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HomeMy WebLinkAbout042-1101-90-150 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488011 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: Ko acz, Mark I Warren, Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: ,ice rN r, :. s-` 36.29.18.� TANK INFORMATION ELEVATION DATA TYPE �� n - MANUFACTURER CAPACITY STATION BS HI FS ELEV. LA Septic Benchmark Dosing )) � p L� Alt. BM Aeration Bldg. Se er 3� 33 �pD. 3 Holding St/Ht In t 7 Ip TANK SE BACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic � � / , 7 � r � Dt Botto Dosing K << 4 �( Header/ Aeration 1 Dist. Pipe Z 2 ( • Z ZZ .S Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Art Manufacturer Demand Cover �c L GPM /� hS . 7• S —� J /' SV'o Model Numb( 3`l. 1 1 TDH L' Fri c ion Loss System Head Ft c 7 3� 3. U 2. 2t H 14A Forcemain gth Dia �t Dist. to Well Z CT SOIL ABSORPTION SYS EM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside D' Liquid Depth DIMENSIONS !/ �- SETBACK ' SYSTEM TO � P/L IYCDG IWELL LAKE /STREAM LEACHI Manufacturer: INFORMATION T S ystem: CHAMBE YP Y 50 / 1 LIN odel Number: DISTRIBUTION SYSTEM S-G Header /Manifold Distribution x Hole Size x Hole acing Ve t�lr4oke Length 2 'S Dia �'� Pipe(s) ength / 26)1 Di ZS Spacing �' � 4 1' SOIL COVER x Pressure Systems Only x Mound Or At - Grade ystems Only Depth Over Depth Over xx Depth of �� xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges Topsoil Yes L Yes COMMENTS: (Include code discrepencies, persons present, etc.) : /�J Inspectio 2: Location: 665 140th Street Roberts, WI 54023 (SW 1/4 NW 1/4 36 T29N R1 8W) Map of Survey Lot �''�'� t+:• 1.) Alt BM Description - � , 2.) Bldg sewer length = ��' - amount of cover = (f(j, � r ` 1 Plan revision Required ?,�� Yes o j Use other side for additional information. O t - - - -- - -- - -� -- Date I sepctors Sig ture Cert. No. SBD -6710 (R.3/97) r Safety and Buildings Division County • 201 W. Washington N visconsirn Madison, WI 3707REICEI ED Sam y Permit Number (to be filled in by Co) ` De artment of Commerce (6 2 3151 S"�o�� TE,US • 1 p �"t �, State Plan I.D. Number .. Sanitary Perini Ni atio L :; r 'i; "l_( OS In accord with Comm 83.21, Wis. Adm. C e, do you provide S t o 6 y /A may be used for secondary purposes PY 04( )(m) Proj t Address (if different than mailing address) S1. CROIX COUNTY I. Application Information - Please Print All Informatio 8f P £E i I � #� (40 fo Property Owner's Na me Parcel I Lo[ k Block X /7?RRA' �sPgt� Na I Property Owner's M ailing Address Property Location City, State Zip Code Phone Number —� A ' AJW 'A Section (circle one) iA, i 546 Jr — T 2'P N, R / 8 F or® � 1 II. Type o f Building ( check all that apply) 1 pp y) I � s+�- Subdivision Name CSM Number 1 I or 2 Family Dwelling - Number of Bedrooms 4 — Public /Commercial - Describe Use _ k) OT lCi[ ❑Villa e - Townshi of Q R I "State Owned - Describe Use Y_ g P sort rC� III. Type of Per mit: (Check only one box on line A. Complete line B if applicable) A' S -New System ❑ Replacement System g p 8 S ❑ TreatmenVHoldin Tank Rc lacemen[ 0,: Other Modification ro Existin S I B. Permit Renewal ❑Permit Revision ❑ Change of ❑ Permit Transfer :o `;e List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all,that appl K 12 M _ = O.Sa U o 7_4 &-X_ Non - Pressurized In- Ground X Mound > 24 in. of suitable soil ❑ Mound < 24 in of suua. !e so.'