Loading...
HomeMy WebLinkAbout014-1057-30-000WisconsimDepartment of Commerce PRIVATE SEWAGE SYSTEM +Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Miller, Robert Forest, Town of CST BM Elev: Insp. BM Elev: BM Description: / ~Z~ Y`t~ 1 G TANK INFORMATION TYPE MANUFACTURER ~~ CAPACITY Septic (~ r V ~C'~OiCJ~ ~~ ~ 1 - 7 1 G ~ 0 Dosing s Go ~~a .7~b Aeration r C° ~;r (.~Fio Holdii.y ~ TANK SETBACK INFORMATION TANK TO // P/ 7oJ~ WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~~ ~ ~ Z ~ / 3 Z / `~' Dosing ~ b ~ z.~ ~ 32. r / 3 Z.. ~ `` Aeration Holding'"' - PASiPHON INFORMATION {r,~ Manufacturer J ~ / + L-+r l~atei,~.-T' Demand GPM _ Model Number G ` ~~ G ~C7.~J TDH Lift, ' G~ Friction Lo s~ ystem He S TDH/ ~ L Ft • 7 Forcemain Length ! Dia. ~ I Z. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 5p6375 0 State Plan ID No: Parcel Tax No: 014-1057-30-000 Section/Town/Range/Map No: 27.31.15.428 STATION BS HI FS ELEV. Benchmark ~ "~ /ab :7 ~ Alt. BM ~'+, ~ /Y"7 ~+ 4! Bldg. Sewer 5•b`~ SUHt Inlet ~~ ~~ ~~ • ~~ SUHt Outlet ~ Dt Inlet ~ ~~ Dt Bottom ~~~ Z ~~. y Header/Man. Dist. Pipe 1. tZ, O r7 ~ • J Q. Bot. Systern Z g ~~ • Q Final Grade ~ ~~ / ~ v C R / 7 St CoveF.. y~ (;p , 7i Z ~ /~(p .~ / ~ 17 ~ ~T . 5 Co,n. '~ cu r X ~ 1 G c/, 3 ~~ BEDITRENCH Width / Length / No. O Trenc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth i DIMENSIONS $ ~ ~\ '`~, ~~ \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHA E OR Type Of y,~tem i [ ? ~ ~ ~ ,`~ /I ) T uN Model Number: G J ~t ~ c~ / " DISTRIBUTION SYSTEM !`' °'`" ww Header/Manifo ~! V Z- Length Dia Distribution Z µ / Pipe(s) 7z ( Length Dia ~ Spacing x Hole Size !~ ~/,J ~ x Hole Spacing ~ 2" V to Ai In ~''~1'1 SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Svstems Only .~ ~ ~~.~._. Depth Over Bed/Trench Center ~ ~~ Depth Over BedlTrench Edges xx Depth of Topsoil [ ~{"' xx Seeded/Sodded ~ r~ xx Mulci,ed ~ + ,Yes No I„- Yes i a, No 7 7 ~. (~ 1 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /b ! 3 ~ / C7 Inspection #2: / /__ Location: 2946 Hwy 64 le wood Cit , WI 54013 (SE /4 SW 1/4 27 T31N R15W) 40 acres Lot G~.~CX-~ ~( Pa cel No: 27.31.15.428 1.) Alt BM Description = ~ P 2.) Bldg sewer length = ~~,~, ~ Z ~ ~..6G~S ~'~. ~.~ `_ 1~,0 1t (~ / ~j ~,~,0 J ,~, -amount of cover = I ~ ~w Oe3•>#-'S ~; ~~'r"~F^Je ~, ¢,~ll/ ' O 5 ~a la a"`- ~~ 7r io-- __5ts _P+~_cd~~;,,,,~ l e~~- ~ Plan revision Required? ^ Yes No /~ Q ~ D~' ', /' ~ ~~ `~ Use other side for additional information. 1 t! 1D / __ Date I epc is Signature Cert. No. SBD-6710 (R 3197) na C~~.. st die. a C- (tio ,r~e.. ;, b a+~e++At~.