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HomeMy WebLinkAbout026-1153-12-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538$79 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: Marek, Todd R. Richmond, Town of 026-1153-12-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: m L GS 1 19.30.18.1150 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ••~,JS CAPACITY STATION BS HI FS ELEV. i Septic S G~ Benchmark i 9 99 ! /ZOC7 ~ Dosing Alt. M 6.6 4A ~o 9W 6.,L. 7 O 2 Aeration k / Bldg. Se er T 7, Holding ICJ SUHt Inlet ~z z \ TANK SETBACK INFORMATION St/Ht Outlet TANK TO ~I! _ (j L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 36 Dt Bottom ~,57 ~ 3 • Dosing ,TU tA / Header/Man. 79 Aeration / t0 V Dist. Pipe A , r ~l cam-, Holding Bot. System /16,7° Lip ___,~;~4 qd b PUMP/SIPHON INFORMATION Final Grade 5• ~O S Q Manufacturer ~~cJ l j ~5 Demand„ Stover GPM 7.6 v o / Model Number TDH Lift Friction Loss System Head TDH U►v (10, 1 AI- , Sto Forcemain Len th / Dia.Z 11 Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Lengtty No. Of Tr52W PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 117Z f Al Z- SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: / INFORMATION CHAMBER OR 1/ f-~` Type Of System: UNIT Model Number _ /J DISTRIBUTION SYSTEM I Z 3 Z"7 Header/Manifold d Distribution x Hole Size x Hole Spacing Ivpeto Air Intake ` Pipe(s) Length ✓ DiaI Length Dia Spacings` _SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded Mulched Bed/Trench Center Bed/Trench Edges ITopsoil 0 No r "Yes [id No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 1483 92nd Street New Richmond, WI 54017 (NE 1/4 NW 1/4 19 T30N R18W) Glen View Lot 12 Parcel No: 19.30.18.1150 1.) Alt BM Description = Pvr f ccoe.', $0 15 care f`,/v Nw Gor j a~ 2.) Bldg sewer length = 30 10 G w~ , n. o a `p" - amount of cover Plan revision Required? [N Yes No Use other side for additional information. ~D SBD-6710 (R.3/97) Date Insepctor' Signatur Cert. No. 4 ~ I V~ G,~ v commerce.wi.gov s Division County 201 W. ashi on Ave., P.O. Box ;7162 S~ s co n n dison, WI 537074706 1 Sanitary Permit Number (to be filled in by Co.) DVVof Cotnmeroe\q~a ~v~ ( 53 IN t tJ~N State. Transaction Number 77 Sanitary Permit Appli atioa '✓~%KU,v In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this r t ,0 rate governmental unit is required prior to obtaining a sanitary permit. Note: Application r state-owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for seconda purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats. 1. Application Information - Please Print All Info Property Owner's Name Parcel # o Po 49 z 6 - ls3 ~l2 ®a~ Property wner's Mailing Address Property Location ~d tOt OQ z Iq Govt. Lot Zip Code / Phone Number YZWC-AJ Y., Section City, State ~bv G t t ( 7 T N; (circlE onM If. Type of Building (check all that apply) Lot # - Number of Bedrooms -t-or 2 Family Dwelling ~L Block t-~~ V l eW ❑ Public/Commercial -Describe Use C, ❑ City of ❑ State Owned -Describe Use CSM Number ❑ Village of 2 , z5 a R Town of l~--l Gtr /K J Z,d Ill. Type of Permit: (Check only [one box online A. Complete line B if applicable) A' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner h¢ c IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ! J O'Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound> 24 in. ofsuitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank O er Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/I real ent Area Information: Desi n Flow (gpd) Design Soil Application Rate( st) Dispersal Area Required (sf) Dispersal Area Proposed System Elevation ~ DD i l~ ©o e f VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units t? New Tanks Existing Tanks , l )D ~ Q ~ w Septic or Holding Tank -K/ J/N l ! U Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for `Installation ofthe POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/hNgtTNumber Business Phone Number a~~ Plumber's ddress (Street, City, State, Zip Code) CO- 6G et"1 Dl VIII ount /De artment Use Only Approved rsap Permit Fee Date Psuel Issuing ent Signature X75, y 7 ~t O iven Reaso rDenial [X. Condt !asons for Disapproval '"ipt~C tank::efiha~ilrlhl and 3~ ar,; l1ku. i0e~el- roe; d1.