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HomeMy WebLinkAbout034-1078-40-000 Wiscongin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanita Permit No.: Personal information you provice may be used for secondary purposes [Privacy w, s.15.04 (1)(m)). Permit Holder's Name: Cit Villa e I Town of: tate Plan ID No.: SPRyI~GFIL FRENCH, BRUCE CST BM Elev.:- Insp. BM Elev.: BM Description: Sa, Q arce1034 o. 1 A "An "i * ` 1078-40-000 (TO .O ► O'fl . o~ Set TANK INFORMATION ELEVATION DATA A9800430 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 12 SA S O~7 Benchmark 5- CC* Dosing a.~ O ,:4 Aeration Bldg. Sewer S 0 o2 Holding St/ Ht Inlet S •S 02,E TANK SETBACK INFORMATION St/ Ht Outlet 01.00' 02-s1 Verit TANK TO P/ L WELL BLDG. A ir Ito ntake ROAD Dt Inlet Air Septic ~(Qp r 32' NA Dt Bottom r Dosing e~►~tTa 01 f ' cry NA Header/ Man. Q ~p J 59 Aeration NA Dist. Pipe 3' 33 '101-51 Holding Bot. System • ° 2 0 :nOO.q PUMP/ SIPHON INFORMATION Final Grade cf Manufacturer De,,mand d12 Model Number W~f7.311L -%P M LTZ) O, ~ Sys tema TDH Ft TDH Lift Friction FDia. Forcemain Length (.O z ii Dist. To Well SOIL ABSORPTION SYSTEM BED Pl=M Width i Len 6th Of To- PIT No. O Pits Inside Di iqui EN I N ( S _ ~03 a)- I;dRS DIMENSIONS anu acturer: SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACH G SETBACK INFORMATION Type O CHA el Number: System: OR NIT DISTRIBUTION SYSTEM Header/Manifold w Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air Intake Length _V_ Dia. Length 1p01_ Dia. r.~ Spacing 3 I4 qS SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 30 2G LOCATION: SPRINGFIELD ,j.29.15.523,SE,SW 3-3.2` 60TH AVENUE R". ~ Sa ~46t-t gyp,, o . ~,yaQ- qa~a.. u}c(.l ~ I0 - s - 4 q (~~P(e..> 6T.~.s ~U •kQ Plan FFevlslon required? ❑ Yes No `Use other ide for dditi nal itt(A4mation. ~_3 1016 2- BD-6710 (R•3/97) 'r t Date Inspector's Signature Cert. No 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION Safety E.WashnggtonAve. Wisconsin In accord with ILHR 83.05 Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number 3.,'20.2. V~ The information you provide may be used by other government agency programs ❑ Check it revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D hlumba& 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Prope Owner Name Property Location - 1 /4 1/4, S T , N, R~ E (or P$er3y wner's Mailing /jddr ss Lot Number Block Nu er Z City, tt a ~y Zip Code Phone Number Subdivision Name or CSM Number II. TYPE F BUILDING: (check one) ❑ State Owned ❑ !tyage Nearest Road Public 1 or 2 Family Dwelling - No_ of bedrooms E3 VIII 3 F Town O III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ®3S/_ 1678- y©-~ 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. jR New 2. ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only-_________-___ Existing System _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 2114 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2_ Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade ] Required (sq_ ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min ./inch) Elevation S 7 Feeti '7 Feet TANK Capacity VII. in gallons Total # of Prefab. Site Fiber- Exper. NORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 860 2 ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, th undersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans. Plu b!; Nam : (Pr' t) I Plumb s at (No ps) MP/MPRSW No.: Business Phone Number: Plumber's ddress (Street, C ty, State, Zi Code IX. COUNTY / DEPARTMENT USE ONLY s) ❑ Disapproved ZOO fy Permit Fee (Includes Groundwater ate ssue Issuing A ent at re No A roved Surcharge Fee) App ❑ Owner Given Initial CIA ~ Ad verse Determination X. CONDITI S OF APP OVAL / REA O S F ISAPPROVAL: 4 SS04398 (8.11/96) 61 DISTRIBUTION: Original to County. One copy To: Safety E Suddirgs Division, Owner, plumber INSTRUCk,"TIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I Safety and Buildings 15837 USH 63 Nvisconsin HAYWARD WI 54843-8107 Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary April 28, 1998 CUST ID No.224263 KIM A O'CONNELL 504 3RD AVE OSCEOLA WI 54020 RE: CONDITIONAL APPROVAL Transaction ID N 75835 APPROVAL EXPIRES: 04/28/2000 SITE: Site ID: 5979 ST CROIX County, Town of SPRINGFIELD SE1/4, SW1/4, S34, T29N, R15W BRUCE FRENCH FOR: Description: NEW MOUND Object Type: POWT System Regulated Object ID No.: 14304 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. 