~- su„1 1./ colnfnerce.wi.goV Safety and Bui)dings Division County r ~ 201 W. Washington Ave., P.O. Box 7162 - te) /'ta ~ ~ ~ Madison, W 153707-7162 Sanitary Petmit Number (to be filled in by Co.) Departmatrt of Cotnrnerc~ ~ 5~ Sanitary Permit Application eTransactio n'Number l [ ~ S In accordance with s. Comm. 83.2!(2), Wis. Adm. Code, submission of this form to the appro ovemmen ta unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned a Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary u ores in accordance with the Privac Law, s. ! 5.04 ! (m , Stets. ~~~ d! !. A lication Information -Please Print All Information Property Owner's Name ~ R E C E i~lE D Parcel ~ ~ D ~-L ~ ~ Property Owner's Mailing Address OCT 2 3 2001 Property Location ~ ~ , Govt of St t Ci Zi Code P ~ ~ a e ty, p ~~~CCOUNTY ~'' A' ~~10° e ~V T ~ N; R/ r W CI. Type of Building (check that app! Lot # or 2 Family Dwelling- Number of Bedro s _ _ ~ ifQ,n 'C` ~~ Subdivis~io7n N~a/mfe ~ /~ k # Bl ~ '" ~!~ /7 ~ ~ oc , Cam ^ Public/Commercial -Describe Use --~ ^ City of 0 ~ /~ r ^ State Owned -Describe Us e CSM Number ^ illage of C 7 wn of ~" J dJ III. Type of Permit: (Check only one box on line A. Complete tine B if applicable) ' `~' System ~--~ ^ Replacement System . ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Trarisfer to New List Previous Permit Number and Date Issued Befa~e Expiration Owner r IV. T e of POW'TS S stetn/Com onent/Device: Check all that a 1 ^ Non-Pressurized !n-Ground ^ Pressurized ln-Ground ^ At-Grade ^ Mound > 24 in. ofsuitable soil ound < 24 in of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersalll'reatment Area Information: D esign glow (gpd) ~ Desigfn Soil Applicati te(gpdsf) Dis/persal Area Re (s 0~ Dispe al Area Pro/po~ L m Elevation / / r Cj dt~ ' ! /- ~7 t G~ !!~ 5 ~~ / 7'7 r ~ V I. Tank Info Capacity in Total # of Manu facturer d ~ Gallons Gallons Units ~ ~ y .° New Tanks Exis ' Tanks ~6 ~ ////]~ Y ~ /~/~/~. V~ , ~ ~ ~ n` U ~ `biz. ~ ~, y N to y _ L t~ 'w V R a, Septic or Holding Tank ~ S Dosing CharnBer VII. Responsibility Statement- I, the undersigned, assum es ibiiity for installation of the PO'WTS shown on the attached plans. Ptu~'s Name (Print) ~ Plumber' a M~MPL RS I~u~~ Busin/ess Phon~ mb~ Plumber's Address (Street, City, State, Zip Code) Vc VIII. C n /De artment Use Onl Approved v Permit Fee Date Issued Issuing ent Signature ^ Given R for Denial IX. Conditi8hf~dEAQQkiANiffitteasons for Desapproval .