~ dhWMd ;1 must all be tlaervkes I maintained. / • /'A tI ft W. MWADOMent plan provided by pkimbp►. 2, AM40**Ck + er atlb mt~ bur; r>bNttalr d P l+~ a t lee r - o e system and subm to the County only on paper not less than 8 t x 11 inches~n size SBD-6398 (R. 01/07) Valid thru 01/09 ff --L ,t f t!nF tyH~+t:,n~„,.,,; flnG= 5ii+~9u .t b9 7w1f,,%if, = a !ir un ' 4 . lat7epttb O' ~':<f 7d'c'JRl2'fi',:;197:1f+f731.pfAi3~9s~~f~ .e al)ILIlirl., 1,;- an f}LE l , z_- f lb jo~ ~i I- L 93 ~b 04 ~a e EGG L i CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: 7 4 pp Owner's Name: 5,4 - Owner's Address: /(1~~J Legal Description: AJ E N (Af S !2 4. 3_ R g c, Township: 2( C I'- /PLO ~VJ1 County: S 4- C (P -,q t)< Subdivision Name: Lot Number: f Z, Parcel ID Number: Page 1 Index and title _ Page 2 Plot Plan P~9~ Page 3 3A System Sizing & Cross-Section ~R~K c2o5s fEcyvnl Page 4 44 Filter Specs IP49 C Page 5 Maintenance Information PuM~ ~tA.rty-6~- Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 _ Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: y~~GJ/~2 ~~LS o License Number: /Vl R Z Z 6 ~9 7 Date: 7 - Phone Number 7 (S Z ?-3 Signature 4L Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 RL,4-~- JP(-AN z GPrLE l ~'~Os r V3.1"" N Q o I ~p,0 /J1 Z ~ 'Ct! O ~ I T p ~ / ,1~.w,✓ ~i 2R DC~ DI Z E t-F" a~ LL ~L+ 93 ~M bp` 'L ~s 44 ~a ~~k~~ l 41011 Absorption System Cross Section k4"1 Schedule 40 Final Grade Vent Pip PVC e ~p th Vent Cap it Leaching Chamber ~~ft ~ System Elevation _ it AL it Soii Absorption System Plan View ~Q v it 3 ft { 1 ft Vent Or Observation Pie Leaching Trench 1 Pipe Chambers 4" Dia. Trench 2 Header Leaching Chamber Soecfficatfons Manufacturer And Model /L EISA Rating 2 sq it per chamber Soil Application Rate gpd/sq it gpd Design Flow T ~ Soil Application Rate LOD O EISA Chambers 2 rows of chambers each. t Page of I HE QUICK410~1 PL US STANDARD: CHAMBER Quick4 Plus Standard Chamber Side and End Views fl 48" (EFFECTIVE LENGTH) 12 A- liw 7A K FA I- - 1i -W - - } € A 34 Quick4 Plus All-in-One 12 Encap Front, Side and End Views 11.2" 7 13" 8" INVERT 8" INVE T 5.3" INVERT ~---18.2„ I--- 33" -I Quick4 Plus All-in-One Periscope QUICK4 PLUS ALL-IN-ONE PERISCOP (360-SWIVEL ) 6" - LAiI IN-ONUS 12.7" INVERT QUICK4 ALL--INANE 12 5" I 9" ENDCAP Ir --(I Quick4 Plus Standard Chamber Specifications Size (W x L x H) 34" x 53" x 12" (86 cm x 135 cm x 31 cm) Invert Height 0.6", 5.3", 8.0"1 12.7" Effective Length 48" (122 cm) (1.5 cm, 8.4 cm, 18.5 cm, 22.6 cm) INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge. and other accessory manufactured; by Infiltrator ( "Units"), when installed and operated in a leachfield of an onsite septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser ("Holder") against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units; provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights, Holder must notify infiltrator in writing at its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units. (b)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT' TO THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty I N F I LT R AT O RO does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, Stems inc. including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. Sy Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure to maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road • P.O. Box 768 the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, Old Saybrook, CT 06475 or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860.577.7001 third party resulting from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's installation instructions. 