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. This approval is for a 450gpd mound. The following conditions shall be met during construction or installation and prior to occupancy or use: This plan action is subject to comments on the plan. 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 inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerel , DATE RECEIVED 04/27/1998 FEE REQUIRED $ 180.00 TOM BRAUN ,ALAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (715)634-3026, M-F 7:45 AM - 4:30 PM TBRAUN@COMMERCE. STATE. WI.US RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project BRUCE FRENCH Owner BRUCE FRENCH Address BOX 274 SOMERSET WI 54025 Legal Description SE/SW 34-T29-R15W Township SPRINGFIELD County ST. CROIX Subdivision Name N/A Lot No. N/A Parcel ID Number 0000000 Plan ID Number 75835 P.O.W.T.S. INDEX SHEET PAGE ONE Conditional) MOUND CALCULATIONS PAGE TWO Y MOUND DRAWINGS PAGE THREE AP ROVED PUMP TDANK DRAWINGS LATERALS PAGE FI ER DEP T ENT OF C MEI .E PUMP CURVE PAGE SIX DIVIS SAFETY UILDINGS PLOT PLAN PAGE SEVEN SEE COR PONDENCE Designer KIM A OC NNELL License Number Signature Phone No. 715-755-3145 Date 4-23-98 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats. SEID-10462-E (R.04/91) Page 1 of 75835 7 0 3 5 RESIDENTIAL MOUND DESIGN Eight Bedroom Maximum Complete information in red framed boxes as necessary. (y or n) n Is the system over creviced bedrock? Slope 8 % Number of bedrooms 3 Wastewater flow rate 450 gpd 1703.3 Lpd Depth to limiting factor 29 in 73.7 cm In situ soil infiltration rate (code) 0.6 igpdft2 20.4 Um2 Contour line below the upslo edge of absorption cell 99.7 ft 30.39 m Use standard fill depths? I A I OR Designer speed depth in cm Place X In box to use standard depths (1$ 24, A+4 inclusive) OR specify design fill depth. Center or end manifold a or e) Estimated hole space 4 ft Not a final calculation. Lateral spacing Minimum dose 10 times void volume use a o lateral spacing for trenches. Pump tank elevation 89 ft Outside bottom of tank Number of laterals 2 Force main diameter 2 in Force main length '.3 ft Force main actual dia. 2.067 in SYSTEM SOLUTIONS Inch-pounds Metric Cell media "x" one only. Estimated daily flow 450 gpd 1703 Lpd x Aggregate and pipe Chamber and pipe Absorption cell Design load rate & area 1.2 gpd/e 375.0 ft2 34.84 m2 Linear load rate 7.1 gpd/ft 88.0 Lpd/m Design width (A) 6 ft 1.83 m Cell length (B) 63.0 ft 1920 .m Depth of cell (F) 9.9 in 25.1 cm Sand filter Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 17.8 in 45.2 cm Basal area required (gpolnfiltration rate) 900 ft2 83.61 m2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.4 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.7 ft 3.26 m Upslope toe length (J) 6.8 ft 2.07 m Downslope toe length (1) 13.1 ft 3.99 m Total mound length (L) 84.4 ft 25.73 m Total mound width (W) 25.9 ft 7.89 m Project: BRUCE FRENCH Plan I.D. 75835 Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) J W= 25.9 ft AA= 6.0ft 1.83m 7.89 m -0 I B= 63 ft 19.2 m ~B --E K J= 6.8 ft 2.07 m I 1 = 13.1 ft 3.99 m K= 10.7ft 3.26m P t.