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HomeMy WebLinkAbout020-1479-03-300 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 552323 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: Bast, Kernon J. & Donalda J. S eer- Hudson, Town of 020-1479-03-300 CST BM Elev: Insp. BM Elev: BM DescriptiqWn Section/Town/Range/Map No: /0 C, b D b d G- Q j 36.29.19.3024 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' Z5'S/7451 Benchmark 6 OsD Ob. p Dosing ' Alt. BM ' 10,0 w (~2S fo T we , v4261 3,a 1J'2 D Aeration 3 Qjgq r` I A ~4 3 r Lo 17 9 Holding St/Ht Inlet 'j X03 y ~ /v s~N y • ~ TANK SETBAC INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet WP 5'y A10,r Septic Dt Bottom 8 Dosing U ~D Head e1lRMan~ 1,7 Q7.3 V~ Aeration Dist. Pipe t H l 01 li- Holding Bot. System mil' WWI Z rS "Z z (3 Final Grade PUMP/SIPHON INFORMATION VV U Manufacturer ~k Demand St Cover / t) 1 rYl t GPM n Model Number 2D vAdhk41,e, 3 TDH Lift Friction Loss Syste U/ d 7-7-1 5H Ft r'A' IrG~ d ' Forcemain Length,, IDia. JlDi~t. to well S 2, IJ A SOIL ABSORPTION SYSTEM -20 : ~s0 4V- KS e w G BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/ EAM ~/ILEACHING Mapu eotur r s INFORMATION CHAMBER Type System: >-30 1 < ti~) Model Number: 17 DISTRIBUTION SYSTEM aJ/ i„t may- ! ~C a lg-,4"k irt, Header/Manifold , ID istribution Hole Size x Hole Spaci Vent o Air Intake ~O 4 e(s) q ~j ra Length Dia y Length ~V Dia Spacing ..mod SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~aer~ Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched B /Tren Center t.^ ed/Trench Edges Topsoil Yes 0 No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:- Ll / 7,0 / Inspection #2: Location: 866 Yost Drive Hudson, WI 54016 (SW 1~/4,~NW1/4 3,6/fT_299N/R19W) Cottonwood Soutthh'07 Lot 3 Parcel No: 36.29.19.3024 1.) Alt BM Description =~o? 01- ~ I`+'o- d / " a-,, 0'~v"t gv(~ ' 'yL r -~b hd~ I~ 2.) Bldg sewer length =4 G t S v~dG t vZ otx, - amount of cover = yO.2n 4~' h~~DUt o- h~ . - 14 '44- Plan revision Required? Yes No 2~ w Use other side for additional information. I cwleo; SBD-6710 (R.3/97)'Date Insepctor's ignature Cert. No. ~ I 'y PLOT PLAN PROJECT Kernon Bast ADDRESS 948 Larbarae Road Hudson Wi 54016 SW 1/4 NW 1/4s 36 /T 2 / N/R 19 W TOWN Hudson COUNTY ST. CROIX 3/30/12 4 MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL XXX IN-G U~iD 4454~RE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1230 # of chambers 60 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.7/95.4 5' below qrade 75' Property Line 94' B-3 All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. 8 B.M.* 31 B-2 3% SLope ' Vent 3 3'3; X 82' cells with>3'spacing , 108'9' A1t.B.M S. Well is to meet all B- setbacks required by o j','fr3'05 WDNR 60 10 too( B-4 w~l~ el-ev~ M2, o w V V ' Plans Designed Using 20' Conventional Powts Huffcutt Manual Version 2.0 Combo Tank Pro 4 Bedroom House 150' Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12" Grade at System Elevation 3471 Yost Dr. v Upy C01111ri •W~ g \NG Safety and Buildings Division County Y~ 201 W. Washington Ave., P.O. Box 7162 ~rmit er (to be filled in by Co.) 129 Madison, WI 53707--7162 Sanitary ~Z ent of Commerce Statc Transaction Number anitary Permit Application A In accordance with s. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for 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 secondary u ses in accordance with the Privacy Law, s. 15.04 1 (m , Stats. 