800.221.4436 (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com original Holder. - The above TepTesems the Standard Limited WaTTanty oiiered by IOMTator * A Bm4ted number of states and count(ss have dft(erent warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. ii 5 !0 !il U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Ouick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. is a registered trademark in Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A. PLUS0510101SI-2 _0 -0 Cil ~ P T r P') O = w cnCO C=? ;u a) pi r- _ ~mZ c'NriO r CX3 cN U) =~0 ~c n r U) c rn nm O g~ z~ c n C= z m m G) m rn Z m o m A z chi) p ° Z o Frr o> 0 c f-" 00 w ~ w o w w w cn 0 N e 110 o q All TI F9 O oo>>o n -n DOO Oror•~ ~ m ~ C/) m Oro N cn z -0 n ;u 1111 1 D" O"' C) m C~ T ;o CD C4 m I Fill Z > c/00 ~ ) m o M X D` -TIC/5°=' m ;o C0 m m n O N cn W 'v, C4() Fn PE3 :,4 0 w m v D cN v O = ° Cl) p Q r to Z Q 4~ rn = C/) O N N m N n 07 to r- Z7 iT C' ----iiii a7 n n q7 -~I ~ V IV ~ 01 u 0 -4 MOP N ~ 1~ 1 Ij A n CT ~ CO D~ N CD i7 ? 7 N ~ N p u C . CT co C IN g t r P II u O O O O 'I POWTS OWNER'S MANUAL & 'MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner p Septic Tank Capacity /00-0 gal ❑ NA Permit # Septic Tank Manufacturer wlf~ re_A_ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer jp ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model Z S ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer (X,~l o ; L h ❑ NA Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer t} uio ❑ NA Soil Application Rate t ~j al/da /ft2 Pump Model ( ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD6) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average - Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD6) 530 mg/L Oln-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ye in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: I ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: El month(s) (Maximum 3 years) El NA a ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 ® year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA ® year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) 13 NA 3 ® ear(s) Flush laterals and pressure test At least once every: ❑ month(s) 13 NA 3 year(s) ❑ NA Other: At least once every: ❑ month(s) 13 year(s) Other: ❑ 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; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank 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 cell(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 requirbs the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) 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 tho.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. GMW (4/01) START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) 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 tank(s) 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 lie 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., 0 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: ❑ A 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. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area Is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ . 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 INSTALLER POWTS MAINTAINER Name © 01 IZ C- L S oN Name Phone -7 1 S- Z 7 3 _ T T Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name C6Ze (X Co u4/f Za E// Phone Phone - 3 g C, 'Y6 fO This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction.) City/State IUD Parcel Identification Number 0 Z ( t 5 3 LEGAL DESCRIPTION W, Town of ~C (G go Property Location /VC '/a , Q '/a , Sec. , T3a_NRZ All Subdivision Lot Certified Survey Map # , Volume , Page # Warranty Deed # Z S~ f , Volume , Page # Spec house ~s no Lot lines identifiable no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 11 I ~I I I I~ I I~ I I II II I I II I I tl I I~ 8005750 State Bar of Wisconsin Form 1-2003 Tx:4004507 WARRANTY DEED 921581 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Hillvale Development Limited Liability Partnership RECEIVED FOR RECORD ("Grantor," whether one or more), 08/27/2010 4:00 PM EXEMPT N/A and Todd Marek , a married nArson REC FEE: 30.00 ("Grantee," whether one or more). TRANS FEE: 102.00 PAGES: 1 Grahtor, for a valuable consideration, conveys to Grantee the following described real Recording Area estote, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): River Valley Abstract & Title, Inc. 1200 Hosford Street, Suite 201 Hudson, WI 54016 Lot92,1 2, and 33, Plat of G1enView in the Town of Richmond, St. Croix County, File # 2805832 Wisconsin 026-1153-02-000;026-1153-12-000;026-1153-33-000 Parcel Identification Number (PIN) i This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of-way of record, if any. c Dated August 27, 2010 Hillvale Devel ent Limited Liability Partnership (SEAL) SEAL) * * Richar S. Nelson, Partner (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Sig ature(s) STATE OF WISCONSIN ) BWQ ii; K. )ss. aut enticated on r' J St. Croix COUNTY ) ST.ATE' :)F * - Personally came before me on August 27, 2010 TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Richard S. Nelson, Partner of Hillvale Development Limited Liability Partnership (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrumen d acjcltowledged the s THIS INSTRUMENT DRAFTED BY: * Attorney Doug Berg Notary Public tate of Wisconsi 1200 Hosford Street Suite 201 Hudson WI 54016 My Commission (is permanent) (expires: 3 ) (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. WA"TY DEED O 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 T e name below signatures. 1 of,1 21:06 FAX la 005 1 UNPLATIED _ LANDS rR UNPLAT7ED LANG -if 43 1. 8 Q. EL - *3* 00 94,64• Sf ,t.. , ( r a 1 - ZIST {122 .EKES) .1. 1 ----~-..r- r,iiiF 1•sa n.. axd6' ` 42 1` 1 -f .Ef .ICrr •x,717 u. ~ ~ ' ~ 71.927 xr'. ' ,1 • • 6 (1 •p ACRES) ♦ • r 0 0 ACRES) r 1 1 e. t-Id 4• UL • !3100 v i! ' 10 9 41 1y "in SF ~ 6 (1 11 ACRES) ~tne~ela t11.za s F d t 79,066 if, 9tttS0 j {11, ACWS) r1 , _ _ (tali mss) ♦ \ 40 1 ' .r. 03.634 air MAN F 't~ '1 It (416 ACRES) (2 is ACPt%) s>p 11~ ►so. p - •ts r'~ ~t _ _ 12 orml, 34 \ \ , jr-' •r r ` M . I,' I 1 ! I \ 61 X16 9F. 15 I ; 3 \ \t 1110 AC*( \ ~ N ~ . i 79017 a (170 AM t ? LAO r •'j','; 33' i A: as CIV60*3 St. ?f "92 at ACM1 32 , ter... 74,•9• s~ ~ ^r,•.':rS.. • (1.71 AG71E5) _ y 1 - ~„--.r~,.,.~ _ ,fir!'-~,* Jec 47 t, 22 47AW OP. Combination Septtic;,Tank and Pl.1MP CHAMBER CRO55 SECTION AND SPECIFICATIONS VEUT CAP WEATHER PROOF JUIJCTION 5OX . 