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HomeMy WebLinkAbout042-1086-90-300 0 ■ 0 -V 0 : ■ 2 ■ 10 ° / A. Cn e x 7s U z o 0 e 2 m (g ( ID i k § Q - ## f Q Q - §§ 2 2ƒ K d E; 11 i 2 e 8 2 ; @ CD ; % CO m $ ° 3 R E E ®. 0 k\ 0 ( =' © E D ± ■ E �� (D a CL e� / CL \ 2 �� k � / } 2 § �! § E $ E k to E �. 000 2 { / Oro @ §(� / § k 0 g J $ ' � �- \� i } Oro g l a 2 / � § :� ■� 2 e � w 7 § § § _ c , y ± 0 % C � � $ CD I k � � \ qb � A / ' % Wisconsin Department of Commer _ PRIVATE SEWAGE SYSTEM county: St. Croix Safety and Building Division �Q �Q �� Sanitary Permit No: INSPECTION REPORT 430628 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: Osburn, Alan I Warren Township 042 - 1086 -90 -300 CST BM Elev: ( Insp. BM Elev: ( BM Description: fon // nge /Map No: tSl . 1 S 02 • IS ctA a,*B2 u" k m - 31.29.18.485A30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Bench ark / lJ�t.S�— ��BL 7 ZS � °� • oz .15 Dosing Alt. B Aeration Bldg. Sewer Hold' St/Ht Inlet t, (� .� �• 901 TANK SETBACK INFORMATION St/Ht Outlet G -1 O •SO P TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' 5 6! 1S f k _ Dt Bottom Dosing Header /Man. . LO ��• Zo , Aeration Dist. 'p� t C, l �• Holding Bot. System 10 p O. q • ZD PUMP /SIPHON INFORMATION Final Grade Z foZ•I Manufacturer Demand St Cover GPM y.0 t , y /• DS . Model Number TDH Lift rictio oss System Head TDH Ft Forcem ' Length Dia. Dist. to Well 4t<016ADS0,RPTION SYSTEM RENCH idth � � Length No. 9f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. T uid Depth DIM _ e1 SETBACK SYSTEM TO G{ P BLDG WELL LAKE /STREAM LEACHING Ma r INFORMATION CHAMBER OR N 1 Type Of System: / 1.., J • 1 C 5 > �. UNIT Model Numbe : 1 N DISTRIBUTION SYSTEM L4 ••. Al --e- f� Q PIL Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) I Length Dia Length Dia in � 00 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 El Yes N No [k Yes U�No COMM ENTS: (Incl de co�le2 crepencies, persons present, etc.) Inspection #1: ! Yk�(Y O J Inspection #2: Jc T� Loc n: 63 st Str et Rober WI �540�2�3 (SW 1/4 S 1/4 31 T29N R18W) NA Lot 10 Parcel No: 31.29.18.485A30 1.) Alt BM Description 5 ' t ' t Ae 2.) Bldg sewer length = Z� " t•�Y' ''� �`� 't""�� c�e fJt A W v,^r Lf2 0,C GV . r - amount of cover = Plan revision Required? Yes No Use other side for additional information. S 6 10 ( 3/97) ` , Date Insepctors Signat e ���� � �_ ^ (f it ) ` [t. -4 , / `0 io ASW_cyp�q, 42 , S� QJ�""�°°v _ J (�;r„� (1G.. N Safety and Buildings Division County 1* is on m 2 01 W. Washington Ave., P.O. Box 7082 2a r g- esin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce 546 State lam [.D �77A- he Adm Sanitary rmit Application In accord with Comm 83.21, W . pdp p� may be used for se o its tion y u provide wn ry pu �eslpn Ct (00 ) Project Address if different than mailing address) I. Application Information - PleasePr' t Allliif&ihf itrbJOUNTY � 9i ST �' ZONING OFFI Property Owner's Name / Parcel # Block # Property Owner's Mailing Address Property Location City, State Zip Code Phone Number y., `54L.X�� Section 3 77 rr e one) G1 7 II. �pe of Building (check all that apply) T N; R or W or 2 Family Dwelling - Number of Bedrooms t/ fr/ Subdivi 'on Name /- C�S7M_ Number p ❑ Public/Commercial - Describe Use 3 vl s ❑ State Owned - Describe Use ❑City ❑Village Pf6wnshi of 1IR I C I-IL III. Type of Permit: (Check only one box on line A. Complete line 11 if applic le) A. ew S t ❑ Replacement System ys er�� ep y ❑ Treatment/Holding Tank Replacement Only her Modification to Existing System B. List Previous Permit Number and Date Issued ❑ Permit Renewal 11 Permit Revision El Change of El Permit Transfer to New Before Expiration Plumber Owner IV. Jype of POWTS System: Check all that appl y)____ N/N on - 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 -Grou lid Iding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter chrn Pb g 7 arnbiJ Drip Line ❑Gravel -less Pipe ❑Other (explain V. Dis ersal/Treatment Area In rmation: (f /,r/ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requir (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks �C Septic or Holding Tank ✓- 1 L V U y / t , (' S Aerobic Treatment Unit (I �� Dosing Chamber VII. Responsibility Statement I, the under igned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum is Signature PRS Number Business Phone Number v e. Stmt r , 2 9 q-5 6 Plumber's Address (Street, City,-Syte, Zip de) 17 V� 3 c G c�t� t r l �e 4A VII Coun /De artment Use Onl Approved El Disapproved Sanitary Permit Fee (includes Groundwater Date sued Assuing A t Signature tamps) Surcharge Fee) El Owner Given Reason for Denial -�—� IX. Conditions of Approval/ReasonsSor Disapproval YSTEM OWNER: 1 Septic tan , e ue Iter and dispersal cell must all be serviced / maintained -�r� G as per management plan provided by plumber. v/ 2. All setback requirements must be maintained �B'�t.Li -r� s per applicable c de /or finances. -ate Attack complete plans (to the County only) for the systenjwn paper not le t 91/2 x 11 ches in il/ SBD -6398 (R. 08/02) AIR• Os9 ,- n i e- SLAn S G - 9l "' �I4dso� NE k,- .5 r s 31 t A? - Na t v w h GJ A4/1 L rl L� 16 dY so kol It 4 do CAE Lr t., 2 7 3' 9 •. g- Zte q- t3 j � i i q1S� �/4c(C -o 2�W3 ?qq - 3 f3j 12 - NE k,- Sl✓ y s 31 r A r -Na it Lt--/ 16 r� Yl 4-K I CAE 1 8r 1 h�r J am; L ( V L I f s� L aA k 3 I loo so V64 I fy) 0 S �- e �' 'Q o n r I a >0 �, V 1, 160 Q1 C�.90z 102 .10 41 q� Los �tioP�. I GA c �• UT CoRn vw 7� 2 2-'7 3 u 7 a sT ff' lls� CsM s -Pet- W6soonsin Department of Commerce SOIL EVALUATION REPORT Dage 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Ws. Adm. Code County St. Croix Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q 0 p — J O - 3 d Q Please print aN Infonnatlon. R viewed by I Date Personal information you provide may be used for secondary purposes (Privacy Law. a. 15.04 (1) (m)). Z Property Owner Property Location 1:1 El Harvey Hielkema Govt. Lot NW 1/4 SW 1/4 S 31 T 29 N R 18 Property Owner's Mailing Address Block # Subd;IN or &,6 //f5 540 Summit Circle 10 Hielk ma 7 City State Zip Code Phone Number fly [] Village own Nearest Road Baldwin yid 1 54002 ( 7)5 - 684 - 2850 CTHN E] New Constriction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD ® Replacement [] Public or commercial - Describe: Parent material t.necc aver nrrtwaah sands Flood Plain elevation 9appliable ED ft. General comments This site suitable for a convention below grade ystem and recommendations. See_ C� MAR 1 2 2002 �cd ' q ( S. ST. CROIX COUNTY / Boring # ®ng El Pit Ground surface elev. 99.82 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eff#2 1 0 -15 10yr2/3 - sil 2msbk mfr as if .5 .8 2 15-40 1 4/6 sil lfsbk mfr cs - .2 •3 3 40 -100 10yr4/6 - is lvfgr ml - - .7 1.2 70 vim'. .r7 - T - F 2 Bortrg # ®� 102.15 >96 El Pit Ground surface elev. ft. Depth to limiting factor In. Soil Application Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef(#1 *002 1 0-12 10yr2/3 - sil 2msbk mfr as if .5 .8 2 12 -33 __I 4/6 - sil lfsbk mfr cs - .2 .3 3 33-96 10yr4 /6 - is lvfgr ml _ .7 1.2 ` Effluent #1= SOD > 30 < 220 mg/L and TSS >30 < 150 mg/L _ < 30 mg/t. and TSS <_ 30 mWL CST Name (Please Print) — — CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number _ 1432 120th Street, New Richmond, W1 9 -11 -01 715- 246 -2454 Property Owner, Hielke Parcel ID # Page 2 of 3 3 Boring ng Boring � 96.22 110 Ground surface elev, ft. h to limiting Pit � n9 factor 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 -14 10yr2 /3 - sit 2msbk mfr as if .5 .8 2 1441 l 4/6 - sit lfsbk mfr cs - .2 .3 3 41 -100 10yr4 /6 - is Ivfgr ml - - .7 1.2 �l F Boring # Boring pit Ground surface elev. ft. Depth to limiting facer in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Str Consistence Boundary Roots GPD/fP- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # Boring HPIt Ground surface elev. ft. Depth to limiting factor in. SoN NVicatlon 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 •Eif#2 ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mglL 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. ssD- 833area cn.wroo> 0 '/4 �1Uti LOA 100 6� a p Q1 q� '`°s � 1 O Osc - Th o a WIN 22-7 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SPECIFICATIONS Owner n 1 S h _ Septic Tank Capacity /2 s a l O NA Permit # 34o6 Septic Tank Manufacturer (,✓ ; e s e 2 O NA DESIGN PARAMETERS Effluent Filter Manufacturer )9=- O NA Number of Bedrooms ❑ NA Effluent Filter Model /oo ❑ NA Number of Public Facility Units - - - ANA Pump Tank Capacity a l ❑ NA Estimated flow (average) �� gal/day Pump Tank Manufacturer O NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ❑ NA Soil Application Rate al /da /ft2 Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L O Sand /Gravel Filter O Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L O Disinfection O Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ©In- Ground (gravity) O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L X NA O At -Grade O Mound Fecal Coliform (geometric mean) 510 a cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. O NA Other: ❑ NA Other: O NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency El month(s) ❑ NA Maximum 3 yea Inspect condition of tank(s) At least once every: Z- 3 ❑ ear(s) ( r: Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cells At least once every: ❑ mo ye ar(s) Ins (Maximum 3 year:) NA O 2 ❑ ear(sl P P � y Clean effluent filter S At least once every: _ Z ❑ month(s1 ❑ NA A l R years) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) O month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) O NA At least once every: ❑ year(s) Other. O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber Restricted Sewer; POWTS Master Plumber; M Inspector; POWTS Maintainer; Septage Servicing Operator. Tank p inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Z of 2 ' START UP AND OPERATION ° For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or-must be taken, to provide a code compliant replacement system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption )� system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T ted to aluat a o ing ank . /� jj ' b e ai a '�fZD+41817ea• COQ- /�/�b✓ CflN ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALJLER POWTS MAINTAINER Name o-y Name Phone 9 / S' - F `1 - �'1 C Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name !!5t, G ( ZDII�I Phone Phone / S— This document was drafted in compliance with chapter Comm 83.22(2)(b)(11)(d) &If) and 83.6411), (2) & 13), Wisconsin Administrative Code. From: To:.ALAN OSBORN Date: 12/9 12003 Time: 4:11:32 PM Page 3 of 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNSMSHIP CERTIFICATION FORM Owner/Buyer y D S b u� v Z 7 °j ST c5T fiLd o yr 1,� LS D 1 Mailing Address _ .,• q 1 51 - , St �r 0' Property Address 131 f _ (Verification required from Planning Department for new CO Qty/State Towx- oD 1, )Wt Vey Parcel Identificaxion Number oy LEGAL DESCREMON y Property Location SLO %4, -50 94r, Sac. 31 T �� R W, Town of Subdivision - Lot it - Ces tmed Sarvey Map # �O S� S� . . Volume Page # wWT=ti► nod # &2 7LI . Volume Page # 9 . Spec house Dyes O no Lot limes idwfiL ble0 yes 0 no cv MrAnvT�.wAxc� Impjwpw udmaintmaaceofyoarsepWsysO= caAd mhu tbs r yst oe consists of puu�pi:>g oat duo septic tank evay throe yeas or woncr, if uw&d by a Tiecasod der. What yon PW i� &c g air affect the 5imctiom� of � sceptic ank u a Eoeatmad sage in t3se waste disipoeal sysOcut. Tire piapc ty owner agrees to swank to St. Cmix Zoning Depactmaut a calif action fa®. Apod by to aw= and W a ma"mph>mbcr.j Pkwbcr. ph=beroralieensedpus arpaverifying "(i)flueoa- sibe systum is in proper operating wndidm and/or Cl) aftwimV=tim and P=4)Wg (if nooeany). flue septic -tank is less drag W fuaU of dtdgm Uwe, flue underdpad have read the above tr gnh==s>ts and agme to mania die private wwage disposal sysoessa wish tie standards set fore, bmia, as set by tbt Dgmtnc et of C.ommm=and *c D%m mart of Nzt =I B=uwer-. SWt of Wisconsin. Mica sating dart your sic system has bean maintaiatd mast be cmVicted and rcd>med to the St. Croix CMy Zoning Office wis n 30 days of the clues year wgimtion daft. i Z ,9 03 SIGH OF APPLICANT DATE a ER 010N I (we) ratify that all sataments on this forces are tie to the best of my (our) lmowledge. I (we) am (are due ownex(s of the property dcsaibod above, by victne of a warranty deed rewT&d in Rcgiswr of Deeds Office. l "' - S - 1GNATdkE OF APPLICANT DATE sassss = t m the sanituy pamtt be gg revd d by due ZonWg Dcpa tnmt. " ass• Arty information that is mis- rcprescated =u Y ss Include with this application: a stamped wsuraaty deed fmm the Register of Deeds oTWC a copy of tha certified survey map if ocfaence is MR& in tiro warranty deed `Wisconsiri department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code •sT. GAO /'x Attach complete site plan on paper not less than 8 112 x 1 t inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. . percent slope, scale or dimensions, north arrow, and location a � sTarice tb road. - ��.�Q Fill Please print all informat' Reviewed by Date 2.— Personal Information you provide may be used for secondary urffo s (Pri cy 4W, s. 5.04 (1f k. Property Owner .:= perty Lo 5W o i1 e ve %e� kE,H /}- ' �'; 7 ' I , G of /d 1/4 S*1 1/4 S 3/ T 9 N R E (or) W Property Owner's Mailing Address _ L Block # Subd. Name or CSM# .sy S0, e-AeGG ST cr Ik1M coutr City State Zip Code Phone r\ ZON;NC > ;ity' , ❑ Village own Nearest Road ST. 134 /N kJ /. SyooL (�iS )� S R�PEw 0 13,eo s New Construction Use: 10 Residential / Number of bedrooms Code derived design flow rate 0 — GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments s �r P 3 l� D d � _— • C ��� d `U/ /� and recommendations: � • 01 P /1 Boring # ❑ Boring Q� •fJ Q io Pit Ground surface elev. v ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft I In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 / o• // /0 — G 17CSA .wr fie 4ZS /¢ 2 • SD 7 S Y t 1/-/& -S IS4 .S4 C — 3 5v o /O Y S-/ S D, S .7 �. Z 9 Boring # ❑ Boring Pit Ground surface elev. � 4 � ft. Depth to limiting factor , 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 l D i3 /v 313 L 1.14 1'e 4S / > . G 2 - /3 - 31 ?