. ❑ At -Grade L� Single Pass Sand Filter Constructed Wetland Pressurized In- Ground Holding Tank ❑ Peat Filter _ Ae bic eatment Unie Recirculating Sand Filter Li Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less P, Other (explain) V. Dis ersaUTreatment Area Information: 62 Design Flow (gpd) Design Soil Application Ratt (gpdsf) Dispersal Ar Required (sf) Dispersal Area Proposed (sf) System Elevation j VI. Tank Info Capacity in i Total Number / Manufacn:rer Prefab Site i Steel Fiber Plasm Gallons_ Gallons of Url w� /I' /Ot7 t:oncrere Constructed Glass New Existing ��Q,� - � Tanks Tanks e tic or Holding Tank 5 P B �O Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement 1, the undersigned, assume responsibility for installation of the I T'S shorsn on the attached plans. I Plumber's Na me (Print) Plum is Si gnarure MP /MPRS Nurnber Business Phone Number � I - Plumber's Addre ss (Street, City, State, ip e) X-8 ff4 ,!Aria go 6+ t 0aye&V -C — VIII. County/Department Use Only_ pproved Disapproved Sanitary Permit Fee (includes Groundsvaier Gate Issued Issuing Agent Signature (No Stamps) X Surcharge Fee) _ ' ❑ O Reason for De nial `�' � 1 �1 �-. il.(a•[l�� -� I IX. Conditions o Approv I SYSTEM O ER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained i as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 3t 2 x I1 inches in sue + SBD -6398 (R. 01/03) + i IT 4 ^ �` f T x s �CA O o n °� id IEN t cr Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sconsin www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary November 03, 2005 CUST ID No. 222774 ATTN.• POWTS Inspector HENRY F GROTE ZONING OFFICE CERTIFIED SOIL TESTING ST CROIX COUNTY SPIA E4366 353RD AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 11/03/2007 Transaction ID No. 1210608 SITE: Site ID No. 706789 Mark Kopacz Please refer to both identification numbers, 140th Street above,, in all correspondence with the agency. Town of Warren St Croix County SWIA, NW1 /4, S36, T29N, R18W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1048837 Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P IN. 01 /O1), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. Condit • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c DEPARTMENT • A Sanitary Permit must be obtained from the county where this project is located in accordance with the ON 0 Sk requirements of Sec. 145.135 and 145.19, Wis. Stats. ,� SEE CORRE • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat HENRY F GROTE Page 2 1113/2005 • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local in pectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday cbratz @commerce. state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I A Mark Kopacz - Mound Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01/01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: SW '/4, NW' /4, Sec. 36, T 29 N, R 18 W Town: Warren County: St. Croix Date: November 1, 2005 Owner: Mark Kopacz Address: POB 394 Hammond, WI 54015 Designer: Henr Grote' HG D_1 MON1E: Signature: g M NIIS• License: WI D — 16 007 0�i�� Este N / Attachments: SBD -10577 - Plan Approval Application SBD -8330 Page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management p g " a elof8 �. cYq� bUl GS SppN S pr I Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BODS <220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 gallons /day hydraulic load Design Calculations In situ designed loading rate 3 ` allons /s . ft. per da g q P Y Depth to estimated high ground water in. 1° Depth to bedrock > 6+ in. Cross slope at system ► { % Force main length b ft. of 2 in. 5 Manifold/header length 2_ ft. of "t z in. Z 3 Drain -back k'; ' g gallons Lateral length "T' @ 0 , 0 ft. of �j 4- in. Lateral elevation `o ft. @ bottom of lateral Lateral hole size �/i in. @ S in. ( ¢ g ft.) Spacing 3 holes /lateral S holes total Lateral volume b gallons Total lateral discharge rate 3 3 Z gallons /minute @ 2 S� ft. head Network pressure compensation losses Elevation difference '7. 3 lO ft. Friction loss 2. ft. @ �� gallons /minute Total dynamic head ft. Pump /si�fion S 3 gpm @ l S' ft. of head Manufacturer ° �``� Model # �S �- Dose volume gallons Lift/si1'on tank � Q-% ' gallons Septic tank t I gallons Effluent filter 2 -Z -1 9 0 Measurement pump on and off o in. Height alarm from tank bottom d in. Reserve capacity gallons specs.calcs.res Page 2' of t N A4 f s IY n x / o � I 9 4 b Z C j L s� V-44 \ b i ..lo t o :1 bN p Sr OC. ^ IL Ala .. �-+�► � � ---�"+ r- 4p Jr TC, CA I�I� QVC tom\ d ro 1 z,s i �evr. -4�i� (� K/ - 4N�•.