Loading...
HomeMy WebLinkAbout006-1039-95-075 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ` INSPECTION REPORT Sanitary Permit No: 488225 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:' �l � Personal informatiori you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ,� 1� Permit Holder's Name: City Village X Township Parcel Tax No: Belisle, Dbu las & Tamera I C Ion, Town of 006 - 1039 -95 -075 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 18.31.16.2698 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer q. 4+ Holding - St/Ht Inlet p /7- / TANK SETBACK INFORMATION St/Ht Outlet / S� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic s �• , Dt Bottom - Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System 1 w , y3.3Z` _- PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover i GPM Model Numbpr TDH Lift Friction Loss System Head TDH Ft Forcemain Length pia. Dist. to Well SOIL ABSORPTION BE-W RENCH Width Length Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME ° SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manuf INFORMATION CHAMBER OR Type Of System: s t .. UNIT Model Nu er: DISTRIBUTION SYSTEM Header /Manifold tt Di tribution - - -. ` ` x Hole Size __ x Hole $pacing - Vent to Air Intake _... tt _ Pipe(s) 1. G Length ` Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil r ] Yes j j No -,, Yes No r i ��,kO�IIMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: - d ) rT & Inspection #2: "" 7 `- T__.__. Location: 2046 215th Avenue Deer Park, WI �4 07 (SE 1/4 NW 1/4 18 T31 R1 6W) NA Lot Parcel No: 18.31.16.2696 1.) Alt BM Description 2.) Bldg sewer length = 4+r •. ar - amount of cover ­2�1 z Plan revision Required? 1 _j Yes No t 9 Use other side for additional information. Date j Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 1 * is a s 201 W. Washington Ave., P.O. Box 7162 I CO��,� o M n, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co ) 08) 266 -3151 , r _ De artment of Commerce Sanitary tion State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s 15.04(lxm) Project Address (if different than mailing address) I. Application Information - Please Print All Information RECEIVED Property Owner's Name JUN 0 9 2006 P ircel Lot f O Block # � Property Owner's Mailing Address ST. CROIX J� pert Location Zo y 6 �!s"' j,� ✓,e v, W p City, State / Zip Code Phone Number l 1 Section L ,� r P G �, l C J S 0 Z (circle one) II. Type of Building check all that apply) T_ N; R � r or 2 Family Dwelling - Number of Bedrooms 3 Subdivision Nante _CSIvI- Ntett3ber Public /Commercial - Describe Use 1 ' ❑ State Owned - Describe Use []City []Village illage Wwnship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) �, , _ . s 0 " k. . A ' ❑ New System Replacement System y ❑ Treatment/Holding Tank Replacement Only 13 Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) ,c Ton - Pressurized In -Ground ❑ Mound > 24 in. of suitable soiC ., (3 Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media F ilter Leachin C hamber t g y g 0 Drip Line ®Gravel -less Pipe ❑Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s1� Dispersal Area Proposed (sfl yytem Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ; s + , !