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HomeMy WebLinkAbout008-1027-90-200. Wiscons:;n Department of Commerce PRIVATE SEWAGE SYSTEM Safeiy and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ^ City ^ Village ^ T~nrn of: Iverson, Jason & Am Eau Galle Township CST BM Elev.:- ~ Insp. BM Elev.: ~ ' BM Description: .{._ '" - ~ tTt) . 0 O . fl I f3 ST g~ N~ ~ ~ v- Vt¢.t~ -~ L TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ -~~ ~~ Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic ~ ~ ~ ) r --- NA Dosing NA Aeration NA Holding PUMP /SIPHON INFORMATION Manu rer D Model Number GPM TDH Lift F ~ ion tem TDH Ft for m Length Dia. Dist. To ELEVATION DATA St. Croix Sanitary Permit No.: 353395 State Plan ID No.: ~---- ax STATION BS HI FS ELEV. Ben hmark • ~~- oy . ~ ~ ~ , ~ 3,~5~ i,l,f2r Bldg. Sewer ~ 6 Z q9. t5 St/Ht Inlet ~•9(o q.~,~f r St / Ht Outlet ~-• I ° 9.63 r Dt Inlet -- Dt Bottom r Header /.Man. 5V -~w~ ll~ ~'z II-~Z ~ 43. 5 Dist. Pipe 13• s~s 91. 2.2- Bot. System i 3.2,•z /-s'S Fi l ~~ per" ( na ta,.eti „ `f•9~ loo.}~ SOIL ABSORPTION SYSTEM (, z~ ~ ~ ~,,,~,~ ~a ~ ~,-Q,,,,~Q, TRENCH Width ~ Length ~ No Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIM S DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manufacturer: ~ ~ ~- S ~(~ SETBACK " ew~ ~ ` INFORMATION Type O . ~ CHAMBER Mo el Num er: System: ,' O ,~ ~ ^-~ OR UNIT .E}i _ C aU DISTRIBUTION SYSTEM ~ ~" ~'T `~ Header /Manifold Dis ibution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake u Length ~ Dia. ~ h Dia. Spacng ~ ~_ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ~y l ( Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center 'V -~ Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: a'/ °~"/ °°Inspection #2: / / Location: 2449 50th Avenue, Woodvill~e-~~WI 54024 8 ,(~T~ 1/4 10 T29N R16W) - -Lot 3 I ~. s~- ~ 5 ~~' 1.) Alt BM Description = ~~s~"^~ S+'; ~~L~' ,•~l1;Yc~ ~l I ~, s s 2.) Bldg sewer length = t ~• ° ~ ~ b ~'° c'-•'~'°'` -amount of cover = > 14 "~qi- ~w.e~ ~ ~T ~;.~-~.,+`~~--~ Plan revision required? ^ Yes ~ No Use other side for additional information. SBD-6710 (R.3/97) O b 2 t on ~w~Xlon~•.- ' ~ '~ Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ,. r Safety and Buildings Division ~•ISC011$-11 SANITARY PERMIT APPLICATION P to g w3012ngton Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7302 1~. • Attach complete plans (to the county copy only) for the sir t{~~s1~-~i ~ s county than 8 t/z x 11 inches insize. /rr`~;.= ~ ~ ` , ~Y'G ' • See reverse side for instructions for completing this a~pliS~tior~~c~,~~ ~ State Sanitary Permit Number S ~ ~~ Personal information you provide may be used for secondary purpose$~_'~,{l ~, ~;~~ " ~ t ~ 3 3 3~ Check if revision to previous application ~~ ~ [Privacy Law, s. 15.04 (1) (m)]. ~ Y~ ~ SO`~~uc /~~~.., ~ ~It~~ ~°, ~ X fate Plan LD. Number I. APPLI ATION INF RMATI N -PLEASE PRIN ~1cL INF f ON ! ~"- Property Owner Nam "" , ~, /YJ U->= `~` ,;%~~ L tigTt ~/a / , S j T ~ ~- N, R ~ E (or Property0 ner's Mailing Address ~ ~ ~1 Block Number ~ ~ ~ City, Sta Zip Code Phone Number Su ivision Name or CSM Number ,p II. TYP B ILDIN (check one) ^ State Owned 3 Ity ~ ° Town o ~ ~ Nearest Road ~ Public 1 or 2 Famil Dwellin - No. of bedrooms ~u f a ~ ~© ,9-u III. BUILDING USE: (If buil~ g type is public, check all that apply) Parcel Tax Number(s) ~e~i^~ 1 f ~ ~~' < <° ' `~I ~ 1 ^ Apartment /Condo 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recrea tonal 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 box on line A. Check box on line B, if applicable) A) 1. ~ New 2. ^ Replacement 3, ^ Replacement of 4_ ^ Reconnection of S. ^ Repair of an ______System -_______System _____________ TankOnly_____-___ _ ExistingSystem ___--___ Existln~S~stem B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ^ Mound 30 ^ Specify Type 41 ^ Holding Tank ~ 12 eepage Trench S-i~,e ~/ ,.22 ^ In-Ground Pressure 42 ^ Pit Privy 13eepage Pit ~ '~~-- 43 ^ Vault Privy ~ 14 ^ System-In-Fill / ~ /,~ VI. ABSORPTION SYSTEM INFORMATION: ~ ( 3 . 