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HomeMy WebLinkAbout008-1007-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division 1 INSPECTION REPORT Sanitary Permit No: 430500 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: Ihrke, Max Eau Galle Township 008 - 1007 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: . 5 - 1 6't- t 10 03.28.16.33A TANK INFORMATION ELEVATION DATA ,t' ,, ; _f TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. c G Septic - / a C� Benchmark S• Z U /6 a. "v Dosing Alt. BM Aeration BldC6 Sewer Holding St/Ht Inlet v �� t � 70 TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' Dt Bottom ".207 Dosing , , Header /Man. �� -.) Aeration ist. Pipe Holding . System S ., C= 3 . �'7 io i. v S Final Grade PUMP /SIPHON INFORMATION - r- j_o' -1 %sfe / fo Manufacturer Demand St Cover �17KIe C: � r t GPM v - 71 1 1 q 7. 19 Model Number Q T H Lift riction Loss, System Head TDH t Forcemain L." th g Dia. s Distrto "N/ell SOIL ABSORPTION SYSTEM (� °l BED /TRENCH Width Length No. YTrenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS - 76 — ` 10 L�l SETBACK SYSTEM TO P/L _......- BLQG WELL LAKE /STREAM LEACHING Manu acturer: INFORMATION - CHAMBER OR Type Of Systemf� ( y S G ) UNIT /✓lam t l/7 A� \ ,7 �Ca Model Numb DISTRIBUTION SYSTEM Header/Manifol w Distribution x Hole Size ,�i I x Hole Spacing Vent to Air Intake Length Dia // Len �`� / 'A Dia )�� Spacing 3 �$ ( 3 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ' �" Bed/Trench Edges Topsoil - `� - 1`es � No s ` j No CO ES: (Include code discr�pencies, persons present, etc.) Inspection #1: /f / Inspection #2: a It( Cb v, 6 i , c+ - a, Sin - rr.f2 a.n �lOv/ - , � "" L� Loc t r 592 250th Street Baldwin, WI 54002 (NE 1/4 NE 1/4 3 T28N R16W) NA Lot Parcel No: 03.28.16.33A 1.) Alt BM Description= $ V, c c — °✓ �, c71 �; c. t {-.: hocn•� I 2.) Bldg sewer length = 7 5" - amount of cover= 8 " 0' #- ' - 1C t 4H of c oa. 1 V &J - 7 c if ;,,• t inso�(K�� c:,,� ,G�c� c Plan revision Req uired? Yes No L Use other side for additional informa ' L Date Insepctor's Signature Cart. No. tBD-6710 (R.3/97) Safety and Buildings Division County 'JAr W 201 W. Washington Ave., P.O. Box 7162 ,SCOnS n , Madison, WI 53707 - 7162 Sanitary .Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 ILL 0 S��i Sanitary Permit Application State P 1ap,I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide 7 7 3 0 � may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Informatio RECEIVED Property Owner's Na me 3 OCT 2 7 2003 Parcel # Lot # 4l Block � l CL _1 00 - 7 - 1 0 —1 00 0 Property Owner's M ailing Address ST. CROIX COUNTY Property Location 3 3/A 2 Z_� ZONING OFFICE City , State Zip Code P �b, t� + Section � (circle II. Type of Building (check all that apply) T �CJ N; R�F o 1 .' ll q � or 2 Family Dwelling - Number of Bedrooms -3 (S� Iv(.{ - Subdivision Name CSM Number A ( n ❑ Public /Commercial - Describe Use b21r1 / _ A ❑State Owned - Describe Use 5T- CE LL lG )( 5 CrJTw,1 /QI ❑City_ ❑Village Township of - 6 44, c - III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ❑ New System Replacement System y p y ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System r � B. El Permit Renewal El Permit ❑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) ❑ Non - Pressurized In- Ground XMound > 24 in. of su itable soil K 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 Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: O • �;7 Design Flow (gpd) I 135 pi Soil Applicati Rate(gpdsf) Dispersal Area Re aired (st) Dispersal Area Proposed (sf) System Elevation .sue s' "—. /- _0 ► �� IUD VI. Tank Info Capacity in Total Number Manufacturer refab Site •Steel Fiber Plastic Gallons Gallons of Units I�D y Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit C: Dosing Chamber / VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown o n the attached plans. Plumber's Na me (Print) Plumber's Si gnature P MPRS Number Business Phone Number /e s <� 11-2 617 1 71 5 Plu is Addre ss (Street, ACity, Stat , ip e) VI . County Department Use Onl Approved ❑Disapproved Sanitary Permit Fee ncludes Groundwater Date Issued suing Age Sign a tamps) Surcharge Fee) J z El Owner Given Reason for Denial 35 J /✓ 6_3 IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: / D G r"4 �' - C� %Y� !�* f�jt 1 ep I an c, effluent filter andejY&M- Q 3� dispersal cell must all be serviced / maintained as per management plan provided by plumber. rJYI ��� TTG�1 -.vii . All setback requirements must be maintained as per applicable code /ordinances. (/►il $-. {a�' - 3 • (/ Attach complete plans (to the Co t only) for the s stem on p r not less th /2 x 11 inches in size SBD -6398 (R. 01/03) ®`�GkJ, �i��,l?iy, -t ��J C,f�'�m.� 33 ST CROIX CO UIITTY J SEPTIC TANK MAINI'ENA.I` "S AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address y Property Address (Verification required from Planning Department for new construction) City /State 46C4� i , Parcel Identification Number /067 10 -066 LEGAL DESCRIPTION Property Location AJcL %<, IJ6 '/,, Sec. , T2_3'N -.R /6 W, Town of _ b:lf-e Subdivision AJ14 . Lot # P4 Certified Survey Map # It>� , Volume, 14 Page # cat Warranty Deed # Volume _ . Page # Spec house ❑ yes 0 no Lot lines identifiable ❑ yes ❑ no SYSI M MAINTENANCE Improper use and maintenance of your septic system could result in. iu 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 di ,posal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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 Zoning Office within 30 days of the three year expirati . is SIGNATURE OF APPLICANT �/— DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property desen�ed a y rtue of a warranty deed recorded in Register of Deeds Office. / /©L S AhJRf OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if refewnce is made in the warranty deed - Q ,J N C- `l+ S 3 T28 tJA 14 w ST. GZ.a I Y C o v.&/-i -r �+4�K Cshu.E �csi.t Z°°�+ SL t5 EXT Ta Soii r14 'iti W C DOOR G �� s '" sl 3.3 R2 = tat•gt' � „ � . 5 't 00 e gAL Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TD #: (608) 264 -8777 \ Visconsln www.commerc .vAs ons s Department of Commerce wuvw.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 21, 2003 CUST ID No.224617 ATTN.• POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 STATE ROAD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/21/2005 Identification Numbers Transaction ID No. 930410 SITE: Site ID No. 666809 Max Ihrke Please refer to both identification numbers, 592 250TH St above, in all correspondence with theagency. Town of Eau Galle, 54028 St Croix County NEIA, NE1/4, S3, T28N, R16W , FOR:• Object Type: POWT System Regulated Object ID No.: 926028 cc 7 MOUND/ DWELLING 450 GPD A The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 4 and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ' 1` chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. DIMS';; 