•SY S D, le 0ex CS i Z lo R S zP • S 0. .7 1. ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/l_ • Effluent #2 = BOD, < 30 g/L and TSS < 30 mg/L CST Name Please Print) o at •GGjT— Signature _ 2 2 4 3 S Num Address Date Evaluation Conducted Telephone Number 9 - �/• a•eaz� 7lS • 3�G • � /�S Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 O RIGINA L • GOT � CS,y Uo /• /D ��.���. ` Property Owner' �GM /I Parcel ID # C) � ��� - � Page Z of 3 Boring ❑ Boring Q 9 I I g @ pit Ground surface elev. �" ft. Depth to limiting factor 2 ° in. �SS Soil Application Rate Horizon Depth Dominant CQior Redox Descriptipn Texture Structure Consistence Boundary Roots ' GPD/ft= In. Munsell Qu: Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o -9 lo YX 3 /3 � 17CAW 'r ie 4v 2 yb /0 W 3/ If D oT GS /6 ye lays �Z E] Boring n Boring # l � I q Pit Ground surface elev. ft. Depth to limiting factor _� 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 I •Eff#2 Z r-1 .3 /oyie 3l SL /� ,�,• �• cw 3 S /O yR C2 0 110 S/L /7 �n � _ Z • 3 7• j F-1 Boring # ❑ Pit Boring + ❑ Ground surface elev. ft. Depth to limiting factor 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 Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you nred 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 -8130 (RAW) i P 6"er' n G M Parcel ID # y ��` /OX � Page Z of Boring # ❑ Boring Q q U {� Pit Ground surface elev. �" / ft. Depth to limiting factor 2 ° in Sat Application Rate Horizon Depth Dominant Ci - Redox Desc ripdpn Texture Structure Consistence Boundary Roots 'GP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0. /o ye 313 i �v G Z ya /a ye f if ' AfO f GS +/W AO ye 12 Boring # ❑ Boring Q S SS ' E Pit Ground surface elev. u ft. Depth to limiting factor 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 / o•IZ �o YR y l3 SL If R l Ao w 7/ 77 Z .3 /O e 3/ SL /f / W cw — C2A rcoTS S/G /fS K w � . Z • 3 ❑ Boring # ❑ Boring + ❑ Pit Ground surface elev. R. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Si. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD �1220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Con rerce is an equal opportunity service provider and employer. If you nt ed iissistance tb 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.6" r of 3 5 Go Ulbrlcht & p ss0clate eultanta private Sewag Con 4 855 O'Nel1 Rd• 54018 Hudson Wis. 3 7 �S� � z z 7 �s '79F .. II Sw /✓��/ ' 3 `f �' So. "7 - .4 .. C.O� TO / P o/a 3/`/'' Y - lXe -Q pl;�e _ FILED 01 MAY 2 3 1995 KATHLEEN H. WALSH Register of Deeds 6 . SLt�o,J99 p�,L i y ,�-o /aQ 4 /q - ie osrz /og7 4 �J t0 -& CERTIFIED SURVEY NA 1rw y e-on d l-zf - HARVEY HIELKENA Part of the Southwest 114 of the Southwest 114 and the Northwest 114 of the Southwest 114 of Section 31, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Owner's Address: C. S . M., VOL 6, PAG /580 Harv4 Hielkema C.S. V I I Century 21 Premier Group PAGE 4 I I 990 Hillcrest Eialdw -, WI 54002 � - _ A- G_ P Ri vA re hoA D R () Rec -Data. 80 R j • Indicates 1" 50' 694.06' R 1894. /7'/ I iron pipe \ - - - - it - - - _S89- O 0' 03 "E 9 13. 