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Home My WebLink About040-1316-16-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 556363 0 GENERAL INFORMATION 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: Schaben, Curtis & Jodee Troy, Town of 040-1316-16-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: / 6Z , 0 rv 4/7 c' ^ 08.28.19.2072 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /66- 0 Dosing Alt. BM Aeration Bldg. Sev qU dq.(,~Kq 01 7 .2 ~3 Holding Ht Inlet q• y 7 TANK SETBACK INFORMATION t/ t Outlet SGF-( 3t~ 3 5; / 6 TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet `mf~, f Septic Dt Bottom Plo ~4A / Dosing Header/Man.-rM 5 r / cif, o / i- Aeration Dist. Pipe Holding Bot. System, o PUMP/SIPHON IN ORMATION ( Final Grad f'r' / t 3. t Lou/ Manufacturer Demand St Cover GPM /!'1 SC~YS 4,44 Model Number P Q c'a~ 1 I" a~ /Cf/ ~ 5 !31•~ TDH Lift Friction Loss ystem Head TDH Ft Forcemain Length Dia. I)RgHo Well SOIL ABSORPTION SYSTEM I f t-/ / BED/TRENCH Width I Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Q/ 1.1 SETBACK SYSTEM TO P/L BLD WEL LAKE/STREAM EACHING M ctu r: r INFORMATION CHAMBER OR Typ Of System: ~5y1 Model Number: Zb DISTRIBUTION SYSTEM 4 Distribut// w i~ % Ix Hol S e Ix Hole Spacing ent t ~Aljr ke W ¢ Pipe(s) ~f 4-I ,,a ~t~r~ V f~ Length Dia Length `Dia Spacing =4 SOIL COVER} x Pressure Systems Only xx Mound Or At-Grade Systems Only ~J g/Gn Depth Over 1115 Depth Over Ixy Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~J Bed/Trench Edges Topsoil t Yes FE No [51 Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 2 Inspection #2: / / Location: 499 Atumn Blaze Trail Hudson, WI 54016 (NE 1/4 NE 1/4 8 T28N R1 9W) Cedar Woods Lo 1 Parcel No: 08/.2/8.19.2072 1.) Alt BM Description = {'J O~LL ~~Q~~Z / .Syl~hN ft )L %a1 f~ b.Lct IGL~.~ 2.) Bldg sewer length = l"!' rLr~~fOfS ~C ~GG( - amount of cover i L Plan revision Required? ❑ Yes ~No ` Use other side for additional information. Date SBD-6710 (R.3/97) Insepctor's Signature Cert. No. A L r ~ ~vJ n Ir ~ x ~ q 4 KNUDMON e~ cn`N swc~ a LLC ¢ S 927150TH ST RbBERiS, 54023- 8 K`f~~ p !ice 5e~q 6e.~ Z 7-n P ~2•, fo v 2 . 0-7 ~ /haws f / ~ ~a erwa'nt~,T Safety and Buildings Division County S C,-a j < D - 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) a?~ Madison, WI 53707-7162 ?J 55(p 36 p, 'rsS101aA~- S e7it Application State Tra sa on Number 90* submission of this form to the appropriate governmental unit / In accordance with SPS 383.21(is. Ain. is required prior to obtaining a sanit~ty ` i~4t Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Pro al Servies. Personal information you provide may be used for secondary purposes in accordance with th vac Law, s. 15.04(1 (m , Stats. l/°D 1. Application Information - Please Print All Information l Property Owner's Name ' Parcel # Gc o~ v .2`' Property Owner's Mailing Address Property Location ~Zo 7Z~ Gj Govt. Lot City, State Zip Code Phone Number /U y, VSection C(circle one) l T N; R E o<n of Building (check all that apply) Lot # ~Y - / Subdivision Name or 2 Family Dwelling - Number of Bedrooms rw"~ Block # ZAJ C)G D k a~! v G S ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use / CSM Number ❑ Village of P Town of T .1 -n III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. &I'lew System El Replacement S System El Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) Y ~ B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner TV. Type of POWTS System/Component/Device: Check all that apply) t Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 10I&A15 ❑ Holding Tank ❑ Other Dispersal Component (explain)❑ Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Ra gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) Sgian Elevation VI. Tank Info Capacity in Total # of Manufacturer - w Gallons Gallons Units - t? c New Tanks Existing Tanks o y IvJ/ a ~,d I ~ k- a. U 'D Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe ' Sign e MP/MPRS Number Business Phone Number !C12' 1Z /7 Plumb ers Address (Street, City, State, Zip ode) --.7 o -2 VIII. Coun /De artment Use Only Permit Fee Date Is ued Issuing gent Signature Approved ❑ Di wen Reason enial $ 475- 46 116117 1 1 G IX. Condito"p ~weasons for Disapproval 3, w ykwb~- J r p 10 1. peptic tank, eftluent fker and I n G / )dispersal cell must all be services / maintained ~L6 G ham[ j~(' 815 4W management plan provided by plumber. ~C r 2. A1111 )wick requirements must be maintained L ats per code / w0wim, Attach to complete plans for the system and submit to the Co ty only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: o ~Z a-6 e-~ , 6rC e- Owner's Name: G' C r 24.,r- 5C-. /,,::s 4e t,z Owners Address: 6 Jam- 2 c7 c. -4aso h /.g Jft ~ ~d Z4 Legal Description: /9J G J7,_r GU 1~ f S @ e_ T j Sly 45 lrC J Township:p t/ County: ~j moo, jc Subdivision Name: Lot Number: l~ Parcel ID Number:j 441D Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cry Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber. 1- License Number: ~T~ l Y Date: _ L A, 7 Phone Number !Lop Signature r Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 12 e~ y 4 Le- - I st v I _ KNUDTSON PLUMBING & CONTRACTING, LLC a l r ao ~5 927 150TH ST ROBERTS '5402.3-8 n , O 2 A ,~3 rrr ~ ~ T r 'r oo7 s c T~ s A~ i Soli Abeomtion S shun So-edon C Sdtedube 40 Final Grade PVC Vert Pipe vm Verrt cap It Leaching chalnber syAwn EWaMon ft ft Z- ft T Soil Absorpdon System Plan View s~ It It Trench t ft Leeching Chambes e Dia. Trench 2 Header Vent Or O~rvatiar Pipe Lmd*w Chamber RAM Manufac lurerAnd Model iZ 1~a G ct EISA Rating -6XO sq ft per chamber sou ApprmaWn Rate • 2 gpd/sq ft 400 gpd Design Flow Sod Application Rates EISA = hers 02 ,~ro s of--- Z chambers each. Page of ~I 0 Filters PL-525 EFFLUENT FILTER ~ The PL-525 Filter is rated for over 10,000 GPD (gallons per day) 1116" Filtration slot's r making it one of the largest filters Alm in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok Ed&Wml PL-525 has an automatic shut } off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. 63 Unm k of >nV . No other filter on the market can F*rdfm- ft Phadforau c make that claim. 10=&O pt _ JAW, G PL-525 Maintenance: SM.40rp ^w The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before -p v requiring cleaning. It is recom- mended that the filter be cleaned T" every time the tank is pumped or N . at least every three years. If the . - r installed filter contains an optional Y alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank Dumper or installer. a~.oR U.S. Patent No# 6,015,488 Fft, T ' I' 1 , .Locate the outlet of the ss7i s4o septic tank. 2. Remove tank cover and pump tank if necessary. PL-525 Instalialon: 3. Glue the filter housing to 3. Do not use plumbing when the 4" or 6" outlet pipe. If filter is removed. Ideal for residential and com- the filter is not centered 4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening 10,000 Gallons Per Day (GPD). use a Polylok Extend & 5. Nose off filter over the septic Lok or piece of pipe to tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page back into septic tank. septic tank. 19-21 for Extend & Lok 6. Insert the filter cartridge back 2. Remove the tank cover and information. into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter the filter is properly aligned into its housing. s. and completely inserted. 