4 A copy of the approved plans, specifications and this letter shall be on -site during construction and open to , inspection by authorized representatives of the Department, which may include local inspectors. All permits SE -L F `� required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maint nce of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer, Integrated Services WiSMARTicode: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Mound System Cover Page ;* of 6 MIEIER CD�IIETE Project Name: Ihrke -Mound Owner's Name Max lhrke Owners Address 592 250th St. Woodville, WI Legal Description NE • % NE 7 Y. Secr� T 28 N, R 16 • w � Township Eau Galle County Saint Croix Subdivision Lot# ParcelID# 008 - 1007 -10 -000 Table of Contents '�- p9 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank L. t= . L' I V E D 5 Management and Contingency Plan 6 Plot Map OCT 0 7 2003 SAFETY & 6LOGS. DIV. total # of pages: 6 Designer Name: Lyle J. Myers MP /License #: 224617 Date: 10/3/03 Ph. #: 715 -643 -2520 Signature: Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N-01 /01) per " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD - 10706 -P (N 01101) Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715.6436068 email: 3ba @3badvisemeM.00m Mound System Page 2 of 6 Mound Sizing Calculations Project Name: Ihrke -Mound Site Conditions_ Design of Entire Fill Project Type: i or 2 Family Dwelling w Cell depth at upslope edge (D): 6.0 in: % Slope: 7% Cell depth at downslope edge (E): 11.1 in. # of Bedrooms: 3 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 30 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 ga WIday Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.5 gal/ft /day End slope width (K): 7.6 ft. Effluent quality i ` Fill length (L): 90.2 ft. Max BOD effluent value: 220 mg /I Upslope width (J): 4.5 ft. Max TSS effluent value: 150 mg /I Downslope width (Toe) (I): 8.5 ft. Fill Width (W): 19.0 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal /day Basal area required: 900 ft Distribution cell width (A): 6.00 ft Basal area available: 1088 ft? Distribution cell length (B): 75.0 ft Area of Distribution Cell: 450.0 ft Observation Pipes Contour Elevation of Mound: 101.14 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 101.64 ft Final Grade of Mound: 103.43 ft Mound Plan View Observation Pipes W K A ) B k---K I Tilled Area/Fill Material I.4 _ L ' Mound Cross Section Final Grade Observation Mpe Synthetic Fabric G Distribution Cell , System Elevation $ F Cover Material Fill Material Tilled Area �-- -'Slope Forcemain System Contour Notes: FRI material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and T above. Mound System P 3 of e Pressure Distribution Calculations Project Name: Ihrke -Mound Lateral Layout (b2 ,1�' Lateral /Manifold Design Lateral elevation: 102.1 ft Lateral diameter. 1' In. Rows of Laterals: 2 • Lateral spacing (S): 3 ft .� Manifold type: End • Lateral to cell edge: 1.5 ft Orifice diameter. o.12s • In. Lateral discharge rate: 7.83 gpm # of Laterals: 2 System discharge rate: 15.65 m Distal Pressure: ft Manifold diameter: In. Lateral Length: 74 ft Manifold length: 22 Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing (X): 49.33 Inches Forcemain length: EV Orifices per lateral: 19 Forcemain diameter. v In Avg. ft /Orifice: 11.84 ft Friction loss in for'cemain: 2.595 ft i Lateral Side View Manifold Lateral Lateral x x x I x x q x x x x x x x 2 - Y Lateral Length 0 K Lateral Length Lateral Plan View C — n 'IL Lateral Length ..