74' R t 912. 76'/ _ - 19.68' f / is instrument drafted b Laurence W. Mu This y P s' „ x `-• :. I 3 Indicates 1 1 � T ; N _ weighing 1.13 h h \SCi ONS yFF ?j � / LOW AREA I M b8 /lin.ft. t M 3 `�� V` �/ * � �� I ° o I 3 set. (iI � • •• I ` \�� W` h : LAURENC •• I I. r y O h 37; i m s W IVIU P = Cr- Dated: 3 -26 -1995 ,/I 3 W o Q S 1 O x a • :RI ALLS� ROAD SETBACK LINE I N b IN J 2 - 't:�VV I 4 3 W W1 a , I F LANG $ �.•`�, COiw A i to 7CT.�A I O N DWI � h MAY 2 3.195 k � ^ Laurence W. Murphy I o � Registered Land Surveyor V V ` N 89 28' 54 "E 557. 74 31 CROIX COUNT ° 4 e+ I U. 535.49" ou!prehensive Ptannir ;^ 1 22.15' ci Zoning and o o LOT 5 a► ` W Parks Committees_ ? __ 4 h 3.393 ACRES 66' 17,604 ACRES ' H 147, 798 SO. FT, 7(1(0 b b 3 If not recorded 766,843 SO. FT. O 3,254 ACRESEXC. ROAD R.O.W. I N N 4 = t within 30 days of I 17. 305 ACRES EXC. 141, 760 SO. FT. approval date ROAD R. 0. W. h K /00' �� I '' O m 753, 793 SO, FT. N 89. 28' 54 "E 557. 74' �pprovai shall be I - i null 534.40' I 23.34' null V Yt Uld I i 3 I I I m L O T 6 M 50'I ROAD SETBACK O Q `1 I I L INE i, p 3.393 ACRES i O O ;t I '1 yj W 147, 798 S0. FT. M) IMj I Q V• i O N 3.248 EXC. ROAD R.O.W. N N v 141, 470SO.FT. 557.74' 24.44\ I I W 354.19' 5 33.30' I $ "�� 9 • 8 ' 54 "E 911. 93' III I I I O S89 28'54 "W 557.74' R f15 89.2/' 32 "W 558.79'�'O I I I U/! 533_03' Rf5(35.60'/ ZI i C � _ -1 24.71' �i /62, 161 SO. FT. \ C ' \ 41 rn3..429 ACRES EXC. h M M C.S. M., VOL. 6 , 1 C.S M_, O t► / ROAD R. O. W. b 3 3 PA! GE '7: = v ^ L . ri, P AGE o' s m / I p 449, 354 Sr.. Fr. .� -- . IN 1 ° : m /662 o I /00' ° �� 1 Cc o 3 h S 88 ' 20' 38 "E 338.881 M O 1 M• O ti Ie q T'. H� Nom' uL H Z o b N 88 20 38 "W 338. 09' O O \ /NB8.29'S0 "W SW COR. SEC. T29N � � V 338.7 . _- _- � O J 2 Q y R 18W (? "IRON P /PE s VN fOUNOJ h 1351.47'R//349.62'1 /3/3.3B'R//3//.59Y C.S .M., V OL. 7 PAGE 18.78 ` LANDS S LINE SW l/4 SCALE /"- 20O' N 88.42'04 "E 1664.85' R1N88.34'32 "E 025'50'/00 200' 300' 400' 500' I • SHEET 1 OF 2 Vol. 10 Page 2924 GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF WARREN COMPUTER NUMBER 042 - 1087 -50 -200 Parcel Number 31.28.18.486A -20 Claimed 1 Date Re- certified / / Relate Number: OWNER NAME: First DANIEL J & KATHRYN L Last O'BRIEN CO -OWNER Mailing Address 619 91 ST ST City HUDSON State WI Zip 54016 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY WD 1560/ 194 633863 11/16/2000 WD 1560/ 193 633862 11/16/2000 PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office School District: 2422 - ST CROIX CENTRAL Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 10/17/2001 Book Number: 1 SECTION 31 TOWN 28N RANGE 18W %160 '/.40 Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: F4 -Prev, F5 -Next, F6- Legal, 177- Value, 178- History, F10 -Exit, F12 -More l U&' - 16 YCJ 11l 04� - (0 8(0 q -160 �18SE} ld c- a-�F-B es w: cs�ct~ q 656455 KATHLEEN H. WALSH 10Sto - 7c) - -0100 q8 519-oZb REGISTEIXOF DEED WI p I-of 9 Cs _ ' h9 RECEIVED FOR REWPJ 0 �a -- Slo -4 9 -12 -2001 1:45 PM -�C� � 8 J l p OPY FEE: 4.00 R l ECORDING FEE: 15.04 PAGEG- L,vF It C'Sc'r/ �1144� d 0 ; Certifled urvey Map -y Harvey and Suzanna Hielkema 31, T f the Southwest 1/4 of Sectio o nship Part of the Southwest 114 of the Southwest 1/4 and the Northwest 1/4 0 _ Survey 29 North, Rang 18 West, Town of Warren, St. Croix County, Wisconsin, being Lot 4 of that Certified Su ey Ma p Owner's Address: recorded in Vol. 10, Page 2924 of St. Croix County Certified Survey Maps. 540 Summit Circle Baldwin, M 54002 LOT / L C .S. M. VO 2, C_S. M•, VO 6, PAGE 4560 PAGE 492 1 O / ( LOT 2 j LO T j b PR/ YA�BDAD °C �— 1 b S B • 00'03 "E .9 /J. 74'R /9/2.76'! 