HomeMy WebLinkAbout018-1083-37-000Wisconsin Department of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)],
Permit Holder's Name:
City Village Township
David & Sarah Weiske
TOWN OF HAMMOND
CST BM Elev:
Insp. BM Elev:
BM Description:
too
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
1 e5e,.t�
DOD
air {'�Se.-�� CL*iatd u11<< 111k�
Helding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacture
Demand
GPM
Model Number
7
TDH
Lift
riction Loss
Syste ead
T Ft
Forcemain
Length
Di
Dist. to Well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: St. Croix
Sanitary Permit No:
651306
State Plan ID No:
Parcel Tax No:
018-1083-37-000
Section/Town/Range/Map No:
16.29.17.609
STATION
BS
HI
FS
ELEV.
Benchmark
�Do-oo
Alt. BM
Bldg. Sewer
St/Ht Inlet
5-�
too- 00
St/Ht Outlet
99.1
Dt Inlet
Dt Bottom
Header/Man.
Dist. Pipe
Bot. System
ti r� T3
2 >g.y .c�
q� y
�7 2 q�,o
Final Grade
St Cover
BED/TRENCH
Width
Length
No. Of Trenches
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid D h
DIMENSIONS
IOC
SETBACK
SYSTEM TO
P/L
BLDG
WELL LAKE/STREAM
LEACHING
Manufacturer:
INFORMATION
CHAMBER OR
UNIT
Type Of System:
'ANeAVA&I
Model Number-
Q, IFLOW
DISTRIBUTION SYSTEM
Header/Manifold
Distrib i n
x Hole Size
x Hole Spacing
Vent to Air Intake
Pipe
Length_ Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded/Sodded
I
xx Mul ed
Bed/Trench Center
(_O
Be Trench s
Topsoil
Yes ❑ No
- -
s ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: (2-/.f[2,,Z3 Inspection #2:
Location: 976 172ND ST
1.) Alt BM Description = p P �nnt D� 5YSaIe -
�S � Vtr�rs o� �.m bb5rr�4iiD� � es Ir; w o�
2.) Bldg sewer length = ISM 4�� 09 Wil
- amount of cover = 1 00 µ,% Of 494J;D, 0114 .-W 0,
Plan revision Required? ❑❑ Yes ❑ No 9 5-
Use other side for additional information. 23
SBD-6710 (R.3/97) Nam: ntw S4 }� WrA r s a (��isibyk . Date nsepctor's S nature Cert. No.
'� .-v �ievwvs 1)i viionRECEIVED
SAN-2023-237
12/05/20231 r� [i;xr�� ('I
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f
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h h t r f r[Jt1 for inns il[,rtion of 111E' 1'���1° 1 ,sholvil oil t1w W.� plans.
�` . Responsibility��ttt ��I c f9 �� 1. �[�i IlJld�dsl'4J[� �:..-I�� ai7��i.'• � ��l'k3�' �
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C:l Il., r Given Reas0 n ik)r Durl i a 1 -jr12,oZ3
Il(;.I& O11",, oI' Appr 7vid/Rea onS for Disap roval
SYSTEM
1. Sepi,�C Cink, P.uen-t filter and d[spersal cell
must bl:� serviced w
Management I-'I,..-r
. All setback
a per a rid e f d I r r1cc-
Ati"I ch to conl plctc° phi ns (OJ_ tilt! )ystum .i rld ti]I lm. i t t(r i Irle Cojtjj ky 01ily Q is pLj E)V J' 1101 i li -1W.S ill xi IA!
S51)-6398 (I . 03/ 1 )
17
CIa,.,,
1P.1i:,;consjn Department of So'ol y and Pt Page of
.41 -f I ndustry Services
LIvision o
U
SOIL EVALUATION REPORT
P -2023-350
-$T* CROIX co u NTY c. n r) CST
tyi
C C) L I 1"17 Ij
I ai�c�Drdaiicc. vvith SFIS 3H, Adm. Code
At t a c 11 c or I I p I E., Ic, � i Ic'., p; rJ i -k ( ) n fj ,7! [ ](.} r- ro I - f., �, ,,; ' h �i r,-, 8. 1 !,) x -' I I ri (.,. : : _� s I r 1 ;� I ,. e F,; �j i i r i , L j� t 1 r, r: t I ( I (,%. I
but not lirl)ited to' v(.,r!7,G�riI m)d horlzmi[ci� polr7l �;-W'1, (rj1FP,(Ji()F1 -1wd G;)(,, F�'a�(,el I D,
scale or dir-.ierir6l(mt�, nurlh 61,41 1c, iieF.re�.,t r�',r,-__'j, 018-1083-37-000
Pleasp. print all inforniatioll, Kc!vkl-,wed by
Personal lriforrn�',110rl YC"i I')^(Mldc r-iuy Le u,.. c-(_; for secof I d 0 P L I F D' 0 -,i CS (Pi, tv c1 c L ci w. s. 15. 0 1'? I'l I (F T 1)),
aeLA& =:Lt I
Dot
P FO J-D e Ft Y OW I I L-� F P "0 P C, Ft V 1, 0 C,�,] 1%,! ELI
David Weiske V'. I W% S VV N VV s 16 29 N F i 17 E= 00 W
Pr Ftr'.)ikI, or CSM and t.-ol 11-
0 1) ey Ownes Mailing Ad d
1721'5 nth Ave Lot 3/ Pheasant Hills
City S ta t C', Zip ccdc i Ph�:!,nc,, NLmn1,)c:-r 1. y ❑ Village Town N C� j r,., s L Roc d
Baldwin W 55 4 0 0 2 172nd St.
N rawCQ11MFUGti(.X1 U,,,;e- Hosidential/Numberof bed ronrm� 3 Code derived dm-,igi-iflow rate, 450 — GPD
PN p I a ce rrent [-,Ljbljc or commercial — DescdL, Floord Pl�dr, c� u---vat ifippllca&e N/A fi.
Pa r(,,, rilk wl:-j to rin I S
�'Systern Type:Cmventioi1@I, going to use .1.3 loading rate dU0 W inassive, S1 at 70"
o F 1:n,
1--intig 101.6
ri it, G rOLI Ild si.,,rc,ce eiev. 1L. Depth to 11rolting fao-;1or 96 in. I oflov._ It -
F-] B (,, ril F I G 101.6
n '. 99 0 pib Grourid s(jrW;e (,!f''v, It. jDopth to lirlilting factor irl. Y, elev. ft.
Soil Application Rk-7-fli'l
G D -7t2
Ffl�r F. f G' rr'P
H I/W
()f7 [I
. . . ........
1
2
Depth
In.