1. Application Information - Please Print All information - parcel ' 5:47 JV Property Owner's Name / Property Location Property Owner's Mailing Address l Govt. Lot f 9 i Code Phone Number f L~ „d,~ /e Section City, State p cle one T_ N; R . E a - - - I . ype of Building (check all that apply) Lot It 1 Subdivision Name or 2 Family Dwelling - Number of Bedr Block # ❑ Public/Commercial - Describe Use - ❑ City of - - CSM - - h ❑ State Owned Describe Use Number Q Village of own of--=~- IlI. Type of P (Check only one box on line A. Complete line B if applicable) T A' New Syste ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner - IV. T e of PO_WTS System/Component/Device: Check all that ❑ nd > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil on-Pressurized In-Ground [I Pressurized In-Ground At-Grade ,((diYUff (~tG Holding Tank El Other Dispersal Component (explai retrea t Device (explain)-- n El ~ r - V. Dis ersal/Treatment Area Information: tpa Des~ n Flow (gpd) Design Soil Applicatti n Rate(gpdsf) Dispersal Area Required (sl) Dispersal Area Proposed (st) System Elev tion C/ 0. V 15- Y 1,::;2 1T0 .5 v VI. Tank Info Capacity in total -#-of Manufacturer a o n Gallons Gallons Units U Existin Tanks New Tanks g r U j - - g Tank Septic or Holdin- M - Dosing Chamber X 11 plansusi.ness Phone Number VII. Responsibility Statement- I, the undersigned, assum n ' lity for installation of the POWT shown S the attached • Piumb s Name (Print) Plumber' t e MP/MP Number Plumber's Address (Street, City, State, Zip Code) VII Count /Department Use Ong Date is issuin cut S' natu _ I 1 Approved ❑ Disapproved Permit Fee r ❑ Owner Given Reason for Denial $ f~.rs ~ x'11 IX. Con~►t'o~~ Approval/Reasons for DisapprovalI'4iLti~ / r SYSTEM ~W Nt ~ C n ~D 6' d uw_ 1/1'4..4 4& 1 Septic tank, effluent filter and Y+ dispersal cell must all be serviced /I lumbedr. }2( I'1 ~~G~1~ 9 ill f~ S as per management plan provided by p U !Z(.~ QT ZL~1~tiGZ(iit GZ N~I,G 2. All setback requirements must be maintained as per applicable C sins for the system and submit to the County only an pap not teas than s 02 x t t inch to sl C~~"ti'p' SBD-6398 (R. 01/07) Valid thtu 01/09 ? Q, 7. 1 G I t PLOT PLAN PROJECT Kernon Bast ADDRESS 948 Larbarae Road Hudson Wi 54016 SW 1/4 NW 1/4S 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX 3/30/12 4 BEDROOM MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 1230 # of chambers 60 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.7/95.4 5' below qrade 75' Property Line 94' B-3 All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. 8' B.M.* 31' B-2 3% SLope 6' Vents 3'3; X 82' cells with>3'spacing 108' 9' A1t.B.M Well is to meet all B-1 setbacks required by 30' WDNR ~~SN fyo 15' cti"~ p N ST IV 1 Plans Designed Using 10' Conventional Powts Manual Version 2.0 Pro 4 Bedroom House 150' Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12" 34" Grade at System Elevation " S Yost Dr. C C z c C O .2 0 w g m € .8 ° o a C I--- o g0 m V s 0 =ci 0 w A > W D z a m o _r O x v t ~ a, ~ L 9 CO CM I CZ U) m I-- %air ~m~.~ U) co noo MCMC.c 06 W _ W 0 wsa~ i;s r Q *,z CL LL. m 0~ - O 0 W LL W 0 > T) U. Z J W > c~ w w w N - z 2 C' w l~1 0°0 5 C0 F- U) w 0 U) J V Z z F- _J N Z 0 _ Z Q R o Z h o W o w Cl) a z M ~q o z ~ o W U) o v -Z p w ~ N W 0 F- z F- a ~ ~o W o U. -J I- U- j% m M w ~ W ~Z O-:2 -j w m~ Z a _ -o .10LuZ 0 0. F- Q CA 104x0.8 I - - - x l I o_ ~4 I X 104218 I x 84.E I _ X NG PIT DEPTH 15' _ 1065.7 •ILTRATION POND ® 1 BORING PR DEPTH 15' 4 I INFILTRATION POND 10 .6 HWL=1048.00 x ` 101 sq. ft ``{yg7--'32"E 97.47' 4. 