--~-~ ft d '~ Z ~ 9 r'ri er an 1. Septic tank,.. effluent li t tom,. is t - .t_ G dispersal cell must all be services (maintained - /n~ ~ ~ ,,_ n/~ L.tJGS~ O ~ as per management plan provided by phmiba. /~ GE, .tX~ ri, d~,~G~4C r S 2. Aft setback requirements must brt rnaintain~d ~ tx>de ~ ate. ~ e Attach to complete pimrs rot the system and submit to the County only on paper not ie~ tnan a trz x t t mcnes m sae ~~ SBD-6398 (R. 01/07) Valid thtu 01/09 ' PLOT PLAN PROJECT Josh Miller ADDRESS 2948 Hwv 64 Glenwood City Wi 54013 SE 1/4 SW i/4S 27 /T 31 N/R 15 W TOWN Forest COUNTY ST.CROIX SYSTEM ELEVATION 98.3' 1.5' sand lift BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter BEST GF10-8 ^ BOREHOLE O WELL ~ H. R. P. Same as Benchmark 1320' Property Line Scale = 1 /4" = 10' .;- 40 Acre Parcel Pro 1 or2 Bedroom Trailer to be someday replaced with a 4 Bedroom House Well is to meet all setbacks found Grading is to be done to in Comm. 83 divert run-off away from system Tank is to be properly bedded and provided 96'8' 97 ~ Huffcutt combo tank with lockdown covers with approved warning 96' labels 95' ~~\ B-3 n Area 1 S' below system is to remain undisturbed 6% Slope B.M. AIt.B.M. 900' _ Hwv 64 PLOT PLAN PROJECT Josh Miller ADDRESS 2948 Hwv 64 Glenwood City Wi 54013 SE 1/4 SW i/4S 27 /T 31 N/R 15 W TOWN Forest COUNTY ST.CROIX SYSTEM ELEVATION 98,3' 1.5' sand lift 4 BEDROOM CONVENTIONAL AT-GRADE MOUND XXX SEPTIC TANK SIZE 1255 gallons HOLDING TANK SIZE LOAD RATE 1.0 BENCHMARK V.R.P. Top of Steel Fence Post ^ BOREHOLE O WELL *H.R.P. Same as Be 1320' Property Line Scale = 1 /4" = 10' 40 Acre Parce! Pro 1 or2 Bedroom Trailer to be someday replaced with a 4 Bedroom House Well is to meet all setbacks found Grading is to be done to in Comm. 83 divert run-off away from system Tank is to be properly bedded and provided 96.8' 97' Huffcutt combo tank with lockdown covers with approved warning 96' labels ~ g _ 1 95 _ B-3 Area 15' below system is to remain undisturbed CONVENTIONAL LIFT HOLDING TANK LIFT TANK SIZE DOSE TANK SIZE 765 ABSORPTION AREA 600 # of chambers none ASSUME ELEVATION 100' Filter BEST GF10-8 nchmark 6% Slope B-2 B.M. AIt.B.M. 900' _ Hwv 64 commerce.wi.gov ^ ^ isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.com merce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary October 22, 2007 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC. 1008 192 ND AVE NEW RICHMOND WI A7TN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/22/2009 SITE: ' Josh Miller Highway 64 Town of Forest St Croix County SE1/4, SW1/4, S27, T31N, R15W Identification Numbers Transaction ID No. 1475930 Site ID No. 731567 Please refer toboth identification numbers, above, in ail corres ondence with the a enc . FOR: Description: Mound /Four Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1157704 