0-1 111
Do:i-din-f-ii-it Coloi-
ML�rlsell
1 0yr3/2
tic, Uosci-iption 10 x I
a',. Az. coItColor
none L
r c t L; r f:-,-
2mgr
2 m ch:<
O�g
B Co W� FY
,-nf r r, S 2 1-11
11'I f I. glov I t
I I I f 1, gov 1 f
.6
.4
8
.6
14-36
1 Oyro/4
none
C1
3
13 6 - 8 0
80-99
10 y?-4/6
7.byr4i6
none
LFS
-5
1.0
4
r.one
_M_
r0 Wa
I /,--1
.2
.6
/Y
fit
C S N a i-n 1 (3 tni- P r i i� i
T
IJ15
sIC; rla I
CS7,N
Shaun Bird
1*7�1' �i cm) I I
2126900
A d d res:5
Telephor-ic. NumL-or
1432 120th St. Nov: Richmond W1 54017
12 1112 3
715-246-4516
3 S) <
3( W.juril i,'� = B01).
Eff I i-i e n t 41 =, B 0 D > 3 0 _< 2 F1 Ig `L �3 r -, d TS S > < '1 .510 r- 1 -L
( R0 4/2
Boring #
Page 2- of
[] Boring 100.5 96
r Pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft.
Anil Anniirntinn Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD1Ft2
*Eff#1
*Eff#2
1
6-14
1Oyr312
none
L
2mgr
mfr
cs
2m
.6
.8
2
14-36
1 Oyr514
none
CI
2msbk
mfr
gw
1 f
.4
.6
3
36-76
1 Oyr416
none
LFS
Osg
mfr
gw
1 f
.5
1.0
4
76-96
7.5yr416
none
Sf
-m-
mfr
nla
nla
.2
.6
i
3 7 -
Boring #
[] Boring
n Pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
Soil Application Rate
GPDIFt2
*Eff#1
*Eff#2
Boring #
[] Boring
n pit Ground surface elev. ft. Depth to limiting factor in.1 elev. ft.
Rnil Annliratinn Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDIFt2
*Eff#1
*Eff#2
* Effluent #1 = BQD > 30 i5 220 mg/L and TSS > 30 :5 150 mg/L * Effluent #2 = BQD, :5 30 mg/L and TSS :5 30 mg1L
Project Name David Weiske
Address 1725 5th A
Soil Test Plot Plan
Shau
Ve
Baldwin WI 54992
Lot 37 Subdivision Pheasant Hills
S W 1 /4 N W 114S 15 T 29 NIR17 W
Boring 0 Well PL Property Line
BM or VRP Assume Elevation 100 ft
System Elevation 97.5797.4797.2'
Date
A 4226900
1 /23
Township Hammond
County ST. C RO IX
Top of 3/4" Pipe
*HRPtiarr a as t3enchmark
System PLOT PLAIN
PROJECT David weiske ADDRESS 1725 6th Ave Baldwin WI 54662
SW 1/4 NW 114 S 16 1 T 29 NI R 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 97.6797.4797.2' 4' Below Grade DATE 1211123 BEDROOM 3
CONVENTIONAL xxx CONVENTIONAL LIFT HOLDING TANK
MOUND
SEPTIC TANK SIZE 1999 Gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .3 ABSORPTION AREA 1500 # of EZ-Fjows3 9
IL BENCHMARK V.R.P. Top of 3/4" Pipe •
ASSUME ELEVATION 100 Filter Lifetime Filter
E]BOREHOLE 0 WELL * H , R , P , same as benchmark
JW% d Dispersal Componen]
L.,ross Section of a Three Cell EZ Flow In-Groun., 0
ell's P af alrQT-1
PRIORI
jjgjj�l 1
%r
Z..
-C
C. # e
e
area Sq Ft
Required dispersa
Design Flow Loading Rate
i .. -nber of uNts)
(nui
Required dispersal area 50 (EISA)
-extle fabric to rri-et, Comm 84.30(6)(g) Wis_ Adm. Code
LU Z Geot I E,
> :3
M I nI M Cli- 12" C)f corer over -top 01 cell
o
L11 Two o bs ervat 1 o nNen t. pipes to be pro viQ e-.d per cell
0
Not to scalle
Cell #1
Ft
System Devati,-M-!
F
F r,ncal Grad -IL
'MI M-A
Svstem Elevat,on-7 /I Ft
J
F I T� a I G ra d Ft
Cell #3
System El" Vation Ft
Ft
F n a I G i'ad e/�L--
I
F ir, a I G ra d e
Observatiol! Pipe
Geotext'le Fabric
System Elevation
0
it r&I 1,
%
lndustiy Services, Division
01;01 Ills
-1822 Madison Yards Way
Madison, W1 53705
-:10 1
Salutary Pe rii I N ti mYr (6b be 1111 ed In by Co
PS - 023 2
P.O. Box 7162
Madison NVI 5-3707-7162
D
ry Per tnit A pplication
Sanita�
stwLe "rransaction Number
In acc(,rd.-tru�e withs[IS 383.21 f12), Wis, Adni, Cady:, subrilission of this form to flic appropriate govurnmerit'al unit
I a u{ I ect Address (If different th aii ina I I i n g address)
is requiNd tii-ior to obtain 'llIg d SaillUry PCT1111L Note- Application lJorms for state-owned POWTS ari;si1bwi-ltc4i to
tine Departmcm of Safety arhl Professional Services Jlt:rsollal filronnation you provicle may be used J'-br secoildary
P1lrPQSeS ill aCCUTdallCe M-1111 Lh-.' Privacy Law, s. 115.04(l)(m).
L ApIflication [nformation -- 11ease Print All Inform'. tion
Property Owner's Nanic
I
Parccl it
AV
AX
Properly 0wrier's Wilirn, A(IdFc.q 4L
Z) 7L4
Propeny Loci uun
GOVL Lot
Iry
7.*Lp Ct)d- I
Phone NUMber
is
23 66'1114MOAC1114, Section
T N R F T W
I lj�-J)e Of BUilding (cheek ali that apply)
Lot #
or 2 Family Dwell ing - Number of Bedrooms
:!>
> 2
Subdivisi n Name,
LibliC/COMMU6311 - Describc Use
City of
Block #
F-1S rate 0-Mi ed - Descri be U se
Vill-age of
CSM Ntimber
Yd NE:
Own of
ii i. 'rN-ve of i-,w�-,,rs Permit: (Check either "New"' or "'Replacement" and other -ILliplicable on fine A. he one box on line 8. Corniflete line C il
New System
ac 7ws- —YS I C n-1)
kcplacerilent SYSIC111
ifical, to Syste (0, i I
DAlier Mod ting M -lei
[]Additional Pretreatment Unit (explain)
gn-C:jr-mi Ind
1000V
01!o1d1ngTank
Individual Site Design OthcrTypc (explain)
C 11VC1k11k,w,',.