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade / Required (sq. ft.) roposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~~ vat' n ~© / ~ ~ 7 ~ yFeet C~, ('/Feet ~ VII. TANK INFORMATION In gallons Tota`I~ # of Manufacturer s Name Prefab. site con- el Fiber- Plastic Exper. N ' E i ti Gallons :Tanks Concrete ste glass App. ew x n s strutted Tanks "Tanks tic T ~k ~ ~© ~ LfJ' l '~ -G.C ~ ^ ^ . ^ ^ ^ V111. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) f r Plum er's S~ atur (No mps) ~ ~ MP/MPRSW No.: Business Phone Number: L n ~ ~ ,-y.,.z ~--~~ ~~ ~ ~.T -~ ~,3'd- Plumber's Address (Street, City, State,Zip Code • ~ ~r-- IX. COUNTY /DEPARTMENT USE ONLY ^DlsapprOVed Sanitary Permit Fee (~ndudesGroundwater Surchar e Fee) a e ssue Issuin Agent Signature (No Stamps) / I~Approved ^OwnerGivenlnitial g ~ '! 7 ~ `~ G / Adverse Determination ZZ ~= ~~ U U-- X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: F/a~6p/~.~,,~ < ~6,,.~ SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety S Buildings Division, Owner, Plumber INSTRUCTION S 1. A sanitary permit invalid for two (2) years. ' 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal-description and parcel tax number(s) of where the system is to be installed. I1. Type of building being served. Check only one and complete # of bedrooms if.•.1 or 2 Family Dwelling. III. Building use. ff building type is public, check al! appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection; or repair. V. Type of system. Check appropriate box depending on system type. VI_ Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval. only if tanks received experimental product approval. from DILHR. V111. 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 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete iiimensionse location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section o#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 number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ~q r 1 '''~'"' l7 ~~ ~' \ °_ I ~~ EV ~~~,L 1 „_ Yo ~=~ R~ ~ p ~r'~, ~~ i ~c S` ~~ nl ~ ~~y ~ ~~ % S~ ~ 1 ~ 7- ~~ tv ti f~ ~ ,~-rn y -~ v -~ ~ s~~., ~6 ~ y :5~7/`~1 ~ 7~Q-- QIY~~-~ Q~ Ld i.w ,~n L~ 7S C /~P ~yyy 7~~7 3~~~,~ l 3~ ~- y ~ ~' / ~? 7- 7 ~1 n~0~~ ~a1/ o~,tt.-,¢~,c. 6i 5 i RQ~`-7 ~ K ~ f~ ~) S, `~~ ~ nd ; R tn~,p Q ~ ,e n e LI .,r h ~hv~ ~^ ~+n c ~ ~ j J } ~ o ~ /.1-L ~ r /Z 7 ~ ~'' ~ ~ ~. ~ 4 /~ ~1lp ~ L ` n ~~~,PL~ ~j Rc<. l ~ '~ Z ~L~ {~0./'~GI U" ~((V~GI~~ J /~ U ~ ~V.ft i L ~n ICJ !)X ~~ ~/a' /4 T/~'eG FLv- 1Qd~ en ~'1 0 f f ,. I frrr~h Alr Inl~lr, And Ob~~rvollon Pip• ~~..- ApprorN Vonl Cay Allnimuen 12~ Abor• fl~ol Orad• ~ `pvc. ,~~ ~s S /a~~-7c -- P~oroseal F L .~, L~.4Tioi 1 i 1 -+~~~~. ~ .~ t ~.s .~, ~ DIS'--RIgUTIrJAJ Plf'F TU BF A7 LEgST IAICNES BELOW ORIGIAIAL G~ADE• AUU AT LEAS72O IAJCNES BUT AIO MORE TNAIJ IAlCNES BELOW FIAIAI. GRApE MAXU`luM D~Qr-•~ OF ~X~AVArIm~.D FRoM a~~~,INgL f3~An~ WILL BE ~ IrvcNEs MIIVIMUrt ©Ept-}~ aF ExcavnnmN ~RoM. ~I~INA~ ~l~AD~ wlLl. BE -S ~ INCHES ;s`'~ SIGAlEO: ' LIGE-JSE AJUMgER: __ 7 ~~7 DAY E : ~~ ~ ~ ©p~ APR, -10', 00 jNION) 09 :1 ? 