Maintenance required; 600 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual =Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and. with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. ~~~; c,~~ . • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption ~'~? area. chs. NR 811 & 812c ,~pp~titENT • A Sanitary Permit must be obtained from the county where this project is located in accordance with the N ~ requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COt;RE • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat SHAUN R BIRD Page 2 10/22/2007 • Comm 83.22(7) A copy of the annroved 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 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with,this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm .83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shalt 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 maybe 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 maintenance of the POWTS. Sincerely, ~~~~~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. ` RECEIVE® ocr 1 z zoo? SAFETY ~ ~UiLDI~GS Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 10/ 14/07 Owner: Josh Miller Location:SE1/4 SW1/4 S 27 T31 N,R15 W 2946 Hwy 64 Forest System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contingency plan 9-11. Soil test n - I Shaun Bird Signature License number `;~~r~rlly ~vE® ~F COMMER Elf ~EikNGS ;'PONDENC !'~ ~ , ;~ ..,. Hv ~.. , Date I~oa-~tove~t F31tez Fabric i k" 4bservatioa Pipe Per~brated ~pestribation- Pitt Berow l~iiter Fabric - _ .r • ~ G-33 Send K.. ~ • I y•~_ ~ , J ~" 5iapt s' Forst 'lrEOits f+ibwtQ . • ~ - $r ~ Of ff~ 2 ~z Lc1Yar . t?ra3n Rock Fso*~s Pv:np / • ~'~ • - tg `~ . ~ . •/5... Crass Section Qt A Mos~na ~ s!=~ Us . ~'• f A Std Far T#s Absor tia+s Aren ~. } 5• ~-~Ft _ •r • • - FL.. - ._ _ •~ . Q Obst tva! icn ?ipe--~ ~ ~ K ' I __ ~ p~~ Moro (i _ ~M~ ~ ~-~~~w~~ w cn r ~.~...~....._.~......__...~.~ .~ L j ~ ~~ •_ ~ O i?'tSttibuCtQt! Q Pipe - p~rairr RocK . ~ •~ • 4"L3bsecvatsoR Pipc~cCa perrnQnen~ Mcttcsr ~5~~ I! '+~ ' 1~c or Ruda ~ . ~~. - f,' Pion Yie~ ©t«~Vlound ~Siin A Bed .Fer The Adsorption Arco . ~ , p~~orestad Ctrs ~at~ :~~ Da astvma. ~~ ~lra •Y~f ~' TO R:eMlllf~~tOn r Gct/L,--G~~os,~~ ^~ ~ Asir Fspt 1-QYOVt ~: ~O~ ~'~. ~~~~ X ids - :/ n~ ~ . ~ Hobe mete . ~~ s3~ect: tetera3 ~.#cersse 1'K~er: ~ ~ O~nifo'~d - " Z.~ fires ate , ~ Force l~etit~ . " Z ,;. ~ts~es # of ~olesf ~~ _ .. . ~ Invert E~evatfas~ o~ Laterats~~,:;~~t= - ~ ~ - . .. !' `~ 4 i • ~a ~~ . ~~ . EAR ~ ~L /~ ~ . F~~~~ •-rte ~ . ,' • ~ . ~ `'~. • Etter _ . ..: ~!!-'3~ ~6K1 • S~~ . ... .~LTfLfC ...---~~ur" ;~ ~ ~ .. ,.