0
ist PreViaffTT'c-r-n-TtNw1ibcr and Datc ISSLICd
I' fcr to Nc V
C'. kcnewal Before I Z t:v I � 1011 lwnge of Plumber r� Wner
Expiration
IV. Dispersal/Treatnient AI-C:L and 'rank Informatio DO -AC4.a,
0
1%,Ion-Flow fov-d'j [)L-mgn S{111 Abill ic-'(1 ion kk il Area Reqizired (sib Dispersal Area Proposed (sf) System Elevati011
Capacity in Tolial # dir
Taok Information 41110115 U S,
Ll �,.��
U6—NewTanks10
rA
V-1 V11
an k 7
E:J
V. ResI)onsibility StatejArtylt- 1, (lie ijnderslgut`d. lllb�un) e q ibililyfor` insta tion of the PONVTSshown on the attached plans,
-n b be Ill ber's Naitit: 01rim) Lit ign ire MP/MPRS Num 13tisiness None r mbtr
t /4j "d
Plumber's Address (Street, City, Slat Zip Co;,)
V-1. County/Delmirt!"I'tent Fise Only
Approved
roved
d
m 11 Pcrn"Ce
$
Date ISSUCd
I s's ag gent sigilahm:
3
De, 1,ni1,;
a4
Conditions oc��131)rov�ai. !�C�
SYSTEM OWNER:, VL6eAk-
1. Septic tank, effluent filter and dispersal cell
must be serviced / maintained as per 1
All, 0-4� -6)
management plan provided by plumber.
2. All setback requirements must be maintained CzA 1/1
as per applIcable code / ordinanCOSr ot
37 I
A�tull TI) celm illpik. fm- ow ,N-ok�m and submit to the 4 ("o u my on ss thmi X lf2 -% 11 inches in s-
Iq -\r
be (V��k,,raN
9y-,(r*4) V. It
SBD-6398 (R, (�,3. 2 1)
A
' a-- �\)R' )ja-s9�- System PLO"I"' PLAN
dop—D LL)4N
PROJECT A D D R E S S
SW 1/ 4 NW 1/4S 16 /T 29 Nilt 17 W T(M'N Hammond COUNTY ST- CROIX
94,07 93-9793-81 2' Below Grade 10.:" 51-12 3
CONVENTIONAL LIFT
WNN FNTIONAJ. XXX
M01'ND Shil"I'lC SIZE 1000 GallonS LIFT TANK SIZE
'FAN K SIZE LOAD RATE .3 ABSORPTION A10"'A 1500 0 of F.Z-F1ows30
BENC11M.-WK Top of Survey Iron A
ASSUME V I I- F i I t e r Li fed me
110 R E' I I () 1, l' (DIVELL same asbenchmark
COPY
RUPROOM 3
[H)l I)IN('r TkNK
Shaun 13M
Bird Plumbing Inc.
1432 1 20th St.
New Richmond Wi 54017
715-246-4516
Date, 10/05/2023
A-1
�' w,� 1 �P 'Ry
Owner.- J
q p I Y
Location SWI 14 NW A S 16 T29 N. R 17/ 976 172nd St, Hammond
Used: In -ground absorb n system (ve Ion 2.0)
Page#
1. Cover Page
2. Plot Plan
3. EZ+IovvCross Section
4-6. Maintance and Conti Plan
7. Filter Cross Sectio
Signature
License nu—Mber #226900
A
a-- �\)R' )ja-s9�- System PLO"I"' PLAN
dop—D L04'N
PROJECT A D D R E S S
SW 1/ 4 NW 1/4S 16 /T 29 N/It 17 W T(M'N Hammond COUNTY ST- CROIX
94,07 93-9793-81 2' Below Grade 10.:" 51-12 3 III-IDIMM 3
D A I L
CONVENTIONAL LIFT
WsN FNTIONA]. XXX
MM'ND Shil"14C SIZE 1000 GallonS LIFT TANK SIZE
'FAN K SIZE LOAD RATE .3 ABSORPTION A10"'A 1500 0 of F.Z-Flow
s30
1 ENC11M.-WK Top of Survey Iron A
ASSUME V I I- F i I t e r Li fed me
110 R E' I I () 1, 1' (DIVELL same asben chmark
414' Prciperty Line
41)'P1'openy, L111c
'07' Property Line
B - --11) [:]
Vcni
X 1.00" Cells Width >3' Spacing
[H)l MV'r TkNK
ME
)ci-ty Line
Cross Section of a Three Cell EZ Flow In -Ground Dispersal Component
Imo- j R F1 I 3
.04
H
A-
.. iQn
•
12" P 4 1 1 9
- - - - - - - - - - . . . . . . . . . . . . . . . .
. . .
..................... ..... . .......•...
Ice
. •
. . . . . . . . . . . . . . . A w w
+ . . •
. . . . . . . . . . . . . . .
d area Sq Ft
Design Flow + Loading Rai\te RequCldispersal
Required dispersal area /30Z�� \SD (EISAI= (number of units)
Cell #1
System Elevation: ( / � rFt
.0�.z
Final G rad e 76 o �Ft
Geotextile fabric to meet Co ni 8 .30(6)(g) Wils. Adm_ Code
Minimum of 12 11 ofr over top of cell
. YC ip
Two observation/vent pip, o be provided per cell
Notto scat
Cell #2
Syst I eva t'o n, �_/ �Ft
e 17; el:
Rnal Grade / Ft
Cell #3
System Elevation. Ft
Final Grade.7-- &Ft
Finali Grade
Observati.an Pipe
Geotextile Fabric;
'
System Elevate t�'
P-
SECT107. A -A
E
1.192t
1�
FILAN
POWTS OWNER'S MANUAL & MAF MENT
NAG
FILE INFORMATION SYSTEM SPECIFICATIONS
ell Septic Tank Gapar-itY
ov�iner J J2
Sepdc Tank Manufaurer
r—errnft Manufacturer #
I Effluent Filter Manufacturer
%P
DESIGN PARAMETED�
r_� I ri m,& Effluent Filter Model
MAINTENANCE SCHEDULE _
1� Servlce Event
Inspect condition of 12nk(s) .
PLJMP otjtr contents of tanks)
Inspect dispersal Cell(s).
aean effluent filter
Flush laterals and pressure test
.................
other
Pump Tank Capacity
UMP
22L-Al NA I
pump Tank Manufacturer
NA
pump Manufacturer
NA
Pump Model
NA,
Pretreatment Unit
NA
0 Sand/GMvel Filter
0 Peat Filter
[I Mechanical Aeration
0 Wet.Iand
C3 Disinfection
0 Other
-Manufacturer
Dispersal Cell(s)
I I n-ground (gravity)
1.
0 In -ground (pressurized)
A r7O
0 At-g rade
El Mound
0 Drio4ne
11 Other:
Values typical for domest:c (non-co mmerdal) Yvastewaler and
sep6c lank effluent -
Values typIcal for pretrea48d wastewater.