� --=� Turn -up wlball valve or cleanout plug a (OT 0 o L Orifices on bottom of PVC laterals forcemain to comply with lateral equally spaced specifications per m 84.30(2)(e) Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes clean -out plug Final Grador ball valve Water tight cap or plug Lawn Sprinkler Box lot Note: Closet Colar 6" Minimum "'a' be in Long Sweep 90 P or 3A bar or two 45's 3/8" ga. Lateral Mound System Page ad8 Septic, Pump and Dose Tank Project: I hrke -Mound Tank Information Dosage Volume Pump tank manufacturer: Wies Co ncrete Forcemain drains back to tank? *Yes O No Pump tank size /model: W1000 /650 -MR - - n Lateral void volume: 15.6 gal Pump tank gaVinch: 17 Dosage to absorbtion Cell: 78.2 gal Actual Pump Tank Volume: 646 gal Forcemain volume: 11.6 gal Tank bottom elevation (inside): I 88 ft Total dosage: 89.8 gal Septic tank size /model: W1000 /650 -MR 1w Pump and Filter Total Dynamic Head Pump Manufacturer. Little Giant Are laterals highest point? y Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter. Zabel A100 System head (distal x 1.3) 6.50 ft V ertical Ln_(! " to lateral) 13.14 ft � Note: Access opening of sufficient size to be provided to allow removal of filter opening to terminate at or above grade. Friction loss in forcemain: 2.60 ft Pressure loss from filter. 0 ft Total dynamic head (TDH): 22.24 ft Pump Tank Diagram Dose Tank Levels trtight eLod cingCover In. Gal A Warning Label Finished A Reserve 18.7 318.2 Grade g Pump off to Alarm 2.0 34.0 C Total Dosage 5.3 89.8 Eted per Comm D Effluent depth for pump 12.0 204.0 1 6.28 and Total Capacity: 38.0 646.0 NEC 300 Weep Hole A or Anti - Siphon B Device FLOP- LITERS/H7UR C 0 1000 2000 3000 D 301 to zv. 5 7 20 75E a 5 Pump must be capable of: 15.7 GPM t0 and head pressure of 22.3 Feet 25 I 0 1 111 0 0 20 40 60 so Little Giant LOW- GALLONSMINUTE 9EH PUP PERFORMANCE CURVE 11SV 60HZ - O r pk k � tfiRK C � 35o t L tit E-KT Tv So V T 14 G A R DOOR p (I 3' ch 7�2 = (d( 4( n �� 1 - B Soo' t (.f &,9 a .--- - 100 ` 1 b0 k FR -^ S��> Zoo � t 350' i- MAX C� 3 tfE' /4 Al S3 7'Z£3A11, /6 Uj �v� NY 5 T e-!•2 c f x Ccv ArT Y 5 '� �itv CsFbtcrC -. Tcro.1 �7 Sth � ,S Soo/ f 40' s. c o, o - - S L / a nl��c "t" "Tc� S aV rA( &Arena E D o c, � p BZ B 3 J. cs aG� `18 5 �ze�E� - LIOS ^T� eo�D Mound System P°0°' of Septic, Pump and Dose Tank Project: Ihrke -Mound Tank Information Dosage Volume Pump tank manufacturer Weser Concrete Forcemain drains back to tank? *Yes O No Pump tank size /model: WJOOO /sso -MR =V Lateral void volume: 15.6 gal Pump tank gal/inch: 17 Dosage to absorbtion Cell: 78.2 gal Actual Pump Tank Volume: W gal Forcemain volume: 11.6 gal Tank bottom elevation (inside): 88 ft Total dosage: I�rc, _ 89.8 gal Septic tank size /model: W1000/65o -MR sys�?,yn Gt SCE 0 M4-e. 15 � �,��y I r�ls � `0 Pump and Filter Total Dynamic Head Pump Manufacturer: Little Giant Are laterals highest point? y Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter. Zabel Al 00 System head (distal x 1.3) 6.50 ft V ertical Lift ('D to lateral) 13.14 ft Note: access opening of sufficient size to be provided to allow Friction loss in forcemain: 2.60 ft removal of filter. Opening to terminate at or above grade. Pressure loss from filter. C�ft Total dynamic head (TDH): 22.24 ft Pump Tank Diagram Dose Tank Levels "Wdh Locking Cover In. Gal (Inch ng La sned A R