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HomeMy WebLinkAbout010-1053-60-100 STC - 104'. AS BUILT SANITARY SYSTEM REPORT' OWNER ADDRESS- e-1 1~y1 C' r^r`~ / r ~0 SUBDIVISION CSM# LOT' SECTION J T -ION-R _jW, Town of ert~ d ST. CROIX COUNTY, WISCONSIN PLAN VIEW Al SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM c.f ~ ,9r U • t' ~v s S ~ I `ti I C, j • f INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. t _ BENCHMARK: 0 i' 'ALTERNATE BM SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: 1Cce.-,, Setback from: Well Alb,-v House Otheerry Pump: Manufacturer Zp CIle~v _ _ Model4 ld Size Float seperation Gallons/cycle: ' Alarm Location SOIL ABSORPTION SYSTEM Width: Length IN' Number of trenches Distance & Direction to nearest prop. line: co 5f ~/$`Setback from: well: AA4* House s~ Other -fl-, `,nti t- d, ELEVATIONS G (4;4, Fusilding Sewer 9,o ST Inlet. ST outlet PC inlet PC bottom Z Pump Off Tuh Header/Manifold ~s Bottom of system Existing Grade Final grade DATE OF INSTALLATION: 2, r 5, ` ye C:~`~ ~So PLUMBER ON JOB: R -,k LICENSE NUMBER: ,.3 INSPECTOR: A Z 3/93:jt n Department of Industry, PRIVATE SEWAGE SYSTEM County: .HLonan Relations sad,Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: StatePIAMP7 DITTMAN, GENE X CST BM Elev.: Insp. BM Elev.: BM Description: Efaer aid Parcel Tax No.: &4,, - A9490356 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark p pZ' dd t Dosing C' ovr, r •'o~- y sco © U Aerati - Bldg. Sewer 0a / H St/IA Inlet 7,~ TANK SETBACK INFORMATION St/yIt Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom 8d1 Dosing " n NA 4Man. I I Aeration NA Dist. Pipe 97, Hold' - Bot. System PUMP/ SWOM INFORMATION Final Grade Manufacturer I =Z ~P r a emand Model Number # _0 TDH Lift 8 Lrictiono 0' System .5D' TDH Ft Forcemain Length q6 r Dia. Dist. To Wel `f SOIL ABSORPTION' SYSTEM BED/TRENCH Width Length ' No. Of Trenches PIT Of its Inside Dia. Liquid Depth DIMENSIONS 25-/ DIM N 1 N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING =:Fr INFORMATION Type >7 ~ CHAMBER Mode Num eSystem: tKc l~v - J`S O ~4- OR DISTRIBUTION SYSTEM M mtter / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake ,Ilk Length Di Length a Dia. Spacing / el ? CP~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over r Depth Over r xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil es ❑ No (3-Yers- ❑ No COMMENTS: (Include code discrepancies, persons present, etc.)-offs-~-`J LOCATION: Emerald.23 30.16W, NW, NW, Lot 1r County Road G 02 CJJnCI iv f7 t' ;ci r / ) / r ; Ilan revision required? ❑ Yes 9_1KI0 'Use other side for additional information. 1// Al 191 SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No. ~u ~ ~ ~ ~a'co ~.o~,,l✓G~~-'-~ f-~, ~.~2.~~~r~-nc% ova-r - L~~,.a ~ ~ r~~ ~ a!r• , z_ ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' i SANITARY PERMIT APPLICATION COUNTY ILHR In accord with ILHR 83.05, Wis. Adm. Code-- Crv env STATE SA ARY MIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% X 11 inches In size. Check if revision to~-,Zapplicatlon -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S 13, y- o S 0 / PROPERTY OWNER PROPERTY LOCATION U ei, e 0 NL,1Y441t_. 4, S TJc! , N, R Id -E`W)V PROPERTY OWNER'S MAILING ADDRESS LOT # / BLOCK # 0!lrc~ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER A . 5-Y 00 Sc i h -J Vru is SA .2 D ~ S 9 II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILTMLAGE NEARES ROAD I~ C c-rte, C C- T R GL ❑ Public lL` 1 or 2 Fam. Dwelling-# of bedrooms ~ PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) a it) - 0 5 3 (6 -/Q 0 1 ❑ Apt/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 in line A. Check line B if applicable) A) 1. ~ fdew 2. ❑ Replacement 3. ❑ Replacement of 411 Reconnection of 5.E1 Repair of an System System . Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 jig-Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 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 71)1--" 7 7r Z_ Feet 5:f- -Feet VII. TANK CAPACITY Site in al Ions Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed F] I F1 F] Septic Tank or Holdin Tank / ' tl Lift Pump Tank/Si hon Chamber S fir! C: d G VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MPRSW No.: Business Phone Number: pi, _4c,t ( C`• 'z>'Cs ham' - C 3 Plumber's Address (Street, City, State, Zip Code): td / 0 s c4 6 )56" e:::-, IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sani ry Permit Fee (Includes Groundwater ate Issued Issuing Agen ps pproved ❑ Owner Given Initial Surcharge Fee) /v- 7- / Adverse Determination ~~CCJJ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: ai r 17 tf, 0 V SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1_.._ A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time cf renew/ai any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to'Uhis permit must be approved by the permit issuing author:Ey. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer,'neinowal Fcrr 6399) to be submitted to the junty prior to installation. 5. Onsite sewage -stems must be propel. y maintained. The -,epfi, tank(s) rri,. st he p._r; r,~ , a licensed pumper °°~~rhr r e,r~,r necessary, usually every 2 to 3 years. 6. If you have questions concerning your ohsite sewage system, contact your ocal .:c•de add inistrator or the State of Wisconsin, Safety..,& Buildings Division, 608-266-3815. To be complete and &ccurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description acid parc~-l ax number(s) of where the syatertl-is to be instaltea.', II. Type of building being served. Check only one and complete # of bedrooms i!' 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete ine B if permit is for tank replacement, ,'aconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list tfrw total gallons, umber of tanks and manufacturer's name. Indicate prefab or site constructed and tank +naterial. Gorir. ete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if ':arks 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 3'f x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complets dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers. wel!:7.; water mains'rrater service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption >ystems; repla(*rnent system areas; and the location of the building served; B) horizontal and vertica ~1lewltion reference l2oints; C) complete specifications for pumps and controls; close volume; elevation differencES; triction 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 nurn-ber o' regulated practices which can effect groundwater. The monies collected through these su charges are 7.,rer! for monitoring gro,+r clv ,ter. ;-lr.-mc, water contamination investigaboos anti establishnicr-; of stan,iards. SBD-6398 (R.11/88) SAFETY & BUILDINGS DIVISION i State of Wisconsin Department of Industry, Labor and Human Relations September 15, 1994 209 West First Street Route 8, Box 8072 Hayward WI 54843 WILSON PLUMBING 410 HWY 46 AMERY WI 54001 RE: PLAN S94-20901 FEE RECEIVED: 180.00 DITIMAN, GENE NW,NW,23,30,16W 70M OF EMERALD COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters IL,HR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, Stanley E. Davies, Jr. Plan Examiner Sections of General Plumbing/Private Sewage (715) 634-3026 7:45 A.M. to 4:30 P.M. 6083R/ 1 880.64331 R. 01/91) Vr 1 It)NAL WUKII,nGG 1 1. • MOUND SYS EL'M II. IN-GROUND PRESSURE SYSTEM-Continued- Wastewater Load, Total Daily Flow ■ SO tai- 10. Forts Main: P 4 • Use s. MR 83.15 (3) (c) Minimum Do6U1g Rate's !{Pete-, Adm. Code and PROVIDE A DETAILED Diameter in. LIST OF SIZING ON PLANS. .21 8 3 11. Total Dynamic Head: 2. Depth to Limiting Factor ■ iL System head • 2.S 3. Landslope = ~-7- R Vertical Lift ■ tt 4. Distance from Dose Chamber to • % Friction Loss • . yo r, tiJ'L = fl O YL TDH • or 1 Distribution System • S. Elevation Difference Between 17. Pump Selection: Pump and Distrlbutlos System • . / IL Pump solo Olscharp at Mast ..~.~3~ {pm 6.. Absorption Area Sking: at Pump /-l 1 ft. w dynamic hsad•Zv~ Area Required ■ N• It. ~ ' *s0w 1GWidth (A) • It• 13. Dose Volume: Trench Spacing (C) • It. 10 Times void Volume of 8 y 6 y 7. Mound Height: Distribution Lims pl. ' Fill Depth (D) II' Daily Wastewater Vokufle + • ~s'~JE) , Dep3b • 1,009, fL 4 Doses In 24 ha. • Fill or tM& wnslope F) a .7 9' IL Backl1ow • ~ Camp and Topsoil eDepth (G) ■ ~j fL Minimum Dote • ..s.i. .