SL%rvice I-requency
I;dyeaf(s) (Maximum 3 yrs.)
At least onc�e every "C3 Months,
When combined sludge and scurn equals one-third (Yj) of tank volume
months �W_year(s) (Maxlnium 3 yrs.)
At least once every (n
At least once every 11fl' 0 months Year(s)
u monint? yucllk-:2; &AVA
At least once every
At least once every (3 months [13 y e aa r (s) NA
At least once every 0 months 0 year(s) Q\ I NA
MAINTENANCE INSTRUCTIONS shall be made by an Individual carrying one of the following licenses or
InsoecOons of tanks and d[spersal Cetts 9 Inspector. POWTS Maint2iner, Septage
mtr �e- Master plumber Resuicted Sewer, POWT,
ceftfficaUons' Master Phuk inspections must include a v1sual Inspection of the tank(s) to identify any missing or broken
Servicing Operator. Tan e vle, volume, of wrnbined sludge and scum and to check for any back up
hardware, idenflfy any craws or leaks. meaSuf 'heck the effluent levels
or ponding of effluent on the. ground surface- The dispersal cell(s) shall t�e visually inspected to C h
y Imo" of effluent an the (11'OUnd' surface. The ponding of effluent on t e
,,pes and to check for an
In the obserwalkion th(� regulatory autho�ty-
ition and requires the Immediate notj ation of
ground surfacc, iI)C-ty Indi.,t9te a failing cond f we Lank volume. the
umulation of sludge and scum In any tank equals one-third (Y,) or mure u (-h, NR
When the combined ac,,c by a ��eptage Servidng Operator and disposcd Of ill accordancc VJ0)
entir-e Of the tank sh-,311 he removed
113, Wisconsin Adrn1n1st(3t'v(," Gode
mech4nic-al or pressudzcid povv7S components, pretreattment c4Dmponv.r,t%.�, and any
The servicing of efflUeT)t filWrS- f'12 mc,�nths or [ess 5;hnll be performed by a certified POWTS Maintniner.
other maIntenan-P (), r-ionitoring at lr.erv2IS 0 �� �. r� � wa (y -ty y�jLhlfi 10 days of COmPletion Of any service event.
A - - Provid(L!d to the jocal regAlt -�)'Y
START UP AND OPLI:'A'l ION other
ri T'S cl'i eck trey
trn ant tank(s) for the presence of pal Ong prod H t S Or
For new cionstruction. p or tO use Of the POVV t 2 iolls are
tre-atment proc�oss and/or the dispersal cell(s)- If high concen r t
clhamicnl-F, t1wit mny rv-cing operontor pnor to use,
sc I
detected have the, c,01"t0j-jt5,,o'1 the tank(s) removod 1�, sff""
Page ' of M�, I
START UP AND OPERATION eck try went tank(s) for the presence of painting products or other chemicals thOt
For new constructon, - p6or to Use Of the POWTS rh If hi h concentrabons are deteded have the contents of thp,
may impede the "atment process and/or damage the dispers2l WHO) g
to nk(s) removed by a septage SenA Cing ape rator P n or to u se
System start up sha I I not occu r when 15 oil condifl ons a re tme n at th e i nfiltmflve su ftdc;e•
r is restored the exoeSS wastewater will br,
During power omqe-s pump tanks may fill aDove normaj h,ighwater levels. When powe-
discharged to the dispersal cell(s) in One 1,arge dose., overloading the cell(s) and may result jr, the backup or surfaioe discharge of effluent.
nterts of the pump tank removed by a Septage Serviding operator prior tO restoflng power to the
q
To avoid this siaudon have the co S MaIntalner to assist in manually operating the pump controls to refire normal levez
effluent pump or contad a Plumber or POVVT
wiIhin the pump tank, not drNa or park over, or otherwise disturb or compact, the area With!n
Do not drive or park ye -hides over tanks and dispersal cells. 00
15 feet down slope of any mound or at -grade sail absorptJon area.
g the Ift of the POWT$'
Redudon or elimination ofrom f the f011owing the wasterwater Stream rya. y improve the performance and pro ton infectants', fat; foundaton dmW
anfibiobcs+ baby Wipes: clgamfte b M ; condoms ; cotLon swabs, degreasers; dental fk)ss; diapers;
um
Gides; meat scrapm
s; edicgbonSL, oil, paimng pro4ducOl
(sp pump) water; fruit and vegetable peelings' gasoline-0 grease,* herb]
P
peistiodes; &anitary napkins: tampons; and water softener brine. I:Sr Prope';-Jy
ABANDONMENT ice the foficwing steps shall be taken to insure that the SySteM +
When the POWTS fails and/or Is permaneLnt�y taken mA of sery
and safety abandoned in compliance withchapfer Comm 83.3.3, Wisconsin Administn6ve COde'.
All piping to to and pits shall be &sconnected and the abandoned pipe openings sealed
The contents of all tanks and pb m
shall be reoved and propedy disposed of by a ePtage Servicing operatOr-
After purnping, all tanks and pits shalt be excavated and removed or their c*vers removed and the Vold space filled with swil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POVVTS fa1ls and cannot be repaired the folloMng mean ms have been, or, must b-0 taklDn, to provide a code, compflii�nt
replacement system. of a repJacement soil absorPtiOn sYstcim-
Itable repia oement area has been evaluated and my be dlized for the localJion
su ed from di turban and oompaction and should not be Infringed upon by requiieed
he replacement area should be protect and wells. Failure to proted the replacement ama will result in Vie nE,ed
setbacks from existing and proposed structure, lot lines Rsycom
for a new soil and site evaluation to establish a suitab4e replacement area. eplaosment stems must ply with the rule� in
effect at that time.
s in POVVTto nologV a
9 oeS ch
A suftable replacement area is not air Table due to setback and/or soil limitations. Barh n advan,
holding tank may be instalW as a last resort to replace the failed POVVrS.
table replacement area. Upon failure of the P,OVVTS a soil and site evaluaqon
13 The site has not been evaluated to Idenfify a sub
must be perforrned to locate a suitable replacement area. if no replacement area is available a holding tank may be installed'as
a I a st resort to repl aoe the failed PODS -
C3 Mound and at -grade soil absorption systems may be reconstructed in place fulloWng removal of the biomat at the infilt-a'fiv'e
ly ith th e ru les i n effed at th at tim a
surface. Reconstip cins of such systems must comP "
<<WARNING>> REATMENT TANKS PAAY CONTAIN LETHAL GASSES ANCVOR INSUFFICIENT OXYGEN. DO N01
SEPTIC, PUMP AlD OTHER T STANCES. DEATH MAY RESULT. RESCUE O� A
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANS
UNDER, ANY CIRCUM
PERSON FROM THE INTERIOR OF A TANK MAY BE EXFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
P.OWrS INSTALLER
Nam
Phone se�
�
POWTS MAINTAINER /IF)
Name].