4V[ ESER CONCRETE TEL ~ ? 1 X6475181 P, 003 infiltrator Sidewinder chambers provide mare than twice the infiltrative capacity of stone and pipe systems. From the makers of Infiltrator chambers, the products that revolutionized septic and stormwater management, comes the Infiltrator Sidewinder chamber. Designed to replace old-fashioned stone and pipe leachfields, these high-strength polyolefin chambers fit in a typical three-foot-wide trench and are available in two sizes, Standard and High Capacity. The patent pending infiltrator Sidewinder chambers sit directly on the trench bottom and latch together quickly, end to end, so installation takes less than half the time of a laborious stone and pipe }ob. infiltrator Sidewinder chambers maybe used for any application that is suitable for stone and pipe. However, by offering greater infiltrative capacity per linear foot, these chamber systems can require as little as half the space of conventional systems, depending on state and local regulations. And, the continuous lowers of the Infiltrator Sidewinder chamber wind fully around its sidewall, offering maximum infiltration (as shown in the circle inset to the left}. Qpen chamber bottom boasts infiltration. The Infiltrator Sidewinder chamber also features a completely open chamber bottom which provides over twicE the effective downward infiltration of a conventional system, where stone restricts the move- ment of effluent into the soil. Leaching chambers are a tested and proven technology with aver 450,000 systems installed over the past 22 years. The Infiltrator Sidewinder's sidewall and open-chamber chamber work together to provide estate-of•the-art leaching system that is more than twice as efficient as 2 three-foot conventional installation, Inflitrator SidelNtnder sidewall. The Infiltrator Sidewinder chamber features the patented Sidewinder sidewall. `• This unique design has 35% mare leaching sidewall area below the invert than the tntlltrator Standard Infiltrator Chamber, Sidewinder sidewall system efficiency. .:J.Y I -~!. ~. l• ~.~AiN.I'+i•Jd'!.._.41i. :.I'_ "Ili : i~l,~.>i; l.~W:. r• ~, ua:~cL'eirn",~~u, •51'19'~Niltl+r~4en:, aww,.a i., ..'a9~ir~mnik,fW~;%~- '. °ir~,flir' 'rr,Jwn:;v+w,..r.7.rn:a,gn~c~,~t~C~~ "~~. };I',ti,,„;~1Li.,r,.s~~~•,.•,i :.~,~~,' l.7ril~.'° :~,r a 7.o y,e 2.1 The Nigh Capacity Infiltrator Sidewinder chamber System Is more than twice as elflClent as asame-length stone and pipe syslam. Polyotefn canstruction_ Infiltrator Sidewinder chambers are molded of PolyTuff'", a proprietary blend of polyolefin plastic that includes recycled resins and is formulated for optimum strength and chemical resistance. It's impervious to wastewater constituents and is stabilized to resist ultraviolet rays- Infiltrator chambers are manufactured using an exclusive patented process to assure consistent high quality. AA$HTO H-10 and H-20 load ratings. Infiltrator Sidewinder chambers have been structurally tested by a registered professional engineer, The chambers are available with AASHTO ratings of H-10 (18,400 Ib/axle with 72" of compacted cover} or hi-20 (32,400 Ib/axle with 18" of compacted cover). Nominal chamber specifications- Standard High Capacity Sidewinder Sidewinder Size, W x L x H 3' x 6-1/4' x 1' 3' x 6-1/4' x 7-1l3' Weight 251b 311b Storage 77 gal/14,3 ft' 122 gaV1fi,3 ft' wiscrn1sln oepartrnent of Commerce SOIL AND SITE EVALUATION .Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Page 1 of 3 A.C.E. Soil & Site Evaluations Attach complete site plan on paper nd less than 8'/: x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal referenrxe ptant (8M), direction and St CiOIX _.__ . percent slope, scale or dirnemsions, north arrow , wr-' and`distance to nearest road. --- -- _-- - - Parcel I.D.# prt of 008-1027-9.0-000 _ _ __ APPLICANT INFORMATION - p~a,~e print ~/l Infonnafion. R,~eW -By oate - u es Privac 15 04 (t) (m)) :*S~ rovide ma be use~fo seconds Law, s Personal information ou . . ' r ~ ~~ ~ y y p y . ~'S ~t , _-_ J _~_~ Property Owner - Property Location Michael L. & Debra A. Jones ~ ' Govt. Lot NE 1/4 NW 1/4 S 10 T 28 N,R 16 W ~ ~ -- ---- - --- --- -- - ~ ~- ~ s -- --- - ----- - -- t-4 Property Owners Mailing Address ? ' ~ .Lot # Block # Subd. Name or CSM# ~ c~ 3~/~ ~' 3 Proposed CSM `'~. 2447 50th Ave. __ _ _ City State ~ Zip Codaq~pii~~ ~ City ~ Village Town Nearest Road Woodville WI `54028.. 715-684-4540, ~~' Eau Galle 50Th Ave. ~ Resitienlial E Nuila~e ~ edrooms 3 ^Addition to existing building New Construction Use: (~ Replacement [~ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/ftz •6 trench, 9P~' Absorption area required 900 bed, ftz 750 trench, ftz Maximum design loading rate .5 bed, gpolftz .6 trench, gpd/ft~ Recommended infiltration surface elevation(s) upper trench:91.5', lower:9o.o'. _ it (aS referred to site plan benchmark) Additional design I site considerations Install trenches using high capac;iry infiltrators. Parent material Glacial outwash Fkxxd lain elevation, If a livable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ®S ^ u ®S ^ U ®S ^ tl ®S ^ U ^ S ®U ^ S ® U SUIL UtSGKIth' 1 IUN KtttF'VK 1 Boring# 1: Ground elev 96.69' ft Depth to limiting factor >117" 2' Ground elev AC 7A~ A Depth to limiting factor >116" Horizon Depth in. Dominant Color Munsell Mottles tau. Sz. Cont. Color Texture Structure Gr ~ ~ Consisten Boundary Roots GPD/ft' _ Bed ;Trench 1 0-6 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 6-17 10yr4/4 None sil 2msbk ds cs if 0.5 0.6 3 17-46 I OyrS/4 None sl 2msbk dsh aw 1 f 0.5 0.6 4 46-57 IOyr6/4 None Ifs Om dh aw - 0.4 0.5 5 57-117 ~ IOyrS/4 None strat.gr.s Osg dl - - 0.5 ~ 0.6 Remarks: Horizon #5 contains bands of stratified s & gr.s & gr.ls. Loading rate of horizon adjusted to retlect petmiabitt[y restncuon creates at interface of these stratified materials. 1 0-6 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 6-17 IOyr4/4 None sil 2msbk ds cs if 0.5 0.6 3 17-31 l OyrS/4 None sl 2msbk dsh aw 1 f 0.5 0.6 4 31-116 10yr5/4 None strat.gr.s Osg dl - if 0.5 0.6 Remarks: Horizon #4 contains ds of stratifi d s & .s & .ls. Load' o horizon ad"usted to reitect tab restrtcuon creates at interface of these strati d material CST Name (Please Print) Signat e: Telephone No. James K. Thompson 5. 715 248 7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 11/3/99 3602 1122 ., •PROPERTY OYYNER: Michael L. & Debra A. Jones -' PARCEL I. # f 8 1027 90-000 -- -- -- 3 Ground elev 94_36' ft Depth to {inviting factor > 102" 4 __ SOIL DESCRIPTION REPORT ~ ~ s2 page _ 2 of _ 3 D. _.lM o 0 0 - _ _ _ ~~..,... ------ Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. sistence Boundary f2oots GPDIftz _ -Bed ~ Trench 1 0-S 10yr4/2 None sl 2fsbk mfr cs 2f 0.5_ 0.6 - 2 --- 8-24 ----- 10yr4/4 - -- None sil 2msbk ds cs if 0.5 0.6 3 4 24-42 42-102 10yr5/4 10yr5/4 None None sl strat.gr.s 2msbk Osg dsh dl aw - if if 0.5 0.6 0.5 0.6 ~ ____i._ . u,..;.,nn d!d rrintaine Franitc o f cFrafifterl ~ Rr. or-s & e r.Is- Load ing rate of horizon adjusted to re flect permi ability restr iction created at_ - -_ ~~~ ~ ~u~ ~.