~r gal. Cap and Topsoil Depth (H) • ~.1.J+i.. to, 14. Dose Chamber. g. Mound Length: Vaium • do giL End Slope (K) • 1t• Total Mound Length (L) • ~ ft. 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound width: 1. wastewater Load. Tow Dally Flew • gal. UpslopsCorroctimFmAw - Use s. ILHR 83.15 (3)(c), Win. Upslope Width • Adm. Cods ad PROVIDE DETAILED • ..moo Downsiops Correction Facto► LIST OFQZING ON PLANS. • Downslope Width (1) • :'L IL 2. Required Septic Task CalowAy • pl. Total Mound Width (W) ■ s3.~ IL 3. Percolation Rate • CIA 10. Basal a1 Ana: 4. Absorption Ana Skin. Ana: Capacity Refer to Table 2 in cb. ILHR 83 of -.3 Natural Soil iN•/M•hlday and PROVIDE A DETAILED LIST OF Basal Area Required • s 14. IL SIZING ON PLANS. Basal Arse Available • /'rO 84. IL Required Ana • q• IL 11. If Standard Tables from Chapter jLHR 83 Length • It. are used, Indicate Table # Width • It. 12. For the Distribution Netwwk. UW Nwmbers S•141n Sectlom 11. Number of Trenches • Trench Spadog • IL It. IN-GROUND PRESSURE SYSTEM S. Distribution System: 1. Depth to Limiting FWW • to. Lateral Length ■ • IL >r Number of Laterals 2. Latsdslope • • _ its. 3. Percolation Rate ■ mb.lle. pMpncSpaacciinn Sidewall to rip • M. 4. Proposed System Elevation • ft. S. Wastewater Load. Total Dal flow' gal. System Elevation ■ IL Use S. ILHR 83.1 (3)(c), Wis Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL LIST OF SIZING Oy?LANS. FUI in All Items Ilmni Section 111, Required Sepik Tank Capacity • 5111' V. SEPTIC TANK 6. Absorption Area SkbV: Percolation Rate • min4in. 1. Capacity ■ gN• Area Required ■ p. IL Y. Manufacturer. System Length • ft. 3. Show Site Constructed Tank Dowbelo PMtt Syaem Width ■ It• 7. Distribution Pipe Siting: VI. DOSING TANK Hole ills • in. 1, Capacity • PL Hula Spacial • fl. 4. Manufacturer: Lalutal Letgph • fl. 3. Pump Mrnul.wtunu. LAMA Site In. 4. Pump Mrxlol: Lateral %prcirgt It. S. Operatins Heads Ui.lance bout %Wwall Ill I'low ..~.erZ Its. d. f low 111416 a gpltU'r' X. Distrihution Pipe Discharole Rate: 7. Show Site Constructed Tank Details ell Plan Number ul I hilts Per Plpr :11L I I luw Per P6IK' 4(, 0 gpm. VU. IIOLDING 'TANK r). ' Manilow Sillmlt: 1. Capacity • PL C e T r 2. MNwlacturer: 7 vIw (center or stmt) Length • It. 3. Show Sits Constructed Tank Details on Pine Diameter • In. -SNOW ALL INFORMATION ON PLANS- 9 -20901 00 I ~~CG . 91 ~ ~ ~ b 4 p~~Pq~BOq d` zo Fryq ~ F Sac. 23 S4 s /00 st th view* It- Ntdyy SA 3ON 14 0 Z 9 4~ 133 q s. S 01 o u 55,7 Lil ~o, ieO~/s° w` crcrr .~N 00 40 4, 10 V . Q t,,,~ r► e r t 100" GO L j,- l roe `~z ~~k~ o.Trw,ah C,Ip it Sr"rk¢ ~41.~ W. • r~~~.) 6 -:aoo ~C V pr~u~we.l er PC..it w( w r if f ta IN N &J I/~ Se- C dot To w a S L% p I' ~Ol Q11G Sr.`ir0~~-- Cow., 'r, Cry . ?al. G SCQ lc' 594-20901 Straw, Marsh May* Or synthetic covering Distribution Pipe 01. Medium S H G WILia Topsoil - " F D ' 3 yorci Main :Plowed Layer a. t Slope Bad of lj"- SW Aggregate Cross Section o! a mound System using ~ D_ 1~,~ t• 4Tr.,,&For The Absorption Area $ I o Ft. t .7 A .Y G • g~Ft. ,t ml~rt. Signed: L L'.--J A+•. L---~"^" 0 --fto J I _ License p~ • .N..$-----Ft. PLUPd163iNG 2 • ~ • W~Ft. Date:_ O. ALLI.nQ® Cond`t~ y ROVED APP 0 L✓ h e r - G e h t 0 ' rT DEPT. OF IN TRY, LABOR, i HUMAN RELATIONS DIV OF SAFETY AND BUILDINGS For" Main .I L • 1 Observation Pipe loooow~ftw Oil A w~~N~~~•~•~ wonow "-2~" • Distribution Pipe of 'Aggregate Observation penent mtarker 2 "oo I 11" virw Of NOLIi1d using aTia~t~ iTOt the AbM0ilow n Arms IJ~.~ ~.i►Ve7 0 1. 4 PERFORATED PIPE DETAIL and , DISTRIBUTION PIPE LAYOUT Perforated Schedule 40 PVC Pipe End. Cap ' ~aprC, e \ 4 ~asy + era i Holes Located On Bottom Are Equally Spaced , k End Gap W 4 Schedule 40 PVC Force Main Last Hole \ Should Be Next To End Cap Owner's Name: hr~,, A TTw.