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~sco,sHum ReltofJndustry, SOIL AND SITE EVALUATION REPORT Page \ of 3
[division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but S-r • C.~ j Lx
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. O0 Z - f 0 63 0 -40bo
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REV DBY DATE
PROPERTY OWNER: 5 U1-1tV l` )O M C *tLp V LC)A PROPERTY LOCATION
~V~'!t ;b1~1-1551 _Df l~j~R(~ pf~'t' 1r'lCl tty -GGvp. =6T K~ 1/4 1JE 1/4,SR-6 T Z91 N,R 16 E(o W
PROPERTY OWNER'S MAILING ADDRESS. LOT # BLOCK # SUED. NAME OR CSM #
°l, ZZ y `1Z1- ST. - -
CITY, STATE ZIP CODE PHONE NUMBER ❑C NfOWN NEAREST ROAD
~Sbw W 1 StCot( (-)IS) 351- S410 D► !!f`1 ~lX~ iij
New Construction Use [•4 Residential / Number of bedrooms AdditiQit,to existing building
j J Replacement [ J Public or commercial describe
Code derived daily flow b O 0 gpd ,4._G%M% Recomme dibsigJ din91ate bed, g ' ~ft2 • b v trench, gpd/ft2
Absorption area required - bed, ft2 you u trtg eh.
ft2 fvtaxim n design loadr~i rlolr,• bed, Y !ft2 10 trench, gpd/ft2
Recommended infiltration surface elevation(s) 4 Y I ft~ to site plan. chmark)
Additional design/ site considerations '7-Kr_QMK n f Y'- `1S`tDti t-•/ j, ` fYBSpV_v-DW ! hlu! s
Parent material t-0k-4~S oU~Z Gt-A-el f1t `ri LL- ° pI elpvaWapplicable ►JIP► It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S g u S ❑ U ❑ S [S U ®S ❑ U ❑ S NU ❑ S C91 I
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trti1
1 0-11) LQ1`_tz .3 L z - s i 1 z Fsb►z s env - -s -6
on,
~ m v Z do 3o tr_'N `tIZ 31 - s t 1 2--k6k Is e-S
Ground 3 -3$ `I-S-m_ 31y 'n.
9elev. It. to Lf R Slb vw. \)j
il_
(4 , S
Depth to S `48=12 107 R Yl/ , l S L( ►LS 143 1`FS n,4, W,
limiting
factor
Z 0-&w S ti~ yl s~ ter' cry
S S. l O `t R 6! , O Irvl v rno S, LT
Remarks:
Boring #
~ O-lu l0`1R3~Z sly ZT~b~ ~`~t^ e.S .S
Z 1~ ~ LO"11Z3Lf~ - S11 ~.'Fsb~ m`FM et,v - - S
3 zQ 4 -i S `~R 3LY
Ground
elev. 4 142_63 1,04M VJL I S Q S A3 1-'s m Ulk
V07--l It
Depth to
limiting
factor
4 L'i
Remarks:
CST Name:-Please Print Phone:
Arthur L. We erer 715-425-0165
egerer Soil-Testing & Design Service-P.O.,Box 74 River .Falls,WI. 54022
Signature I dot -Z-°!v _ Date: 11, I p g f CST Number:.
Bar-►~S=
PROPERTY OWNER ~f'~tt~rtel~rv SOIL DESCRIPTION REPORT Page?-of 23-
PARCELI.D.# DO-Z-- V )l - LO -060
Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft
Boundary Roots
in. Munsell Gr. Sz. Sh. Consistence
,.:....,,w,..,, Qu. Sz. Cont. Color Bed. Trends
p%-t 2 3 l Z - s i Z`FS 12'P>^ S , s .6
2:>»»::>' Z lp z.S ~o` l2 316
sit Z'P-s b k eS . g . ~
Ground 3 s -y0 •S R SE~b - 1 1 csb>z >k U `F>,. Lg
`
elev. !
a8.brc. y ~to-so l•s ~t R ~l y -S R S l t; el o►~-. r►-t - l~ Z..