4 AC. x 'era x 1065. )50. o1048.:~p 1 3 x`\\105 2.00 ACr 7125 s ft N ► a 87 sq. s C.B.A. = 1 AC. 2.00 LBO=1 0.00 871 sq B.A. = 1.1 AC. a, L =1050.00; B. =2 AC. N t T 1066.7 1 1 IN t 1p x 9i ~p 0 1 1 Z Ot ' i 0 I2aE ` - BAST ROAD- 37 - - - 201.89' ( i b )U OT 1 1067.1 Z 73 AC 1069.1 x t "909 SQ. ET. x 1 72.9 a~ 0 Q N x 8 7 1071.6 3.27 Acres 142341 sq. ft Q 2.00 Acres C~y A.= 4.0 AC. 87125 sq. 2.00 A ft 150.00' 1074 C.B.A. = 2.0 AC. 8 sq A.= 2.0 stand a -rd.' r _ Frostorrol r for T &.2 Panly DwellIng Construction Sites. According to Chapters'ILHR 20 fay 21 of;the Wisconsin Uniform Dweiling bode, soil erosion control information needs to be irtcluded.b the plot'pian vvhlch is submitted and a roved nor pp p to the issuance of building perrTiits for 1-.&r 2 family dwellirig°units;:in tho$e. jurisdi ctions where the soil erosion control provisions of the Uniform Dwelling Code: are enforced This Standard Erosion Control Plan is provided #o assist in, meeting tFis requirement Instructions: 1. ,Complete this plan by fllimg.in -requested infarmation, completing the site dlag~arnand marking appropriate boxes on the inside of** tkiis form:: 2. !n completing the site dlagratti, glue consideration to potential erasion That ma occur before, dunng, and -after grading. Waterrrunpff atterns,can.chan sigrn ' ge . ficantiy as asite is reshaped:; .3. Submit this plan at the tlme'gf bullding perrrtit application. PROJECT LOCATION 111* 3 w0 So.11i~ q ~ ~ P 'BUILDER A~4 leaseindiCate north ER 4&w e. ,Wi' by OOPleting the arrow WORKSHEET COMPLETED DATE 3/ loll • N Scale- 1Inch . feet I 7 177., 97. ERO$ION CONTROL PLAN LEGEND , PROPERTY LINE., : EXISTING . . DRAINAGE : _ TD TEMPORARY DIVERSION-...;; FINISHED. DRAINAGE . LIMITS OF .;.GRADING SILT FENCE 1►•-i--.~. STRAW SALES... • GRAVEL VEGETATION O SPECIFICATION . TREE.'.. PRESERVATtobi . . OILSTOCKPILED. i W m EROSION CONTROL PLAN CHECKLIST o u a Check (rte appropriate boxes below, '.compete the site diagram with, necessary information.: R1. Q Z Site Characteristics North arrow, sca ite bountlary. ,Indicate.and name adjacentstreets'or roadways ~7 O Location odraina eV1+ s reams, triers, lakes, wetlands.:orwelis, D Location ofatorm sewer inlets.. Location of existing and; proposed br~fidfngs and paved areas; The disturbed. area on the lot. Approximate gradient and direction o.:slopes. before grading ©perglons Approximate gradient and direction of slopes after grading operations ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas, Erosion :Control 'Practices d.f l~ O Location of temporary soil storage piles. Note: 5oll storage piles should be'placed behind a. sediment fence, a.:10 foot wide vegetative strip; or should be covered,.with. a tarp .or more`than. 25 feet from any downslope road or drainageway. Location of access dri(s ve . . } Note: Access drive should have 2 to 3*'inch aggregate stone laid at least? feet wide and 6 inches.thlck. Dnves should 'extend_frorn the roadway 50.. feet or.to.the . ' house foundation (whichever is less) D L~ Location of sediment controls (filter fabric fence straw, bale fence or 10406t wide: . vegetative strip) that wilf prevent eroded soil. from leaving the site O Location of sediment.barriers"around on=site storm sewer Inlets. ❑ Location .of diversions. Note: Although. not specifically" required by code; it is :recommended that ebhben trated flow (drainageways) be diverted (re4nkted) around d►sturbed areas Overland runoff,(sheet flow)fro'm adjacent.areas greaterthan 10,o00.sq;.ft should also :be diverted around disturbed .areas: O Location of practices that will be applie .to control erosion on. steep slopes (greater than 12% grade). Note: Such practices -cl i . ude maintaining,dxistJng;vegetattan; placement-of additional