~.., p 9% feet Plumber/designer's Signature: x _z/7 inches y/ inches Date: - / - g License No.: /*P 9.3k e Hole Diameter inch Lateral Diameter inch(es) Force Main Diameter Z_ inches PLUMBING I,'Z-_ Holes per Lateral OI't ~`601ZR1~>~ 9 Y, feet. Invert Elevation' of Laterals A P, K or, f4) mPo"OVED DEPT. OF INCU Y, LABOR, & HUMAN RELATIONS DlVIS SAFETY AND BUILDINGS tS94- 209 01 • Page of 1 • SEPTIC TANK 8_PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE 8 WEATHER PROOF 25' FROM. DOOR, WINDOW OR JUNCTION BOX APPROVED TH CONDUIT MANHOLE COVER FINISHED GRADE 4" CI RISER W/ PADLOCK 8 6" MIN - WARNING LABEL . FRESH AIR INTAKE )GAS- ABOVE G BADE ------4" MIN. 18" IN. 6" MAX. INLET s► TIGHTi I `WATER TIGHT SEALS 4" BAFFLE A SEAL i APPROVED CI PIPE , ALM JOINTS W/ CI 3' ONTO W1131NQ B s 1 ON PIPE 31 ONTO s , SOLID SOIL SOL C I S Oft otio It %FF ELEV. FT. OFF ' RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER swc HAS APPROVAL o'A.tiv AN PROVED BEDDING UNDER TANK ss,s CONCRETE PAD ` SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: L✓'cstrs NUMBER DOSES PER DAY: TANK SIZES: SEPTIC /ood GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: //9 GAL. ALARM MANUFACTURER: gS Gt~a, CAPACITIES: A = -r-~c- INCHES = 0 7 AL. MODEL NUMBER: J / SWITCH TYPE: ~e•-cw~., ~b : ~tf B = 2 INCHES = /r, y4 GAL. i~ ' .~ncE = /12 S-9 AL. PUMP MANUFACTURER: Zv<, Ile,, C ,J~_ INCHES = MODEL NUMBER: S~ Llf, SWITCH TYPE: ~yeicKrg Y 1 c D INCHES = J-L.rF GAL. REQUIRED DISCHARGE RATE lkff GPM PUMP 6 ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE .l FEET + MINIMUM NETWORK SUPPLY PRESSURE . . 2.5 FEET + FEET FORCEMAIN X L.YLn FT/100 FT. FRICTION FACTOR FEET T.OTAL DYNAMIC HEAD = FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID DEPTH S3 s?.~ScCr/~ law SIGNED: LICENSE NUMBER: rHP 6?P~ DATE: S-i~_sy p c, ~ e - GeH S D% T-rw, ti 1/88 94' 209 .0 l JAN 19 ',94 01:45PM ABLE DISTRIBUTING CO 715 8486269 P.1/1 HUDJCAPACITY CURVE ' EFFLUENT and DEWATERINQ less then 8o left TON. WARNING: MOdei IN 041110 Oct he $11bocted to r•- % tou► 9TLgX9 dAWAPA1m NA 1"M OFLY81TAM NOT61" ,;.,.x Nil , p. °o-Y •.tt, 11 ,x. :u ri ::qX } ej•~ 11 x111: Z:t 4 go. ~ 11 t0 ' 'k y ~ tT • TY ' HI' ~1' , v zp tt ' 1' 1 32 100 30 95 28 90 26- 'Y~ 24- 175 1 e6 Q 22 70 ' T"Nis A v 10 05 166 16 i 163 16 60 14 45 12 105 i 10 1lIQ i r ; , e 5 Z a,t 61 15 186 4 10 is ; S 13 130 ' 39 ' a- jo 1 140 1 3604 511-E _ 0 9 100 110 1 U.S. MWO1l1S 10 20 0 40 1 240 3:0 400 660 640 0 Fowl PER MINUTE I I Model 112, lnd I igl aoiumn-explosilon prooof pump, aces FM0219 Note. . For Heed Cep»o tV on D_IL i ! R in accord with ILHR 83.05. Wis. Adm. Code COUNTY Attach.comptato site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not"limited to vertical and horizontal reference point (BIN), direction and V. of slope, scale or PARCEL I.0.8 dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFO RMATION-PLEASEPRINTAL T REVIEWED BY DATE, C PROPEATYONNEIR ATYLOCATION Jwe- r ~~roS_ ~ i P 41- •~s OT N 114IVI 14•S73T3 0 N,R 16 I(a w PROPERTY ONNER S MAIUUG ADDRESS LOT i BLOCK I SUBO. NAME OR CSM 8 F, .5 C C IX 1n.31) CITY, STATE ZIP CODE t PHONE MBEA ' []CITY VILLAGE OTOWN NEAREST ROAD New Construction Use ,pQ Residential / N "'btr;ol''tt~rbbrtts` t) Replacement f ] Public or commer d ' - - A'; Code derived daily flow gpd mended design grate bed, gpd e trench. gpd/ft2 Absorption area required bed, 112 trench, ft2 Maximum design loading rate bed, gpd/ft2 tench, gpd/(t2 Recommended Infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design ! site considerations Parent material Flood plain elevation, if applicable S = Suitable for system oONYENT"4AL MOUND INGRID NDPRESSURE AT-GRADE SYSTEM IN FILL HOLOM TANK U= Unsuitable basystem ❑ S J$, u w s ❑ U ❑ S U ❑ S U ❑ S O U ❑ S Pd U SOIL DESCRIPTION REPORT Boni # Horizon Depth Dominant Color Mottles Structure GPD/ft ng Texture Consistence Baxida y Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>ct > > Alr7c Ground 3 2S 3y '7~5' lC; .1f orb C w Z a L 5 elev. y y Depth to limiting Y, 13 fact Remark's: Boring # / C>-g 75 ,Y, 5 I Y~ 3 z /~e~.ae ~.,N.sb r^Tr t!'