'I, C.I. VENT PIPC APPROVED LOCKIIJG l TQ' FROM DOOR,. M&WHOLE COYER rN1V ` ~ yuA(t►J11JG L.a6EL.. ,WINDOW OR FRESH S Co>JDVtT t+~sP~cS1a~J 1'tPE AIR WTAKC a j w rY~tzT1 s ttl- ~rrP ~ II ` (,".nw. l00 T 6"MWC • ~ i `f" MIlJ, ~ I I ~ I b' MI1i. i., PROVIDE I --w-- 11JLE T AIRTIGHT SEAL I III A . I III APPROYED J011JT: APPROVED JOIIJT ZPSB~L Ft~ I I I W/C.T. PIPf~~` W/C.I• PIPER Tank construction I I I shall comply with ALARM ~I II ILHR 1,3.15 and 83.20 a I I I ow c 'I I . I PUMP--~ __J OFF 0 COQCKETE L~! BLOCK 3" ADP~. RISER EXIT PEFMIITED OIJLy IF TAWK MANUFACTURC.R HAS SUCH APPROVAL 6 p01NG SEPTIC F 5PECIFICAT10QS DOSE W 1~5~t coi 0- TAiJK MAi`lUFACTURCR.: IJl1MEiER OF DOSES: PER QA~ TA)JK :+IZE: OO GALLOAJS DOSE VOLUME ALA11M MANUFACTUR G.R: S 5.1E-Le=TTZC) SLIS`L~1.S IWCLUDIMG 6ACKFL.OW: GALLONS MODEL QLIMbER: LQL Hw CAPACITIES: A= Z CHCSOR GALLONS SWITCH T7PC: ~ez-~~"-1 8 = Z 11JCHES'OR G~,LLOUS Pump !'lA}JUFACTURER: k~~-~S[ f WCHES OR cs 7• ~L~ALL0u5 MODEL FJUMDER: 0 67 l 11 (o INCHES OR WALIOIJS . SWITCH TYPE: d T NDTE: PUMP ANO ALARM ARE TO 6L MI1.11MUM DISCHARGE RATE GPM INSTALLED 0Q SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF ANO..DISTRIBUTIOW PIPE.. FEET 17 t MI►JIMUht NETWORK SUPPLY PRESSURE 0 FLIT -f- FEET OF FORCE MIM X -qJ1FYofLFKICTIOU FACTOR..Z A FEET TOTAL OyWlc HEAD FEET As per, manufacturer gal/in. APR-12-2005 16:28 FERGUSON ENT HUDSON 715 386 6144 P.01 HGOULDS PUMPS Submersible Effluent Pump PE 44ye7T PUMP p.~ SPECIFICATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistant • Discharge: 1 li4" NPT • Single phase construction. • Temperature: 104°F (400C) • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 and 130 volts X Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover, • Solids handling:'/" tection with automatic reset. ■ Upper sleeve and lower maximum sphere, • Class B Insulation. heavy duty ball bearing _APPLICATIONS ' Automatic models include a • 011-filled design. construction. float switch. • High strength carbon steel s Motor Is permanently SpedaIly designed for the • Manual models available, shaft, lubricated for extended following uses: • Pumping range: see PE31 Motor service life. • Mound Systems performance chart or curve, • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • Low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. • Heavy Duty Sump/ PE41 Pump: • .40 HP 3400 RPM ■ Quick disconnect power Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts cord, 20' standard length, • Maximum head: 29' TDH • PSC design 1heavy 15 or d230 uty 16/3 Sj w with grounding PE51 Pump: PE51 Motor. plug. Maximum capacity: 70 GPM .50 HP, 3400 RPM ■ Complete unit is heavy duty, Maximum head. 37 M14 115 and 230 volts portable and compact. METER5 FEET • PSC design ■ Mechanical seal is carbon, 40 - ceramic, BUNA and stainless - MADECS: Pf41, PEST steel. !'E~1 I PE31, 35 r I i I i ! I I N. .33,.4o, .so ■ Stainless steel fasteners. 10 30 I I^ 2 GPM .I I I I (I I AGENCY LISTINGS 1 FT I i i a♦ c zo ( • I i i I Tested to UL 778 and I i I;' I. I-~ . i^ I I j CSA 222108 Standards o~ 15 I ( I By Canadian Standards AssmWon l I ; File #Ut3asq 10 i ,•L ' i : I I ' ' I : Goulds Pumps I$ ISO 9001 Re9Larcd. I I ,I O I I ^I I 0 0 10 20 30 40 50 60 70 GPM 8o 0 5 10 15 man, Goulds Pumps 0 2004 nTwater Technology, CAPACITY InC Eff•ctiw June, 2004 "W/4, ` ~u I ITT Industries ST CROIX COUNTY PLANNING Z®~ o caowes4e- r\ FAX MEMO 7JZlltslo DATE: 712-116 (c 5- cQ~ `g w rA 1 TO: Le-[,D t~ n FAx NUMBER: 71, - 7al 2517 Code Administratio - 715-386-4680 Land Informati & FROM Planning FAx NUMBER: 715-386-4686 715-386 Ti74 PHONE NUMBER: `7/6 - 38",o - Re roperty -386-4677 Re NUMBER OF PAGES, INCLUDING COVER SHEET: /0 P .e ing 71 6-4675 RE: l e Co t P e*Av- ~-mlmw- va Ei, G vim-) lGx~ µ1Q_ (w ow ro 94-4 5 . ~ nn laok5 4u vim- A*,e--~ G- Go~.uC,~~1 0 e.lG Sys~ew` af, wnJ~ Le. ST. CRoix COUNTY GOVERNMENT CENTER 110 1 CARM/CHAEL ROAD, HUDSON, W/ 54016 715-386,4686 FAx PZ@)CO.SAINT-CROIX.WI,US WWW.CO.SAINT-CROIX.WI.US R Wisconsin Department of Commerce -EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. 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. Please print all Reviewed by Date Personal information you provide maybe used for s Gonda FAVE; , s. 15. (1) (m)). 