5. Replace and secure the septic 7. Replace septic tank cover. tank cover. Private Ousite'Wastewater Treat CRt Spstem In-4Groilad M"agemeat Pisa Pur=ktt to SPS 38354 Wis. Adm. CAde eKh Private OUBM WasWvrab= Ticaftent System (POWTS). Sail include Wocmatitan and procedum far the s9~ vMlinft pKamcom of SPS 383 aad 3K and the conditions of appaval by to dreg t, ageat, or g 9camn nud unit Ibb Mpoved. pbm and pamits for the system wM be fiord with the county zoe mg ac health depsttrtummt- 'Ms m=Wmst plm codes with SPS 38354, Wis. Adm. Cow and the In-Cxr~ SoR Absorption Compaoot Msaasat for Private Onsite War Treamrtent system (Version 2 ) SBD-10705-P (N-01/01) Table 1: System DesiV Specifications Permiitl~Tiuuber Number of Aedrooms Desilp Flow GPD p Sail Size ft. septic. Caplaw Tank GaL Gal- CaPWA Chembex of Wasd~ TM Table 2= Soil. Absomptian Component Limits of Reliable Opernfim s Tam _ _ ' GPD Max. In$a®ot Pattide size NA M BOD 5 NA 220 Maximmn TSS NA 130 AdaxMmQ FOG N 34 Table 3: Maintenance Schedde - Tank andlor srzamioe once eveg 3 Oudet F'%w Should ' once a and clean as needed- ammber Umea once every 3 ifappficable Soa1 Service Provider_ 12ower's POWTS Re ulator t Croix Zoning- - - ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 011111 74 S Mailing Address Property Address z-ov pefZCe 5 (Verification ieq "aired from Planning & Zoning Depart`r new construction.) City/State 1, k~~a 1 Parcel Identification Number LEGAL DESCRIPTION Property Location /A44- V. ,1Y. , Sec. , T _ N R_,/? W, Town of 7;;o cz Subdivision Plat: Lot # Certified Survey Map #~rs~ X314 f~ - C5(~ , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house D yes R,-n-o Lot lines identifiable &I/es 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms - r~. SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) • LINPLATTED LANDS cr% cc W (SOUTH) " ~ io S00'56' 40"E 259.33', °D o -C co cv 2 193.33' E .6 4 ~°Ili co CC) co 6019 I 3«90,LS.OOS , fA I rn 247.77'SOO'52'56"W 240.17' 1 w c o 11 m r :2 cr) LU Lo - 10 - U) CD - I C I Lo (n I to 1-1 I lQ 'M N cn a) .14- _ rn ~ CO tV aD Co I { 1. { Q N CD 01 I tD z r~ { ~o a; Q ui `n J l~ N -ft d' t Q r LLJ o f > I I ai c a) i- o n { 00 (NCO-34' 40 (u L-" SOO'37'45"W 38.93 NOO'54'01"W- 218.86 - 1 Q) ~ ~ - 257.79' u'' W _ tp ) •`U r'` N ~ 257.79' CO 0 lt Lo 102.68 155.11`' ~ Q ai o w NOO'54'01 "W J 00 N co 0) r\1 V) CX M-04Zk M :31IJ 95-v8-5Z~-008 OLOZ •Nv 03SIA38 0 \ 09L44 IM '>1008 N301VW OL MAH Sn 9LL£M Z :anod-1SOd 313 0 OLOZ laVnNVP ' y0 313801100 ivnNVV4 OIld3S w o :anod-3ad „0-,l=„ti l :3lVOS 3wS :A8 NMVaO 2 13531M 21W-OSZLdIM N \ F J ~ z N w O 0: J o w H lj a J Z U Q U Q w (n U) w 0 m w w z p=O 0 0 U N 9: m W O U UJ H w J O (n 0 J a Q 0 Z - w a LL 0 ¢ Om 0 Q z M z a w~ ¢ w °w m a Q 0O mN WJww C7 C9~ z z 0 CL 0 0125 U = o Z o> O I L~ U} _ Z V1 V n w c[ o C) M s e iD J Q a Q w to @ J F- p fn Z 1-- Y n a a O LL. U N\OstM w~ mWN 0U z~ Q~ 00 z F v ¢ Q LC) N U Nw N~poF-I,JJO JWQ¢ JW N ¢ yM- Ja loJJ= `°,io z` cr>~ > J ~ ~n S2 Z D N LJJ \ N LO - * -i ao J ~ U I- z w F- = U 0 n N - i F~-(n ~zw U Y J Q J \ WN aF- ZJOJZMUF-Oom 00tn 0N~ Q ~OF 0 NJ0 ma X~ aU < N~ Y 'n3 m oco~~=ma za~< ¢~0 U OD0 z z a U ~O Z W W Fww- 0 O H Y WAL~1 Y oLi Q J J 0 0 00 Z Z >Z to p Z Z J 2 J H 00 Fa- U J Q W N I Q 1 H N Q r U W s P~ 6£ 0 12 o z w w w j l I w C, w SVO N O J N •8F do i ~m _ N w w N c° „ 9£ w N O CL LLJ I Q w W V) 0 N < it svo o l Y~ \a „odo ~ 0 0 W s ~ F N ~ U Z ~ Z 0038 a SV „ZS Q N Y Z Q H _ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer •2 S