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W+sconsin Department of Commerce R A I-101- EVALUATION REPORT Page ~ of
Division of Safety and Buildings
in accordance with C m 8sL5 n c
Attach complete site plan on paper not less than 8 1/2 x 11 in es in size. Plan must ry
include, but not limited to: vertical and horizontal reference po it (BM)ydirection and I.D.
percent slope, scale or dimensions,. north arrow, and location nd dis&6 to sie2lkes}?rf 4
eDate a __b i
[)~w
Please print all information. PnvaLa~WrT(m~-
I- G
Personal information you provide may be used for secondary purpose
Property Owner P. operty
rGovt. Lot 1/4~5 1/4 S T N R/ ly E (or) W
Property Owner's Mailing Addre Lot # Block # Subd. Name M#
1112 tj S 5
Gty State Zip Code Phone Number ❑ city ❑ Village Town Nearest Road
W New construction use: esidential / Number of bedrooms Code derived design flow rate C J J - GPO
❑ Replacement Public or commercial- Describe:
Parent material Flood Plain elevation if apicable ft.
General comments GStnti Nod QeG e(~d[~
and recommendations:
Cor.. oJr
❑ Boring
[Esoring #
Pit Ground surface eleva 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. 'Etf#1 'Eff#2
Boring # ❑ ring
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
2
3 r--
AZ
• Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD 130 nV& and TSS < 30 mg1L
CST Name (PWw Print) re CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 715-246-4516
5
Property Owner _ Parcel ID # Page of
❑ Boring # E] Boring 19 Pit Ground surface elev. ft. Depth to limiting factor ~0 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2
e-s- 7 f- 1 ,6 ,S
Jr- L
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eif#1 'Eff#2
❑ Bonng
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 GPDlfF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
FT
Effluent #1 = BOD$ > 30:E 220 mg1L and TSS >30 5150 mglL ' Effluent #2 = BOD5 < 30 mglL and TSS 30 mglL
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SOD-8330 (PL6 )
i
1
Soil Test Plot Plan
Project Name Gloria Vorwald Trust Shaun B'; 'd
Address
1108 Cty Rd N
Roberts Wi 54023 (CSTIVI #22600
Lot 5 Subdivision Date 12/28/05
NE 1/4 S W 1/4S 4 T 28 N/R18 W Township Kinnickinnic
n Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Iron
System Elevation 107.2' *HRPSame as Benchmark
Alternate Benchmark Top of 1/2" pipe @ 100.4'
CtY Rd N
Scale is 1" = 40'
unless otherwise
noted
52'
30' B-1 85
20'
85' -2
106.5'
35'
9% Slope
AtI.B.M. B-2
B.M. 103.5'
78' Property Line
. RECEIVED
11111111111111111111111111111111111111111111111111
SEP 5 zoo? 856769
KATHLEEN H. NALSH
ST.cout ST. CROIX ► REGISTER OF DEEDS
RECEIV
EDIFOROR
08//02/2002/2007 09:30
~IED SURVEY MAP
:30AM
LOCATED IN PART OF THE NE 1 /4 OF THE SW 1 /4 OF CERTIFIED SURVEY MAP
SECTION 4, T28N. R18W. TOWN OF KINNICKINNIC, ST. NORTH 1/4 VOL: 22 PAGE: 5429
CROIX COUNTY, WISCONSIN. CORNER
SECTION 4 • REC FEE: 13.00
~o~So(tv~- COPY FEE: 3.00
REPARED FOR: - - - : OV111ffER:2
ANNE WILLIAMS a d(OL- p(Go I ; 5E, i GLORIA F. VORWAU)
108 C.T.H. 'N' - I i n J p REVOCABLE LIVING TRUST i3
OBERTS, WI 54023 EAST WEST 14 LINE
S 3
N89-42'37"W 660.08'
_ _2a'L C.T.H. "N" 3s3.o4 _ ° sauw SMVW3~r
297.00 ; - £21 / ~ FROM SET
N 31;3_00' cC:\
.........58 .0.0"9- ........6l30.OP . I o
WCH Top
oof 11 aM10N+ , A A 1 66' 0 i (0
LOT s LOT 6 i o, - J~
Sn? A 9 r j °
3 g C i( - a,= w I j This Certifled Survey
was prepared
pursuant to a
partition order issued
It 4 _ Z b the St. Croix
~E7•.~ J O ~ County Circuit Court
a g r
g v a; O a i \ ,o.~ .5 April 30
4011 1 c pF w~G'0
~d W cc
couatm.A
ZAHLM
Cie
8PJ14#-et4-( 8-2146
;M ro
time J~ ~v EASE?3.' 166' kAC o
zt~U
{,,gg 7.3 363.04'
si 9i I Cn w
on rn 1
13-
S8942' TE 660.07' j cn po O
V
r.,
~ o BUILDER SHALL BE
66' j RESPONSIBLE FOR
'
53
DETERMINING PROPER
STRUCTURE ELEVATION
to i AND APPROPRIATE SITE
N LOT T GRADING.