7 LI db Property Owner Prop rty Location Lakes and Hills Develo entJUN 12 2006 Govt Lot NE 1/4 NW 1/4 S 19 T 30 N R 18 E(r® Property Owners Mailing Address Lot Block # Subd. Name or CSW PO Box 338 ST. CROIX COUNT 1 City State Zip Code ity ®Village ■ Town Nearest Road Balsam Lake Wl 54810 ( (6)51) 484-1818 92nd Street E] New Construction Use[B Residential / Number of bedrooms 4 Code derived design flow to 600 GPD Replacement Public or commercial - Describe: ( s . l) Parent material Loess over outwash over bedrock Flood Plain elevation if applicable N.4- 64 ft. 7111 General comments Conventional System - Lift station recommend dosing and recommendations: Load Rate 0.6 System elevation top 93.2' bottom 91.2' recommend placement on the 92' contour Place system between borings 1 and 2 1 st Benchmark top of power box 100' 1❑ Boring # Boring Pit Ground surface elev. 94.2 ft. Depth to limiting factor 72 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-9 1 OYR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 B 9-25 1 OYR 4/6 LS 2csbk mfr cw lvf 0.7 1.6 C 25-72 1 OYR 5/4 - S Osg ml 0.7 1.6 Native Soil , Ao~ 2 Boring # Boring 94.3 100 El 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-17 1OYR 3/3 SL 2mgr mfr as 2vf-f 0.6 1.0 Bw 17-37 1OYR 4/6 - LS 2csbk mfr cw lvf 0.7 1.6 C 37-100 1 OYR 5/6 - S Osg ml 0.7 1.6 Native Soil It * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Kathryn DesFor a Evergreen Soils #254260 Address Dat valuation Con ed Telephone Number 2705 Agnes Street Eau Claire, W1 54701 May 10th, 2006 (715)520-2693 Property Owner Lakes and Hills Development Parcel ID # Page 2, of 3 3 Boring # Boring 92.8 Pit Ground surface elev. ft. Depth to limiting factor 71 in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-8 10YR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 8-71 1OYR 4/6 fill mixture LS/S LS/S lcsbk mfr cw lvf 0.7 1.6 2Ab 71-100 IOYR 4/4 L 2msbk mfr---- 0.6 0.8 Fill soil a Boring # Boring Ground surface elev. 93.6 ft. Depth to limiting factor 69 in ■ Pit ElSoil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-6 10YR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 6-69 l YR 4/ (fill mixture LS/S) LS/S lcsbk mfr cw lvf 0.7 1.6 2Ab 69-100 1OYR 4/4 L 2msbk mfr 0.6 0.8 Fill soil ❑ 5 Boring # Boring Ground surface elev. 95 ft. Depth to limiting factor 55 in. ■ pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-8 10YR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 8-55 1 OYR 4/ fill mixture LS/S LS/S lcsbk mfr cw lvf 0.7 1.6 L 2msbk mfr 0.6 0.8 2Ab 55-80 lOYR 4/4 Fill soil * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30:s 150 mg/L * Effluent #2 = BODS < 30 mg& 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-9330Test (807/00) s ra..,.,na.m _ Property Owner Lakes and Hills Development Parcel ID # Page' 2 ' of 3 3 Boring # Boring 92.8 71 E] 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 A 0-8 10YR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 8-71 IOYR 4/6 fill mixture LS/S LS/S Icsbk mfr cw lvf 0.7 1.6 2Ab 71-100 10YR 4/4 L 2msbk mfr - 0.6 0.8 Fill soil L a Boring # O~ Bo Pit nng 93.6 69 EJ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-6 10YR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 6-69 10 4/6 (fill mixture LSIS) LS/S lcsbk mfr cw lvf 0.7 1.6 2Ab 69-100 10YR 4/4 L 2msbk mfr 0.6 0.8 Fill soil Boring ❑ Boring # Ground surface elev. 95 ft. Depth to limiting factor 55 in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 0-8 IOYR 3/3 L 2mgr mfr as 2vf-f 0.6 0.8 Bw 8-55 10 4/6 fill mixture LS/S LS/S lcsbk mfr cw 1vf 0.7 1.6 2Ab 55-80 10YR 4/4 L 2msbk mfr 0.6 0.8 Fill soil * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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. s1113-8330rest (R07/00) Lot 1,2 GLENVIEW PLOT PLAN TN A BM# S°t roperry ine 94' ' nat' e 4.3' /Zd / 94.2' ~b 93' native 2 9 2 n dye 3 92.8' 3% fill soil S ~ 95' h~ t fill soil 5 4 93.6' e e fill soil t 93' 94' Proposed Home property line Conventional system A BM 100 (0' ) top of power box ***No Well onsite A BM 100.4' (0.4') telephone box SCALE: 1" = 50' ❑ 94.2' To scale within drawing F2-1 94.3' NOTE: Benchmark 1 is top of power box 0 92.8' Benchmark 2 top of telephone box ® 93.6' Within borings site less than 1% slope 0 95' Lakes and Hills Development Kathryn DesForge PO Box 338EVERGREEN SOILS Balsam Lake, WI 54810 (715) 520-2693 (651)484-1818 Page 3 of 3 CST# 254260 k UNPLATTED LANDS UNPLATTED LANC - N EO'49'S4 E - -y-;-------1591.33' N ------------z~~w ib~f~3' N 88'49 54- - { E----- - - - - ft l I I jr it 1 III 88,852 S. F. lj 'PS I~33` 'III (2.04. ACRES). I 43 I 11 I L.B.O. EL. = 934.00 I 1 96,664 S.F. I III x,111, I ' '7 (2.22 ACRES) V* / 1,:1 \II II C. \r '1 1 1 ~pl 85,897 S.F. V f+ ,~I 11~-- \'i ' (1..97 ACRES) ~ \nYg 1 ! --~--~III Ilr. & I L.B.O: EL. = 934.40\; 5i III ~ \ Y' ; ' g 1617 42 83,787 S.F. Ail, s1 71,927 S.F. (1.92 ACRES) ' (1.65 ACRES) ,I L.B.O. EL. = 934.00 ppoo II . 10 + I 9 I • 1~ 41 y 11', III 83,385 S.F. i 1 S. F. I~\ (1.91 ACRES) ' 84,299 S.F. I III I S.F. 79,056 S. F. \ (1.94 ACRES) 929.50 (182 ACRES) - ry i - - 7 -'-C3'0-€l 9_2 . O ~ - i~ - 11 -t _ia. - - 93,934 S.F. 40 1\ •331 1\` 96 ,840 S.F. (2.16 ACRES) i 1 \ C .ti (2.22 ACRES) II II\ L.B.O. EL = 923.00 2 6.6E s. _ 1 \ - ;.~•~\I L B4. EL. ~.'~a• _ '?~`~c \ /111, 1\ V\\ 77 _ 12' A 1 \ ! y1~ 88,777 S.F. \ X\ 11 / r, / OftACRES) 1 II 11 , ,ter \ ® L.B O 0. EL. = 923.00 1 I 54 ~4 ...I \ 81.425 S.F. 74 ~ \ \ \i ~ ~ - _ 037 S (1.8"7 ACRE'S) / / 1 ' \ \ \ :.~1'~" 1 1 (1.70 ACRE 35 L.B.O. EL. = 9 124.079 S.F. '(2.85 ACRES) \ \ \ i I L.B.O, EL. - 9?7.00 76 5 14 ` i 4 I 33 2. 42 _ ~ i I \ 105,60 ACRES `\c ...O-- L £L: 9923 00 L.EI:Q EC 92300 ~--~14. 1 \ \ 6&.223 S.F % (1.52 ACRES) ).y . \ \ I "RQ(1•~. >~g• % 74,625 5F. \ i (1.71 ACRES) \ Js _ \ - - - - - - - - - - - - - - - - - - 47 :31 I /~I~ I 22 89,518 S.F. 8 S.F. Kathryn DesForge RECE~V been Soils 2705 Agnes Street E eau Claire. WI 54701 MAY 2 4 2006 ST. CRO/X COUNTY May 22, 2006 Croix County Zoning 1101 Carmichael Road Hudson. WI 54016 Dear Sir or Madam: ) have performed a soils test on the lot#12 owned by Lakes and Hills Development in the Glenview development. The site had an original soil test performed that was a conventional system. Since that lame the site has been filled and graded. Most of the lot has fill covering it which is comprised of 6 aches of topsoil over a loamy sand/sand subsoil fill over the original A horizon. The fill ranges from 4 to 5 feet in depth. On this site 5 borings were dug with an excavator. Two holes were in the native in-situ soil with the other three in the filled areas. Pictures are enclosed of the borings that were dug. recommend that the conventional system be placed between borings 1 and 2 at a load rate of 0.6 in the in-situ soil an avoiding the area that has been filled. if you have any questions please call me at (715) 520-2693 Sincerely, Kathryn DesForge Soil Scientist #254260 6JA A a ~-5 -717-616(c p tpc~'^✓ = 4or: r w" i I ` Wisconsin Department of Commerce SOIL EVALUATION REPORT Page-L ofL_ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County G' n Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must a L' f " 1 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. 