sediment fences, diversions, and re-vegetation by.sodd1 g or seeding: wittth use of erosion control gnats. O Location of practices that will control erosion on'areas of coricentrated runoff flow Note: Unstabilized drainageways; ditches, diversions, and Inlets should be protected from erosion through uscof such practices as In-channel fabric orstraw'bale barriers, erosion control mats, staked sod, and.rock. "p. - When used, a given in-channel barrI& should not receive. drainage from more; than two acres of unpaved area; or one. acre of paved area. in-channel. practices should 6 of ennial ot be, . pen stre in ams (streams with 'year round flow) O Location of other planned practices not already noted. m Q Q U r.. W Indicate manegernent stmt a . egy: by checking (se). the approprla e box, . J I.. . A. Q 0 a nagement u z St~raitegies O I~ Temporary stabilization. of disturbed areas i Note. It is ,recommended that disturbed areas and soli plies left ma ve for extended periods of time be stabilized byseeding.(be.tween April.'1 and September 15), or by other cover, such as tarping or mulching: Permanent stabilization of site ya by re-vegetation or other means ai soon `as possible (lawn establishment). • Indicate re vegetation method 1.4 Seed: C3 Sod C3 Other • Expected. date of permanent re-vegetation: Re, vegetation responsibility of I Z Builder ❑ .C)wrrer/buyer • Is temporary seeding. or mulching planned if site is not!seeded by Sept. 15 ar sodded: by Nov 1ST Yes,. O No O Use of downspout and/or. sump pump outlet extensions.` Note: It is recommended that flow from downspouts and sump pump outlets.be routed through piastic,dralhage pipe to stable areas such as established sod or pavement: . O Trapping sediment during.de-watering operations. . Note: Sediment laden discharge water from pumping operations should be ponded behind `a sediment barrier until most`of the sediment settles out.. Proper disposal of building matenal waste so that pollutants and I'debiris are not. carried - off-site bywind or water . Maintenance of erosion control practices • Sediment will bexemoved from behind sediment fences and barriers: before it.reaches a depth that is e, ual.to half the height, f the:bani"I • Breaks. and gaps in sediment fences and barriers will bed repaired .Irnme- diately Decomposing straw bales will be replaced .(typical bale life is three months). • All sediment that moves off4te due to construction activity will be. cleaned up before fihe. end, of the. some. workday... • All sediment that moves off--site. due to:storm. events.will be.deaned.up before the end of the next workday:: • Access drives will be:maintained throughout construction. li • All installed erosion control practices will `be. maintained until the disturbed areasthey protect are stabilized.:. For more assistance on plan preparation, refer to the Wisconsin Uniform Dwelling Code; the NR lNiscoiasln Construction Site Best Management Handbook, and UW-Extension publication Erosfan Control for Home Builders. The Wisconsin Uniform Dwellirg Code and the, Wisic6nsln.6nstructfon Site Best Managem ent Handbook are available through the State of Wisconsin Document Safes; (608)266-3558: Erosion Control for Home Builders (GWQ001.) can be ordered thro ugh Extension Publlcatlpns, (608j 262: 3346 of the Department of Commerce, (608).267-4405: 4 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 3/6/12 Owner: Kernon Bast Location: SW1/4 NW1/4 S36 T29 N,R19W 866 Yost Dr. Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-5. Maintanance and Conti gency Plan 6. Filter Specifications Sh e Signature i License number #2 1900 PLOT PLAN PROJECT Kernon Bast ADDRESS 948 Larbarae Road Hudson Wi 54016 SW 1/4 NW 1/4s 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/30/12 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 1230 # of chambers 60 66 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.7/95.4 5' below qrade 75' Property Line 94' B-3 All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. 8' B.M.* 31' B-2 3% SLope 6' Vents 3'3; X 82' cells with >3'spacing 108' 9' A1t.B.M Well is to meet all B-1 setbacks required by 30' WDNR ~~SH 60' k, B-4 15 ST G> 5Awe 1) Plans Designed Using 10' Conventional Powts Manual Version 2.0 Pro 4 Bedroom House 150' Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps r4'Long 12" 34" Grade at System Elevation 5 Yost Dr. Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 10.1ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 100.0 Vent Grade Vent 4' 4" 4' i~30/34 Septic Tank 4' Long 1 5 4 Long Grade at System Elevation 3 4" Grade at System Elevation 3499 Spacing 5' 3-3' X 82' Cells Observation tubeNent Same on other end To be located on end of Cells A B System elevations: C A_96.0 B 95.7 20 chambers per cell C__95.4 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C ency Plan Option #1 f system fails, determine cause of failure, use alternate area and install new system in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 KO CJD, _...-r___- --J b, VIO~ t`s~.U en N J Li OD - ( A 4 m I. R 11 m 1. ~ r --1 l~ ~Z n Q ~ rn o m a c off., ~ ! J ~ 7.. S1 'O.M SEPTIC TART : 4AINT AGIEEM ENT AND-. 0)ANfi ; ~I F' CMRT$FtCA'.l`IQN POI! Ownw/Bu er Mailing Address Property Address g Drtnseat VOW Cityfstare N(ID,Saw I W_ IS CAnfs,(n1 Parcel Iclmfificadon xumbt N 7 J M GAL D] CR1fM Property Location Scu tf4 T. ~i:,'Qwn of ,tS~ Subdtvision - Lot # Certified Survey Map Vale , Page # 'Wairrenty Deed # ~f Voluiue 7 ~l ,Page 1' to Spec use ..,.ee.. hot Sines &Wif ile M MARN► 04 Improper use and maim of your septie 811Eem co. c' 1' t'i its prei #~aif to is 3le asfies. PYopcx . n?SIttteDB CC cbn5;StS ~ ow the Sept G:tank -very ~ yean Or. CT: if needed,. by a lkez*ed -'What You pu't into ttit syste w can affect the function'of ttw septic tank as a tietitracit ~ thtt araste diVOW system: Owner maintenance responsibilities are specifwd'iti §C 52(I? sitd iu t 12 -St. tit County SWiitnry. Ordhma. The property owner agrees bo,'s3ibxnit :lo g Croix Cowity Fia3ittg. & Zoning 7epzfrtinx t a Certification form; sigrcd by the awtter and by a aster plumbez; l y plurnber restricted plumber or a hoensed puroper ven y xig that 1 j. the nn=site.. Yastewfter disposal system is in.proper operiting, COnd1 i *;*U&*r (2-)'ft ins tion Md pUnIping (if nwessary);. the wp.& tank is iess than 1/3 full of sludge. Uwe, the undersigned ha vedead the :above rec}uir$ments t a to Vaibtafnt the pinata sewn- disposal systeriri evith tF stxhdaros set forth, h=4 n, `asset by t1tc.Dcpartirteatt bf ~:b eite grid tie of N. Outral Rte; Stare of Wiscc nsitt Certification stating that your seoc system has been stained nod :be con*laed and revmwd to the St. Craws' County:P.lmdng Zoning.Depamnert within 30 days. of the.dwee,yeafeVi;atiorrdaEe: 'l/we certify that all stateramts au this forware !WOAa.tho best of my/our knowledge. 1"We aware the oWner(s) of "be . property describeda. , by virtue. of a vvazra?tt/ deti i+ecoriled itt Kagis of Deeds:Cce. ;N"ver ort AA A OF APPLICANT(S) DATE ~,,_,/**Any. information that is misrVrment d May rat iii:the savitaty pecttut bed revoked bv'the F3araWng .7,on* Deparlsrterat. 