~__ ;, i` ..~ GlES" ~ $ +~F~L a ' ~~ ~ ~vj ~~ iiI FI~~IC ,.cam ~ ~ ~ • ~s'~ ~~~ •# . Q ~~ .~+E ~~ I ~ w ~•l U`°~" SPA='~ZCA'~~5. .-_,,:. ~ ~ _ b •-- l ~ ~ ~• ~'~iS[ :. ter---- • ~ ~•~,,,~, cam' _ , 2.. ~,s = ~~ ~t~ ~~aC - '` z~ ~ PFD _~ ~~~~~ ~~scs~~ ~ ~ ~ F ~~ .5/ . sue: ~ ~~°~`_-=--- ~~ ~ ~~ ~~~~n . ~ ' °~~ ~t ~~/ • ~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address City/State (Verification required from LEGAL DESCRIPTION Property Location 1/a ,.~'~.cJ'ja , Sec ~ , T ~/ N R~~Town of ~ Subdivision ~ / ©~~/tom"" ,Lot # Certified Survey Map # ~- / ,Volume ~ ,Page #'+ Warranty Deed # ~~~`~~ ~/ , Volume ~ ~ ,Page # © ._ Spec house yes no Lot lines identifiable ye 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 113 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 sta men o is form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the desc ' d above, f a arranty deed recorded in Register of Deeds Office. ///'//////~" VVVn /~~/~ SIGN TURF OF APP CANTS} 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. 08/05) Pazcel Identification Number ~~ ` ~ / /l S ~ ` 3~ ^ ~~ gem ,~y;. t~ LassrJet 3100; 1 T75J' bC i~"L! ~ M~7r 7 ~' ~ i -~ 9EH SERIE8 SUMP/EP'~LVENT PUMP s eum- re 1+s ~, ,~ 1~ ~ 95 " ~taa ~ ~ ,~ ~ 13a 1(~ I9 Et 5S M ~ .~ ----sierlWd-~' ~ !!R ~ 115 flM >~ fLS~~-.. LITERS/~R ~ / ~ ~ ~ ,~ ~ ~ sn : tsa~sss~ ~ 1as Za a as =u~=~ d:..~ ~ ~~ ~ _ g Fast~uas ~' SMft -----..._ POfy t -- ~_~ .. .. , +~W~ . . 1~~C w~ caamic facxs Sn+nlescSud' . ..._. Sauniaac So,,,_oet Upper Steers and t.a~-er ~~ ~~ ~~~ tAll~s ~,~~~~t,OS73tSl lUava'Ni-e17?all ~~ts MS22i1s~ s...it ~ FORSt qq~6-fflA3 gam- ~A(„~QISJ'.~R3F~ Pl.M'4~ ~~ RYE COat . A Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings _,.... III dl:l:Ul U21I IliC Wllll IRI YYIS• Ufll. I.iUUC County~~ r /~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in si ` ~ l t' indude, but not limited to: vertical and horizontal reference , direction an paw percent slope, scale or dimensions, north arrow, and location and dis crest road. Please print all information. Revi d by Date Personal iMorrnation you provide may be used for secondary pu w, s. 15.04 (1) (m)). p ~d ~ a b Property Owner RG Property Location .~ a ~ ~, / Govt. Lot s~ 1/4 ~1.Ji/4 S ~T ~ N R ~ ~E (or W P rty Owner's Mailing Addre 1 7 OCT Lot # Block # `- Subd. Name or M# %~ 6 .