►.bLj� Y'• i.:w�t w`X/�rIL� �4 \oro�� J \ • i 1 I f. 1 � Hnr. t; 'A IT �� k T 1L,. wE�►TREapaooF WD CKIWGGOVER � JUN bb Q lcv. 0I4C.O441cr --\ C ;el z 4 P Pkof' 3' oKTo kHOIbluR8ED \SOIL 24 u MAx11OLS Y E NT fl T. p p � H �aovtl7 A � tZ5lCl^T ANT'S CAF F L E 3' ow'r o .64. Lo<cU5TUlm. C.0" EC.TI0 044 u'/ wee �X. 11 -` t` lT ( � TON ) /j, �7ROU►10 IF Q © Oc•R PLAP y CoNutFr , 3� SEP c E SPEGIFI'CATIOiUS 005E TAkiKS MAWLFACTUREK: QUMbER OF DOSES: PER D ^y TAWK SIZE: � GALLOWS DOSE VOLUME Sa' F1a INCLUDING BACK /I.OW: b ` }Z ALARr1 MJWUiACTUif,EFt: ° G���oNS MODEL iJUMpER: X01 � _ 3 0' 0�, I o ' CAPACITIESt A _ IuCHf 5 0K WL1 -045 SWITCH TyP[S — 'i" rl�, B 2 L.`2 t 1910 IucHES oR PUMP IIAIJUFACTURER; `�� ��� C■ �� IULMES OR �� D '� 2 'GKL�OVS MODEL WUMBER; LS �- O ■ 9 ' 0 INCHES OR (4�'y g uA, '.0).:5 5WITCH TYPE: � "" ``�� WOTE: PUMP AWD ALARM ARE TO DE MI►JIMUI'1 OISCKARGE RATE GPK INSTALLED OW SEPARATE CIRCUITS V[RTICAL DIFFEIlEMCE BETWEEW PUMP O 0 013TRIWTIOW PIPE.. 16. FEET � y + MIWIMUM ►JETWORK SUPPL' PR fI:LURc , . . . . . . . . . FCET A- O'�S i + 6 FEET OF FOiICC MAIIJ X �' F YortFRICTIOU FACTOR....r4 v FEET dh .2l TOTAL OtiWAMIC HEAD = FEET IUTERQAL. DIMEQ610A1i Or TAWK: L£IJ&TH `tl'L -' " 1 'WIDTH � 9 LlgUID DEPTH r - tM � TOTAL DYNAMIC HEAd /CAPACITY -HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING a MODEL 152/153 UJ ~ MODEL 152 153 UJ 50 Feet Meters Gol, Liters Gal. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 15 4.6 53 201 61 231 = 20 6.1 as 167 52 9 7 30 a 8- 25 7.6 34 r 129 42 ; 0 30 9.1 23 87 13 25 '59 20 35 10.1 — - 22� 85 0 40 12.2 -- -- 1 4 2 4 10 Lock Vol 38.0 Fl. (1?.6 m);ca. 0 FI. A\ oisos 0 20 40 60 80 too GALLONS LITERS 0 80 160 240 320 3 27/32 ° ''/a - " ' j I FLOW PER MINUTE — CONSULT FACTORY FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ® e r • Electrical alternators, for duplex systems, are available and supplied with 3 2':' an alarm. ' • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. �- Sealed Qwik•Box available for'outdoor installations, See FM1420. - Over 130 °F. (54 °C.) special quotation required. 1521153 Series 12 /8 _ _1521153 MODELS Control Selection Model Volts-Ph Mode Amps sim lox Du lox I r1 Nt52 t15 1 Non 8.5 1 2or3 _BN152 t 15 t Auto 8.5 Included 2 or 3 -- E . 1 5 2 230 t Non 4.3 1 2 or 3 1 L sKZOa+ B 152 230 1 Auto 43 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 1 15 1 Auto 10.5 Included 2 or 3 SELECTION GUIDE E153 230 3 1 Non 5.3 1 2 or 3 1. Single p variable level float switch or double pig variable level float BE 153 230 t Auto 5.3 Included 2 w 3 9 p 99y p 99Y switch. Refer to FM0477. o CAUTION 2. See FMO712 for correct model of Electrical Altemator E -Pak. All installation of controls, protection devices and wiring should be dons by a quallfled 3. Variable level control switch 10.0225 used as a control activator specify duplex (3) licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float System, RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 [�' Louisville, KY 40256.0347 L� Manufacturers of. SHIP T0: 3649 Cane Run Road Louisville KY 40211.7961 Q p ,S ,vcE /9�9 http:l/www.zoeller.com PUMP !D 15021778.27 776-27 928 -PUMP VA( /TY UMPS FAX (502) 714.3624 0 Copyright 2000 Zoeller Co. All rights reserved. ik J System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run- off, final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be nece ssary. la e8 oT8 — '` SOIL EV LUATION REPORT #2323 Depadailant of Commerce `. in tdance ith Comm 85, Wis. Adm. Code Page 1 of 3 Division I Certified Soil Testing, LLC Attach complete site plan on pa r not joss than 8'/ k' -1 h+ inbhes i size. Plan must County St. Croix include, but not limited to: vertic and h' Xontal referenda of M), direction and percent slope, scale or dimensio s arrow, and a ion and distance to nearest road. Parcel I.D. pending Please print all information. R viewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).. 