14611 de'wittt this application a rEcorded vian' 'Way de+:d Evora the ltegi9te of Dft& Office- dad a oispy of the certified survey imp F, reference js made in tree warrauty,deed. Wisconsin Department of SOIL EVALUATION Page f/ of Division of Safety and .r rdan with Comm 85, Wis. Adm. Code r Attach comple site plan on p ~bt as 1 inches in size. Plan must include, but not ited to: veal d ence point (BM), direction and Parcel I.D. 2 percent slope, sca or dim ion rd location and distance to nearest road. - -7 - Q - J % pi ®S~i~ all information. R 'ew Date Personal information \ y provi used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot~5bj 1/4S[ 1/4 S 3 4T N R E (or Gw Prog" Owner's Mailing Address Lot # Block # Subd. Name or CSM# g 44~ 3 c / 1-3 4 /2)' City State Zip C e Phone Number O city ❑ Village RLTown Nearest Road Sol ( ) New Construction Llse~EdResidential / Number of bedrooms Code derived design flow rate G G GPD ❑ Replacement ❑ Pub'c or commercial - Describe: Parent material (cJ~ cl i✓ Flood Plain elevation if applicable General comments cyr System Type System Elevation / 2 /91r, Boring # ❑ Boring Pit Ground surface elev. e) ~ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 312- (4 Ds 17 / <S v 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 50 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L Effluent #1 = BOD > 30 1220 nxyL and TSS >30 11 CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 a~o~ Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~~p _ 715-246-4516 ppppr- Property Owner _ Parcel ID # Page of Boring # ❑ Boring F-1 ❑ 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 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil lication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD3 130 mg/L 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-8330 (8.6/00) 01 83 4 lot DRAINAGE _ ` °--.2, A EASEMENT 2.02 Acres 66.7 88,010 SQ. FT. LBO=1050.00 N87'45'22'E cl~ C14 2.00 Acres 87,125 SO. FT. ~E . ~ SSS°26'18•~ 388,01' ~ ~ . 153,47' 2,00 Acres 'Rio 87,125 SQ. FT. !.S® =1{750,00 2,25 Acres. v 98,137 Std, FT w1c 4 0 ! -y LV a. ~S 151 TOP OF FjEaAn _.tfltA7dQf+i~ 1057,96 • a..,~.., •,,,,a•,.a.e,,, 189.43- i t 3 .~sy[y w 7d.3d' 199. • . a, 9 52 SSE 135.00' S8 TL T 0,73 ACRES 31,909 Sta. FT. b Wisconsin SOIL EVALUATION REPORT ~ A -1 3) #1989 • Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel LD. Please print all information. Rev' ed By Date Personal information you provide may be u ed for aes~gA~1~t11c5 flYivacy w, s. 15.04 (1) (m)). /`11 1 Property Owner ICC~iG~ V CLJ Property Location Bast, Kernon ovt. Lot na SW1/, SE1/4, S36, T29N, R19W Property Owner's Mailing Address of # Block # Subd. Name or CSM# 948 Labarge Rd. 3 na Cottonwood Ridge South City State ip Co e' one Number ❑ City ❑ Village ❑ Town Nearest Road Hudson WI 54016 15-386-7775 Hudson Cty Rd N New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material Silty sediment and underlying reddish sandy loam till Flood plain elevation, if applicable na ft. General comments At Grade or Mound design, sytstem elevation 100.50ft based on cont~ur line elevation 100.00ft. and re me ations: L41iz 11171a ` t a ' 17 is . (7 C7 i L ~ _ t Gi I - 4Lc /t (cam, ` ci dQ. ❑ Boring # ❑ Boring D61(L ❑ Pit Ground surface elev. 100.00 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Efr#2 1 0-10 10yr3/2 none sil 2msbk mfr cs lvf .6 .8 2 10-31 10yr4/4 none scl 2msbk mfr cs na .4 .6 3 31-110 7.5yr4/6 none Is osg mvfr na na .7 1.6 Fil Boring # ❑ Boring ❑ Pit Ground surface elev. 100.00 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-16 10yr3/2 none sil 2msbk