} i Concrete Constructed Glass New Existing Tanks Tanks t a.... l 4 r . eph or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement I , the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Michael E. Wilson - j f: C 1 225150 715 - 268 -6626 Plumber's Address (Street, City, State, Zip Code) 894 State Rd 46 PO Box 232 Amery, WI 54001 VIII. County/Department Use Onl pp Disa pproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing�tgent Signature (No Stamps) A D�sa Surcharge Fee) ,�� _ } � El ben Reason for Denial « ":I, +v- IX. Conditions of Apprwm vat SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 z 11 inches in size SBD -6398 (R. 01/03) J� , Ali• .3jrIX le - XZ's Z t i I , I ; I I i 's z - : y, I I � , I I r D�IT Ai I i hc� 1 I :I - - - : I : - I I � : 1 I I ' I I + I I i- I I , 1 I , 1 i I T � I i j : : 1 + y 1 i , r , I � I I I ; I a r� I ' ' I I : I �7�- I / ve c C es. 1 - fi�T C ci I . _ J � r `G O ioj _ I S , } : 1 1 ; 1 l 1 . ; I e 1 � I t i f.. 1 ; , , I ._ - . �....- 1 - , RECEIVED P -A Wisconsin Department of Corn erce O 9 20 06501 EVAL Page �Of Division of Safety and Buildings JUN in accordance with Co 85, Wis. Adm. Code County Co�1 TY ' Attach complete site plan on per r�le�5>�� r S T!Z z 11 inch in size. Plan must include, but not limited to: ve I and horizon M), direction and P I.D. percent slope, scale or dimens ons, north arrow, and location and distance to nearest road. - P /ease print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). .` Property Owner Property Location Govt. Lot 1/4 1/4 S T N R (or Property Owner's Mailing Address Lot # Blo # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village 2 Town Nearest Road ( ) 1 W ❑ New Construction Use: Residential / Number of bedrooms _ Code derived design flow rate > GPD Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable IVA4 ft. General comments and recommendations: © Boring # Boring ,Q7 9 Pit Ground surface elev. ft. Depth to limiting factor � //S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. *Eff#1 *Eff#2 c s; Boring # [j Boring Pit Ground surface elev. ft. Depth to limiting factor VL in. mil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 B a v r^ 4 4 / c:. _ * Efflue t #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ffluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name ) Signature CST Number - Z Address ' DaAiu Telephone Number w Property Owner Z e �, Z/" Parcel ID# Page of Boring # O Boring 17 /9 4 Pit Ground surface elev. �Y ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ,s s e a - s F 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 GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 ❑ Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soit Application Rabe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtrf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 220 mg/L and TSS >30 _< 150 mgA- * Effluent #2 = BOD < 30 mg/L and TSS < 3o 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 -5330 (807/00) / �_30�'� s�+�,/ s � �.� >�- �� �'s� .sue /- ,t/r.J %- sic /v�' - - T,3 /,1/ - ,� ° /6 � /'� ..� �� �,�,� �go e� L�,1e�lr:}� �o fay � ��� - .�'mli�,d - (� � _ �.5 f?�s Gs�.�i f����� __. 3 ' ' _ __ 3o T .— �i.-,� , ,�s� ,� � - I I yi` /1ecF5' i � , —_ _ __. r ���,{ � J.� �' � __. - - ��` j h �`� �' _ __. i. -lK i� _- Cross Section of a Two Ceii In Ground Component Using Leaching Chambers 2- T• -.,, 70-- 6Y Observationt /Vent Pipes t • i F inished Grade Fir. .sh ed Grade —ft. Ceti + slope % 6eparatio ; Origin G rade = `�1— _ �Y ice;' ; �; V briginai Grade �7 Top of Chamber _`�� �y Top of Chamber = �� _ y'' i ,�r i ; •' System Elev. ,� % System E1ev_ 3 6Y _ `� ?.�� • ���• • .. � _ . �reotxr�ent'pnd'Dt9P .Moi one_•; .. y ' -.'