eserve bel 18.7 318.2 ini Minimum Grade B Pump off to Alarm 2.0 34.0 Altemate C Total Dosage 5.3 89.8 outlet D Effluent depth for pump 12.0 204.0 Location Elec per Gomm 16.28 and Total Capacity: 38.0 646.0 NEC 300 Weep Hole A orAnti- B Siphon Device FLOP- LITERSMOUR C 0 1000 2000 3000 D to 7s Pump must be capable of 15.7 GPM 10 2s and head pressure of 22.3 Feet 0 0 0 20 40 6o So Little GWA FLOv- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ Mound System Management Plan pursuant to comm 83.54 W. A. C, page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owners agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemicaVbiological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump /Dose Tank If an effluent filter has been installed in the pump /dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump /dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in its current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. 4 RECEIVED Wisconsin Department ofCommer ALUATION REPORT page /of Division of Safety and Buildings OCT T in a mss. Adm, Code County .ST � o /.k Attach complete site plan on pa not�sttfaltze. Plan must include, but not limited to: verb nd howdirection and Parcel I,D, percent slope, scale or dimensions, no to nearest road. ��Q 0'] — 1 D!7 Please print all information. viewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location k /�RKE Govt. Lot AILC 1/4 AIE1 14 S ,3 T N R W Property Owner's Mailing Address Lot # Block # Subd. Name or CSMff City State Zip Code Phone Number ❑ City Q Village Wown Nearest Road �aojj�cGE Gv I ( 6•9ecE I i 2 New Construction Use: Residential/ Number of bedrooms Code derived design flow rate '¢'Sv GPD Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation N applicable ft General comments and recommendations: Boring # C] Boring / J& Pit Ground surface elev. 16 A /T d ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence P cqI S Roots PD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etl#2 o - 5 ma A-?/ s/*1 3s6h i V- 3 .5 - 8 6 3 / S ' 3s6k rx (- .6 . 8' 3 14-32 aVX 5 / S 2sbK IKV L 5 -5 2- /e M 9 /2- l �' l b't R s /Y ,5 t2,s AL C S — • a Boring # Boring pit Ground surface elev. /d/ 9/ ft. Depth to limiting factor JU in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 "Ef1#2 U" 9 /o YR- /i S'! f Y5 6 kS n t V r S 3'r' 2 - 0 Gl s /'l 3sbk * Effluent #1 = BOD > 30 220 mg4 and TSS >30 < 150 nxyL " Effluent #2 = BOD < 30 mg1L and TSS < 30 mg/L CST Name (Please Print Signature CST Number �il<<ff tke- -J ALf,54-f .7Co 7 ?85 Address We Evaluation Conducted Telephone Number 2 Q 3 /-?6 Al 715- z 6 S- f/G Z ,I Property Owner Lt14k �MR kE Parcel ID # Page 2 of 3 ['31 Ong # ❑ Boring ® Pit Ground surface elev. AOO , 80 ft. Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 0 -/6 / a YR - 3sb k -Pr CS 3� . S • g 2 /0 -20 14 Y9 5 /3 S%% jsbk Mvpr- CS IF .57 c3 V - 3( o Yx ' /G S Z .k cis cS — - `� /. 16 Y1? 4 /0 -F I o7R -t' 8 S p /h 4' CS r Z 3 F-1 Boring # ❑ Bing ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ❑Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EfF#1 'Efl#2 ` Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 * BOD < 30 mg/L and TSS < 30 mg& . 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. SM -8330 (807/00) 2� �f 15 mAk ll,fEY.¢. AIE fit- S3 TZ /6 U f 57. Q-Rorx CovArTl( �`- �-�tv Cs �4cc,C, T ern..