= 84.4ft 25.7 m tYP. obs. Pipe A X B refers to absorption cell width and length (anchored securely) J = upslope width I = downslope width K = end slope dimension L J, 6' (150 mm) MOUND CROSS SECTION T subsoil cap D= 12.0 in 30.5 cm lateral topsoil G H E = 17.8 in 45.2 cm invert 101.2 ft _ F = 9.9 in 25.1 cm elev. 30.85 m see noteF G = 1270 in 30.4 cm E ASTM H= 18.Oin 45.6cm ~ ' D ~ C33 sys. 100.7 ft Sand Fill elev. 30.69 m 99.7 ft contour 8% 30.39 m slope Note: Absorption cell media will D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe Aggregate F = absorption cell depth as specified F"]Chamber G = subsoil + topsoil depth at cell wall at rigtt. H = subsoil + topsoil depth at cell center Designer notes: If aggregate is used, it is covered with code compliant material. Project: B1'~UCE FRENCH Plan I. D. Page 3 of 7 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 6 ft 1.83 m Length (B) 63.0 ft 19.2 m Lateral specifications Number laterals 2 HolesAateral 16 holes Lateral length 60.0 ft 18.3 m Perforation dia. 0.25 in 6.4 mm Lat. dis. rate E12§2 gpm 1.2 Us Sys. dis. rate gpm 2.4 Us Hole spacing 48 in 121.9 cm Lateral diameter Pipe diameter Design options Design choice Designer must l inr25 mm _ Place X in red "X" one choice 1 1 /41n/32 mm box of chosen from the options 1 12in/40 mm x x diameter. provided. 2nM mm x 3in/75 mm X Manifold diameter Pipe diameter Design options Design choice Designer must 1 inr25 mm wXw one choice 1 1l4 nrm mm Place X in red from the options 1 12in/40 mm x box of chosen provided anW mm x x diameter 3inr15 mm X 4n/100 mm X Distribution system contains 2 lateral(s). LATERAL DIAGRAM - END CONNECTION Place cared lateral diagram by clicking in one of the drawings at tight and dragging the diagram into this area. atera t enters otter ensron Last hole drilled next to end cap en~oap f P Ali laterals are identical 1(-X---.>l Holes drilled on the bottom of the lateral equa g spaced S • Force main connection uia tee or cross to manifold at any point. Laterals & force main of PVC Soh 40 • = permanent end marker (per COMM Table 84.30-5) Inch-pounds Metric Lateral length (P) 60.0 ft 18.29 m Lateral spacing (S) 3 ft 0.91 m Manifold length 3 ft 0.91 m Hole diameter 0.25 in 6.35 mm Lateral diameter 1.5 in 40 mm Number of holes per pipe 16 Invert elevation of laterals 101.2 ft 30.74 m Project: BRUCE FRENCH Plan I.D. 75835 Page 4 of 7 Total dynamic head System head = 3.25 ft 0.99 m Vertical lift = 11.30 ft 3.44 m Are laterals the highest point in the Friction loss = 0.81 ft 0.25 m system? Yes 'X here. L~ Total dynamic head = 15.36 4.68 m If no, what is the highest elevation Dose Volume downstream of pump? Lateral void volume = 12.7 gal 48.1 L Force main drain Minimum dose = 127.0 gal 480.7 L back to tank? (")e' one) Drain back = 6.1 gal 23.1 L x Yes Dose volume = 133.1 gal 503.8 IL No Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover weather proof wAvarning label and padlock grade levels junction box T grade levels quick disconect alternate 4" vent pipe electric as per NEC 300 and outlet Comm 16.28 WAC location 16'(46 cm) min. wall of pump approved chamber or outlet combination joint tank A j 1/4" weep Grade levels / alarm on hole as pump tank manhole - 4' min. above finished grads pump on B necessary pump tank man. =100 mm min above finished grade Vert = 12' own. above finished grade pump 89.9 ft Ci Vert - 300 mm min. above finished grade off elev. 27.4 m D 3 " (75 mm) of bedding under tank and anchor tank as necessary 89.0 It Pump tank elevation 27.1 m bottom of tank Tank specifications: WEEKS Pump tank = 19.04 gal/in Pump tank volume = 800 gal Capacities: Inches Gallons A= 25.0 476.5 Pump manufacturer: GOULDS B = 2 38.1 Pump "I number: WE0311 L C = 7.0 133.1 D = 8 152.3 Project: BRPCE FRENCH Plan J.t3. a 835 Page 5 of 7 . Performance Q curves Pumps MET t4 FEET - MODEL 3885 2' 80 SIZE 3/4" Solids WE15H _ 70 20 WE10H - O WE07H 15 50 NE05H 40 - - 10 30 WE03M E03L - - - 20 S 10 0 0 0 10 20 00 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 ml/h CAPACITY ,raw,; r~, GOULD5 PUMPS. INC. METERS FEET 120 MODEL 3885 110 WEISNH SIZE 3/4" Solids 100 30 90 25 - 80 10 - - 20 60 O _ 15 50 ~ WEOSHH 40 10 30 20 10 -,4+H 0 0 - 0 10 20 90 40 50 60 70 6; j 90 1(A 110 120 GPM ` ' L 10 ?0 90 m'!h CAPACITY • 1008 Goulds Pumps, Inc. Eas"Vo July. 1 W s 7 , c(L.