- % C~ ~ City State Zip C e SPTh~ ^ City ^ Village Town Neare t Road ~ n ~ ) Yo (?i v w ~ New Construction Us Residential / Number of bedrooms Code derived design flow rate ~ v GPD ^ Replacement __e~ //~ ^ Public or commerdal -Describe: _`__~__. __-_r._____.._____ __- Parent material ,~%c-'cs~>Cl Flood Plain elevatilon if applicagbl//e i ft. General c~rrunents CI rL`o~r / (o r and recormlerxiations: System Type //iO ~l /r~CX ! ~ /~~ ~// System Elevation 8 ~ ~J Boring # Boring / pit Ground surface elev. ~~ ~ ft. pepth to limiting factor in. Soil lication Rate horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2 ~-~ JJ O ~/2-- .---~____ f ~ ~ /n~ L-f- /~ r / ~ - y ~ ~'Lc,~ ~/3 tee/ Q ~~, ' ~/~~ ~ oZ- ~~ # ^ Boring ®Pit Ground surface elev. ~~ ~ ft. Depth to limiting factor ~~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0- ~' ~/~ ~-- s~' ~s , 3 ~ -yo .~ b ~ ~~/ ~ ~ ~ / ~ ~ 3 • Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and T55 < 30 mg/L CST Name (Please Print) Sig r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 jO ~~ ~ ~ 7 715-246-4516 ., ,' ~, Property Owner ~ Parcel ID #.,,,,, ~ Page of ^ Boring ~ 1 /'~ . ~» _,= :.y J ~. pit Ground surface elev. 5 ft. ~,: " >~epth to limiting factor ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. 5h. `Eff#1 `Eff#2 2- -a ~ .~ ~ ~ i` 1 rn ~ 1 ~ ~ ~ c. ~ 3 ~yD s ~ ~ ~0 / sal «,~ . rn~,'- i~ w~ . 3 a Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ^ Bonng Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Prt Soil licetion Rate Horizon 7epth Dominant Color Redox Desrxp6on. Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 `Effluent #1 = BODS > 30 < 720 mglL and TSS >30 < 150 mglL 'Effluent #2 =GODS < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance io access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-6330 (R.6A0) Project Name Josh Miller Address 2948 H 64 Lot SE wy Glenwood Wi 54013 ------ Subdivision ----°-- Date 1/4 S W 1/4S 27 T 31 N/R15 W Township Forest [~ Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 98.3 *H R pSame as Benchmark Alternate Benchmark Top of 3/4°° pipe @ 97.6° Soil Test Plot 10/10/07 U~,. & MAI~G'~~T P~ i~C1W~'s 01t1~ER~S NfAN ~,r~~[ SP~TIO,NS ~cf@~°~~ ~~~~~ Ut>t~s ~~~~x ~sS~e ~.~.~--- ~~ $~ . ssv m~- s~ ~- _ _ ~dtamate~ -----~'e~rdc ~`a~`A`°` ~ p~6e,~ l~'a E.l~u~ . P~?arc pclmp Tam ~~ Pismp PuenP Ut~R ~~ F~ o Q ~~~ d z~ r- C11iUt G ~lD- Q wa n Naha t3 Peat FIIber D 1Atatland Q t7~er: C~4~ L31t~ ~ ~} Q At-sc~ ^ - ,~ ,,,. --- anQ v~,~caoea~BC(~'p01oet~s°daA~'~` v ~ra~"""0°` serrfco Fry-c'ia~y insp~` n ~!a P'urttp ~ cxtctCeuu'tts ~ ~~~ d oet~s) ~f~er ~rucads ~ ata~ Flssat~t snd ~~ fast p masts At fa=st onoea eve' wrier cocrt~lrted s1uQ9e aRd scasirs a+4~ ,. 2 At ier~st onoe eveiry At least onoe a+-'~Y p~ mast onos every qt least onos ~Y ~ feast ortoe avert Ai least ands e~Y ~s~dtetctat 3 y~•i ~ p(t9nk valunte ~) {Maadent:r:: 3 ys.) !3 o'..