"E 889.19' I _ I j .rn 856 . IS' 3 1 :I Lor 4 I~ Il o zo.S! 1NZC_ L-i Ni o NC t I a► m ►9 ~5 ExcL 31O 0 • ~ al 1 ~I I zl I I l I I _ I I 1 I I I I I 1 I 859.95' I 11: 09'33.40--W 8R3_ 20" '.o 10 .a IUL-02-1997 09:39 ?1, 9r~ P.01