Depth to ;
limiting
factor
4O
Remarks:
Boring #
~iititi:ti\~}:;t:• it
1 I
Ground '
elev.
It.
Depth to
limiting I
factor '
i
Remarks:
Boring #
t
i
Ground €
elev.
ft.
Depth to
limiting
factor j
Remarks:
3oring #
,round i
elev.
ft.
)epth to
imiting
actor
Remarks:.
PLOT PLAN Page 3 of 3
SCALE 1"=~ '
843 Tit ')Utz cOU U O _
` D . wt I -t-
1-043.-0 X1.orv ~rJ4Met+, 31q b1A_ RUC plPE k!! .
Q~
o 'N'{
r
X98°_ • z't ~COkj-pu\Ztr
l0u•5'
pipes
i
•
vwu:g Prr _ LM ST Z S`' - 1 -S Y- T
JJ q~l-Zak
L~Ii1~DMwl. el. l I- LO - zzoz 5 y
(715 ) 425-m65
CST Signature Date Signed Telephone No. CST #
e
At-Grade System Onsite Verification Report
December 20, 1999
John Momchilovich property
NE, NE, 26, 29, 16W
Town of Baldwin
Parcel ID: 002-1063-10-000
An onsite verification was completed on November 22, 1999. Pit #3 of Art Wegerer's
soil test was left open. I found what appeared to be a pocket of clay loam starting about
29 inched below ground surface in the northwest section of the pit. This material started
about 40 inches below surface approximately one foot to the south. This material was not
found in other areas of the pit and may have been an isolated pocket. I agreed with the
rest of the certified soil tester's report and a verification report was sent to Art Wegerer
on December 20, 1999.
Kevin Grabau
Zoning Technician
I
SAFETY AND BUILDINGS DIVISION
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
isconsin
Department of Commerce Tommy G. Thompson, Governor
Wiliam J. McCoshen, Secretary
At-Grade System
Onsito Verification Repor
Are the soil and landscape features accurately reported on the
Soil and Site Evaluation Form
yes no
If no, provide a further description by including an onsite
report, which may consist of a soil profile report, or provide a
brief explanation below.
If yes, what other type of Private Owned Waste Treatment System
(POWTS) could be used?
- 99
County Official Signature, Date
h, B aNXw ~N
2 : I~r- Ce Q~dt . Q
/JE NE ~l~ S: z 6 T': 9 /V
Property Location _063
~~MocJ►%IoViCl1
Landowners Name
i
I
SBD- lOS13 (N. 11/96)
PLOT PLAN Page 3 of 3
SCALE 1"= qO '
-3,q wt -M
r
D r c " ~ro suv'R►
~ t
IM .d one ~o" MIS j4,
y y D1R- RUC p t PEwlr .
1 y
r..
J
o
GAS
KOZO
51
STxIBv~ pipes
i
:CMT Z S.' w1- S z)ft
k + 1 N
ZZoZS~j
(715 ) 425-m rS
CST Signature Date Signed Telephone No. CST #
Parcel 002-1063-10-000 03/27i2007 09:25 AM
PAGE 1 OF 1
Alt. Parcel 26.29.16.384 002 - TOWN OF BALDWIN
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - DAHLBERG, MELISSA K
MELISSA K DAHLBERG C - MCLAIN PATRICK A
MCLAIN PATRICK A
621 GRANDVIEW DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 35.330 Plat: N/A-NOT AVAILABLE
SEC 26 T29N R16W NE NE EXC PT TO HWY Block/Condo Bldg:
DESC 1012/171 EXC PT TO CSM 14/3797
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-29N-16W NE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
02/02/2000 617826 1488/036 WD
07/23/1997 1049/623 QC
07/23/1997 1012/171 WD
07/23/1997 455/373
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 10/25/2006
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 33.328 3,300 0 3,300 NO
UNDEVELOPED G5 2.000 200 0 200 NO
Totals for 2007:
General Property 35.328 3,500 0 3,500
Woodland 0.000 0 0
Totals for 2006:
General Property 35.328 3,500 0 3,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00