e
Phc!ne
SEPTAGE SERVICING OPERATOR (p4MPIER) LOCAL REGULATORY AUTHORITY --
a 1're
Name
Phone Phone
ry
(PI a n d 383 �4 1), (2) & (3), Wisconsin Adm I I istMitive C od e
This dcojme nt was 'd re ",d t.n 00nVjj an ce wfth rh aptei SPS 383.22 (2) (b)
Sr. Caoi ry SANITARY SYSTEM File
OWNERSHIP/ADDRESS FORM Office Use 0111yCreated 212021
Comt,nunity Development Department will utiHze this informaton to provide the property owner with
inforniation regardire g operation and maInterra rice of your new or replacement sanitary system! This
infornration will be pi-ov[ded as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and COUI-ity resources. Once approved, the s conipleted form and educational
informatlon will be sent to you by ernail, It YOU WOUld like to view your issued sanitary permit online, YOU can
do so by using the Pro t)ertv Files Scanned, weblink,
.0
01fi'%ER/BUYER INFORMATION
J
Owner/Kfyer i e
i
Mailing Addre.
City/State/Zip
Phone Number (required)_
Eniaill Address reqolred) J7 lln- ff F
Parcel Identification Nu mber (21 z E
(found o.-) the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Property LocaCIOO�A
U/A Sec. T NR 2wTownof
Subdivision Plat' # r Lot #
Cerfified Survey Map # Volume Pa e
Warranty Deed 1109� Lf (before 2,006)Volume F Page P
Number of bedrooms Spec hOUse 0 ye/tzl-no Lot lines identifiable C1 y 7,LJO 0
OFFICE USE ONLY
cc
New Pro;�erty Address
z
(Verific Lion cif addrt�ss rcquirt2d from Comri�unity Devel"oDIMent 6epartment for new construction.)
l�
13 ��
(S t a f II it 1'� 15) (Date)
This form must be subiritted wit17 alb Pr�votnsitWater Treatnnent System (POWTS) uppli,cations.
1-.1 �his form a recorded wut-rciln! i 1� ( lec�i oni the Re ' - cf Dees offf-C �-71(' Cj Coj�y 0ffje CCj-t-r'e(j
IN ew Sy5tem: -Include vvill If -q�stef k.,
J
-survey incip if reference is mode in the warranty deed.
Cornmunity DevelOpMent Department - Land Use Division
715-386-4680 St. Cr6x County Government Cent.ol, '715-245-4250 Fax
�-d -4� U www- gw.
dALLC'�Vviaov 1101 Carmichael Road, Hudsci i, Wi 5 ')1 r' [.-gp V
State Bar of Wisconsin Fon-n 1-2003
WARRANTY DEED
1) 0 V u,.,. Ic r I . N, "A..-,,,
-weeii ir.a ti-cicli Pka Tara Camevale, a shi' ncrson
('7:-a I itor, " 1 1i et I') c r o ii c 4) v 1i i i ore)
I
I LA I C
and. David We] s kc, -,1% tid Sarah Weiske, hus�h,.d , - d wi:_
("Grailtee," whethor one or more).
GL-alltor, "I Conside:uLioii, cum-evs to (,;rmitee 'L1ie �6110-witi�; described real
estate, t()g01hL-3_ ��' i":'. the I ��L] l�profits, fi.marcs 'L,Iiid odder apput-enant, mterestslw In
St. Croix County, Statc of WIqco.-sin ("Propertv") if more sj)ace is
m!eded, pleask: atiach adde dul-n):
Lot This ,LV-scvci1, (37) Plat 011-64sam In the OW11 01'Hammond
dill
Rq
—H 241
F. . . qI I."' T
1168744
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
07/10/2023 11-102 AM
EXEMPT#:
REC FEE 30,00
TRANS FEE 75.00
PAGES,- I
kccc.-ding Area
Name and Rcturr AdiK%,tS
Tarr(4 co-'erlevaib
018-1083-37-000
" L f"a r CC I kkntifJC3*iC3n Nowbu 0,11",
'I'llis is 110t humcstead property.
Ea
Gran tor�tar%wF ls]i;il ;.hu tillp to the property iqgood, i11defea,-;ih'1x c
In�simplk, .,,.,id frce and clear ofencumbrances except,
emelis a dk h
Dated June 27, 2023
i
N, 0
r1V 9
INorth % vcr7 E.kpjr.
J 2
A ["TI4 ENT I CAT I ON ACK 7� %VLED GM ENT
Sigriature(.$) , )il ' X-A autl,�mcated on COUNITY
Cirand FoTIL I
Per: I ly Came bef6re me Oil _SUjNFr V! Z07,
thabove-nmci LFeld,
ELU'L 1 1 1',,
TITLE: ME.%,V31.`R S'l ATI 13AR OF WISCONSIN
(I I riot) 11) Inc knowii to be the poi-son(s) who executed [lie
()
L. r_1 S�,
A. 7� instrumeni and acknoMe4ycd the same.
`T'AaA 'fi a tS G V AtjFd� *Marsha K. Clow
ek5T a!-v Pnblic, St,,�,t, o!,
JjL0_k -7
L%lv (,oimnissiol'l C,
(S] gn aw res may be W1 I I L'11 t Cd o r ;i c 1i ji o N� I �: d B U t 1 of I'L' I 1 31 C c essm ry.
M. A -N'� elf 1) 1 FI A Il ON S T0 111 IS F0 10 1 S I 10 U L D b L C L 1*,A RLY I D EN 11 FI E D. E: THIS IS A STANDARI) FOR F'0. 1
ONSIN NVA RRA N. TY 1) E L D fCZ10LQ.STAR A`1-L BONVISCFO R.M N -2003
111 C he 10 ws iAl I attlr�s.
St, Croix County 1168744 Page 1 of 1
-------
A7
6%r
- - ------- - ---------- -
-------------- - ------ 6�.q 1/7
.. . ............... - - - — — - -----------------
- -- - ------ -
Ai r swvw 4- P%m moo Cr ow A' #mM
P*w potawlap
a OkO% WON AOMW of
somw ObAwNwhow am ON a U-w df rw
kww IF Oftarw ASO bw poftew 46 Aw
i I PQNdm sw st "wo roa"M ow Va b iw 21
Af LA Oft-m
..... ...... .. ....
-- - --------
... ........
4
•
saw Gr ft. Onv vwsdp-r4Rov -&Vft S." A-
%wo-s *wM AIM 10 Avb- do "'Aw CRd ohNe." ff
wip do ON Qphv Pw�
S� *w 44,0ft Dmrkw - nev vsys+w
low Ca+w* #AV 4+rjpw andr-di-o 4-*
ti
Oir-s S! 8*
#NDV PO-OWIF W O�W
xi
560 Ipt
It
............ . ....