► •J SKn � S od � S5 ! = 46 ` s i� ►tit = � o c,, o � - s c.,� a nt ��c -(- 7a S ov ��{ �� Cs/-r 2 /4G boo?, f�P .T vl " , 3 a Ic,o'fi FO •Rrrl GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF EAU GALLE COMPUTER NUMBER 008 - 1007 -10 -000 Parcel Number 3.28.16.33A Claimed 1 Date Re- certified 04/17/2001 Relate Number: OWNER NAME: First MAX & ETHELYNE Last IHRKE CO -OWNER Mailing Address 592 250TH ST City WOODVILLE State WI Zip 54028 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY 446/ 93 07/23/1997 / PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office 592 250TH ST School District: 231 - BALDWIN- WOODVILLE AREA Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: I Last Changed on: 03/08/1993 Book Number: 1 SECTION 3 TOWN 28N RANGE 16W %160 '/.40 Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: F4 -Prev, F5 -Next, F6- Legal, 177- Value, 178- History, F10 -Exit, F12 -More �RTAX or WIBCONRIN> 235.1d. wl". st.tl� T t Form NoL I PubllAhM by Zan cw nook & Htationor, k> 302SUO ,� This Indenture, Md 3 u day of A. D., 19 70. between Myrtle Haugeland, surviving joint tenant, part y of the first part, and Max Ihrke and -,thelyn Thrke, huAand and wife as joint tenants, parties of the second part CGhtntOOrtb: That the said part y of the first part, for and in consideration of the sum of * * Twenty -three Thousand and no/100 (423,000.00) il_k)llars** to her in hand paid by the said part ies of the second Part, the receipt whereof is hereby confessed and acknowledged, ha s given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do es give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said part ies of the second part, their heirs and assigns forever, the following described real estate, situated in the county of St. Croix and State of Wisconsin, to-wit: I II Beginning 25 rods N of the SE corner of the NhJ4 of Nh14 of Section 3 -2 0 -16; thence N to the NE corner of said NE)4 of NF,14; thence W to the railroad riF-,ht of way of the Chica„o, 3t. Paul, Minneapolis and Omaha Railway Comnany in said N" of N: thence in a SW'ly direction I. along said railway riFht of way to a point on said railway right of wa directly W of place of beginning; thence _,', to place of beginning, all in the Nr of Nr;y- of ;ection 3-28-16. lid l � n T l i t �I � III lit k t0ffftbtr with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim, or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises and their hereditaments and appurtenances. Co I?abt anti to C�alb, the said premises as above described with the hereditaments and appurtenances, unto the said part ies of the second part, and to their heirs and assigns FOREVER. 2n73tDt%Jb Myrtle Haugeland for herself and her heirs, executors and administrators, do P, covenant, grant, bargain and agree to and with the said part ies of the second part, their heirs and assigns, that at the time of the ensealing and delivery of these presents she is well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever, and that the above bargained premises in the quiet and peaceable possession of the said parties of the 0 A Q13, U 1 fb O Q a � �= o C a, rd ! l o b o j J o i ZU r" 1 (YQ p 1 Q p (� �. H i M. 