2g ZQ?S Property Owner Property Location Kopacz, Mark Govt. Lot SW1 /4, NW1 /4, S36, T291N, R18W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# POB 394 36'•O/ atNL. City State Zip Code Phone Number City ❑ Village ® Town Nearest Road Hammond WI 1 54015 1 715 - 796 -7089 Warren 1 140Th St. X New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe Parent material loess over pitted till Flood plain elevation, if applicable NA ft. General comments install 4'x 150' rock cell mound on 100.0 contour as upslope edge of rock w/ 0.5' sand fill and recommendations: 1 Boring # -'' Boring Z Pit Ground surface elev. 100.0 ft. Depth to limiting factor 57 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh; *Eff#1 *Eff#2 1 0 -8 7.5YR 3/2 - sil 1 m sbk mvfr cs lm .4 .6 2 8 -24 7.5YR 3/4 - sl i m sbk mvfr cs 1m .4 .7 3 24 -57 715YR 3/4 - s 0 sg ml cvv lm .7 1.6 4 57 -67 10YR 8/2 - fs 0 m mfi - - 0 0 horizon 4 is generally weakly cemented, effective SSBR; irregular inclusions 10YR 4/4 fs &fsl @ 32 -42 + 5YR 4/4 sl @ 42 -44 T Boring # El Boring Pit Ground surface elev. 99.0 ft. Depth to limiting factor >60 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 *01#2 1 0 -10 7.5YR 3/2 - sil 1 f -m sbk mvfr cs lm .4 .6 2 10 -25 7.5YR 3/4 - sil 1 m sbk mvfr cs im .4 .6 3 25 -30 7.5YR 4/4 - Is 0 sg ml CS 1m 1 .7 1.6 4 30 -60 5YR 4/4 - sl 0 m mfr - im .2 .6 H 4 is clay rich sl (almost sci) w/ inclusions 10YR 5/4 is & 7.5YR 3/4 sl * Effluent #1 = BOD 30 < 220 mg /L and TSS > 0 < 150 mg /L * Effluent( #2 = D < /L and TSS < 30 mg /L CST Name (Please Print) Signa r : CST Number Henry F. Grote l 222774 Address Certified Soil Testing, LLC Date Evaluation Conducted Telephone Number E. 4366 353rd Ave. Menomonie, WI 54751 10/712005 715- 233 -0398 SBD -8330 (PU7100) Property Owner KOpacz, Mark Parcel ID # pending Page 2 of 3 3 Boring ❑ Boring # Pit Ground surface elev. 100.1 ft. Depth to limiting factor 38 Soil Application Rat Horizon Depth Dominant Color Redox Description Texture structure' Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color ©r,'S Sh.', 'Eff#1 •Eff#2 1 0 -12 7.5YR 3/2 - sil 1 m -c sbk mvfr cs 1m .4 .6 2 12-25, 7.5YR 3/4 - sil 2 m sbk mvfr cs im .6 .8 3 25 -38 10YR 4/4 - fsl 1 m sbk mvfr CS im .2 .6 4 -42 10YR 4/4 f1d 7.5YR 4/6 fsl 1 m sbk mvfr cs lm .2 .6 5 42 -62 10YR 8/2 - fs 0 m mfi - - 0 0 horizon 5 is generally weakly cemented, effective SSBR; soil depth indicates suitable for at- grade; soil loading rate suggests a 6" mound would be better suited for site " Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOO 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. SBD -8330 (R.07100) Certified Soil Testing, PLC -- r" to / DO q d c/I s f , '1 0 s b o � o D 6` r D � n '� ' . LA t n %a 4 o v J o r4- ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERS11 P CERTIFICATION FORM Owner/Buyer kepeke Z Mailing Address t"• y't�C Property Address S 0 t4 " ' (Verification required from Planning Department for new construction) City/State /� (/� Parcel Identification Number OL ' v � LEGAL DESCRIPTION Property Location Sw ' /a, �✓w /., Sec. 34 . T 2 9 N -R 18 W, Town of N � Subdivision _ Lot # _ , Certified Survey Map # —'� Volume , Page # Warranty Deed 24 , Volume 2 4 zZ . Page # (o If I Spec house ❑ yes 0 no Lot lines identifiable fZ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance gf 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. 4 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 113 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 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 dZhreear x lion date. n ?