~. 1 2 uttertace 0-8 2-27 of these stravuea m 10yr4/2 l Oyr4/4 atena~s. None None sl sil 2fsbk 2msbk mfr ds cs cs 2f 1 f 0.5 0.6 0.5 _0.6 3 27-59 10yr5/4 None sl 2msbk dsh aw if 0.5 ~ 0.6 4 59-91 10yr5/4 None strat.grs Osg dl - _ l f 0.5 _ L 0.6 ~____~,. . u.,ri~nn J!d .wmtainc hanrtc o f stratified c Rc er_s & e r.ls. LOad ing rate of horizon adjusted to reflect pemtiability restriction created 8t Ground elev 93.52' ft ', Depth to limiting factor >91" 5 Ground elev 93.67' ft Depth to limiting factor >94° Ground elev 1 tntertace 0-7 of these strannea m 10yr4/2 atenars. None sl 2fsbk mfr cs 2f 0.5 0.6 2 7-2d 10yr4/4 None sil 2msbk ds cs 1 f 0.5 0.6 3 21-41 10yr5/4 None sl 2msbk dsh aw _ if 0.5 0.6 4 41-52 10yr6/4 None lfs Om dh aw - 0.4 0.5 5 52-94 10yr5/4 None strat.gr.s Osg dl - - 0.5 ~ 0.6 L]nm~rlre • Horizon #5 contains bands o f stratified s & gr.s & g r.Ls. Load ing rate of horizon adjusted to reflect permiability restriction created at Depth to limiting factor ~~_____ _~y ~.3,0~3 !~ . • ~SD~~ E -- /,3.20 ^ 5oi l Obser/ux~-o,-~ p; E E/eda.~ar~ Scc~Ce~ ~=s~D" U,~er: r~ c~aeC G . ~ ,D~6~ ,4. ~ne.,S 2~{S(7 Sa'e i4v~e. u~c~tli~Le~ ~Jl• SyDZB' .L-~~R.-~i'O» /IEyVrI~Jyy~ See. ,D, T..ZB/t., ~Q. i~ u~ y T , a ~' Eacc C-~.L~~ S~. '4~%r C'ey c.9/. E/o/ar trte. ~Qssccmeral lc.d` = ictD.ca' ~~o~ /douse /ocaaFi'o •-~ as SfaXrs/ 8 f ^ , io%7j' ^. 82• ^ b3 BS ^ Bel Grit / Cs,+~ ~ f~lzio~ map c ee. , EIQt~ =87..x5! ~iN'isoar~sin'[~p~trnent of Cornmeroe SOIL AND SITE EVALUATION Page t of 3 Division of Solely and Buildings in accord with Comm 83.05, W is. Adm. Code AC.E. Soil 8c Site Evaluatioffi Attach eorripfete site plan on paper not. less than 8'~ x 11 inches in size. Plan must County but not luruted to: vertical arxi horizontal rererer-ce pant tBN10, direction and include St. Croix , percent slope, scare or dimerrtsions, north arrow, and location and distance to nearest road. Parcel LD.# `~'~ prt of 008-1027-90-000 APPLICANT INFORMATION - Please i~aiff~i>ifonmaid7a~. 04 (1) (m)). Law s: 45 oses (Privac ur n ai d f b Reviewed Date Z~ I~~ , . y p or secg d y P e use Personal information you provide may 1 Property Owner r `"~~-'fr/~ ~ Property Location `Lot NE 1/4 NW 1/4 S 10 T 28 Go f N,R 16 W . Michael L. & Debra A. Jones + v . _~` ~' " ~ ; ~ Property Owners Mailing Address ' Lot# Btodc # Subd. Name or CSM# ~., 2447 50th Ave. ~~ , i ` ~ ~~ I ,3 Proposed CSM City State Zip Code Phon ~ tX ' "Y; ty ^ Village ^Town Nearest Road Woodville WI 54'02`, 7~ N 40 `~" Eau Galle 50Th Ave. 3 ^Addition to existing building : , ^ New Construction ^ Resit~al , , ^ Replacement Dse: ^ Pub{ic ~ • l d .6 Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpdPft~ trench, gpolft~ Ab~tion area required 900 bed, ftz 750 trench, fl:~ Maximum design badmg rate •5 bed, gpolfl~ •6 ~~. 9P~ Recommended infiltration surface elevation(s) upper trench:91.5', tower:90.o'. ft (aS referred in site plan benchmark) Additional design I site Considerations ~~ trenches using high capacity infiltrators. Par~1t material Glacial outwash Flood ain elevation, if a icable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ®S ^ U ®S ^ tJ ~ S ^ U ®S ^ U ^ S ®U ^ S ® U SOIL DESCRIPTIO N REPORT Depth Dominant Color Mottles Structure t ~ B d Roots GPQi~ Horizon Texfitre en Cons s oun ary B d ;T h Boring# in. Mansell C1u. Sz. Cont. Cokx ~. Sz. Sh. e renc 1 0-6 10yr4l2 None sl 2fsbk mfr cs 2f 0.5 ! 