3 �I /90.00' 704.06' W OI _ 0 723. 74'. /9.6 ' v %I _89 �� loot k t- � v '`fJ I AREA L or a b 2.818 ACRES �\� 1 �'� h L o T 9 I V/ N i l/� 9.96? ACRES N ,� j ti b 4J4, 090 SO.FT. b �p I 9.666 ACRES EXC. R040 \\ V h 74 49' b R/6NT O WAY L1W ARf h W O F to JI V1 w ® ? !•,yy� 421,031 S0. FT. 1y � � � a � a 1� $011. BORING o v"1 tu 0 o O ��� Q +Q • �.s, , \� 333.49' _ ~ w L S B9 • 28'34 "W 3 ?7.74' �I W C) G TJ ,h a a O O o ��P��\ •�,� ROAD AREA y `�' H _ — — -- - - ? / 00 in 0.789 ACRES Cdr O a rf 34, J6/ SO. F7. ` CL o O I O d• r 14 W �° O G. ACRES J �I 3 Q N (/) Q I 17,344SO.F O N 3 m b ICI 1 I #80-20.5 V7.71. .0 IAA • O s LINE SW114 0 I -j) I I p io O O 1351.47'R f /349.62'! Z � 0 r r b \0•I I •I w 27027 ACRE h 8813/ ?SO.F N18. 42 "E 2664.8 ?'RIN88• ?4' ?t "Et66 1. I V SW CDR. SECT /O #3/, 729N, R/BW, S 114 CORNER OF SECT /0N 3/, — 12" IRO P IPE FOUNOJ r29N, R IoW, /BERNrsEN NI I S 89.2 "W 3 54. I9' ALUM /NUM CAP FOUNOI 16 %J t; I LO = G . S . M ., VO L. /O, - �0 �p3 I PAG 2924 ��� AMgOX. PROPOSED DRIVEWAY LOCAT /ON ALL BEARINGS REFERENCED TO THE SOurN L /NE W OF 7NE SOU 7NWEs r 114 OF SECTION 3/, S 1713 ASSUMED # 18.42' 04 "E RN FALL& SCALE / "J 200' VA 0 s0' /00 200' 500 400' Soo Dated. September 5, 2000 S heet 1 of 3 This instument drafted by Laurence W. Murphy i . Vol. 15 Page 4169 WARREN PLAT T -29 —N • R -18 —W k $1 (Landowners) See Page 112 For Additional Names. RICHMOND PAGE 48 L JA In \ E REE Clue nce & a & Gar �j G. Unitd KES saes• a1r w 6 Connie Inc G 78 Hutg Club Inc G Martin 4o s 5 o Mueller e, is s 118th 0 � ^ _ Robert � 0. I 158 ae tl3 AVE , ab 1ru■t 158 275 Nickelson Vernon �. �a1 A a Louis 114th x 1 euneees Nelson • vwl+ B &�lenny AVE , Maloney g Hri iff 12 Donald t i 'r • i! ' tr Greenfield ilreel.sn 154 318 240 tr - z 39 ,0 4 ~ L �$ saaua $ pond■ 110t ps &40 _ 216 r"'• 180 Dale R 80 110th AVE "so 0 Irwa Iand u ^ ^ o C9n� P Kenn� & ! Ronald Virginia a.a LiC 79 iron.- $ 3 H Redmon 60 Herink Meyer Frederick RHK s! x 107th AV q — a Wesley & Farms I c L1ayald L �M����Jy LW ! w O •^ ! p1K■ oe► 6 S 'rry!! {� [ITdck f/1 so ' g 67 O 14 n ■ w 160 40 310 120 S 1 1 t Rusmar ` AVE Raymond & Thomas `Gordon Farms A a y: 40 I SeBskt Sullwold TmesdW Inc 4 ' _�� 142 160 470 160 Q � z S ' i _145 M_u 138 x ' , 200 —1 so 150 1� 100th AVE Burl � 25 "r IT I5 s tr BS avid do R a Walter VanBeek St Croix � • Nechville 80 DO +�^�' an a 60 Kenneth Girl Vly th ST ' 15 d w n Frederick r n 80 rat m Scouts to Henry I $ Bloom AV �- : \ 168 Necltvwe� We & F A rr]] 195 232 Ifatn 1 s: ru repe Delores 1J Gillis �n� ° ! Trust ' Schulte Farms r ql an Corp David & Land Dean & Trust Inc r r Camill A gown x McKenna t Corp Mueller w w Holden Leveritt p Is 6 Trust x Mal 24 12 zoo 16 , ■ tr p udla lso 148 ° i 80 119 s 78 x� �s 3 rem Ms 1t e 2 = o cac R ^ 0e g . eere• 8 rc mole Barb= JP a + w s so _ `r a a r s n bW 9 T ' _ 37 y tl�sa 10 _ a Farms 4 e � u ue. lgl x- g Flaccid Land( g N ° ewd a mod' p JR 5 ca i L Inc Company I 79a th 148 14 u 11 s u \ _ - 179 160 78 3 a2 a Earl J$ n o h AV N sm•+ • Q o � A E th t y�� var & -- t s1 116 Pechuman 4 p � e� m Gillis Ptr G Mark !o �t F 47 we s 3 g rn[aham = , 1� '.oC2 Q gg A '6 Inc 4 I G & 8 ` ^� c� • O ^ 122 —163 ROB lob 154 s Ii.,.8� z TT L°� _ — LO � Q 1 � James & s ! E x 99th '�" w' Guy a e7i "g p& FJIa W1aypnne dt 10 1 a p eeg�gyp & ST Maly £ tl ! • Katltrfne w : B OConneB Honor • so.o.e� OSO� Fh I 34 Dak I : 3 55 e � Y a 80 Hwker so Trust Mark s s �� M� ` G ' 6 � E 70 \ 307 in 2 160 ov !