• _ :� ; .. , : = Limiting Factor Observation /Vent pipes to be constucted and capped with approved materials for the particular use. Nat to Scale POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ! of 2 FILE INFORMATION SYSTEM SPECIFICATIONS caner�� Septic Tank Capacity ga l ❑ NA Permit # Septic Tank Manufacturer W ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms NA Effluent Filter Model _ ❑ NA Number of Public Facility Units NA Pump Tank Capacity al Estimated flow (average) 3c'C:' gal /day Pump Tank Manufacturer A Design flow (peak), (Estimated x 1.5) 2' gal /day Pump Manufacturer "A Soil Application Rate gal/day/ft' Pump Model (INA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit M- Fats, Oil & Grease (FOG) :_30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :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 (BOD :_30 mg /L X In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :10 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA =� IiLyear(s) Clean effluent filter At least once every: / ❑ month(s) ❑ NA . + year(s) Inspect pump, pump controls &alarm At least once every: ❑ month(s) NA ❑ year(s) Flush laterals and pressure test At least once every: ' ❑ month(s) A ❑ year(s) Other: ❑ month(s) At least once every: ❑ year(s) NA Other: A 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 requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y 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 the 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. Page 2 of 2 ' 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 be 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. • 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. T alua ' t be ' e ai a FR0441 nR - a"S'TRdC --A O 8 Tf� A/6-%A/ tank ❑ 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 f ' I (,� fZ a €rt Name a" S Phone �5. W6 Z_ Phone s SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name s C d U 20A AJ Phone 6Ax u VAIL Phone 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 -! la S ' Mailing Address '� l� Ae Property Address /�" (v ©� &'e (Verification required from Planning & Zoning Department for new construction.) City /State �itJ -� �,� �H k Parcel Identification Number 00 LEGAL DESCRIPTION Property Location S cs 1 /4 , W c--' 1 /4 , Sec. ! 8' , T J1 NR 16 W, Town of Subdivision 1� /G><� : , { � Y , f� , Lot # Certified Survey Map # , Volume Page # -- Warranty Deed # 7 S `� Y 3 , Volume 'Z- , Page # 0 5-3 Spec house yes � Lot lines identifiable 6) 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. Uwe, 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 «rithin 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. Uwe amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 3 SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** I_ Jude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if -eerence is made in the warranty deed. RED 08/05) 781443 2 7 0 7 P 0 9 3 KATHLEEN H. NALSH REGISTER OF DEEDS Document Number QUIT CLAIM DEED ST. CROIX CO ., MI RECEIVED FOR RECORD 12/02/2004 09:45AN Tamera M. Tornio, Grantor, quit claims to The Douglas P Belisle QUIT DEED and Tamera Marie Belisle Revocable Trust dated October 28, REC FEE: 11.08 2004,Grantee, the following described real estate in St. Croix TRANS FEE: County, State of Wisconsin: COPY FEE: CC FEE: PAGES: 1 The East 793 feet of the Southeast 1 /4 of the Northwest t/4 of Section 18, Township 31 North, Range 16 West in the Town of Cylon, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights -of -way Return to: of record, if any. Barry C. Lundeen Mudge, Porter, Lundeen & Seguin, S.C. This is homestead property. 