/ Q S OF AlyllkN 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 owners) of the property desc 'b ove, b virtue of a warranty deed recorded in Register of Deeds Office. _ Dc 1 /Ij�° SIGNATURE OF LIC X DATE •'•••• Any information that is nus- 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 Parcel #: 042- 1102 -10 -000 11129/2005 05:26 PM PAGE 1 OF 1 Alt. Parcel #: 36,29.18.563 042 - 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): O = Current Owner, C = Current Co -Owner 0 - DORWES FARMS INC DORWES FARMS INC 1387 70TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 36 T29N R 1 8W 40A SE NW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36- 29N -18W Notes: Parcel History: Date Doc # Vol /Page Type 06/07/2004 765200 2591/099 EZ -CON 12/25/2003 747552 2463/92 EZ -CN 429/508 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 25.000 3,600 0 3,600 NO AGRICULTURAL FOREST G5M 15.000 15,000 0 15,000 NO Totals for 2005: General Property 40.000 18,600 0 18,600 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 18,600 0 18,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 042 - 1101 -90 -100 11/29/2005 05:14 PM PAGE 1 O F 1 Alt. Parcel #: 36.29.18.562A 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): O = Current Owner, C = Current Co-Owner O - DORWES FARMS INC DORWES FARMS INC 1387 70TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC /s Legal Description: Acres: 31.645 Plat: N/A -NOT AVAILABLE [� 0 �) SEC 36 T29N R18W PT SW NW EXC CSM Block/Condo Bldg: 14/38 & EXC CSM 14/3891 FKA - 1101 -90 (562A) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 36- 29N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 2005 SUMMARY Bill #: Fair Market Value Assessed with: Use Value Assessment Valuations Last Changed: 07/14/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 31.145 4,800 0 4,800 NO UNDEVELOPED G5 0.500 100 0 100 NO Totals for 2005: General Property 31.645 4,900 0 4,900 Woodland 0.000 0 0 Totals for 2004: General Property 31.645 4,900 0 4,900 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 - 811264 �l KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED RECEIVED FOR RECORD Document Number Document Name 11/04/2085 10:20AN WARRANTY DEED EXEMPT 1 THIS DEED, made between Dorwes Faris. Inc. i ( "Grantor," whether one or REC FEE: 13.00 TRANS FEE: 428.80 more), COPY FEE: and Mark G. Kopacz and Kelly J. Kogsez, husband and wife CC FEE: PAGES: 2 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum }: " � • See Attached Exhibit A " t�s 042- 1101 -90- 100:042- 1102- 10-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated Dorwes Farms, Inc. t / (SEAL) (SEAL) * *By: David Cowles, President (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT S i ) L S i gn ature ( s ) Dorwes Farms Inc. 8gn" l By; David Cowles President STATE OF ) authenticated on o ) ss. COUNTY ) *Kristine O land Personally came before me on , TITLE: MEMBERS ATE BAR OF WISCONSIN the above -named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Op-land Notary Public, State of Hudson, WI 54016 My Commission (is permanent) (expires: ) (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 ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO -PRO * Legal Forms 800 - 855 -2021 www.infoproforms.com i s ' 1 v J ` i r' � � 9 _..._ EXHIBIT "A" A parcel of land located in the SW% of the NW% and the SE' /, of the NW% of Section 36, T29N, R18W, Town of Warren, St. Croix County;_ Wisconsin, further clbscribed as follows: Commencing at the W% comer of said Section 36; thence N00 °14'48"W 835.93' along thq.West line of the NW% of said Section 36 to the point of beginning; thence continuing NOW I4'48 "W aloe§ "said West line 125.85'; thence S89 °50'1 7 "E 1318.90'to the East line of the SW% of the NW/ (also being the West line of the SE% of the NW %); thence S89 °53'56 'E 1318.84' to the North -South % Section line of said Section 36; thence S00° 13'32 "E 661.63' along said North - South % Section line to the East- West % Section line; thence N89 °53'56"W 1901.86' along said East -West % Section line; thence N00 "14'29"W 836.11; thence N89 0 5444 "W 735.65 =to the said West line of the NW% and the poinj of beginning. St. Croix County, Wisconsin. n ® o ■ - n c ; B g t § a 2 $ . \ ( D q \ 7 � (Di /& ( (� z 1 e\} S. k/ 2 0 \ 0 0 ƒ - # \ j f / \ % % 2 \ / k 6 ] } / 2 @ @ q Cl) \ K > \ ( \ \ a @ § f E c » . o (D \» 6 \ > , % s = 2 § » @ J (D \ § § \ \ F ) § [ n r U . > (A o c ° \\ rT C z o 0 0 , � g E E ■ i \ � 0 o o . 