mfr cs ivf .6 .8 2 16-47 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 47-110 7.5yr4/4 none is/Cos osg mvfr na na 7 1.6 Horizon #3 is wet. * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <-30 mg/L CST Name (Please Print) Signatur CST Number David J. Steel ~92 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/10/2006 715-760-0347 SBD-8330 (R.07/00) Property Owner Bast, Kernon Parcel ID # Pending Page 2 of 3 M Boring # ❑ Boring Pit Ground surface elev. 98.30 ft. Depth to limiting factor 54 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 10-24 10yr4/4 none Sid 2msbk mfr cs na .4 .6 3 24-54 7.5yr4/4 none sl om na gw na .2 .6 4 54-96 5yr4/4 c2d 7.5yr4/6 sl/scl om na cs na .0 .0 5 96-110 7.5yr4/6 none cos osg mvfr na na .7 1.6 F-] ~2`'l.~c.~r ❑ Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limitin f g acttSr in. Soil Application Rate Horizon Depth Dominant Color cri tion Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell r. Sz. Sh. *Eff#1 *Eff#2 dk i N' IYU:: ❑ Boring ❑ Boring # Pit Mg factor in. ❑ Soil Application Rate Horizon Depth Dominant sistence Boundary Roots GPD/ft2 in. Munse *Eff#1 *Eff#2 MMM a An F k' * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BODS < 30 mg/L 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-8330 (R.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Kemon Bast 994 200t' St. CST-POWTSM SW1/4,SE1/4,S36,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Cottonwood Ridge South, Lot 3 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be s shown, as permanent lot lines were not established at the time the soil test was conducted. : 3b~~ Legend N 1"=40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ =Borings Boring Elevations 1 = 100.00 ft 36 B2 = 100.00 ft B3 = 98.30 ft B4 = 0.00 ft I~ I Q-Ijc~4- v 3 7o wPs ~ - l III 1320 000 FEET R. 19 W-1 R. 18 W. a ^r I ~s .t t o° 0 v t •i z Ql N F- s~ d m M Y F Y~ ~ F { N O j N BXC2 ~ P,. ~ R p. S Pr U 2 7 3 9 P 3 1 6 '7 8(=-s 1 003 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/28/2005 03:15PH WARRANTY DEED THIS DEED, made between Neil L. Wilcoxson and Mary Jo EXEMPT # Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer-Bast, husband and wife, Grantee. REC FEE: 13.00 TRANS FEE: Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE: 4212.90 the following described real estate in St. Croix County, State of Wisconsin. CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title, Inc. 400S.2 nd St. - Suite I IS Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights-of-way of record, if any. 456780 020-1109-10-050 020-1110-30-000... 020-1109-55-050 Parcel Identification Number (PIN) This is not homestead property. Dated this 28 y of January, 2005. ~/'//Y Il L. Wi cox * Mary Jo i oxson AUTHENTICA.q N) pUb~1C ACKNOWLEDGMENT ay t ~ Signature(s) ~L,t C ~i STATE OF WISCONSIN ) Cyte, 'T ST. CROIX COUNTY. )Ss. ~ authenticated this 28th day of January, 2005 Personally came before me this January 28, 2005 the above named Neil L. Wilcoxson and Mary { Jo Wilcoxson, * { husband and wife to me known to be the person(s) who TITLE: MEMBER STATE BAR OF WISCONSIN execut the foregoing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Cherl Town Notary Public, State of Wisconsin Peterson, Fram & Bergman - Steven H. Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 55101 3111/2007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names ofpersons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 U 2 7 3 9 P 317 EXHIBIT A Parcel l: A parcel of land located in part of the SW of the NW '/4 and part of the NW '/4 of the SW '/4 of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; more particularly described as follows: Beginning at the W '/4 comer of said section 36; thence N00° 16' 10"E, along the west line of the NW '/4 of said section, 1248.49 feet to the north line of Lot 1 of Certified Survey Map recorded in Volume 3, page 669 at the St. Croix County Register of Deeds Office; thence N63°02'59"E 148.42 feet to the north line of said SW '/4 of the NW '/4; thence N89°26'58"E, along said north line, 1182.70 feet to the east line of said SW '/4 of the NW '/4; thence S00°2 1'37"W, along said east line, 350.04 feet to the north line of Lot 73 of the Plat of Cottonwood Ridge First Addition recorded at said office; thence S89°26'58"W, along said north line, 10.00 feet to the west line of said plat; thence S00°27'24"W, along said west line, 2096.76 feet to the centerline of County Trunk Highway "N" and a point on a 1999.00 foot radius curve, concave southerly, whose central angle measures 7°10'30", whose chord bears N84°30'4 1"W and measures 250.16 feet; thence westerly, along the are of said curve and said centerline, 250.33 feet to the point of tangency; thence N88°05'56"W, along said centerline, 83.64 feet to the point of curvature of a 2700.00 foot radius curve, concave northerly; whose central angel measures 3°17'53", whose chord bears N86126'59.5"W and measures 155.40 feet; thence westerly, along the arc of said curve and said centerline, 155.42 feet; thence N04°29'56"E 244.01 feet to the point of curvature of a 167.00 foot radius, concave westerly, whose central angle measures 34°24'12", whose chord bears N12°42'10"W and measures 98.78 feet; thence northerly, along the arc of said curve, 100.28 feet to the point of tangency; thence N29'54'1 6"W 274.22 feet to the easterly extension of the north line of Lot 1 of Certified Survey Map recorded in Volume 12, page 3456 at said office; thence N89" 12'45"W, along said easterly extension, along said north line, and along the westerly extension of said north line, 670.44 feet to the west line of the SW ''/4 of said section; thence N00°37'50"E, along said west line, 496.89 feet to the point of beginning. AND Parcel 2: A parcel of land located in part of the SW '/4 of the SE '/4 of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; described as follows: Beginning at the South '/4 Corner of said Section 36; thence N00°27'05"E, along the north-south '/4 line of said section, 1216.78 feet to the centerline of County Trunk Highway "N"; thence S76°47'47"E, along said centerline, 1354.82 feet to the east line of said SW Y. of the SE '/4; thence SO0°07'02"W, along said east line, 897.02 feet to the south line of the SE '/a; thence S89°33'25"W, along said south line, 1326.80 feet to the point of beginning. e ~ ' 1-3 M. O Z' n y H 7 0.: ® Do 00-1 z mom:.^-.. ; ' ' , m~ 4„a l - w.: O' a~ ~ a 1'.8 1/4" o BUILDER: SPEER-BAST CONSTRUCTION RR3'183oNS ++orE coxrpncrorrowNRRmveu:wncc:vwuwor AU.. ' B UI'LDERs B&OURCE. GROUP MATRR:A48pNCIp CAMON&DWRNR ON&OIWONBANOMRAM y tAr > APYWGRW]0006'CONPWWCR'(D LOCAL CODR6. 0+ PH y bBY'THE126'S(/L15 YOU RXPBCYW.WW.BROROf1164M. CON DD MERA RAROUAOR OROUp w NOr RRRpONtlll„41i phR M'r [a n PROJECT; "The Braden 8" ' foB NAOBNDRNB PHON671&d99-498! • 611SOM DR INCORRUT:NRORNA•nnu• ' OVIIDRRR RRMURO60ROUp OWNA AW. N1aNr8ANU CAIPYRIONTN WOOD VILLS: Wl.$078 F'.UD V15d88A707 PUILD9 KWU ANr DV IGTIONe OprN1A ORAWINO IR IIA,RWI. I .,68:.8.,. ..z',a• .22'8, 6'•6" 19'.0»` 1'•161/2"4'.7 /2"' 4'•81/$" 9'•31/2". 6 y d&§ m d- c om pl w~ mgao 3? x x Q. 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