0.6 1 2 6-17 10yr4/4 None siI Zmsbk ds cs if 4.5 ~ 0.6 Ground 3 I7-4b IOyr514 None sl 2msbk dsh aw If 0.5 0.6 elev ~•69'tt 4 46-57 IOyr6/4 None Ifs Om dh aw - 0.4 0.5 €3epth to 5 57-117 IOyrSl4 None strat.grs Osg dl - - 0.5 0.6 liming facer ~ >117" k _a -. Remarks: Horizon #5 contains trands of stratmea s do gr s ~ gr is I,oaamg rare of „once„ au~u~w-~, w ,~.~,... ~,..,,,,,o.,...., ....~ .............•.....-- --- 2 Ground elev 96.34' ft Depth to limiting factor >116' 1 0-6 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 6-17 I Oyr4/4 None sil 2msbk ds cs l f 0.5 ~ 0.6 3 17-3I IOyrS/4 None sl 2msbk dsh aw If 0.5 0.6 4 i 31-116 IOyrS/4 None strat.gr.s Osg dl - If 0.5 0.6 °-'~~ se kql. Q ' _a -. Remarks: Horizon #4 COIlt81r1S oI Sg'aWICa S ~¢ .S ai .Ll. i.vauui rau vi ii~,uuu au .w...., .., .~.,..... - - -- --- -- -- interface of these materials. 'CST Name (Please Print) Sign re: Telephone No. James K. Thompson 715-248-7767 ',Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 11/3/99 3602 1122 `Qfiy1~R; Michael L. & Debra A. Jorres ARCEL lD# f008 1027 90-000 SOIL DESCRIPTION REPORT ttri Page 2 of 3 Pn ~ - - .~...,.....~. ,..... ~.....,......_...,.Y - Depth Dominant Color Mottles Structure i B d is R GPD/R~ Horzon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. stence s oun a ry oo Bed ~ Trench 3 1 0-8 10yr4/2 None sl 2fsbk mfr cs 2f O.S 0.6 2 8-24 10yr4/4 None sit 2msbk ds cs if O.S ! 0.6 Ground elev 3 24-42 lOyrS/4 None sl 2msbk dsh aw if O.S j 0.6 94.36`ft ~ 42-102 10yr5/4 None strat.gr.s Osg dl - if O.S ~ 0.6 Depth to limitin -- - g factor > 102" 0 ~,/ ~~" 1 ~`~ -- - - - -- -- - 4 Remarks. Horizon #4 ntains bands of stratified s & gr.s & gr.ls. Loading rate of horizon adjusted to re m ace o ese strat e~materTals. 1 0-8 10yr4/2 None sl 2fsbk mfr flect permia cs bility restriction created at 2f O.S 0.6 2 2-27 10yr4/4 None sit Zmsbk ds cs if O.S i 0.6 Ground elev 3 27-59 lOyrS/4 None sl 2msbk dsh aw if O.S ~ 0.6 93.52' ft 4 59-91 lOyrS/4 None strat.grs Osg dl - I f O.S 0.6 Depth to limitin g factor >9f" _ - - -- - -- Remarks: Horizon #4 contains bands of stratif~d s & gr.s & g - r.ls. Load - ing rate of horizon adjusted to reflect. permiabdi-y restriction created at m ace o ese m 5 1 0-7 10yr4/2 None si 2fsbk. mfr cs 2f O.S ~ 0.6 2 7-21 10yr4/4 None sit 2msbk - ds --- cs if O.S 0.6 Ground elev 3 21-41 - --- lOyrS/4 -- None -- sl 2msbk dsh aw if O.S j 0.6 93.67' ft 4 41-52 10yr6/4 None lfs Om dh aw - 0.4 O.S Depth to limitin S 52-94 lOyrS/4 None strat.gr.s Osg - dl - - - O.S ~ 0.6 g factor >94' _ __ -_ - - Remarks : Horizon i #S contains bands of stratified s & gr.s & g r.LS. Load ing rate of horizon adjusted to reflect permiability restriction created at m ace o stra m Ground elev Depth to limiting factor _ ~ Remarks: .. ~~~ ~f ^ Soi I Obser/a~o,~ P- E Eleda-~5'an ~c.~aeC G. ~,O~dnz ~. mores 2~f'/7 Sa'e i4ve. tvc~rJicLe, ~i. S~OZ~ ~.~c'~ " a ~~orjcb~d Csrt ~Ej'yrlcJ`y~ See. iD, T..zBrt., .Q. i~ u~y T , a ~' Eau C-,o~,L&~ -SE.~ ~ir ~B~ c..9/. t4j. 3 0~'3 -~ --~--+ 50~,4ve. /~~o~ /1okse ~oeax~i`o ~ aS SfaX~tt/ /O/. xj. ~ ~ k W(cu'~C ~ //a~ / %h a '" ~'te.,IQSSGtmGII~ '`. ic~D.c~' 8~ ^ ~~o~ ~~~~ ~_~ ^ b3 ~ ^ B~( ,cat i es„t ~ ~1~~ G~•~ • ~a;/:r~ map/r frce. El~rf =87. Sy ST CRO[X COUNTY SBPT[C TANK MAINTENANCE AGREEMENT AND OWNERSIiIP CERTIFICATION FORM Ownedl3uyec Mailing Address ? G fD ~j pP~q c~ ~.e~- ~~~, ~ ' r Property Address a '-E o ~ ~. ~ z (Vuifrcatioa trquircd from Planning Dcpartincnt for new CitylState _ CeJ ~ o ~ U ~ L L ,~- Paral Identification Number ~,F,,trAL DESCRIPTION Proputy Location /~ ---~.. , = %, Scc. ____~, T~N-R_~ ~ W, Town of ~v.,~ (r',.