110 Second Street, PO Box 469 Hudson, WI 54016 Dated this 28 day of October, 2004. Tax Parcel ID #00 -IM9= 3(1+1100 (SEAL) Tamera M. Tornio AUTHENTICATION ACKNOWLEDGMENT Signature of Tamera M. Tornio authenticated this 28` day of STATE OF WISCONSIN ) October, 2004. )ss COUNTY OF ST. CROIX) Personally came before me this 28 day of October, 2004, the TITLE: MEMBER STATE BAR OF WISCONSIN above named Tamera M. Tornio, to n known to be the If not, authorized by §706.06, Wis. Stats. person who executed the foregoing insuume acknowledged the same. L THIS INSTRUMENT DRAFTED BY: �TaRY '', Barry C. Lundeen, Attorney I 1A if Mudge, Porter, Lundeen & Seguin, S.C. Notary Piblicjtate of Wisconsin 110 Second Street, PO Box 469 My Commission (expires): BLIC Hudson, WI 54016 J► (Signatures may be authenticated or acknowledged. Both are not necessary.) KAROLYN E. WITTHO Notary Public -State of Wisconsin - Names or persons signing in any capacity should be typed or printed below their signatures. QUIT CLAIM DEED My Commission Expires June 1 � j AMMS Viewer Page 1 of 1 1 iYY http: //72.21. 230.178/ website /LRPortal /ARCIMS/MapFrame.asp ?PIN= 6/12/2006 Wisconsln Department of Commerce SOIL AND SITE EVALUATION DiMslon of Safety and Buildings Page of Bureau of Integrated Services in accords ' a. ILHR 83.09, Wis. Adm. Code 3 a Q Attach complete site plan on paper not less than 8 1/2 w 1 as in siz . PI a County include, but not limited to: vertical and horizontal refefen int (, ction ai1d, -`} percent slope, scale or dimensions, north arrow, ancVI ion and ¢v eares'1 fda . Parcel I.D. # � , ..._r J l/ APPLICANT INFORMATION - Please p�n _ .. i ill info bn.149$ j Re i by J �� Date Personal informatioM p de ma a us ondary pufp ges (Priv 115.04 l Property Owner j ;ti - INGOPFI Pr r ovation J" 0 t 7114 1/4,S T N,R E (o Property Owner's Mailing Address ` �,' • # I Block# Subd. Name or CSM# City State Zip Code Phone Number El city El Vil age Town Nearest Road {{ New Construction Use: ® Residential / Number of bedrooms' + dditi n to existing building El Replacement El Public or commercial -Describe: LUG1� S/ /��� Code derived daily flow n gpd Recommended design loading rate s Zbed, 9Pd/ft�` r� trench, gp� Absorption area required - ,' bed, ft ranch, 2 Maximum design loading rate 1 2 bed, gpd/ft trench, gpdfit?,, Recommended infiltration surface elevation(sn• ° P �e ft (as re erred to site plan benchmark) N i / Additional design /site considerations rZ 7 G =/ KJ <° Yf� /G/1 �uv oor Parent material Flood plain elevation, if applicable S = Suitable for system I Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system S U 4 S ❑ U 4 S ❑ U S❑ U ❑ S 4 U ❑ S EQ U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft 9 Texture Consistence Boundary Roots • in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �J Be ^ , Trench `�. k► Ground � _"/ „ e , Depth to limiting factor s � Remarks: Boring # Ground Depth to limiting factor &in. Remarks: CST Name (Please Print) Signature Telephone No. L Add � /� � � � Date _ �� C N Q�� /0011- DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 13 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed , Tre Ground IL a ll— Depth to limiting factor q , Remarks: Boring # 13 Ground Depth to limiting facto j in. Remarks: 3 9 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bou � GPD/ft R in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground lev. Depth to limiting factor , Remarks: Boring # Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) 0 011 , r . o � of �. o o o " Ln I Ir' IF IL o= o F '� ►—' rn - ro K 0 I ,— ° c o f i� On CD El El A f. Soil Test Plot Plan Project Name Steve Halleen By Address 2162 170th Ave N R ichmond Wi 54017 CS #220527 JI,-6t -- Subdivision ----- ------ Date 8/30/9 NW 1 /4N / T / T / �/ 1 N / W Towns or Well PL Property Line CoVnty C ROIX BM or VRP Assume Elevation 100 ft.Top of Wood Stake with Orange Ribbon System Elevation 9 1.4/90.9 * H R P Sa a Benchmark Alternate Benchmark Top of Wood Stake with Orange Ribbon @ 98.0 220th Ave C 2 5 1320 Property Line 18% Slope 18% Alt. Slope B.M. NB.M. 15' 15' B -1 9 5' B -4 Pri A ep 0 7% Slope VV CC 80' 80' B -3 18% Slope 500' B -2 -5 30' %y