. ......
#*Aft Habbf 1
A"bow Op*Nh Aft"
O"M h—t-M
XAd%qOA%ow Pena
1
3J
Vh
2
v*wrowtv 0AW
P File orch
36 W-Cy
4 sR ft
POO
i Offium HNrw
120"
Crob-ariv aw Owpodlor
•1
. . .. ................. . .
moo
4
q� oWAV
1 tw
L L�L
2-1 *4W Mr LK AOMAPr
.......... : ---------
AMdI
Kitchen
9QWAQMrW 16�
A
LaundrV- 1/2 Bath
-15' a V-8 3/1r
72 sq f1t
4,4
MOM 2W M:,; OF
—S.
Momw VJ*&-Ttwu Clas
sy.
V-4 314' Jr 4.
24"
no,
2'11 TZ 14"
Mast" Bath
----------- --- - - G4
. . . . . . . . . . . .
40
YJ U7' "V
Master 84r
Is'-s S 'a" x W-6
243 Iq Ift
entry
T-O' x V-7 3iW
4ssq ft
Ming
01-3 3.,4, 3t M-O #/8,
t9a aq ft
. .. .......
LMng
F.
P-2-71".413t Is, -to 7rG,
384 sq tt
4 -Ir
Z� A
....................... . . . .
4--2.W-
k • 3-4117
3'J' Y-4 1/7 4' 5. If 114'
1/7
- 3.,6-
T 10 N"
15t- I I'
11 V4.
13.2 I1Z
---------- ---- - ------
Front Porch
80,-0,
MainFfoor aces sr-
Gara" SSG SF
4 PONOK --d 1ApWffl*V
sq
IPV %006•
Front Porch 360 5r-
Rear Porch 342 SP
kdN6
12.1 91411fV IIX LVL Nvedw #0 on
TMA" p*w sat Ov
12-
1.7
Main Floor
Plan
iske 9-27-23 RVH We
Scale 1/4'-1'-0'
pw wbm some sum ww
rN5ftwffltAMLy-E!ft*
Lom Cluds Am"w"wAs and Moo ftama ftow Valq$ Nwom Vow Is S&AN
ku .... ..... ............. Adwompo
RIVER VALLEY
HOMES
_ _ _ ....................... — -- — - - -----
------------- - - -
1 4ppef" AN PAW
and
tin.M
Pr*a Neel-ICd
Urwxcavatod Hu to Stab
631-Kr . MI-3 7.,tr
Locations of Ail Water, Waste, Electric
and Gas Lines to be determined by
Carpenter, Plumber, Electrician and
Heating Contractor— Marked and or
t� ar.s.r,&A
wani#y
j
Urwxc avat4ed Fitt to Slab
i
I
_...------------------.... -- ....... ...... - m..... -... _ ... -- _ m............
Foundation Plan
-. -. RIVER VALLEY
H 0 M ES
;:.o;=
on
arias
11-MMIEFEEM'Imum
gear tnt4gvaitic
11 INV 11 u� m 1111 11
11 11' 11 1111 11
Clili C[fVd�[i.�
ations R 1 Y E R YF
r-of HOME
isconsin repa*Ornent of Commer OIL AND SITE EVALUATION Page I of 3
4 Owision of Safety and Buildings 10RIGINAtcord filth Comm 83,05, Wis. Adm. Code Cerfified Soil Testing
Attach complete site plan on paper not less than 8'/.,; x 11 itriches in size. Plan must County
include, but not limited to. vertical and horizontal reference point (13M), direction and t C r o i x
percent slope scale or dimemsions, north arrow, and lQcation and distance to nearest road. Court r I
Parcel I
APPLICANT INFORMATION - Please print all information. Reviewed
Personal information yoti provide may be used for Secondary Pure es (Privacy Lavv, s '1 5.04 (t) (m)) FRevi ew;edBv Date
f
Property Owner
rr
Property
Prooei-ty Locatiori
B o n
Govi. Lot SW 1/4 N W 1/4 S 16 T 29 NIR 17 %Y
P pvn "7)p
rooely Cw-es Mari-,j Adoress
,'
Lol: # Block #
Subd. Name or CSM#
1011 170ili St.
37
Phea�ant Hills
itta(
c y S6
hq �L� Code Pneur N�ber
lill Town Nearest Road
y Vage
Haniniond W 1 -.5
015 7 15 - 746 - 52L. 4 0
T-Timmond
New Construction
Residential / Number of bedrooms 3 Addition to existing building
Use-
Replacement
Public or commercial describe
Code Derived callflow 4 5 0
gpd Recommended design loading rate..... ._bed. gpd/ft' .4 trench, gpdtl
Abs°ortie area required
bed_ ft2 1 1 trench, ft2 Maximum design loading rate .5 bed, gPdjft2 6 trench, gpd/tl
Recommen dec infilVation surf ace elevation(s) 24" contours ft (a,s referred to site plan benchmar
Addlb.ona! design I site considerations
' r br 3
Z - 5' 1 1 x 2.5' shallow trcnchefir
Parenr. r�,aterial
Flood plain eievation, if applicable NA ft
SzSuitabli'n fcr systern
Conventional Mound
In -Ground Pressure AT -Grade System in Fill
Holding Tank
U=Unsu;tab,,e for system
U S U
S LU Z S u
—
S U
Boring#
29
Ground
eley
95.5 ft
Depth to
limiting
factor
2
Ground
ellev
96.0 M
Depth to
limiting
factor
> 700
Horizon Depth
i n.
Dominant Color
Munsell
.6+ Texture a �S
C%j ...,.,nt Color
vu ctu re
Gr. Sz, Sh.
Consistence Boundary
Roo t 5
GPD/ft 2
Bed Trench
I
1 0-3
2 3 -20
7,5YR 3/2
51
2 rn g,r
i ds CS
I f
5
C), 6
7,5YR .3/2
S1
2 m -sbk mvft
CS
I m t ( 5
Jo .6
3 20-45
7-5Y1 4/4
sl
2 m sbk
m fr
cw
I m
6 5
+7
'06
.8
4 45-88 10 Y R 6.,'4
S/Mcos
0 Sg
dl
bo—Ir-A
ar
" tf n ' FrC V_U I -)ctween noril()11� 4. varies oetween4) - i 4 LICCPCF � I MIS I 11C I k1 S1 011 S I U Y K + 4 Is
Remarks�
0--5 YK 2,5/1
2 3-13 7.5YR 2.5/1
i s1
51
2 ni or d. S CS
I r -5 C) .6
2 in sbk
in sbk
mvfr
M&
CS
CW
I f _4
Im .6 5 1-0,6
4
10YR 4/4
51
4 40-70 7.5 YR 4/4
S1
0 M
m fr
14
2 `f �
�r
I L
Remars-, I It I L I U %_� I U I I N J I M 41 U I b k V, N i�, U I lk" I a-!) I I t-; I
Te;.ephone No,
SST rase Print) Sirinatuf"� '7TT -
Henry F. Grote 7 15-665-2681
e ri i Fi e d 9'o_TTi�,,_i
D at & CST Number Ref #
I .- =774 1046
P. Box 57, Knapp, W1 54749 4:111"1'1000 2 22
PROPERTY OWNER: Bonte, Ron
PARCEL l.D.#
SOIL. DESCRIPTION REPORT1046 ' �2 3.