~ ~ Is'~.J~ SL ' ~-s~~ ~-5~- 5rc 9_-~?%~✓- ~jScu I 24-,1.2e 411:4 ire eot y _t !cam /GfrP.2 ,i I ; loci kk _ i I 2A 12 _ ~ ro ~~~~lwwll i j I I I I Wisco&tn Department of Commerce SOIL AND SITE EVALUATION Page I of Division of Safety and Buildings ith Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not leiR 1 - size. Plan must include, but not limited to: vertical and horizontal Preerelnm porn M), direction and County percent slope, scale or dimensions, north arrow, and location and distance to nearest road. St. Croix Parcel I. D.# - 34 1 g APPLICANT INFORMATION - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location French, Bruce Govt. Lot SE 1/4 SW 1/4,S 34 T 29 N,R 15 ti? roperty Owner's Mailing Address Lot # J Block # 1!ubd. Name or CSM# Box 274 West 1/2 (20 Acres) - Ity State ZT0' ode PhoneNumber City Villa e 'Town Nearest Road omerset WI 525 715-247-3927 Springfield' 60Th Ave. New Construction Use: X Residential / Number of bedrooms 3 Addition to existing building Replacement i Public or commercial describe Code Derived daily flow 450 gp Recommended design loading rate -5 bed, gpd/ftZ .6 trench, gpd/ftZ Absorption area required 900 bed, ftZ 750 trench, ftz Maximum design loading rate .5 bed, gpd/ftZ •6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.7 ft (as referred to site plan benchmark) Additional design / site considerations install 4'x 95' rock bed mound on 99.7 as upslope edge of rock w/ V sand fill tParent aterial loess over glacial till Flood plain elevation, if applicable NA_ ft e for system Conven tional Mound In-Ground Pressure AT-Grade System in Fill Hoding Tank ble for system r x U >C S" U S X U S X U U U 5UKIP Horizon Depth Dominant Color Mottles Structure GPD/ftZ Boring# in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistenc Boundary Roots Bed Trench 1 1 0-3 10YR 4/3 - sl 2 If sbk i ds II cs 2f/m .5 .6 2 3-8 10YR 4/3 - sl 2 f-m sbk ds cs 1 f/m .5 .6 Ground 3 8-18 10YR 4/4 - s1 2 m sbk dsh cs I f .5 .6 elev 98.0 ft. 4 18-30 7.5YR 4/6 - mcos 0 'sg ml cs - .7 .8 5 30-43 l OYR 4/4 m3p IOYR 6/2 SO 0 m mvfi NP .2 Depth to - limiting - factor 30" - - Remarks: occasional gr & cob 2 1 0-4 10YR 4/3 - sl 2 f sbk ds cs 2f/m .5 .6 2 4-12 l OYR 4/3 - sl 2 m sbk ds cs 1 f/m .5 .6 Ground - 3 12-31 7.5YR 4/6 - mcos 0 sg ml as 1 f .7 8 elev 99.6 ft. 1-37 l OYR 4/4 m3p IOYR 6/2 scl 0 m mvfi - i, .2%. Depth to limiting ECE'IV L factor 31 it I 7 1997 Remarks: occasional gr & cob, especially 12-31 CST Name (Please Print) Signature: Telephone> A-& zONINGOt115 Henry F. Grote 715-665-26 Ad .e s . Box 57 Knapp, WI 54749 Date 23/97 T2~ ber Ref # PROPERTY OWNER: French, Bruce SOIL DESCRIPTION REPORT Page 2 of PARCEL I.D.# 34.29.15.523 Depth Dominant Color Mottles Structure GPDIft2 Horizon Texture onsistence Boundary Roots Bed T Trench in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 3 1 0-4 10YR 4/3 - sl 2 f sbk ds cs 2f/m .5 6 2 4-18 IOYR 4/4 - sl 2 m sbk ds cs If 5 .6 - Ground 3 18-33 7.5YR4/6 - mcos 0sg ml as lm .7 elev 98.9 ft, 4 33-47 l OYR 4/4 m3p IOYR 6/2 scl 0m, mvfi NP .2 Depth to limiting factor - i Remarks: occasional gr & cob, especially 4-18" 4 1 0-3 10YR 4/3 - sl 2 f sbk ds gs 2f/m .5 .6 2 3-21 10YR 4/3 - sl 2 m sbk ds gs if .5 .6 Ground elev 3 21-29 7.5YR4/6 - mcos Osg ml as lm 7 8 101.5ft. 4 29-44 10YR 4/4 m39 l OYR 6/2 scl 0 m mvfi - - NP .2 Depth to limiting - - - factor Remarks: - Ground elev - - - - ft. Depth to limiting - - - factor i. Remarks: Ground elev - ft. I I Depth to - - - limiting factor i Remarks: Z..'~ a, ?O S Q~.~ 3-4 ~ o,•~ 1 I ~ 4 ~ ` '~+~r Qom/ ~ ~ ~Y jyL~ ) c i OOO jjjSSS 4&Y s 0.) NO a.a.~O s0. bK~C ~W O~\A'r't U -10 116C.W't IL Sr WlH.y 1 0 3 ° S ML ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP/ CERTIFICATION FORM 0,,vner/Buyer R (W e / ~(~,~'i✓ A Mailing Address -13-0,Y 0229, j-- Property Address Zo 9 4n /Q (Verification required from Planning Department for new construction) City/State JF' Parcel Identification Number 03y- 1072?