■! 239 59 Donald & 'µ tr tr z N n d etal 98 Fa E V 1 ! Anderson 4 ^ CT Pechmnan ry & �{ 110 = v a IOf R mat 61 40 ]64 w s TW IN 5 Smi G 8 PaWd a z y W Hudson a R& S �t a LAKES 9' K_ Ketth a B'7 x And n Delanda c� � i salsa 85 7 160 143 !•ve se h AVE s 187 80 9 e 4s 80 3 hk Lmatr aoo+u ree Th s a a Dorwes & 7s 4 Fume 4 ax 7xkloW 45 L C 87 a ^ 1 ^ F Sormentag Clar Farms S ar O / NN 40 c a Ltd Inc 13 Land ALEX Richard & m ea, o N I Gip Trust N Sanet 132 u a m • sw •m ^ ,". M7ese tr = 115 160 �+, 223 fr 110 �C40 64t CQ1tt praada, u n !! . 99 3 / A tend maws I Robert a 'STAR Andrew & Dpn & g K to s- a LN Rose N 1e p °a° �e ■t Brenda gym! EECKER 7 Rudesill a Glenda C. tr S r /l g F m.ae a Bray !� & ! $ysur . LN tr � 126 ' 92 a3 a� I.matr x,m, m Sr L. a Butler 21 b rlaoe hence sae meRf M 194 •■ tr 4 176 u 50% xa tr sw— !� 60th AVE KINNICKINNIC PAGE 18 1 85 P.O. ox 1 4 65 ROBERTS GROCERY r . Box 1 , Roberts, WI 54023 Phone 715- 749 -1718 MEATS • GROCERY • PRODUCE Fax 715 - 749 -1719 HOURS: Nort hLand Surveying, Inc. Monday - Saturday 7:30 a.m. to 9:00 p.m. ; Sunday 0:00 a.nO. to 6:00 p.m. ' Boundary Surreys • Certified Survey Maps • Major Subdivisions • Topography Surveys (715) 749 -sSUO gdWn Fiannm Michael Erickson ROBEM. WISCONSIN RL.S. No. 2487 R.L.S. No. 2592 i .................. ............................... ...................... 12/ 10/2403 18:18 F9.'� 715 749 9839 ...... OSBURN & DAUrHTERS 1�j001 U 1$6aP 399 s7.e+sma STATE BAR Of WISCONSIN FORM 2 -1482 6ATOLEEN if. YALSH WARRANTY DEED ST CQ DOCUMeNf NO, RECEIVED M REC RD Harvey N. 133elkema and Suzanna ff. $ielkema W -26-22 fi.25 AM us an an �► a RtfF)t{(� BM RRC FEE: 11.60 cnttveys and warrar+ta two TRAMS FEE t 246.00 Alan C. Oenurn nd Joan M. 0sburn h sband CDPY' CERT COPY REE; and wife PAM- 1 rplS SPACE RESERVED FOR RCGoAowo nAfA NAME AND RC'rURN AMR= the following descnlmd teal esuate in S t . C LO i x County, 5tate Df W1Fcaneint 1 042- 1086 - AARCEL IOE/e'rIFIGAIIOa �+� Part of 5W 1/4 of SW 1/4 and part a€ Nw 1/4 of SW 1/4 ofge 31 ,bed Township 29 tforbh, Range E. West, St. Croix County. U an As Follows. Lot 1 11 of Certified Survey Map Filed september 12# d 2001 in Vol. 15, Page 4169, 170C. NO 656458. I i i I This i s n o t homesread Propeay. (ls noel fgcepdue to warrsntks � Dared This 22nd day of March . A-D., X 002 (SEAL) (SEAL) Hal V09 N. flie kema (SEAL) (SEAL) Sll nna H. t ;1e 11Lema 1 AUTRENTICATION ACKNOWLEDGMENT` State of Wisconsin. Stgrlature[s) ys. St. Croix Count. Bullteivicined this day L)f 19— Petsona lh canke before me,rhls Zp02, —.— 1d day of Mach _, heabrwenamed ^� HaxveY_N- Hielkema and TITLE: McMBER STATE BAR OF WISCONSIN Suzanna El. tlielke (If not, authon sd Qy 71k5.06, Wis. SiaLs,) to me own to bt the Person 9_ who executed lilt 4 �,p,yy ir�src nr and ackflaPlcdge t samo. THIS INSTRUMENT WAS URAH'FD BY ' �A' ; Bec ----- can - Notary Public, Canniy, Wes. M Commission la t � nL. (If not, nLUrc cKpiruion data (Srgndt u.rrc may lx aurhpntioted Of aeknowdcdd. 1 y )2J i7 /2UV2 I I • N-.ttsof perm, NA ­S In any f— y.h..Id M.yped W pei-�d bdn �., fiefs. ' 4 Wt$CQI'Ia1N Wwra— Lapel — Ca, K N'ARRANYY tl t:� Yarn a, 2- LOU