Mailing Address Property Address T (Verification requi ed from Planning & Zoning Departm for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location G(J%4 , Sec., T ~ R_,~? W, Town of 7;:;o CZ Subdivision Plat: C c~~ (J2 6 Lot # Certified Survey Map 0,$0 .14:~ - 6C , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house ❑ yes [B no Lot lines identifiable Dl es ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of 7anty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) 8095921 State Bar of Wisconsin Form 1-20 Tx:4074288 Ile WARRANTY DEED 965373 ~ BETH PABST Do tNu' be.,Document Name REGISTER OF DEEDS ST. CROIX CO., WI y~~~ 10/16/2012 09:06 AM THIS DEmade between G & L Land Development, Inc., a Wisconsin EXEMPT#: NA corporation REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE: 175.50 and Curtis A. Schaben and Jodee A. Schaben, husband and wife, as PAGES: i survivorship marital property ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): FSA Tide Services, LLC Lot 16, Cedar Woods Subdivision, St. Croix County, Wisconsin. 5645 Memorial Avenue Stillwater, MN 55082 File No. 120743 040-1316-16-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: This property is subject to Covenants and Homeowners Association By-Laws. Dated September 4, 2012 G & L Land Development, Inc. (SEAL) . W,C~ (SEAL) * * Glen M. Wiese, President (SEAL) ,Z,-44i / L' 1 4e- (SEAL) * * Lola M. Wiese, Secretary .AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF authenticated on ) ss. w COUNTY ) * Personally came before me on September 4, 2012 TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Glen M. Wiese as President and Lola (If M. Wiese, as Secretary of G & L Land Development, Inc. not, authorized by Wis. Stat. § 706.06) to the known to be the prxson(s) who executed the foregoing i ment and ack o ledge a same. THIS INSTRUMENT DRAFTED BY: Baiers C. Heeren, FSA Title Services, LLC Notary Public, State of 5645 Memorial Avenue; Stillwater, MN 55082 My Commission (is permanent) (expires: (Signatures Ina) be authenticated or acknowledged. 13oFh~i a n_ot' ece, lri: NOTE. THIS IS A STANDARD FORA. ANN' NIODIFICATIONS TO THIS FOR I:SIIOUI~1>'I3pa ItE~l 1.L1~1)1?►~1P~FI wARRAN) DEED 0 2003 STATE 13A12 OF WISCO~i- 'N s:NA Notary Public FowNi N .1-2003 'I"Itq~d name below SianatUres. i,., c [41if1R@S!J18 Aly Commission Expi.es Januarv 31.2014 Wisconsin Department of Commerce SOIL EVALUATION Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. CCounty St. Croix Attach complete site plan on paper not less than 8 %3 x I 1 inches in size. Plan must Include but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. O4O- Percent slope, scale or dimensions, north arrow, and BM referenced to nearest road. - - Revi by Date Personal information you provide ay be ses vacy Law, s. 15.04 (1) (m)) Property Owner Property Location G&L Land Development, c. Govt. Lot NE NW %4 s T 28 N R 19W E (or) W Property Owner's Mailing Address Block # Subd. Name or CSM# / ZD 7-al W12491 890 Ave. 6)1 Cedar Woods c I ST- CROIX COUNTY City State Zip Code Phone Oeffy 0 Village El Town Nearest Road River Falls WI 54022 715-386-2928 Troy Coulee Trail / FF 0 New Construction Use: 0 Residential / Number of Bedrooms Code derived design flow rate GPD 0 Replacement 0 Public or Commercial - Describe: Parent Material Flood Plain elevation if applicable ft. General comments and recommendations: B-1 was completed during the preliminary soil assessment on July 22, 2005. The lot lines were not clearly marked during completion of the final soil assessment. Sufficient area is available for installation of the POWTS, however