62 0
fO- s j i Z LEGEND
y~ o I ~ O FOUND 1-1/4' OUTSIDE
$p j 0 DIAMETER IRON PIPE
FOUND 1' OUTSIDE
40
I g 3 m S89'16'01 "E 660.02' DIAMETER IRON PIPE
$ S89'16*01'E 660.02' 13' SET 1' OUTSIDE
DIAMETER BY 18' LONG
u NJ nMP(t At5T[DD LANDS IRON PIPE, WEIGHING 1.13
LBS. PER LINEAR FOOT
u A SOIL BORING
g SOUTH 1/4 LOWEST BUILDING OPENING
CORNER LBO - THE LOWEST WINDOW OR
SECTION 4 DOOR ELEVATION
LOT AREA TABLE
LOT /E DESC. SQ:.FT. ACRES EASEMENT
C', LOT 5 INC RW 217.802 5.000 LINE TABLE
LOT 5 EXC RW 200.765 4.609 or BEARING D/ST. ,V BEARING D/ST.
LOT 6 INC RW 266.202 6.111 £1 N011091.3. 31E 55.01 Eft 567176 07'W (32.43' ,
LOT 6 EXC RW 243.865 5.588 £2 N01'09 33 E 234.52' E13 567176 07 W 186.85'
o m LOT 7 315,319 7.239 E3 N010933 E 81.67' E14 S401»5 06"W 201.14'
vi Q+ RW - C.T.H. "N" E4 S36:3530E 100.28' C15 1V0117933 E 154.56'
E5 S0871OS E 19763' E16 N67106 07 E 51.34'
m m " E6 N67176 07 E 122.25' E17 N082105 "W 198.03'
gv SCALE IN FEET 1 = 200 E7 N6717607E 325.25' C18 N36U530'W 23.13' ,
E8 S01179 3 3"W 311.17' C19 N011 .9 J3 E 73.58'
45+ 200 O 200 E9 SOf17933W 139.59' C20 NO1V933E 109.51'
E70 N3917339W 780.50' £21 N885908'W 115.12'
i of IS INSTRUMENT DRAFTED BY: WILLIAM KANE Elf N247958"W 138.29'
I~OB NO. 6514-02 DATE: 06/27/2007 SHEET 1 OF 2
Vol 9.-)- -m sq 23
Parcel 022-1009-75-000 02i28i2008 02:47
PAGE 10F 1
Alt. Parcel M 04.28.18.57B-10 022 - TOWN OF KINNICKINNIC
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
08/02/2007 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
0 - VORWALD, MICHAEL A
MICHAEL A VORWALD
577 FAIRHOME DR
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 1143 CTH N
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: 5429-CSM 22-5429 022-07
SEC 4 T28N R18W PT NE SW BEING LOT 5 CSM Block/Condo Bldg: LOT 05
22-5429
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
04-28N-18W NE SW
Notes: Parcel History:
Date Doc # Vol/Page Type
10/26/2007 863083 TD
08/02/2007 856769 22/5429 CSM
09/26/2003 741459 2420/375 SC AF
07/15/1992 485896 959/292 TI
2008 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/30/2007
Description Class Acres Land Improve Total State Reason
I
Totals for 2008:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00