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HomeMy WebLinkAbout026-1155-22-000 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of Divisiorfof Safety and Buildings in accordance with Comm 85, Wis. Adm. Code >t County C ( Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, bt*not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 4E percent slope, scale or dimensions, north arrow, and location and distance to nearest road. e'E I VE ® vow Please print al info'IW Personal information you provide may be used for econdary purposes (Privacy Law, s. 15 4 (1) (m))._ Property Owner -7 1 Pro Location LL FEB .2 8 2003 Go .Lot 1\) 1/4 NC 114 S ZZ T ~j0 N Cc i C ST. iROL< Lot Block # Su Name or CSM# / Property owners Mailing Address GOUNT, ~ -fir ~ ~ W S 310 ZONING OFFI ' City State rp Code Phone Num City ❑ Village E}Town Nearest Road MD I~N 2 V'2(C~rv1U Cf• ~i GPD New Construction Use: (9 Residential / Number of bedrooms Code derived design flow rate _ ❑ Replacement Public or commercial - Describe: - - Parent material 1 / --Sit in elevation 9 applicable ~1!!--------- ft' General comments SYc/r~ -G~C(/ r 41,36 and recommendations: T 7 I~ 7 s).,sy~~ ~QeV, u Q S dd ~'~2 C~~ -~-ec.(~I-~- neEcr b Boring # Boring I ZU Rate Pit Ground surface elev. ft. Depth to limiting factor - in. Sod Acation Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots +E GPD Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. f 0-1 I 312: 511 o C~ t q -241 C) 51,61 2 r n-5 b, r• ` 5 - (P 3 2y- 7z ro r - sK1 1,-6bi< < _ 72 --/20 10 y 1-n,5 V-7 Fu- 1- -5t, Boring # 0 Boring L1s1 pit Ground surface elev. /N)190ft• Depth to limiting factor_ ~L- in. sod lion Rate ff#l GPD Eff#2 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots +E in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I o-i to x312 - SiI 2rY CLs Iv~ 5 8 2 1C) yl - << 2M's r - 3 '72 (D 5 ~ -S i c I ZmSb r~~ c • - ~ m S ~s m 1 - L/ 2 9. " r r Sr • Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number - ZS33c~I r Telephone Number Address Date Evaluation Conducted J Property Owner C V- \'c IL----- Parcel ID # Page ~ of Boring # ❑ Boring F-31 21 Pit Ground surface elev. /22_/ 'f. Depth to limiting factor ~d in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Efr#2 6__12 lb 2 S' 1 ZrnabL 2~~ c 1,X' S 2 12-2q I h L4 14 c v), C5 - 3 Z -~t rv s _ I rr,s k C~ ~I (~-~(U I y l~ m~ i l26 -A) 2 s ❑ Boring # ❑ Boring ❑ pit Ground surface elev. _ ft. Depth to limiting factor -_-v in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlffz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 F-1 Boring # ❑ Boring pit Ground surface elev. _ ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtftz in. Munseti Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mglL ` Effluent #2 = BOD5 < 30 mg1L and TSS < 30 mg1L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need rmaterial in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07100) L i PAGE3OF NAME Dot<<c.IC LOT# ZZ LEGAL DESCRIPTION y XNEX,S 2 z T 30 ,N,R, /9'E(or) y0 SCALE: I"= BM 1 ELEVATION 06 - Q BM 1 DESCRIPTION 1 -4 BM 2 ELEVATION /OG 1 BM 2 DESCRIPTION o-.!r fyr Sf ~-c Keo~ ~'~G' Z r SYSTEM ELEVATION 3 a SYSTEM TYPE o v e r~ o v`a. CONTOUR ELEVATION ~p Sao P2. g,M z 33~ ~ 8-~ c)(o 00 83 SIGNATURE / DATE ll l~ U, 2611 P 2 0 8 768074 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO.. WI This Deed, made between Loren D. Derrick. Rose H. Derrick. RECEIVED 2004 FOR 1RE RECORD COR 1 Richard L. Derrick. Joan L. Derrick and Robert J. Derrick Grantor, WARRANTY DEED and Loren A. Zirbel EXEMPT # Grantee. REC FEE : 11.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE : 136.50 the following described real estate in St. Croix County, State of Wisconsin COPY FEE: (if more space is needed, please attach addendum): CC FEE: PAGES: 1 Lot 22, Pond View Meadows II. St. Croix County, Wisconsin. Recording Area Name and Return Address Estreen & Ogiand 304 Locust Street Hudson, WI 54016 ! y 026-1065-10-000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this o(Q~~ day of n 2004 Robe J. D i 9.L. I I * D. Derri * Richard L. Derrick * ose H. rri * Joan L. Derrick AUTHENTICATION ACKNOWLEDGMENT Signature(s) Loren D. Derrick, Rose H. Derrick, STATE OF 01'SGa~S2_►i Richard L. Derrick, Joan L. Derrick and Robert J. Derrick ) o 'X County ss. ) authenticated this day of June 2004 Personally came before me this 0), day of SV r~ e _o c_t the above named L.ore..b.3)er,6',-k• RoS-e 14. Dom' ;c4,a ~L.~Qtc~ O'er4i 'r tpcb be flaTt, S * Kristina Ogland NI C TITLE: MEMBER STATE BAR OF WISCONSIN ~r--' C (If not, ~ ~Ne own to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) ! Y1 ; um and acknowledged the same. THIS INSTRUMENT WAS DRAFTED N Attome Kristina O gland P U '60 r~C . Hudson, WI 54016 . Public,3tate of Of . wist' Commission is permanent. (If not, state expiration date: o o o (0 ) (Signatures may be authenticated or acknowledged. Both are not neces 010 Cl * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du L, wl STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No. 2.1999 l _ _