Page of
Certified Soil e�ig
3
Ground
elev
uepcn io
limiting
factor
Horizon
Depth
in.
Dominant Color Mottles
Munsell Qu. Sz. Cont. Color Texture
Structure
Gr. Sz. Sh. Consistence
Boundary
Roots
GPD/ftz
Bed I Trench
1
0-6
7.5YR 2.5/1 - sl 2 m gr ds
cs
if
.5
,p6
2
6-12
7.5YR 2.5/1 - sl 2 m sbk mvfr
cs
if
((6 .5
+ , b.6
3
12-44
lOYR 4/4 - sl 2 m sbk mvfr
cs
-
.o
' b .5 .6
4
44-66
7.5YR 4/4 - sl 0 m mfr
-
-
,2
.4
2� �D
Kernarxs. aava at.vaa -T aasa.z iJ►.rv[L,71%JFAA"i I .J L 1\. "Tf W A0 kV) -Jby ALAS l J 111v1%401 A10 VAI 31&1 %A, 1. VT V►CL11.7, 1LJ VVCL11 114AZ 1 V 11V '?I %J 111MUa kV! a6l U1I ►rV/ 61 M %.VU
below 5011
Ground
elev
uepcn io
limiting
factor
> 700
1
� 0-4
7.5 YR 2-5/1
-
s l
2 mr
g
ds
�s
1 f
i .5
l j. p.6
2
4-17
7.5 YR 2.5/1
-
sl
2 msbk
mvfr
cs
If
' , .5 ,6
3
17-43
1 oYR 4/4
-
sl
2 m sbk
mvfr
cs
-
. to , 5 6
4
43-65
7.5YR 4/4
-
sl
0 M
Mft
cs
.4
5
65-70
1 oYR 4/6
-
IMCOS
0 sg
m1
-
-
.7 .8
a^r,,,Ar&-
Dery occasional
i
2� �D
7. 77 K 475 s inclusions to ortzon
orizon
3 nas some Own
1
0-4
7, 5 YR 2.511
-
sl
2 rn gr
ds
Cs
If
to .5
�. c,G
2
4-10
7.5 YR 2.5/ 1
-
sl
2 rn sbk
mvfr
cs
If
.5
, 6.6
Ground
elev
3
10-36
1oYR 414
-
s1
2 m sbk
mvfr
Cs
I
.5
` .6
96.4 ft
4
36-43
1 oYR 4/3
i
-
1s
1 rn sbk
ds
Cs
if
.7
! .8
Depth to
5
43-59
10YR 4/4
-
s
0 sg
d1
as
-
.7
.8
limiting
factor
6
59-64
5YR 4/4
-
sl
0 M
Mf
-
-
•Z, 3
,4
Ground
elev
uepcn co
limiting
factor
Remarks:
KernarKs:
lzi
. Ls, 9�7z
4.
7
................. .......... ............. ...... ................ .......... ........... ............. ................... i .......
0.
-10
,ten - ..1
Parcel #: 018-1083-37-000 021191'2008 04-02 Fl,'
PAGE 1 OF 1
Alt. Parcel #: 16.29.17.609 018 - TOWN OF HAMMOND
Current X ST. CROIX COUNTY, WISCONSIN
Creation Data Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address, Owner(s), 0 = Current Owrier. C = Current Co -Owner
0 - FELCH. JEREMY & TARA
JEREMY & TARA FELCH
606 SKYVIEW CIR
GRAND FORKS ND 58201
Districts: SC = ci'70 I SIP = special Property Address(es)-
P(IMLM
Type Dist # Description 976 172ND ST
SC 2422 ST CROIX CENTRAL
SID 1700 WITC
I
Legal Description: Acres 2.090 Plat: 07-086-PHEASANT HILLS
SEC 16 T29N R17�%' PT SVV NVV PHEASANT HILLS Block/Condo Bldg, LOT 37
1'-� 1) C4 A C,
I
Tract (s): (Sec-Twn-Rng 40 1i'4 160 11"44)
16-29N-17W SW NW
2000
Notes:
0.P-arcel History-
Dzi t e Doc
VollPage
Type
06110/2003 72 5221
2269/594
WD
uui-i ui 003 725220
2269/593
WD
03/10/2003 712696
21661!553
0C
06122/2001 649071
16 6 6;`4 6
Li,
2008 SUMMARY
Bill #: Fair Market Value: Assessed with:
0
Valuations,
Last Changed,
10,2212001
Description
Class Acres Land Improve
Total State
Reason
RESIDENTIAL
G 1 2 090 26,300 0
26.300 NO
Totals for 2008-
General Property 2.090 26,300 0
Woodland 0.000 0
Totals for 2007:
General Property 2-090 26,300 0
Woodland 0-000 0
Lotte ry C re d It: C1,nin-1 Count: 0 Certification Date,
Specials:
L j S 1) k. a.• 14l I C (") d Category
'
26,300
0
26,300
0
Batch #*.
5 pe, c ia I A 111' 17t Ly pecial Ch',--irges 0061([Liurat
T
A rr i 4, ),,., r i t
4
# .0 3
.474i sconsin bepadment of Cornmerc OIL AND SITE EVALUATION Page _1 _ Of
Oivisllon of Safety and Buildings IGINAficcord with Corrim 83.05, his. Adm. Code Cicrtifitd Soil Testing
Attach complete s;'te p;,ari on paper not tress than 81/z x 11 inches in size. Plan must Colin1:y
include, but not limited to' vertical and horizontal reference poirit (W), direction and St. Croix
percert slope, scale or dimernsionS, noi1h arrow, an�joaa�Q,�and distance to nearest road,
Pa�cel I D 4
C ,, Fnly Pa
3
APPLICANT INFORMATION - I Q"p�jAt affjrjforri�a�tlon.
P,
Pev wed B11�Date
Rar5rC).r)al inn-rmation yDu pfovide may be u&e rseqpndary pur S (p4vacy LOB, s. 15 04 (1 (rn))
Fr
-y Owrer'sM aillingAdd ress I P10 Subd, Name or
I -- 1�0th St.