0 » - 7 i D £ D c cn � E § � c e / § � ) � z J { 7 / $ n \ \ ° ± a N) \ C ; g \ ® k I o z k \ ƒ k z \ � � � = \ 7 § % ƒ \ CD - 0 o \ z . / z \ \ CD E < � ^ \ {22 /> � � }2\ k /IE a \ = 5// E 0) JR:3a . ®CL (° » \Ak \ § g0 < ƒ � §// \ / . ; 0 \2 m0CD 2 : 3 < \ \ : ! ~ s / � \ \ Wisc,nsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safe and Building Division INSPECTION REPORT Sanitary Permit No: 488011 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: Ko acz, Mark I Warren, Town of CST BM Elev: Insp. BM Elev: I BM Description: SectionlTown /Range /Map No: /0 Q �`� l 36.29.18. TANK INFORMATION ELEVATION DATA TYPE h MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 7Z 103.72 Dosing L� Alt. BM Aeration Bldg. Se er 3 -.33 Holding St/Ht Inlet 4//_ �! St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 5Z�) t , r t Q . ' Dt Bottom q , Dosing K t 4 I Header /Man. Aeration 1 ( Dist. Pipe Z.z( r � , •2. Z•Z G•2/ Holding Bot. System Z,q PUMPISIPHON INFORMATION Final Grade Manufacturer Demand St Cover Asti GPM Model Number TDH Lift Friction Loss System Head TDH Ft C Forcemain Length Dia. � Dist. to well Il ci io c SOIL ABSORPTION SYS EM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside D' Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHI Manufacturer: INFORMATION Type Of System: } c � y / CHA UN E 16b OP J odel Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Inlpke Pipe(s) Length Dia Length 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 Sed/Trench Center Bed/Trench Edges Topsoil =`1 Yes { € i j No i Yes I No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /_�/ 0( p Inspectio #2: 06 *(�tc Location: 665 140th Street Roberts, WI 54023 (SW 1/4 NW 1/4 36 T29N R18W) Map of Survey Lot +� Parc o: 36.2.18. Q 1.) Alt BM Description = P1 2.) Bldg sewer length J - amount of cover = (r( j ', �� � � 1 I ell- Plan revision Required? _-1 Yes ��] No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division - County ` 201 W. Washington _ S 77 0 lo e i y consi� Madison, WI 37G7R ��IVED Sani y Permit Number (to be filled in by co) Department of Commerce (608) 3151 ��� = T".kj /6 Sanitary Perm p ' atio NOV 2 2 200a� State Plan I D Number � In accord with Comm 83.21, Wis. Adm. C e, i do you provide �� �� e • may be used for secondary purposes Pr w, sl .04( )(m) ST. CRUIX COUNTY Proj t Address (if different than mailing address) I. Application Lnformation - Please Print All Informatio Property Owner's Na me Parcel 1t #` t? �t C Block N A WAA' If s P4 (9 ) ( IVIA j Property Owner's M ailing Address Property Location ?I o , Z.�,k 394' City. State Zip Code Phone Number - 4' A.l&J 'A.Secuon IA-) 1 54 t) t , 5 i ts- X94 '77001 (circle one II. Type of Buildin check all that apply) T 2!' N. R /8 E or� 1 or 2 Family Dwelling - Number of Bedrooms t Subdivision Name CSM Number J Public /Commercial - Describe Use O� Sukf -4 _, -- A) OF ❑ State Owned - Describe Use JCity_ ❑village RTownship of SIgA jt WAC( III. Type of Permit: (Check only one box on line A. Complete line B if appiicable) A. 1�-New System ❑ Replacement System y p y ❑ Treatment/Holding Tank Replacement Or :y ❑Other Modification to Existing System I B. Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer :o "e�a List Previous Permit Number and Date Issued Before Expiration Plumber Owner It t IV. T of POWTS System: (Check all,that a 1) >C 12 JV) Non - Pressurized In- Ground 19 Mound > 24 in. of suitable soil ❑ Mound < 24 .ri of suitable s.;:! ❑ At -Grade D Single Pass Sand Filter COTWructed Wetland Pressurized In- Ground Holding Tank ❑ Peat Filicr Ae:.bic - ; Unit Recirculating Sand Filter u Recirculaung Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -iess Pi ;< Other (explain) V. Dispersal/Treatment Area Information: (pQo Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Ar Required (sf) Dispersal Area Proposed (sf) System Elevation 0.0 Sd..l Vic, /�65 mo m �� /oo, S j V1. Tank Info Capacity in Total Number , Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units a jw_Q A -mo �uQ,� .oncrete Constructed Glass '. New I Existing Tanks Tanks _ Septic or Holding Tank Aerobic Treatment Unit T i Dosing Chamber i VI1. Responsibility Statement- 1, the undersigned, assume responsibility for iastallztion of the 1'0�t'I'S shown on the attached plans. Plumber's Na me (Print) Plum is Si gnawre MP /MPRS ,Number Business Phone Number i 1 �Ysesc •/• MYE.tS 22 4.4/ , "{t3— l,���tG3Lo Plumber's Addre ss (Street, City, State, ip e) *r ssE s-wra Ro 4+ 0 13.yc��rr� I VIII. County/Department Use Onl Approved Disapproved Sanitary Permit Fee (includes Groundssa(er T ) I!c Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ O Reason for Denial � o _ 2,9. 4US I -n_. IX. Conditions o Approv SYSTEM O ER: i J 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained i as per management plan provided by plumber. j 2. All setback requirements must be maintained j as per applicable code /ordinances. t Attach complete plans (to the County only) for the system on paper not less than 8l 2 x c1 inches in sue SBD -6398 (R. 01/03) r +- i d f ril 1 p. s 4 cJ © o 4- s _ n 4" d O U � C- S r vp N O � s O n� N 0 rj Nf td OF o C V d iar C 0 `4 IR t �9 � i Parcel #: 042 - 1101 -90 -150 07/31/2007 10:46 AM PAGE 1 OF 1 Alt. Parcel #: 36.29.18.562A -05 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/04/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - KOPACZ, MARK G & KELLY J MARK G & KELLY J KOPACZ 1155 VINE ST HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 35.010 Plat: N/A -NOT AVAILABLE SEC 36 T29N R18W PTS SW NW & SE NW COM W Block/Condo Bldg: 1/4 COR; TH N 00'W 835.93FT TO POB; TH CONT N 00'W 125.85FT; TH S 89'E Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 1318.90FT; TH S 00' E 298.75FT; TH S 89' 36- 29N -18W SE NW E 1318.84FT; TH S 00' E 661.63FT; TH N 89'W 1901.86FT; TH N 00'W 836.11 FT; TH more Notes: Parcel History: Date Doc # Vol /Page Type 03/31/2006 821887 AFF 01/03/2006 815548 EZ -U 11/04/2005 811264 2922/641 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/08/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 36,500 171,300 207,800 NO 2 AGRICULTURAL G4 18.010 2,700 0 2,700 NO AGRICULTURAL FOREST G5M 15.000 15,000 0 15,000 NO Totals for 2007: General Property 35.010 54,200 171,300 225,500 Woodland 0.000 0 0 Totals for 2006: General Property 35.010 17,900 0 17,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 'M'` ke" SOIL EVALUATION REPORT #2322 Department of Comm Frence e with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety a Buildings '` r - ° r° Certified Soil Testing, LLC on a e less than must County Attach complete site Ian 8es in size. Plan p p p p St. Croix include, but not limited to: vertical and h tai rnt (BM), direction and percent slope, scale or dimensions, north arrow, and distancetmheares road. Parcel I.D. pending Please print all inform Reviewed By Date Personal information you provide may be used for second (E5t a L#tk; 4 1 16.04 (1 (m)). Property Owner P rop tion Kopacz, Mark Govt. Lot SW1A, NW1/4 S36, T29N, R 1 BW Property Owner's Mailing Address Lot # Block # Subd. Name r CSM# POB 394 1 S.¢.e_ d City State Zip Code Phone Number n City [] Village ® Town N Wa yes oa Hammond WI 54015 715 - 796 -7089 Warren 140Th St. New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement ❑ Public or commercial - Describe Parent material loess over pitted till Flood plain elevation, if applicable NA ft. General comments install 5' x 91.2' rock cell mound on 100.0 contour as upslope edge of rock w/ 0.5' sand fill for 3 br and recommendations: M Boring # J Boring Z Pit Ground surface elev. 99.3 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Cotor' Red4x Description Texture Structure. Consistence Boundary Roots GPD/ft= in. Munsell -Qu. Sz. Cont. Color Gr. Sz. $h. 