-L 2 Ale r, e- C L-L) '?T Ground `3 7 Y~ y /a n elev. It ZL-3 Nc, 6 1,5 Depth to 3f- 7 5 51-s- SG ~y;~ ~ y • Z , 3 limiting factor ai_ I Remarks: CST Name _Please Print L Phone: / TYC 1~1 ~ y~ ~ f q Address 1,2 Signature Date: CST Numba: _ " i--3) f Boring # I-lorizo Depth Dominant Color Mottles Structure GPD/t1 Texture Consistence Roots ' ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Y Bed :Try; 13 Ground /C elev. Depth to - limiting factor , I Remark's: Boring # 13 Ground elev. . tt. Depth to limiting factor -FT Remarks: Boring # t- t:,v:Nr =ant Ground elev. fL Depth to limiting factor Remarks: Boring # Ground elev. IL Depth to Gmiling 1 factor -T Remarks: row ✓1 LAY . A Oak ~Jus~ p;.,es /lP 4,(29 ~nJ ~r1, cs T m 3,Y 13 a2 Bololrs Pl LO- 20' Sac. Z3 S; to /00 Nw~ NO No. Tao N R /G ~ /oL J33 z5 a~ /0O.O 55 gs.79 to a B2 - 93,GS" k C BM a3- 9s•99 U ~c l3e►,c~, 'lark aT "2 C°PPer s~a~e . 56 - 237" • Lot Lot Sf4~ Stake. C' y . a~. G Sc4 /e /'f yo' 520659 CERTIFIED SURVEY MAP LOCATED IN THE NW4 OF THE NW4 OF SECTION 23, T30N, R16W, TOWNSHIP OF EMERALD, ST.CROIX COUNTY, WISCONSIN. PREPARED FOR: Sween Bros. Farms I NOTE: BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE NW 1/4. ( ASSUMED). I I UNPLATTED LANDS NW CORNER SECTION 23. N 1/4 CORNER SECTION 23. I (COUNTY MONUMENT FOUND). ( COUNTY MONUMENT FOUND). N i NORTH LINE OF THC\ NW 1/4 M C. T. H. EAST 325. 00 "G" a WEST 2286.06' N v EAST 285.42' T --0 EAST 7:00' I N. V 33' 33' 0 F o ° y 0 0; FILED 3 I to 00 01 A U G 2 5 1994 4 N JAMES O'CONNELL • o 6 Register of Deeds v ml L -0 T I It Z. St. Croix Co., WI tS <Z 3.05 ACRES J• ( 1 32, 829 S0. FT.) w 2.51 AC. EXCLUDING RIGHT-OF- WAY w W ~I 3 3 3I ( 1 09,;486 SO. FT.) m 2 - ~ 0 • W. W M in W. -M m t0 ,~liPROVED H' a o I<-- l o o LL ' o F. . . p O N Q N 2 BUILDING SETBACK N Q J. I W Z Z LINE N a' AUG 2 5,941 a ~ I Z 2 :3. w 3 ST. CROIX COUNTY 3 3' 3 3' I i% l.-,.Prohensive Plzttwtir 33. 00' Zoning and 2 9 2. 0 0' F3'k S Committee I l..•: S 88° 12'2 4"W 325.00 O.: If not rocorded UNPLATTED LANDS vAthin 30 days of I N' approval date approval shalt be to nt111 g void I 3 . o M:N ~f M O N N N 2 ~fr;e`o~nofaniiAr CIOUNTYOMOWUMENT SECT FOUINOND)2 0= SET I"X 24" IRON PIPE WEIGHING 1. 13 Les. PER LINEAR FOOT. • ~'O o td JAMES M. ? -WEBER 3ti + S- 1804 SPRING VALLEY ! WIS. rrf SCALE- I"=100, S U F, 0 ' 50' 1 00 ' 2 00' JAMES . WEBER S-1804 SHEET 1 OF 2. NELSENM WEBER LAND SURVEYING 04-95 THIS INSTRUMENT DRAFTED BY JIM WEBER DATED VOLUME 10 PAGE 2809 N. DIESCF2I PT I O1tT A parcel of land located in the NW 1/4 of the NW 1/4 of Section 23, T30N, R16W, Township of Emerald, St.Croix County, Wisconsin, more fully described as follows: Beginning at the NW corner of Section 23, T30N, R16W: Thence EAST along the North line of the NW 1/4 a distance of 325.00'; Thence S2046'17"E 403.89'; Thence S88012'24"W 325.00' to a point on the West line of the NW 1/4 of said Section 23; .Thence N2043'31"W along said line a distance of 414.05' to the point of beginning. Contains 3.05 acres subject to conveyances for highway purposes. Also subject to any and all additional easements, right-of-ways or conveyances of record. SUI2VBYOR. ' S C1~RT I F I CPS= I, James M. Weber, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of Sween Brothers Farms, owners, I have surveyed and mapped the above described parcel of land and that this~~ a correct representation thereof. ~►+~~iPys/ Dated this day of 1994.- Ik .LAMES M. - ,s James M. Weber S-1804 ~ WEBER NELSEN-WEBER LAND SURVEYING S - 1804 SPRING VALLEY WIS. 9 ''`le 4 S U R % ,6481184100 NOTE: The parcel shown on this map is subject to State, County and Town laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St.Croix County Zoning Office and the appropriate Town Board for advice. VOLUME 10 PAGE 2809 i SHEET 2 OF 2 94-95 This instrument drafted by Jim Weber STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS c t~ / U U 3~~2.? /c L✓, PROPERTY ADDRESS (location of septic syste ) Please obtain from the Planning Dept. CITY/STATE l-y' PROPERTY LOCATION 1/4, 1/4, Section TN-R_Z~;_ _W TOWN OF e ;~>Zt ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER 63y CERTIFIED SURVEY MAPZ 2,, 4s-5 , VOLUME/oS~ PAGE W LOTNUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained ust be completed and r turned to the St. Croix County Zoning Officer within 30 days of the three y expiration date ~lx~~~ SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property, .;r Location of Property _-&I& Section , T 3C) N-R~ W Township i~ ff L > , - IL s ~r T Mailing Address Address of Site `:Subdivision Name Lot Number Previous Owner of Property ~L{ 'ern ~ctHlyZ C' Total Size of Parcel «J'~,d_- Date Parcel was Created ' oajz` Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? 