0' ZTown Nearesi Road
Gtat&' Z� Code
;11111 - ii, Fl Village
41er j
nd
Wamrno I 70'Fh
I laniniond
rooms Addition to existing building
D
New Construcdon enball I Nu'-"rpb'e 9� b6
Use-
ReplacennewPublic or-cornmerCial describe
.
450 bdd/ft' '4
Code Derived daily now gpd Recommended design loading rate -e, gp
3 trench, gpd/ft'
.Ah r ie area required 1500 bed, 1112 1125 trench. ft" Maximum design loading rate -5 bed, gpd/ft' .6 trench, gpd/ft'
Recommended infiltration surf,ace elevation(s) 24" below COTI�Ours ft (as referred to site plan benchmar
install 2 - 51 x 112,5' ShallOW ITenches for 3 br
A,Jdl',')onal design I site consideranns Flood plain elevation, if !2plicable NA ft
Pareriall _e,itmmtill
Q'7.Su�lable for system Corivertionai Mcod In-Grourd Pressure AT -Grade System in Fill Holding Tank
__! U F_ r .
-Un U S i_ U rL 5 [.1 1 - " S X U S X U
j suable for system 5 'Ll U
I % a K I -IFT—F IT-1 - vir - %&F rvffTpm
Depth
Dom'.1nant Color
Roring�
Horlz On
in.
Munsell
29
0-3
7.5YR 3/2
2
3-20
7,5YR 3/2
Ground
3
20-45
7,5YR 4/4
elev
- 4
45-88
1 OYR 6/4
Depth to
limiting
faclor.
- > M4
Mottles
Stir uct
Qu. Sz. Con(. Color
Tetu e
xr
Gr' Sz.
2 rn
S1
2 M
M
S/M Cos
Ds
ire ',_,Onsistence
Boundary
Roots
GPOV
Bed T re rich
ds
CS
if
5 .6
bk
ins fr
Cl 5
l
.5
bk
rn fr
1 M
.5
.6
dl
.7
.8
t
- st hj�s unclus tons 1. U Y K 4i-4 J S
RrS:
very irregular boundary beiween horizu.,is 3 & 4, varics bet en 45-74. - deeper.
nMa
2) rn gr ds l` .5 6
CS
7.5 Y S1
1 3 R 2.5/1
2
A.
3 2 3-13 7.5YR 2.5fl 2 rn sbk m v Fr C5 If .5 .6
Ground 1 3 -40 10YR 4/4 S1 2 in sbk mvft CW Im .5 .6
elev
96.0 ft 4 40-70 7.5YR 4/4 0 in m fr 43 c .4
Depth to
factor
Remarks,. horizon 4 has inclusions 7,5YR 4/6.1.11s (0, sg, di)
C 7TN Name Ta:ephwe No.
H - �
ST Name (Please Nii'.) Signature:
henry 715-665-2681
enry F. GraLe
Ad
,jreS5 Certifieoi d Sl lcsting 0,ST Nmef Ref 9 T�.o Box 57, Knapp, W1 5."49 4; 3/ 2 0 00 2*212774 1046
d. I
PROPERTY OWNER, BCntc, Ron
PARCEL I.D.#
`� 4
SOIL DESCRIPTION REPORT: �r .4= ' � ; �:.:.' Page of '3
�. y M �7/
tea` Ccnii"icd Soil cs mg=
Ground
elev
95.5 ft
Depth to
limiting
factor
> 669
OL
Ground
elev
95.2 ft
Depth to
limiting
factor
> 700
i
Ground
elev
96.4 ft
Depth to
limiting
factor
' 640
Horizon
Depth
in.
Dommanl Color
Munsell
Modes
Qu. SL Cont. Color
Tenure Structure onslslence
Gr. Sz, Sh.
Boundary
_
Roots
GPDfft�
Bed Trench
1
0-6
7.5YR 2.511
- s1
2 m gr
ds
cs
If
.5
.6
2
6-12
7.5YR 2.511
- s1
2 m sbk
Mvfr
cs
If
.5
.6
3
12-44
1 OYR 4/4
s1
2 m sbk
mvfr
cs
-
.5
.6
4
44-66
7.5YR 4/4
- M
0 m
mfr
-
-
.3
.4
KemarxV. la%/s 64~11a -V aa&W VVVSi.7sL/sa%44 ■ s✓ a •i Zi i! 5.0 `M,* .wb% 6a50/ i1,4%00 aVyav ►raa ► v A.V %~ a ■ ■. ■.".awl v .r w.■ ■m*~ Na a 0% a! •y aa...rv. '%wj we) r.) .•• Ci.
1
0-4
7.5YR 2.511 -
s1
2 m gr
ds
cs
if
.5
.6
2
4-17
7.5 YR 2.5/ 1 -
s1
2 m sbk
mvfr
cs
If
.5
.6
3
17-43
113YR 4/4 -
s1
2 m sbk
mvfr
cs
-
.5
.6
4
43-65
7.5YR 4/4 -
s1
0 m
mfr
cs
-
.3
.4
5
65-70
1 OYR 4/6 -
imcos
0 sg
m1
-
-
.7
.8
is
,5
Ground
elev
Depth to
limiting
factor
KemarKs. ■ vs j VWwwyVsyaaf ! .%# a 4% T= V aal• sisViiirlsValai $No aiVa iLVay ZI a.Vs iLrVas U? ;s.a s .7V959V fPsf VVV
1
0-4
7.5YR 2.5l1
-
s1
2 m gr
ds
cs
if
.5
.6
2
4-10
7.5YR 2.511
-
s1
2 m sbk
mvfr
cs
if
.5
.6
3
10-36
1 OYR 4/4
-
sl
2 m sbk
mvfr
cs
1 m
.5
.b
4
36-43
1 OYR 4/3
-
1s
1 m sbk
ds
cs
1 f
.7
.S
5
43-59
1 OYR 4/4
-
s
0 sg
d1
as
-
.7
.8
b
59-64
5YR 4/4
-
s1
0 m
mft
-
-
.3
.4
nemarxs:
marks
L_
12��
�o.%-��-P1ok
ti
F
.I
V3� A
C A!{ - L
4
................
-4 3
.... .... . .... .... ...... .....
V � L Ch
gar
. . . .......
Si cv-wo I *A COUNTY
No.
.. .. ..... ..... ... .....
...........
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
n b 1�2'� 94ST
11RANSr'E �'ic�:T�'�`�i. PREVIOUS NO.
........................... .......
;2we)(
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval..
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought, and that
changed regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: 1f you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
- DATE jo/1312.D93
IF T
jr NLT-j r-j rj" -"r-jYU 1-n
TH"IS 112�-" 15
IL
.... ...... ..... ........
. ..... . ...... .
SBD-06499 (RI 1/20)