-VO° 4vp _4~1" LFtJAL DESCRIPTION Property Location . Sec.:3q , T R N-R /-4-- W, Town of ~A1 .:T-LD Subdivision Certified Survey Map # S6 5_ f3 Volume , Page # W,* rranty Deed # , Volume , Page # Spec- house O yes rk no l ,ot lines identifiable )d yes O no SS',"~TEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can ,affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mw, ter plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wasteu aterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 13 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 Wisc+rnsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of he three year expiration date. S ~NATL'RE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. S At7TURE OF A PLICANT DATE . \hwc-0 Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed /00 t~ .~l1151ow.5 7 y S85$S ` STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED DOCUMENT NO. .ti Hudson Diesel, In^_.,MPPP T, CROCOWI - ~y M Mo~n1 Bruce A. French and AUG $ 6 I, conveys and warrants to Ruth A. French 9~~ AM x.° THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADORESS the followiro described real estate in St. Croix County, t` State of Wisconsin: , DAVID J. ESTREEN That pert of SE 1/4 SW 1/4 Sec. 34-T29N-815W LOCUST ST. II a described as follows: HUDSON, WI 54016 I~ Lot 1 of Certified Survey Map recorded in 034-1078-40-000 I t: IJ Vol. 12 of Certified Survey Maps, page PARCEL IDENTIFICATION NUMBER ± J, 3393 as Doc. No. 559596. a RA~ISMR Yy I. ~ x I' I I f: +r. I ry~i I; This is not homestead property. !i W 'yl (is not) # Excep6an to warranties: 1 ~ li • ' Dated this ~s day of _ July , A.D., 1998 (SEAL) r- (SEAL) I`. tudson Diesel, Inc.,MPPP by i i; ii - ,tN~ ristine A. Seidling, Trustee (S (SEAU I! LEBAWCtm AMA JL z AU"1 HENTICATION ACKNOWLEDGMENT .7 ate of Wisconsin, Ii Signature(s) L10 Eau Claire II County. authenticated this day of , 19Personally came be(cn: nx this eday of n July 1998 the above named Christine A. Seidling L TITLE: MEMBEK STATE BA;Z OF WISCONSIN I ti` ~I (If not, _ ..uthorized by §706.06, Wis. Scats.) so me known to be the person who executed the foregoing iistrament and acknowledge the same. I s. ii I ' FORM NO. 085-A r swam- Stock No. 26273 !l o~ FILED 3 DEC 0 8 1997 ► V VVS~~• w~C'a.i. n.h CERTIFIED SURVEY MAP N4. 3393 VOLUME 12 , PAGE 3393 HP, Q '97 THE SOUTHEAST 1/4 OF THE SOUTHWEST 114, Planning SECTION 34,. T.OWi SH 29 NORTH, ktANGE 15- WESTa Pad Canmitto TO'R'N OF SPRINGFIELD, ST. CROIX COUN'T'Y, WISCONSINrnotlOCOln4d NOR7HM a` of SCALE: 1"=200' OWNER: SFND E !i Nbe 3W HUDSON DIESEL, INC.. MPPP . nuN awu>d void s 0, 100' 200' 400' CHRISTINE SEDLING, TRUSTEE I 445 UNPUTTED DRAFTED BY. EAU CLAIRE VAUS 54703 DONALD M. CLARK, RLS LANDS 5 89'48'19" E a° 1318.30' illf.~Clu:• w NW. COR. SE-Sw NORTH LINE THE SE 1/4 - SW 1/4 NE. CM 5E-SW r LEGEND 7' + GOVERNMENT CORNER (AS NOTED) a UTLa T 1 ` f ` • SET. 3/4"X24" REBAR 224,856 SQ.FT.(5.16fAC.) TOTAL I WEIGHING 1.502 L ISS. 1 : PER LINE=AL FOOT. " E 659.32' _ DRAFTED BY:329• p~. Donald M. gait I ! a, r X ~i I I 876,28 Q.FT.(20.12tAC.) TOTAL LOT ' LOT 3 ` 21,77 SQ.FT.(0.5O±AC. RW - Ile, a» R 85 . 11 SQ.FT,(19.62±AC.) LESS RW z ! I w too w 0, 0, I DONALD M. y+;* ~ (160 zI I d ^c9 ~ W S-1580 i <n ^ ) I I 'I'1 ~ ~ u► '041 - r Q AI I 1•• 0 7 SETBACK LINE 133' FROM CENTERLINE (100' FROM R\M 33'~ e~ FORM NO 985•A . / ~~!'rlAmr Stock No. 26273 ER77FlED SURVEY MAP No, 3393 VOLUME 12 ~ PAGE 3393 r THE SOUTHEAST 1/4 OF THE SOUTHWEST 1/4, SECTION 34, TOWNSHIP 29 NORTH, RANGE ' 15 WES'T', TOWN OF SPRINGFIELD, ST. C.ROIX COUNT,' WISCONSIN SURVEYOR'S R71FICATE- 1, 1, Donald M. Clark, Wisconsin Registered Land Surveyor, That have surveyed, divided and mapped the Southeast1/4 of they Southwest 1/4, Section 34, Townahip 29 North, Range 15 West, Town of Springfield, ST. Croix County, Wisconsin, more particularly described as: Beginning at the South 1/4 Corner of said Section 34; thence N 89'41'39" W 1319.53 feet; thence N 00'15'42„ E 1328.12 feet; thence S 89'48'19° E 1318.30 feet; thence S 0012'17" W 1330.67 feet to the point of beginning; Containing 1,753,423 square feet (40.25*acres) more or less, and being subject to existing easements. That I have made such survey, land division and mop at the direction of Mr. Bernard Seidling, for Hudson Diesel, Inc., MPPP, 4445 Old Wells Rd, Eau Claire, Wi 54703, Owner. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. That 1 have fully complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the Subdivision Regulations of the Town of Springfield and the County of ST. Croix in surveying, dividing and mapping the some. Ito 1r& Dated this_ Z4 day of_ 1997 ° e~i S q~ 6* 4 Donald M. Clark, R.L.S. 1580 * .fro DONALD M. CLARK : ~4. S- 15W MENOMONIE 1 $1 -AT . wI a••r•4.rr..,,,..•,.4 r 1* ee++ean+rrs~Ye" TT er le vol f t 16 4 ,_,e".H,:. NSC,xrk'.'k60u nk~H,•.~.tvflwwraum._ .m.. P{ s r aso. t i t _ .w f F ~...y.~._,.~..~....>..~....~ .~a ray...::,. .x .F E 10, s i r. re yj F 5 , : 6r c,, W r L f/` I ! I ~ NOW ~r..... , i ; I i - s ~ r ' I I I I ! h r I I I I E I I i , { I I 1 i ~ ~ I I ~ R ~ 1 I i Y'^ _ 1 F F : TS e #J7 I , ( I r I ~ ~ ~ I I e I a ~r._I I i .f I I I : - _ - - s .AmentofCommerce SOIL AND SITE EVALUATION L„ ly and Buildings : Page of 3- E In accord withrGomm 83.05, Wis. Adm. Code ,;ice Attach,, mpiete site plan on paper not less than=B2 x 11 inch s n size. Plan must include, but not limited to: vertical and horizontal reference point (BM); direction and County percent slope, scale or dimensions, north arrow, and location and distance to nearest road. St. Croix APPLICANT INFORMATION - Please print all information. Parcel I.D.# 34.29.15.523 Person al information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (t) (m)). Reviewed By Date Property Owner Property Location Hudson Diesel, Inc.,MPPP - - - Govt. Lot -SE 1/4 SW 1/4 S 34 T 29 N,R 10 Properly Owner's Mailing Address Lot # I Block # 1Subd. Name or CSM# 4445 Old Wells Rd W1/2,E c eS Citv State Zio Code PhoneNumber City Villa e ,f:,Town Near - ,f Eau Claire WI 5470.3 715-839-7969 Sprtng ield' 601TAAv New Construction Use: Residential / Number of bedrooms 3 Addition to existing ing Replacement Public or commercial describe 3 11997 r Code Derived daily flour 450 gp Recommended design loading rate •5 be /ft, ~ OR nch, gp . Absorption area required 900 bed, ft, 750 trench, ftZ Maximum design loading rate .5 be z C Recommended infiltration surface elevation(s) 101.9 ft (as referred to site plan benchmark) Additional design / site considerations install 4'x 95' rock bed mound on 100.9 as upslope edge of rock w/ 1' sat Parent material loess over glacial till Flood plain elevation, if applicable ft S=Suitable for system conventional Mound in-Ground Pressure AT-Grade I System in Fill I Holding Tank U=Unsuitable for system X U TX. S U S X U S U U U Horizon Depth Dominant Color Mottles Structure 2 Boring# in. Munsell Ctu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistenc~~ Boundary Roots GPD/ft I ~ Bed Trench Ground -8 7.5YR 2.5/2 - is 2 f sbk ds i cs 1 f/tn .7 .8 -24 7.5YR 4/4 - icos 1 m sbk dsh gs If 7 8 1 A3,,'4 t - - - - i - - -42 7.5YR 4/4 - mcos 0 sg ml aw IM I 7 ! 8 elev 100.9 ft. 4 42-50 l OYR 5/6 c I p 7.5YR 5/8 scl am mvfi - NP 2 t -4 - Depth to limiting - I - factor 42 Remarks: occasional gr especially 8-24 2 1 0-6 l OYR 3/3 - sl 2 f sbk ds I cs 20m T-75 ! .6 -24 I OYR 3/4 - s1 2 m sbk ~ds cs I if I 5 ~ .6 Ground -----f----- l-- T 3 24-40 7.5YR 4/4 elev - lmcos 0 sg ml I as 1 m 7 8 10.0 ft. 4 40-44 l OYR 4/4 m2p IOYR 6/2 scl am mvfi I - - NP ! .2 Depth to limiting - - , factor - I I 40" - _ - - I Remarks: occasional gr & cob especially 24-40" CST Name (Please Print) Signature: Telephone No. Henry F. Grote _ 715-665-2681 1'.