'Yes No /o5s- 6~Y Volume _ and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) cexti.by that att 6tatement6 on this bonm ane true to the best ob my (oun) knowledge; that I (we) am (ake) the owneA (s) o j the pnopen ty des cA bed in this inbonmation bonm, by viAtue ob a waA arty deed neconded in the Obbice ob the County Register o b Deeds as Document No. 1, s- , _ and that I (We) pees en tty own the proposed site bon the sewage di,6pod ~S ystem• (on I (we) have obtained an easement, to nun w.cth the above deAcA bed pnopeAty, bon the construction ob said .6y6 , and the same has been duty neconded in the Obbtice ob the County Regiaten ob X l SIGNATURE 09 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED SL CRO X CO., %Vj 120 SEP 21 1994 j LWISCONSIN SPECIAL WARRANTY ESTATE OF WISCONSIN COUNTY OF ST. CROIX THIS DEED, made this 30th day of August, 1994, by and between S`NEEN BROTHERS FARMS, a General Partnership, of the State of Wisconsin and County of St. Croix (hereinafter referred to as "Grantor"), and GENE DITTMAN AND DIANNE C. DITTMAN, husband and wife, x3cpoi -tor ls, (hereinafter referred to as "Grantee") of the State of Wisconsin and County of (the terms "Grantor" and "Grantee" to include their respective heirs, successors and assigns where the context hereof requires and permits. *holding as survivorship marital property WITNESSETH THAT: Grantor, for and in consideration of the ~unl of Ten and No/100 Dollars ($10.00) and other good and valuable consideration, in hand paid at and betore the sealing and delivery of these presents, the receipt, adequacy and sufficiency of which being hereby acknowledged by Grantor, has GRANTED, BARGAINED, SOLD AND CONVEYED, and by these presents does hereby GRANT, BARGAIN, SELL AND CONVEY unto Grantee, the following described real property situated in St. Croix County, Wisconsin, to-wit: A parcel of land located in the Northwest Quarter (N W'/e) of the Northwest Quarter (NW'/4) of Section Twenty-three (23), Township Thirty (30) North, Range Sixteen (16) West, Township of Emerald, St. Croix County, Wisconsin, more particularly described as follows. Beginning at the Northwest cornier of Section Twenty-three- (23), Township Thirty (30) North, Range Sixteen (16) West; Thence East along the North line of the Northwest Quarter (NW'/4) a distance of 325 feet; Thence South 2°46'17" East, 403.89 feet; Thence South 88°12'24" West 325 feet to a point on the West line of the Northwest Quarter (NWI/%) of said Section Twenty-three (23); Thence North 2°43'31" West along said line a distance of 414.05 feet to the point of beginn; :g. U4011,Pa.,~f35 f Containing in all 3.05 acres, more or less, subject to conve),ances for highway purposes, and also sulliect to any and all additiona easements, right-of--ways or conveyances of record. 1 a' TO H AV!', AND TO HOLD the above described tract or parcel of land, together with all and singular the rights, members and appurtenances thereof, to the same being, belonging, or in anywise appertaining, to the only proper use, benefit and behoof of Grantee, forever in FEE SIMPLE. AND SUBJECT TO the title matters expressly set forth hercinabove, if any; Grantor will warrant and forever defend the right and title to the above des :ribed tract or parcel of land unto 4 the Grantee against ::.e claims of all persons claiming by and under Grantor. r Words and phrases herein, including acknowledgement hereof, shall be construed as in the singular and plural number, and as masculine or feminine gender. IN WITNESS WHEREOF, Grantor has signed and sealed this Decd the date and year first above written. SWEEN BROTH~'IZS FARMS, a Cjmcral Partner ~iip _ By Paul V. Swee,, is Partner STATE OF MINNESOTA ss. COUNTY OF MOWER On this 30th day of August, 1994, before me appeared Paul V. Sween, to me personally = known, who, being by me duly sworn, did say that he is a partner of Sween Brothers Farms, a General Partnership, and that said instrument was signed on behalf of said partnership, and that he acknowledged said instrument to be the free act and deed of said partnership. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal at my office in said County and State the day and year last above written. MARY BETH AAETT WTARY PU8U0-ES0TA No ry Public, Mov~,cr County, Minnesota MOWER COUNTY My CoUsOSSICN SX?11E3 14548 THIS DOCUMENT WAS DRAFTED BY: Alderson, Ondov, Leonard, Sween & Rizzi, P.A. 105 East Oakland Avenue P. O. Box 366 Austin, MN 55912-0366 (507) 433-7394 4; I :.rk Z' iv ST. c?ON CO., Wt y p%ld hr'r Ecxd SUP 2 7. 1994 l art Q~'~`9 :'4 0 M Loan No. 11932-LC WISCONSIN SPECIAL WARRANTY DEED STATE OF WISCONSIN COUNTY OF ST. CROIX THIS DEED, made this 26th day of August 1994, by and between THE MUTUAL LIFE INSURANCE COMPANY OF NEW YORK, a New York corporation with its principal place of business at 1740 Broadway, New York, NY 10019 (hereinafter referred to as the "GrL itor"), and SWEEN BROTHERS FARMS, a General Partnership, (hereinafter referred to as "Grantee") of the State of Wisonsin, and County of St. Croix, (the terms "Grantor" and "Grantee" to include their respective heirs, successors and assigns where the context hereof requires and permits). WITNESSETH THAT: Grantor, for and in consideration of the sum of Ten and No/100 Dollars ($10.00) and other good and valuable consideration, in hand paid at and before the sealing and delivery of these presents, the receipt, adequacy and sufficiency of which being hereby acknowledge 1 by Grantor, has GRANTED, BARGAINED, SOLD AND CONVEYED, and by these presents does hereby GRANT, BARGAIN, SELL AND CONVEY unto Grantee, the following described real property situated in St. Croix County, Wisconsin, to-wit: A parcel of land located in the Northwest Quarter (NWI/4) of the Northwest Quarter (NWI/4) of Section Twenty-three (23), Township Thirty (30) North, Range Sixteen (16) West, Township of Emerald, St. Croix County, Wisconsin, more particularly described as follows: Beginning at the Northwest corner of Section Twenty-three (23), Township Thirty (30) North, Range Sixteen (16) West: Thence East along the North line of the Northwest Quarter (NWI/4) a distance of 325 feet, Thence South 20 _ 46' 17" East, 403.89 feet; Thence South 880 12'24" West, 325 fee*. to a point on the West line of the Northwest Quarter (NWI/4) of said Section Twenty-three (23); Thence North 20 43' 31" West along said line a distance of 414.05 feet to the point of beginning. Containing in all 3.05 acres, more or less, subject to conveyances for highway purposes, and also subject to any and all additional easements, right-of-ways or conveyances of record. TO HAVE AND TO HOLD the above described tract or parcel of land, together with all and singular the rights, members and appurtenances thereof, to the same being, belonging, or in anywise appertaining, to the only proper vse, benefit and behoof of Grantee, forever in FEE SIMPLE. AND SUBJECT TO the title matters expressly set forth hereinabove, if any, Grantor will warrant and forever defend the right and title to the above described tract or parcel of land unto the Grantee against the claims of all persons claiming by and under Grantor. This deed is given in partial fulfillment of that certain Land Contract between the parties hereto, dated April 24, 1990, and recorded April 30, 1990, in Volume 869, at Page 250 as Document No. 458069 ►n the Register's Office for St. Croix County, Wisconsin, and conditioned for the conveyance of the above described property, and the covenants of warranty herel 1 contained arising by, through or under the Seller ►n said contract, and shall not apply to any taxes, assessments or other charges levied, assessed or becoming due subsequent to the date of said contract. Words and phrases herein, including acknowledgement hereof, shall be construed as in the singular and plural number, and as masculine or feminine gender, according to the contract. IN WITNESS WHEREOF, Grantor