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ILLS nk— 3= N treBe ammo RK MC ., a p P In :� s tz e� 3o`I u 5 Albrightson �r„y,. ]5 wn,wraa 9 137 a zo teoroem3 & � Maomee / y Donald & Judith Jg J S 67 3s 136 3 "a °�° `' 72 N;: MP 7 HaidenO° 54 Rodel saga ^' r ,eawea 94 72120 148 � r 1 4f A r� 3s Michael Joy v , a 7 Art 3ecrosc H Ostlie L a avid &Trudy. aroQ a — _ — - _ _ — - - 3 3� X 37 ^ 1 n ae 3 94 ,�,� ml Reinsch 70 Trapp 53 r eterson I > GlendaJ al ry vanmena terry 50th AVE cs « 80 �� 31 4 „ Lund " T a a Lyla Greg & 6 N aftley a q F y watx ,, a ,,, ti Laurence & M w ) swiss O G Harvey & Euuggene & a n 20 39 n 13 ,� 3 0 Nancy Jacobson c'1"rs 34 Marvell 011ve etermn Mal la & Chris & Donald & Trust Holm ] & Seder Terpstra T & s 20 Monicken 60 40 Arlene Judith Walter & 6 0 e Jr 59 5t AVE Wangen 80 J Dorene s g' June Carroll a Rodel 75 160 Jacobson Nelson I F Kevin Kroening �y °o a Dennis 38 B g 22 Wilma Donato a 12 j ' v N N Setter i3tl dra av Molly \Hageseth Margaret � LN s) e t , Wo od RB Olson 9 � 1ego -dibn David N , M Trust x H o 40 114 21 267 Benck 155 N N 240 ]2 =i N 5 ` 42nd VE $ a � y I N G Rump 14 ho 100 z m ae _r 60 Q r « �i hex 20 3 '— — — J _ 117 40 - 38 _ _ 170 j 18 m q 100 19 Kevin 55 26 Janet Leoe d � wBee a sou, nvEy 40th AVE Rasaamd a mart a 47 Lund 40 40 1 Norvold a Sylvia Victor & I Sexier J sa�ala.aai7 BM 60 Ram HM 103 B William & 40 40 FaR$i°d°k 70 rEBzabeth 11 — 0 144 B g et on ° & Ivgerson Z dVey gNk�l n— 17 Q c 142 I C 20 K 7 son W PECAN Gloria sa Glen & d ^ 0 Ian Dennis F Craig s Chapin 9 et N 1 s 2 John 1 LN _ Lund 1« 3o a„a 4 a l 3 H -ley eo 40 E uckworth 62 P dh — 1 gL5 141 L 5 Kelly c- n Ronda M 1003Ynt1 Larson b Ear & M " Mary +tl ° N 2 xa 3s 40 Teter 40 100 116 P1U14o Giezendanner 306 lw Y o aa $ r M AVE Bruce p ° 76 1` 40 4 3 60 152 a_ t° I 'C Cynthia J 4! ane Tam Ma,.a+s m - e F .' 3., A ", co ,> LE Sri Erickson 60 Duane & P� �u cafe l � '� 15 m 19 l o S . g V r @@ 2 loo xoo� t a Ludnda 5 lt� 37 40 $J 1- 0 9 t4d.o $ cy so l �� 60 Bauer � Haannssen ro �7 u r G Teng & 35 $ 3 6 - awes c 143 1 46 40 40� °' °' as °.'' son 4o Ia My Vang p torayne a lyn 3 25t AVE Lee $2 34 00 Johnson 97 12 Arthur Jon f pp „ Patrleia& snedra a ,-4 a 00 Steven 3 Ame Thomas a 1 s & E $a �� Bad 3s io] : i Faille 80 " ° L 3UU �r 0. Amy Amy Jac o�son i X 110 & 8 Linda 4f �i 4o Casey 75 200 �o Larson 80 Johnson Donna Sturtevant Wayne & v Sp & Thomas & 80 Lee 60 a 20th AVE 80 Alb n r ' Fensstra anet 7 t N Da°- It, RC 13 o RH s s os 80 8 0 _ 3 _ _ — _ Ellefson go — 2 a '+ ism 00 Verlyn tai W 1 lYacy Dehnai & — 4 - 31 Gerald 10 r 10 udy es Kai Ti & La rso n 10 u P dda D a L zo f- %[dge:b invest- 34 Jean I t Thommes a.a Inc aide Siemer r ent Ziebart� e a N w 9 4 S Land Cl a 59 Ras K evin arbara Dougl er s°u I LLC Fugate k"� „ n B 40 a Mehin • 160 , a 15th AVE Larson G e 3 S I Orville & B X 119 & N 35 Dondd Olson 2s u~i 46 Q- 4o F a C 17 Darlene t 60 x a v ' u'1 A BB S Schlegel Shirley to ,w 2s N g z Gc a N Peter &"°d°m°n 101 40 121 Roche O tan : rneBen Sheron x f B& K c w P a 2th AV 1 ran yrea ohn I& z 78 266 .10 279 M x S tits 1 s B z o — 4o 11!111111n a 30 a l etae 10th A 40 _ — - 115 to So Kent sa.aae tick- Donald B Pantos 50 52 31 oe o - R 40 N I ,s r � Diane Pax LM D 20 a c a ae 2 I° Clark BOSTON 2 Brunkow 3 o Anderson D 3 r 79 t- 70 Harwood o $ Ross & 2 3 275 Corp 80 80 �� 150 Elizabeth as a a Leonard ����' A„oo Keehr t Dar z €j 6f ^A 1 g poseur Dian & Dmar a Rae— Steven & d T z u WlldWOOd James 3 I James x &J L Brooke R 20 °e° ° Jon o a 120 0 "' View a Amy 67 erth ° mo wff.m a w olte Anderson gp Madura .- Inc 100 O r« oaas gp x C7 Seaind RMichard Terry l a e Hom Harry & N � ^' � g°fro marl ad a )erem 3 140 � & F so 40 7s so 120 Swenson °` Audrey v Tegro Humph- ohnson f 1 x Anderson t 40 4o Blue 80 w Zr g`° s t0 40 3 139 s N PIERCE CO. PIERCE/ST CROIX RD