~. Box 57 Knapp, WI 54749 6/14pa /97 Sjj[,rrlber Ref# 116 PROPERTY OWNER: seidling, Bernard SOIL DESCRIPTION REPORT PagIB 34.29.15.523 PARCEL I.D Depth Dominant Color Mottles Structure Texture onsistence Boundary Roots r ,4h Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 1 OYR 3/3 - A 2 f sbk ds cs l f/m 5 6 2 6-18 l 0YR 3/4 - sl 2 m sbk dsh cs i f 5 I 6 Ground 3 18- 7.5YR 3/4 - mcos 0 sg ml aw If .7 elev _ 100.9(1, 4 24(28)- l OYR 4/4 m2p IOYR 6/2 scl 0 m mvfi - - NP Depth to limiting factor - Remarks: occasional gr & cob & occasional l OYR 4/6 mcos & s inclusions 6-24" Ground elev - ft. Depth to limiting factor Remarks: - i Ground elev Depth to limiting - - - t factor Remarks: I Ground I elev Depth to - limiting - factor - --4 - I i Remarks: ` Hudson Diesel Snc'. MPPP- 40~ -2C.c-lam: • 'iz- L'lL-S ~ -s -3~ J2 ~ l3~ t~- L-/ L 13µ ~S-l - C3-3 f d-4 ~iL q > ~ ~ ~ is S i i 0 3 Wit-on: q 9cpartmenl of Commerce SOIL AND SITE EVALUATION Page 1 of Division of Saf iy and Buildings in accord'with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8/2 x 11 inches in size1. P an,must include, Lit not limited to: vertical and horizontal referlence-poingBM),~dt.1 1 11and County St. CCOIX percent slope, scale or dimemsions, north arrow, and location and'/distance to!riearest road. Parcel LD.# ~ APPLICANT INFORMATION - Please print all information. 34.29.15.523 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location "y Hudson Diesel, Inc., MPPP Govt. Lot SE 1/4 SW 1/4,S 34 T 29 ~lfi 1` L.2"; Property Owner's Mailing Address Lot # Subd. Name or CSM# .4445 Old Wells Rd _11107.1 West 1/ Acr RFEIVE0 City State Zio Code PhoneNumber City Villa e Town Nearest - Eau Claire WI 54703 715-247-3927 Springfield 60Tiye i New Construction Use: Residential / Number of bedrooms 3 Addition to existing buildin ST CROI~ OOUNTY Replacement Public or commercial describe 'lNeew Code Derived daily flow j• 450 9P Recommended design loading rate .5 bed, gpd/ftZ 4ench N Absorption area required 900 bed, ft, 750 trench, ftZ Maximum design loading rate .5 bed, gpd/ftZ 4 ctl,~ptll 2 Recommended infiltration surface elevation(s) 100.7 ; (as refer rd to site plan benchmark) Additional design / site considerations install 4' x 95' rock bed mound on 99.7 as upslope edge of rock w/ 1' sand fill Parent material loess over glacial till Flood plain elevation, if applicable ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system X U X S Ll S X U S U U U Depth Dominant Color Mottles Structure I GPD/ftZ Boring# Horizon in Texture iConsistenc Boundary . Roots . Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I Bed Trench 1 1 0-3 10YR 4/3 - sl 2 f sbk ds cs ! 2Urn .5 .6 2 3-8 l OYR 4/3 - sl 2 f-m sbk ds cs 1 Vrn .5 Ground 3 8-18 1 OYR 4/4 - sl 2 m sbk dsh cs If .5 .6 elev 98.0 ft. 4 18-30 7.5YR 4/6 - mcos 0 •sg ml cs - 7 8 5 30-43 IOYR 4/4 m3p l OYR 6/2 scl 0 m mvff - - NP .2 Depth to limiting factor - - - 30" Remarks: occasional gr & cob 2 1 0-4 1 OYR 4/3 - sl 2 f sbk ds cs 2f/m .5 .6 2 4-12 l OYR 4/3 - sl 2 m sbk ds cs I f/m .5 .6 _ - - r - + .4- Ground 3 12-31 7.5YR 4/6 - mcos 0 sg I ml as 1 f .7 1 .8 elev - ___-__.__l-___ - _ -___~---__.I _ _ _ 99.6 ft. 4 31-37 1 OYR 4/4 m3p l OYR 6/2 scl 0 m mvff - NP .2 Depth to limiting factor - 31" Remarks: occasional gr & cob, especially 12-31" CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715-665-2681 AdP.O. Box 57 Knapp, WI 54749 ~~3/97 ~~T21~u~ber Ref # 115 PROPERTY OWNER: French, Bruce SOIL DESCRIPTION REPORT Page ~_Cr PARCEL I.D.# _34.29.15.523 w . Depth Dominant Color Mottles Structure GPD/ft' Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. onsistence Boundary Roots Bed i Trench 3 1 0-4 1 OYR 4/3 - sl 2 f sbk I ds cs j 2f/m .5 ! .6 2 4-18 10YR 4/4 - sl 2 m sbk ds cs if 5 6 Ground 3 18-33 7.5YR 4/6 - mcos 0 sg ml as I m .7 .8 elev 98.9 ft. 4 33-47 l OYR 4/4 m3 p, l OYR 6/2 scl 0 m mvfi - - NP .2 Depth to limiting - factor Remarks: occasional gr & cob, especially 4-18" 4 1 0-3 l OYR 4/3 - sl, 2 f sbk ds gs 2f/m .5 .6 2 3-21 10YR 4/3 - sl 2 m sbk ds gs if .5 .6 Ground 3 21-29 7.5YR 4/6 - mcos 0 sg ml as Im .7 .8 elev - 101.5ft. 4 29-44 l OYR 4/4 m3p 10YR 6/2 scl 0 m mvfi - - NP .2 Depth to limiting factor 29" Remarks: Ground elev Depth to i limiting - - - - - - - ( I. factor I { { Remarks: • I Ground elev Depth to -f limiting I - factor Remarks:._ 14, -Lct Z. Hudson Diesel, Inc. MRRPI))..