~ ~. Subdivision ~ I.ot #,3 wed Stuvtp Map # ~ / ~~y ~ Volume ~ Page # 3 ~ /S~ warranty Deed # _ :~ 2 6 ~ Q 7 Volume / ~^Q ~ .Page # -~~~-~l . Spot douse D Yes ~ no Lot lints identifiable (9, yes ^. no T~ANG'~ • ~~OfY'~'~spsocmooalda-sultmiSspcrctatatic.tohan~dicwuGcs.Properc ooasis~s of p oat dye scpti~c taaic ~Y t>zroe y,~ ~ if wooded a ~u dye ,f mcbi~a~a of Sye ~ .~ . ~ y'~ P~.iato Bye system septic tanlt-a~s.a treztmeatstig~e is 8~e vrastedi~osalzys~, 1Le P~'~Y ~; =S~xs to u~mit to St C~c Zoning D ~ oaiifi~cation form, signed by bye ewmx and ~y- i u'P4~]~y~aPt~Oodpinmbcro~ralie~edP~~Y~B~(Ij gye oa~ita~vastcavatatdisposalsy:beat papa opes~ag co~itioaa aadlar (~) aRa iaspoction and pumping.C~Y), ~ scptiatauk~is less t#raa U3 faII of shydge. . ~ ~ ~ ~ the abvtre tugaic~ sad agzve to t#yc .~ ~ , gas act 6y dye Depsctarayt of (aoarmcyce and bye ~~ ~g° ~~ with Ere standards Dcputmeat of Natacal Resoanocs; State of Wisooasia.. Cer#~adaa ~ Y~ has'boca maintained must be ~~ and ychnmed to tlyc St. gvix.Cocmty Zoning Offia within 30 dayr~ of tin dme year ppiation date. SIGNA OF APPLICANT `~ DAZE O'GVNER• G~RTII~CAZION I (ure) oectify that all stat~cmcnts on this form arc true to the best of my (our) Icnowtcdgc, y~ proP~Y dexa~bod above, by vic0ue of a wutanty deod roooraod is Register of Deeds Office. %~'' ~ ~- _ SI r~'NA ~ OF ~APPI:ICANf I (wc) am (nre) the owner(s) of DATE assess ~ ~ ~ ~ mis '~~Y ttxult in the sanitary permit being ncvoked by the Zoning Departuicat. eessss «e Iaticlndc Frith tlyls appGcatlon: a stampod warranty dad &~ the Rcgistu of Deeds otlicc a copy of the eertifiod survey map if c+cfer+eaa is made in the warranty deed n ~ FILED ~o FEB 2 5 2000 - ~ aoWaem 11 stctaltco.wt w ~~ ~ ! ~~~ NW CORNER ' 1EC. ,° CERTIFIED SURVEY MA P ALUMINUM cav FouN° Located in the NE 1 /4 of the NW 1 /4 of Section 10, T28N, R 16W , Town T of Eau Galley St.Croix County, Wisconsin, including Lot 1 f sao°oo'oo"E Owners: Mike & Debbie Jones of that CSM recorded in Ijzz.<s' ; 0 2447 50th Avenue Vol. 8, pq. 2209. :, ,, Woodville, WI 54028 Bearings referenced to the ~' -- - North line of the NW 1 /4 of DETAIL a NOT TO SCAL Containing (and being a replat) Section 10, assumed to be °: of that Certified Survey Map S 0°00'00"E. ~ recorded in Vol. 8, page 2209. 50TH '~~~'pb`'-0~"E^132'48' A VEN'UE T JJ0<~ ~ _ ~ ` S 90'00'00"E 1322.44' ~--_~ n JS.OJ' T ~ _ _. r es3-es - - - '~. ~4 --~.~ 3 ~.~e~ - - ' J L . ... .. © 7B Ioro,s6 NORTH L/NE OF THE NWl/4 6 <.A ~ N' 33A ~~~ s~ N~~ '^ ~~ N B°; ;'+0"E ~.,j!' .-... 104'SETBACN... LINE -+~ '\~ `~ J6 / , a ~' . J~ NI/+ CORNER i SEC. 10-28-16 _..... q . . .._ • ... ... ....... .: . F, i . ... .. Note: this private road ease- `~ p~p, ~65~~' N3B°00'+0°E ' COUNTY ~• SURVEY me et Will SQT V1Ce Lot$ 2 and 4~ ?\o`~ / .dpi 67.17 1 / ~ 01 N NAIL '~ ` < N FOUND. 'p N90°00'00'£ ~ i ~~ :216.96' J 'a•, ~ ' r ~ ,. ~ J ' y. ,10.17 l6B3! ' ~ 6 sa ' ~~ 16.17' ° mo .e~4 ~ 283.9 B'. o ' \ .. .. _ \ , " S 0 00'0 "E ' I 96.71' '' ~• 20E11:~'~ ~ II N ? 1,256, 178 Sq.ft.(28;84 Ac.) :~ I IL®7T i l di i h f ~ N w N 2 nc u ng r g t-o -way. w N I /JO,sB/ s¢Fr.l z17 F B s r• i N'v .~ , - , . OO o. o J.ooacRESj 1,222,799 S ft.(28.07 Ac.) a q' Y) . b 5.00 ACRES I l71 Nm N .+ . N 3: excluding right-of-way. n ~' j mm N I to~ ° N^ N .m-t ~ Q ; s m I ° Note: Easement recorded ~~ ~ I ~o°; I gy m` W Z i ~ m o z on CSM in Volume 8, page ° ~ ~ ~ I ° n Q I ~= 2209. This will be a ~ I N IL®7T 1 I w 0 ~ ~ In ~ joint driveway easement for I o I ? "~ i Lots 1 and 3. ~ ~ o W ~ x APPROVED ~._o ........ 