W 0 00' 0 b c� 1 4 r 1320' Property Line V q �� • Parcel #: 006 - 1039 -30 -050 03/28/2007 11:49 AM PAGE 1 OF 1 Alt. Parcel #: 18.31.16.263A -5 006 - TOWN OF CYLON 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 - BELISLE, DOUGLAS & TAMERA TR DOUGLAS & TAMERA TR BELISLE 2046 215TH AVE DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 0119 AMERY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 59.000 Plat: N/A -NOT AVAILABLE SEC 18 T31 N R1 6W NW NE & PT NE NW LYING Block/Condo Bldg: E OF THE FOLLOWING DESCRIBED LINE; COMM N LN OF NE NW & W LN CSM 10/2879; TH Tract(s): (Sec- Twn -Rng 40 114 160 1/4) 01'E TO S LN NE NW AND THERE 18- 31N -16W NE NW TERMINATING; EXC CSM 10/2879 Notes: Parcel History: Date Doc # Vol /Page Type 12/02/2004 781444 2707/094 QC 05/15/2003 721259 2239/553 QC 05/13/2003 721258 2239/552 QC 10/24/2000 632346 1553/243 C /LC more ... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/09/2004 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 39.000 39,000 0 39,000 NO PRODUCTIVE FORST LANDS G6 20.000 40,000 0 40,000 NO Totals for 2007: General Property 59.000 79,000 0 79,000 Woodland 0.000 0 0 Totals for 2006: General Property 59.000 79,000 0 79,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CYLON N T.31N. - R.16W. i i U .sue au +1 ®,995 C,.ad Cartogap/u , s c,«a 5, B, Polk County ° ° F c kK T '" Herbert 90.93 0 Thomas & Lau ray Pietsdl s 10 .° °' Herbert Struss 0 172.94 Norman Reed N 181.31 t - i wBiam 126.75 Struss m 92'05 '�� Sresniak 84.06 He m M b 106.15 vceaixn :°. 87.33 65.72 etal George & Gerhard & Mchae l William 160 Wittstock LE etal & O° 193 5 z 19 z Florence Florence Jones ", tRao-;'. Gerhart n Kathleen Krogh oe<M Kjeseth Henke Barbara o q� m Me s; fit m N Fam Tr so 4;i to o Voedisch ag &11 2 w 85.14 Hove Steven & 0 FkR Beni]amin & LM s .34 Fam Tr Michael Luhman Vernon _, N Ogden Kermit & Kennil Marian �' T &M Group 166 > `' a y m m a, 46 cnnaan rarer 40 Jones 18.3] e�cm�a Blombe 151.97 Sala g0 , a ui G Gloria Thom son rhom w warn Rvdna g dl E m s Sr - Ra morel &Lois Elden Wayne &Beverly James &Esther Delmond v ua.id - vomon Jr q - y 5, 4Awa &cad+r o �x a iaaona &�+rdeu / �J Z u.e 40 H amme l an Setter Alvermann smna min F o Thompson warner ianaRe r a rama 0 m.ai 51.69 41 p h 114.99 '� �1 80 u.43 249.63 120 40 120 H eec m 147.95 sL Arthur & Florence a &ia� Lemoyne wi oa 140 Katl - DEER PARK 6 Moore 38.31 "addok 80 Derrick & a6 Everson harles & Barbara sw Rodger& sre ear 194 1 &s Jeffrey George Joanne l? ° T ° W s are Amanda M d ae1 Eleanore s annen Setter ^ ^ a Bergrm 6 D- Lvh 235 Cody w F�le s Babcock �$ Jaques "� H 40 Kevin Luke & 139, m. Marlys 48 Ronald 4' .r & Rita 120.01 ,g Lena a Raymond K marski �.. _ Jennifer Waidellch sronZOvv1� 89 165 Bce 160 &Lois 80 w Hammelman t K ema°t, 1 SH Y dne 31 s C m Darrel & 48 03 i� xns amp ovde n�na o °u State of Wisconsin DNR p� ry , 7 1 � Wj$m p o Yvonne Kuhn 1.3s Tap r 4o Fouks Taper 160 40 z s DNR 160.22 160 80 David N L 343 d & ' ii Eric & Kristie N Gary, Arlene & y°` v -nvve d Marie Harsh 40 Solbert ,o & Mav,s . Steven Halleen 114.62 crag 6 > 77.91 57$'22 520 560 v m I.o I { Lavon & Bar6�arz uer 7 4 3 ;? Dean Lehrman St Cmax w 130 s1a Barbara Krvmm 67.Zy u k County o& < 21 g9 4 sA B89 (] ~ < 9B /, 40 A s 3 . Y / 4 3.a ❑ } 39 m W 66 1' LoweB & William Fouks Beverly 147.82 a 180 David & Susan c1 120 Theme]] State Of WLSCOnSIn State of Anderson 1 Ra DNR J o hn , €; g K.v W isconsin Grace 115.59 V 85.28 c € _ Joel &Alice Kosbab r Larry R ` I. y caeswt 08.11 LL�z wwa Maa zc �od waa Bowie R1� DNR y Kobernick C David & ° C �a oas r u Kelvin Norman Do ald Hilbert & L1a f1a 2 � Susan Dagger >' ° x 9 91 ellbe[ Mary 4 Mams I< O a Robert Fitzer i w .a a A K4 4o g & ludltn spencer Larson 280 & BA State of `� ,B N i m G Q _ Reiss 80 Johnson r/1 &, DFa1110 X °° c r q Wisconsin Sydney Crane _ John Oden Asdieman 100 0 0 60 6 Radigan 40 > lzo DNR Hovde .5 ° �; n , 160 120 1 a w ^� o as o BFa11 to 02 1969 illiam dt yy m UA 1 am W m 323.59 160 �ti Beverl Sellent 110.79 > m _ Zwolensk 118.43 Robert & v S 3 B & y .