~ ti t-K La1 ~-~-4 (3-t~~it•o) V3. ra tic $ .QS t3 44.E e-4 o S 3 $ C # S 0-0. Ll Li ? 1Qp~ 3 tr S 3 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of Division-of Safety and Buildings ff"a 'n r h omm 83.05, Wis. Adm. Code Attach complete site plan on paper not less t 11 s Plan must Count include, but not limited to: vertical and horizon fe p t (BM , irection and y St. Croix percent slope, scale or dimensions, north arrow, and location and dis ante to nearest road. Parcel I.D.# A- _ l ` 59 4- APPLICANT INFORMATION - Please print all information. _ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location French, Bruce Govt, Lot SE 1/4 SW 1/4 S 34 T 29 ,,R 15 - - - - - - Propertyy Owner's Mailing Address Lot # Block # Subd. Name or CSM# Box Z74 West 1/2 (20 Acres) - - ity State Zi Code PhoneNumber City Village u Town Nearest Road ~omerset WI 54025 715-247-3927 Spring tgield' 60Th Ave. New Construction Use: X_~~ Residential / Number of bedrooms 3 ;Addition to existing building Replacement Public or commercial describe Code Derived daily flow 450 gp Recommended design loading rate -5 bed, gpd/ftZ .6 trench, gpd/ftZ Absorption area required 900 bed, ftZ 750 trench, ftZ Maximum design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ftZ Recommended infiltration surface elevation(s) 100.7 ft (as referred to site plan benchmark) Additional design / site considerations install 4'x 95' rock bed mound on 99.7 as upslope edge of rock w/ F sand fill Parent material loess over glacial till Flood plain elevation, if applicable ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system U S U i S X U S X U : U U Depth Dominant Color Mottles Structure GPD/ftZ Borin9# Horizon in. Munsell Qu. Sz. Cont . Color Texture Gr. Sz. Sh, CBoundary Roots Bed - Trench i h 1 1 0-3 l OYR 4/3 - sl 2 f sbk ds cs 2f/m .5 .6 2 3-8 1 OYR 4/3 - sl 2 f-m sbk ds cs I f/m .5 t .6 Ground 3 8-18 1 OYR 4/4 - sl 2 m sbk dsh cs if .5 .6 elev 98.0 ft. 4 18-30 7.5YR 4/6 - moos 0 'sg ml cs - .7 .8 5 30-43 1 OYR 4/4 m3p IOYR 6/2 scl 0 m mvfi - - NP .2 Depth to limiting factor 30" i i Remarks: occasional gr & cob 2 1 0-4 l OYR 4/3 - sl 2 f sbk ds cs 2f/m 5 .6 2 4-12 l OYR 4/3 - sl 2 m sbk ds cs I f/m .5 j 6 Ground 3 12-31 7.5YR 4/6 - mcos 0 sg ml as 1 f .7 8 elev 99.6 ft. 4 31-37 l OYR 4/4 m3p IOYR 6/2 scl 0 m mvfi - - .2 Depth to limiting - factor 3 1 .0 Remarks: occasional gr & cob, especially 12-31 OUNTY CST Name (Please Print) Signature: Telephon Henry F. Grote 715-665- A1e6Box 57 Knapp, WI 54749 ' h/97 SDwAber # PROPERTY OWNER: French, Bruce SOIL DESCRIPTION REPORT Page .r 2 of J__ . PARCEL I.D.# 34.29.15.523 ` Depth Dominant Color Mottles Structure GPDIft2 Horizon Texture onsistence Boundary Roots - - - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed i Trench 3 1 0-4 10YR 4/3 - sl 2 f sbk ds cs I 2f/m 5 6 - - - E 2 4-18 1OYR 4/4 - sl 2 m sbk ds cs if .5 .6 Ground 3 18-33 7.5YR 4/6 - mcos 0 sg ml as lm .7 .8 elev 98.9 ft. 4 33-47 10YR 4/4 m3p IOYR 6/2 scl 0 m mvf - - NP .2 Depth to limiting factor 33" Remarks: occasional gr & cob, especially 4-18" 4 1 0-3 10YR 4/3 - sl 2 f sbk ds gs 2f/m .5 .6 2 3-21 IOYR 4/3 - sl 2 m sbk ds gs if 5 .6 Ground 3 21-29 7.5YR4/6 - mcos 0sg ml as lm 7 .8 elev _ t 101.5ft, 4 29-44 l OYR 4/4 m3p l OYR 6/2 scl 0 m mvfi - - NP .2 Depth to limiting factor 29" - Remarks: Ground - elev ft. ing ~ - - I IDmp o factor Remarks: Ground elev -F - - ft. ~ Depth to limiting factor Remarks: ~~a• To S T ~,o.,~ ~O 4. ~3w-~-z -►3.1 z ~ 3 -4 ~ o ~ •S v~ ~l o'S>ti~ ~ ~ Swvc..t o"~ i nn nn CAA~ Ll A-0 1 Z-g L ~ ~ ...Q