the plumber prior to installation of the system must confirm the location of the lot line. F 1-1 Boring # OBoring 0 Pit Ground Surface Elevation 93.2 ft. Depth to Limiting factor > 110 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3/2 None SIL 2-f-sbk dsh gs 2f 0.6 0.8 2 10-22 10YR3/3 None SIL 0-m dsh gw 1f 0.0 0.2 3 22-39 10YR4/4 None SIL 1-co-sbk mfr gw 1f 0.4 0.6 4 39-110 10YR5/4 None S 0-sg ml - None 0.7 1.6 Boring # 0 Boring DPit Ground Surface Elevation 88.2 ft. Depth to Limiting factor >110 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-16 10YR2/2 None SIL 1-m-sbk mfr gs 2f 0.4 0.6 2 16-31 10YR4/3 None SICL 1-m-sbk mfr gs if 0.2 0.3 3 31-39 7.5YR4/4 None S 0-sg m1 gs if 0.7 1.6 4 39-110+ 10YR4/4 None S 0-sg ml - None 0.7 1.6 * Effluent # 1 = BODs> 30 < 220 mg/L and TSS > 3001i<_7150 g/L * Effluent #2 = BOD5 30 mg/L and TSS 30 mg/L CST Name (Please Print) Signature CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 December 20, 2005 715-796-5664 1 Property Owner G&L Land Development, Inc. Parcel ID# 040-1022-70-000 Page 2 of 3 a Boring # 13 Boring Elpit Ground Surface Elevation 88.3 ft. Depth to Limiting factor > 110 in. Soil Aoolication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10YR3/2 None SIL 2-f-sbk mfr Cs 2f 0.6 0.8 2 13-28 10YR4/3 None SICL 2-f-sbk mfr gs 2f 0.4 0.6 3 28-37 7.5YR4/4 None S 0-sg ml gs 2f 0.7 1.6 4 37-110 10YR4/4 None S 0-sg ml - None 0.7 1.6 I ]Boring # Boring OPlt Ground Surface Elevation 85.0 ft. Depth to Limiting factor >110 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-10 10YR3/2 None SIL 2-f-sbk mfr Cs 2f 0.6 0.8 2 10-25 10YR4/3 None SICL 2-f-sbk mfr gs 2f 0.4 0.6 3 25-38 10YR4/3 None SL 2-m-sbk mfr Cs 2f 0.6 1.0 4 38-44 7.5YR4/4 None S 0-sg ml gs 1f 0.7 1.6 5 44-110+ 10YR4/4 None S 0-sg ml - None 0.7 1.6 Boring # 0 Boring opit Ground Surface Elevation ft. Depth to Limiting factor in. Soil A licati n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 • Effluent #1 = BOD5> 30:5 220 mg/L and TSS > 30:5 150 mg/L • Effluent #2 = BOD5 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Site Diagram 0 ft. 24 ft. 40 ft. 80 ft. Page 3 of 3 a) N 0 0 C', O N n O CD Lo M -p~ 0 00 CD N B 882 SI pe r r l~ ti 8_11% `1 93.2 85. ' 16 r B- 88 ' J BKW - Top of 1 /2"PVC 'pe _ 1 r "mil 89.2' - - - f i 1 - r r ti ti =Lot Lines BM# & Description Bench Mark B_1 = Boring Location & Elevation House and well location to be determined Elevation - 100' Owner: G & L Land Development Inc. Site Information: Completed By: Mark Iverson, PSS #197 W12491 890th Street NE 1/4, NW 1/4, S8, T28N, R19W 680 Larcom Street River Falls, WI 54022 Town of Troy Hammond, WI 54015 St. Croix County 715-796-5664 Phone: 715-386-2928 CST# 46672 oi= n.aoxoa r ^ N ^2 &$d MOM IM'NOSOOH ~sn~ p $ 9 s. 9x~3p g9j 4 n;ii ~ ~o'~ d ~ N38HHDS 33Q0f''8121f1o j..-°~ C E 6' 6 ~~t4 NOLLOf1i11SNOO SS3N3NOH3€~wc~'~'§S°-g o ~~~Y ¢aa J g R C 9 .r.rr .r.n ~ n ue amn a8 ~ s ~ °yO J y LL ~ b w R II II P p OW III C ~ Are III ~ ~ a fJ _ : b I'',I a I' i _ Ilia ~ a 4 b - sdI, p~g ~r o"w II bee Cb^ ~d Em„ - - &I' ~mTa ::2Z 4 k C i ~ II I ~ ~ ~ III it 4 111 X0[1 nuarmoa w r' v 9LOb9 IM'NOSOf1H fe,111 iY" ? gg M a }x a n n eq _ q $ ~N~ aM` a°ze ~~q~gB t % 99 r a a~ s qqry ao a N38dHOS 33dOf''812if1o ;'1111 , ~ €q ; g g o ems.+~.~~ 55 g38 is E8 NOuonld1SNOO SS3N3HOH yF f e`' e~ 6~e4'- F4 i€ ' N Hil 2 Q LL az 8 a N m n a - p x i as a.rx om~ - k s.r 9'8 St $~e 4 I y g a!4 a.., t - - - b . mb - " ggk ' y 9 FF. w qi ~ y aa~ a,m,Mx Ae; d r 0 's.: _ - - ¢v g am, a ! a o so i S9 . - - - 9N 8 A9 41oi~ b 4 m no 7T 8L d a. sl[ aor ~J as ~ § I;w°y me'if S sim y rb ~ $ p b .ox tr tl~Nr au I.