has signed and sealed this Deed the day and year first above written. „ The Mutual Life Insurance Company of New York 1 By: David L. Brown, Assistant Director of Agricultural Investment Attest: David M. Brown, Assistant Secretary Signed, sealed and delivered in the Presence of Q6:~►`~ fitness Witness Page 2 of 3 Pages • VI) ! STATE OF MISSOURI COUNTY OF ST. CHARLES On this 26th day of August , 1994, before me appeared David L. Brown, to me personally known, who, being by me duty sworn, did say that he is the Assistant Director of Agricultural Investments of The Mutual Life Insurance Company of New York, a New York corporation, and that the sea] affixed to said instrument is the corporate seal of said corporation, and that said instrument was signed and sealed on behalf of said corporation by authority of its Board of Trustees, and that he acknowledged said instrument to be the free act and deed of said corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affi,ced my official seal at my office in said County and State the day and year last above written. C otary blic, t e of Missouri My Commission Expires: Printed Name of Notary: This instrument prepared by:~ David M. Brown JO TWO One Mid Rivers Mall Drive, Suite 120 NOWYSW St. Peters, Missouri 63376 WONUM CAWWWORDIDEL SWEEN-WI.DED Page 3 of 3 Pages r- _ 56'-0" VAULT CEILING O 5'-8" 0 16'-4" 0 10'-0" o D 10'-8" o 13'-4" o CLASS _I$ 3060 O 0 K [ .:.:c: I O o = :€r:r 4280 , 1 DINING a'T 4ItEF3 A AR:: ter. OPT g+" FAMILY ROOM F FRZ.SPC. A ; pPT.OR. ;DR ROOM s ~ SNACK 1 OPT OR 8AR OPT.` Q I. OPLBUFTET r ENT.CTR.I W OJ BEDROAi/ ,3 N 3Y 17 7 OPT. LIN SHOWER 0 LIVING 0 10'-8" 03"-40'... 17'-4- ROOM BEDROOM 1 BEDROOM 2 BEDROOM 3 Optional ~ Statrwett . Plan CA-450 C O K K ` 0 11'-4" 0, 11'-4" 0 20'-0" 0 13'-4" G f ~ VAULT CEUNG CA450 28x56 3BR-CK-2B+R 1531 SQ. FT. f I 56•-O" f VAULT CEILING 17'-4" A 13'-4" 1T-4" K 8"_p" t0 G C BATH 2 BEDROOM Z BEDROOM 1 F SHBWR ~LAUNDRY W . 3 ' N n OPT _ 00 n w- V u LIVING BATH 2 i BEDROOM 3 :i. H'11t= ROOM `VIAf;:;: F 0 j 'r'JII u " W000 u I n F F RAIL E•i}ii:Fa:,:ii?i fiiiii; (OpWopdmw ia Tt* 12'-0" 20'-0" 0 10'-8" 13•-4" Plm CA-iW VAULT CEILING 3'-4'b 16'-8" CA-452 28x56 3BR-FK-2BA-COVT-SH 1631 SQ. FT. 60'-0" VAULT CEILING VAULT CEILING 12--0" 0 8'-4" o 14'-4" 0 9--4w G G K K OPT SNwR ¢ .1. CAB `BEDROOM 2 FAMIL Y 1 : LBATH i BEDROOM I ROOM SPC:- F 100 . -~-r- OPT ~ :CAB N , OPT. OPT. n DOOR ISvim LAND pIVA~fG 0. u LIVING DINING 0 ROOM BEDROOM 3 t - ROOM ROOM .'c....... 0 x G Q F F P K GL00 ASS - OptiO o 12'-0" 0 5--4" 0 16'-0" ' 0. 10'-8" o o Plan CA-470 VAULT CEILING CA-470 28x80 3BR-FR-2-1/2B-0PHT4H 1640 SQ. FT. t I t 4Y c I o• c O r~ G 0M v M C1 M I J V 7 a% C~ co r~ ` CL O N c -C a r CD Z7 -Y O Q ro Co V1 C: C N ' v q Y a O+ N aZi a~ a A E a c a d o a o 0 t p p a N a LL H a ~ T G1 p v Fa C a ro t7 N C LL aj V v O m ro o V L V ~d q d Q ; Q C 0 O Q L.Li L1. C o m~ m q a ~ a ~r/ O N 0 ~ M C C a 'Ev J _ 1V~ 0 •N r O V « J C p N c A E E o p O E V Q. ; » N N ui 4A J a :3~ 3 V W r N I r J o 0 w O 4 0 N O a ' O %A U t 1\ C c ~1 c ro O V Q 2~ v N ~3 C N l o•° E ~v C.2 o a a O -ld C o ai 7 x o y C E a J, C p"o d p- a v 0 o E' E r w N J1 M N~ ~ C J C~~ •C ~ ~ a m ~ V J Z Q4 V V .~i \ S Q -.Z ~_J O - J co Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations - 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 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: 5~ h r S PROPERTY LOCATION GOVT. LOT , to 1/4/)0J1/4,Sa3T N,R E (or) W PROPERTY OWNER'.S MAILING ADDRESS LOT # LOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VI GE NEAREST ROAD ( Kew Construction Use[ ] Residential / Number of bedrooms [ ] Addition to e)asting building ] Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, 11:2 trench, 11:2 Maximum design loading rate bed, gpd/ft2 trench, gpolft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S 1:1 U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U El S El U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxivy Roots GPD/ftin. Munsell Clu. Sz. Cont Color Gr. Sz. Sh. Bed mnch Ground elev. ft Depth to limiting factor ~z Z-90~1 Initial: Date L v r 'ro, n(1 ~ n I