'Eff#1 'Eff#2 1 0 -10 7.5YR 3/2 - sil 1 f -m sbk mvfr cs lm .4 .6 2 10 -18 5YR 4/4 - sil 1 m sbk mvfr 9 s lm .4 .6 3 18 -33 5YR 4/4 - sl 1 m sbk mvfr cs 1m .4 .7 4 33 -66 10YR 4/6 - sl 0 m mfi - - 0 0 horizon 4 is very tight, weakly cemented, effective bedrock Boring # U Boring 31 2 7 Pit Ground surface elev. 99.6 ft. Depth to limiting factor in Soil Application Rate Horizon Depth Dominant Color Red'ox Description Texture' Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0 -10 7,5YR 3/2 - sil 1 f -m sbk mvfr cs 1m .4 .6 2 10 -18 7.5YR 4/4 - sil 1 m sbk mvfr gs im .4 .6 3 18 -31 5YR 4/4 - sl 1 m sbk mvfr cs lm .4 .7 4 3 ;-46 7.5YR 4/6 f2d 5YR 4/6 s 0 sg ml cs - .7 1.6 5 46 -64 SSBR horizon 5 is very tight, weak) cemented effective bedrock ry 9 Y , e ' Effluent #1 = BOD 30 < 220 mg /L and TSJ >30 < 150 mg /L " Efflu t = < !L and TSS < 30 mg /L CST Name (Please Print) Sig at re: _ CST Number Henry F. Grote *,; 222774 Address Certified Soil Testing, LLC Date Evaluation Conducted Telephone Number E. 4366 353rd Ave. Menomonie, WI 54751 10/7/2005 715- 233 -0398 SBD -8330 (R.07100) Property Owner Kopacz, Mark Parcel ID # pending Page 2 of -.3_ F- Boring Boring # Pit Ground surface elev. 100.0 ft. Depth to limiting factor 32 n. Soil Application Rat Horizon Depth Dominant Color ` Redox Description Texture Structure Consistence Boundary. Roots GPD /ft' in. Munsell Qu. Sz. Cont. Cola Gr. Sz. Sh. `Eff#1 'Eff#2 1 0 -10 7.5YR 3/2 - sil 1 f -m sbk mvfr cs 1m .4 .6 2 10 -21 5YR 4/4 - sil 1 m sbk mvfr gs lm .4 .6 3 21 -32 5YR 4/4 - sl 1 m sbk mvfr cs i 1m .4 .7 4 132-34 5YR 4/4 f 10YR 6/ 2 sl 1 m sbk mvfr as 1m 4 7 5 34 -47 10YR 4/6 f2d 7.5YR 4/6 s 0 sg ml as - .7 1.6 6 47 -62 SSBR horizon 6 is very tight, weakly cemented w/ occasional loose pockets of s, effective bedrock ` Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 5 150 mg /L ' Effluent #2 = BOD < 30 m /L and TSS 30 m /L s s < - g - mg /L 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.07 /00) Certified Soil Testing, UC d ¢.._ cr, AA e 5 � M !� N r.. • U 2,S°1 �. qg5 Z s v e_4? a 1S 3� 3a�3 Parcel #: 042 -1101 -90 -150 09/14/2006 12:32 PM PAGE 1 OF 1 Alt. Parcel #: 36.29.18.562A -05 042 - TOWN OF WARREN Current [X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/0412005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner MARK G & KELLY J KOPACZ O - KOPACZ, MARK G & KELLY J 1155 VINE ST HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 35.010 Plat: NA -NOT AVAILABLE SEC 36 T29N R18W PTS SW NW & SE NW COM W Block/Conlo Bldg: 1/4 COR; TH N 00'W 835.93FT TO POB; TH CONT N 00'W 125.85FT; TH S 89'E Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 1318.90FT; TH S 00' E 298.75FT; TH S 89' 36- 29N -18y SE NW E 1318.84FT; TH S 00' E 661.63FT; TH N 89'W 1901.86FT; TH N 00'W 836.11 FT; TH more... Notes: Parcel History: Date Doc # Vol /Page Type 03/31/2006 821887 AFF 01/03/2006 815548 EZ -U 11/04/2005 811264 2922/641 WD 2006 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessmer Valuations' Last Changed: 05/31/2006 Description Class Acres Land Irprove Total State Reason AGRICULTURAL G4 20.010 2,900 0 2,900 NO AGRICULTURAL FOREST G5M 15.000 15,000 0 15,000 NO Totals for 2006: General Property 35.010 17,900 0 17,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Chats Delinquent Charges Total 0.00 10 0.00 z of Cs 5 0 m z LU O_ 0 ------- ------ - -- Q h- ¢ Y LL Q N �M.wn.00N M v3 ao l a3wnssv(INVSV SoN`d� a311t/�dN(1 `: z w o co z CO < a30W03M,kisnOIAMId'9£ N01103S 30 XMN 3H1 a LU LL ` O � O 30 3NIl iS3M 3H101430N3M333M SJNIMV38 r, o Y 3Nn N011038 HirOS - H1MON W Z J z N > ¢ �` �£9•�99 3.ZE.U.008 F e}. tL'L£9Z 7 co o W O z 9L'8L61 z 3.ZE.U.00S >� x < I o W 3.ZE.£L.009 M Q p w O p ka U W Z tx w v3 F.: Q U. 0. 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