30o.oo/L _. ' ' ' ... o- iv i ~ ~ z, N 90 M 00 0 ST. CROtX COUNTY ° in~' _~,n Ph ~ • ~ ~ i 4 nn eq r hN (~ ~ I 0 N N Q~ i f kB 2 4 200 313.94' •, ~ d I i ~' t. ~ ~ S 90'00'00"E = Z ~ ~ ~ If not recorded within 30 days of LOT 3 A C REAGE ~ i i w 3 "~ approval date approval shall be 140 , 097 S ft . (3.22 A ~ q ' h I Q` nWl and vdd including right-of-way= ~ L I29,835 Sq.ft (2. Note: Rock pile at SW 98 A)~ l >I excluding right-of-wayb corner, witness corner 2 ~ found 502°55'33"W $.55' ~~ from corner. vi' U~ SOV 7H LINE OF THE NE-NW 502°19'33"w s es' 58 ~ 18"w 3320 . ~4' 8.11' UNPLATTED LANDS _ LEGEND ; _ ST. CRO1X COUNTY SECTION CORNER (AS NOTEDI. ~ . o `~ ,~ et ~ I'X24"IRON P/PE WEIGHING L6B LBS./L1N.FY SEY. ryQ~i • I"/RON PIPE FOUND. 2 M !R/ PREVIOUSLY RECORDED INFORMATlO N. s1/+ CORNER CURVE NUMBER. I SECTION ro•2B-r6 ° ! IRON PIPE FOUNOI. -. -. - OLD LOT / LOT L• !NE (C.S. M. V.B, P. 22091. SCALf 1N FEET / "> 200' O 200 400 600 This instrument drafted by 4992656 Vol. ]4 Page 38]5 V p V(11..15()1 PAGE 448 IT CLAIM DEED Dated this +~ID day of I , 2000. RECEIVED FOR RECORD Michael Jones, a/k/a Michael L. Jones and Debra Jones, a/Wa Debra A. Jones, husband and wife, quit-claims to Jason Iverson and Amy L. Iverson, husband and wife, holding as survivorship marital property, the following described real estate in St. Croix County, State of Wisconsin: ~/ • el L. Jo es Debra A. Jones Name and Retum Address Thomas A. McCormack 102010`" Ave. Baldwin, WI 54002 008-1027-90 (Parcel Identification Number) Part of the Northeast Quarter of the Northwest Quarter (NE '/. of NW '/,) of Section Ten (10), Township Twenty-eight (28) North, Range Sixteen (16) West, Town of Eau Galle, St. Croix County, Wisconsin, including Lot One (1), more particularly described as Lot Three (3) of Certified Survey Map filed February 25, 2000, in Volume 14 of Certified Survey Maps, Page 3815, as Document No. 618846, office of the Register of Deeds for St. Croix County, Wisconsin, TOGETHER WITH AND SUBJECT TO anon-exclusive driveway easement over and across the above- described property as shown on said Certified Survey Map, in common with the owner of Lot One (1) of said Certified Survey Map, which easement is shown on said Map as 66' easement, as described in that certain Joint Driveway Easement Agreement between the parties of even date. AND FURTHER SUBJECT TO the Terms and Conditions of the Protective Covenants for said Certified Survey Map of even date. This is not homestead property w AUTHENTICATION Signature(s) authenticated this day of , 19_ signature type or print name TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, WI 54002 620957 KATHLEEN H. WALSH kEGISTEk OF DEEDS ST. CkOIX CO., WI 04-10-2040 1:30 PM QUIT CLAIM DEED CERTPCOPY FEE: 8 COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 ACKNOWLEDGMENT STATE OF WISCONSIN ST. CROIX COUNTY ; Personally came before me this day.of ~' , 2000, the above named Michael Jones,' MicfS et• L•,. Jones and Debra Jones, a/k/a Debra A.:..lone3; to -ne~odyn to be the rson(s) who executed th ~fQre~ngrins~m~na and ac e e the same. ~ y ~, - J •' ~ =~ ~'~', Q •~,~ si ature pe or print name ~ Notary Public St.~Croix County, Wisconsin. My mmi ion is permanent. (If not, state expiration date: ,) 'Names of persons signing in any capacity should be typed or printed below their signatures. l V ..7 1~ r Informatlon Professionals Company Fond du Lac, Wisconsin 800.855-