0 l!i J-64AI Please print all information. evi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~I s • 2 Property Owner Property Location I -/W/"/ 11r /0,0 Govt. Lot MW LAA S ~p T3 0N R E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City tale Zip Code' P one Number ❑ City El Village ' To Nearest Road 637-7 New Construction user Residential / Number of bedrooms Code derived design flow rate, GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material <~/!d ~(.t✓ crr iC/ Flood Plain elevation if aapplicable rr General coments and recommmmenndati dations: e',,~t/ J'f✓ " I ~7 { ►vtJ~n ~e 0. 1° TC<Jf' e /qu., /G,4,~ 1 L l ~ l ~ 0•~~ 11fwd I M Boring # El Boring n W-hr pit Ground surface elev. v . ft. Depth to limiting factor n. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. J l~0 4 ®Boring # R Boring Pit Ground surface elev. 1.0-l ft. Depth to limiting factor ~~~~i' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 -Eff#2 D -'g e Ll & ly, m t c'P , 7 l3 / 1 S O to 1 In hL 0 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 mg/L Efflue = BOD < 30 mg/L and TSS < 30 mg/L CST Nance (Rem Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 / - C, 3 715-246-4516 Property Owner _ Parcel ID # Page of 1 7-] 3 Baring # ❑ Boring Pit Ground surface elev. -1Ob -4. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJft` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a Z 3 8- y/ Qs ry' a7 9~ (o a a Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil ~Eplicafion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Eff#2 a Boring # ❑ Boring 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODE > 30 < 220 mg/L and TSS X30 < 150 mg/L ' Effluent #2 = BODS < 30 mg1L 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. SOD-8330 (a.6=) w. + Soil Test Plot Plan Project Name Lakes and Hill Development Shaun Bir Address P.O. Box 10598 White Bear Lake Mn 55110 CSTM # 6900 Lot 12 Subdivision Glen View Date 7/18/03 1 /4 N W 1/4S 19 T 30 N/R18 W Township Richmond ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 99.6/99.4 *HRpSame as Benchmark Alt. BM Top of Survey Iron @ 96.4' Pro Town Road Please note: survey was not Please Note: Tested area completed at time of testing, 105' may not be suitable for setbacks from lot lines may desired building area. change. Installer must verify Check system location all lot lines and setbacks 104' before excavating. before installation. B-2 40' -3 100 Scale is 1" = 40' unless otherwise noted 6% Slope 20' 40' P- L-J B-1 II a~ t~ a~ 0 IA Property Line ~XB.M. W~ o UNPLATTED LANDS 1 M NOO0O IO'W . f 0! 53M.6W I P na • . SOOVCt07~.___ SOO*00'10'E 605.11' 256.16' O _t~-• r- r----------------- NOOVWIO' r 604.43' Q 1 I 16.19' 226.61' - 12A53' 84AO' 1 I $ 1 1 I off ~ ~ 1 ~ f 1 1 n N 1 1 R • i M m 00 I •Po 003 ~ 01 6; ~,v o / ♦ 1 % % N N 4♦ i i I ♦`♦~1 m1 p ' m• t M 1 1 Y, [ V y i S00'00'26'E 456.40' _ 'j • m I / e•- m .L16. ♦t. 219.56 M ~ / / m 1 .M.94oGN5 I C40 Sb3l$ - H $ .29 si, ! 1 I o Z 1 113.35' - , f. Q I , I OO bMeq,~>F i L~i N 7, M ~I ~ Q I t. i sr .-3 • M : m - m• N m• M N M • i I• ! 1 I Co 11 m I 1 • N0746'~7N 696.24'• 36.20' m n t 1 3MO4' air • I ! ' 162.02' itc6.o2' \ 166.01' "4 ,Y', . b ! g N M m . N 1 a na; ! ~ A . 1 1 t' z ! ; N B i ! t N g m sa : 7S • In b t,YU,' t'a~ yf► IJ I ro O n1 / t I r r r N• "Ar- h 1' 1 1 • cli I W ! ! W m M m i I ~ I z • ~6 ~ . yp i 31 Luiaa 166'AO• M I I j 16600 ' ! t sor3r01•E 579.7 1 Q - 1 _ _ t M 1 i I p j SEE SHEI Lakes and Hills Development Inc. - Glenview LOT #12 PIT #1 . z, ~r Native in situ soil PIT #2 4 Native in situ soil Page 2 • Lakes and Hills Development Inc. - Glenview LOT #12 PIT #3 . 4 y 7 ii yt x r r r►•'~t t, 1! i4 r +P. ' _ , a yy 1f! y, 3 vyrr '9 6~ Several feet of fill over original A horizon. PIT #4 1Z 4 sal 6t. .'xF It AFa "I~✓tn ~ ~ r ,fir ~ I Several feet of fill over original A horizon Page 3 Lakes and Hills Development Inc. - Glenview LOT #12 PIT #5 g J' { r¢ ~a t Several feet of fill over original A horizon