� acal Steffen Wayne Moe a6 etal 1 3'n eta] hi , 5 a S Bobbie & Deloris Ko Gary R &e Steven & i s Be. Bethke Kr'6 Keith y _ il LN a.4 Sk a Warner 6p.31 Berndt 0 98.42 41.ss Swiggum 143.02 Tonnes Wilbur Linda Wirth 1 i lo.s 50 160 j Do 150 40 j P. N .6 M) "ender°^ Richard & 120 40 ° Geor e & v ohn & Teresa John Peirson e a 52.27 d 90 $ 40 0 o Duane J Elaine RK d etal T, 66.6 Beth Bos l j , Wright �hachtner 160 Elaine Gleason 'A Howard & z m - • Scott & Elle 46 Richard Krueger Bend re Olson 160 240 235.16 120 n Haym 63 89.9 235 - , - 8 _1 L 29 Curtis Donal - 115 D & v ° to .3 Richard A Ned & & Carol & Nancy 96.55 34 273 G Roger ' ° . °8 Harold u Bedry H�,,, Jones Gleason ,� ; U G € &Gayle H F' 0 9529 ' 4 9247 sse 73.38 Goa l & La lcll Q o 41 ❑ Sullwold Melvin Wayne & Harvey& w ura Donna 120 s- Hie lkema o M. 4 159 0 200 BaoB v sl a0 440 79.54 rn 64 Fonw + .-. Ro 165 Eleano z m Richard 63 3s Ke,4a v James 120 Goodrich 199.99 40 . �� suu oia 'B 268.48 eR a+ aw. L N ,y 7 r etal ^ &M s u. 40 m a w ughes & Carol Ronald & J ohn & Henderson w $ s 2 etal Dittman t4 v;� *� Gary.a 76.91 Thomas O Pa .. James & etal Kemii Alice VOW Beverly M Orville 5724 Sharleen w v 158 46.62 WI 87.E en i Y `� 147.7 4 Croes 355 Joseph & a James & S Richard & 63 C J M. Gf-* LN L d �jz Ellen Alexander 4 Don Eliason Patricia Casey Weeks Henderson 102.75 R 183 e 292.42 153 etal 183 S 87.35 yl 40 Lornane t 222 S 2000 See Page 48 + 22 0o See Page 50 2aoo 2500 2soo 2100 r, World s Largest Seamless Steel Siding Co. Seamless Gutter k • � Seamless Siding Metal Soffit & Fascia Windows & Doors 3 South Knowi PETERSON CONSTRUCTION INC. ' �, Orel, Wiscoh )� Serving Western Wisconsin and Eastern Minnesota ' ' John Peterson (715) 246 -5650 Steve Peterson (800) 657 -7050 MAR - 8 05 I FILED FEB 2 2 1995 ► 9 ST. CROIX COUNTY KATHLEEN H. WALSH SURVEYOR'S RECORD 5 Register of Deeds Z St. Croix Co., WI !� � 52612 CERTIFIED SURVEY MAP ti �• Located in part of the NEJ of the NW4 of Section 18 and the SEJ of the SWj of Section 7, all in T31N, R16W, Town of Cylon, St. Croix County, Wisconsin. O t w bg�`' et3 ' 1 ' ! ; ; ' Pi �° ���'' .+ �f" � Legend end ,, . � L g Owner Steve Halleen 410 V3 w o e ALLEN '.. p ; � 0 2162 170th Avenue woo H 100 200 400 w �y y g . New Richmond, WI 54017 C a3A b NYMAGE. r Z � ^4 0 L w 0.0 L r7 P /ff � L 0 tLY C < UNFl_j1 TED LAND pf•� N v( 0 000 N89 ° 55'18 "W 831.04' • � Section 7 — Section 18 -,� -�® R ® SHED SHED 2 TH ~ ©; SHED ❑ HOUSE O SILO I AVENU_E ,,SEPTIC BARN r1 O SHED L SHED NW Corner of WELL Section 18 �� Q p � BARN � .. �- . • \ (�I cr1 SHED V71 el l o -?/Y9 C : 01 -� L < o I Ln 0 _ s o Lr, LOT V) 0 i o nl <n — N 19.95 Acres (869,022 Sq. Ft.) o I LJI 4 - � ° Including R/W 1 I —I CL 19.94 Acres (868,543 Sq. Ft.) 0, Excluding R/W POND / z 10—I 41 .)I 0 o •• 0 � W � V .,..I _ W S89 0 31 1 28 11 E \ 1929 .45' S89 °31'28 "E 835.85' ' 'NPL-,-'11 T EI) L- - NDS w Lines Legend z LINE Bearing Distance Aluminum County Monument Found A - B N79 0 05 1 59 11 W 14.51' • 1 Iron Pipe Found 0 h c B - C N10 0 54 1 01 11 E 66.00' 0 1 x 24" Iron Pipe set, weighing 1.69 A - C S01 0 29 1 55 11 E 67.58' lbs. per linear foot 9 * Existing Fenceline ""'' " ""' 50' setback line for roadway — — 75' water setback line Wk Corner of ' Section 18 This instrument Drafted by Michael Erickson Job No. 95-07 VOL. 10 PAGE 2879 r