-. D c:t sc(s} D 1rtA Q enoa cts) Q Mn ~ _ II ye~tE:;) ~ ~ a n y~ersr{s} DNA ---- oes4 0~ tris m t~~~ ~~~ oe~ st+a~ be made by 9Ut ired"iVtdlbi C ~ PAS : S~~ i~p~pc~ d`taetlca aad P1 R S+as~r POw1'~ ~,y a bemoan ~. >' ~' rest tredt~ds $ v ~ ~ ~ ~~ ~, ate m deede fot z~tN 6~ic uP TSnk ~ S t)pst~ tfte volutsta of consbb+ed SUt mart Cta ~adca at lei. .t.~ ~{S) shall be vt~~ eM tbt rte, arty po~~ °~' ofltt>e3nt an the 9t~ti~3 of tl~e loc~u ras~e~5"wd'°c~ 9~ suriacs ~t ~caoe s ' ~ ~y ~c eq~Is ~ °t a~e~ ~ nvitt' ch. NR poet otskx~ge a~ . ~ tares ~ be; r+esr+cved bit s Sept! Se ~ ~ - and ant ~f~ ~~ao~ Cexie. ~ ~ prsssur~ed Pf3WT5 comP~• by a ~~ °"~ ~ ~ of.~i2 months a ~ be ~a~ ~~ ~~ ,. ,~ a ~o t~ ~ "~"t~y a~ w~f'in 4o days ~~ STAN' t1P AND ppEliATli?~ taae of ~ POW'~$ •~~~ t~n~s} ~ ~ s f! ~ lfrs ~ arttl/o~ dsma~9e ~ e3 m sse~. d~ t'laltie the ocmber>1s of tt~t ~ntc(s) ~ _ ~~~'servJctn9 open . _ __- ~~~~r ,l._ !3bi<d~,- as_L Sa:s:;Ia~ .:+4_ °'ad~z=r, ?~es:oassd ai+id ~aai:, s3~ aTh^?~?~ Y.Gi3~s*3 ~5. rT~ga dS~ --'---- -~_- -- »71'+f"I~S ~~'37i.7sa7e7~5 £D _ ~~'e?~fi ~ ?!1i ? p gs aresrp ,a axes .r.F.a ?-- "4`3.d a:E_~' 7s 'c. g.L3'~,.~f9Srcd ~.Ta c ~_-_...~5.~.£.? as a- ~,t°:a ~rnr•y -. ~..r..3.,:._:..isi... r i'i17E ~?!~ (SF eL9$Ti343.~~dil - Ffit"ii! ^a. . «r,~~l~arrrr cameo. - ..-..~ e=rg ~::~ ~:~-~ ~; .x,9., : z-: {~tfii? i'YS C~~~ILi_ a t "~"" ~ , s«.i_ r ..~ ~~ ~~ d ~. -._~. _ - -~_.~ .--_- FuE7L'9ili FO ~ . - _ . ~~-~CO~L 7C r Pff~G ~?~ Cr::i@ ~.43ii:~e7 -_..._.-._ ~._ --~.1'.~a![eiv, ~.~'~+ .~' 4.a 'S f"+ "..~ . '- :rtat~2@i3'.[^~ ~'sS+4"E7983ifsC c' - r <~ °. .. - _ ..;.? Ear~e aP:xe~..a' ese 8?*Qer&sz:rst ~ce~rc:~.r t~'; e~ SEc~) o)i S~tir~~ss ~ . _._ i~~ra~ rg-~s~ «Eab .~ ~'s) „ "~cnoaRSCa >S as B'tt.i r act-o:tie ~ 3t) ~'o r tie ; cz s -: ~ ~'LLFi:&^~;!a; d~-~) ~~r~.-5t aGrm.d.~ Fcaucs~_ U~°es~essss>~s, ~cta~ Ta~cKeya!;!c~- rMgesa~~.¢ ~i~rt~r cL'. So~a~9a^.a~.sE, C~uast~c ~ea'~'"-r. os: Sl~~-~) .~~rcB - _____._ ,' ~as~c.h ~"1=vr~ rr'~A .~r.r~.s +ariF ~~asr.i.~es4 ~v~r~~r ~cst Souc@~vrEnsc eja~rrrr CSt1~!: v~ 5t~z) a~ $~~Ca.~on 'ltr~c~- s Cgg-.$~v~c a~~?'r, T'a~rias3+ap^.: °C~6l.rt,v-ot?e aC31) ~2ac~1a, ~~ riLaa~r~ F`1Eer~i=:e di-S) E,°~st, St. Croix C+nunf:y- 43L~«:w.r6~_ ` "[i~ir. .~T>$v~ iE~+~rdyw~cB r~ar•E ~~t~ir~e' fs su5)~cec co ;~ t^inrr:~~„e Sy Ftvg~.r .,a_ ?tiAl~r end SusiEn n'~i_ L".91.Ld•~r'« zt~ 6e.fxt arLaGre aaniai L.ub lk~r o~a.+n raT.glrcy ::c~ "[ate: tc~d~r71 Land Sank of Sainc 1'~icel, .~+ t~orpae-- n ~!tf.~a~ ~-.[9 ~g3Z* ~®4ksli)t~ d~~'"P~:~i). tis"l'C£>4 ^~F~irus ~~, 1'tJT~ xt;nca r~aardaca t` ~°il !iD, lh'PEt 1>n Flallvrzre . 5~"1, {s:~~;~ ;l,ty~ i.~ ~{'ii°3~~~ tr6 R~gf~ttsr oi- 17~~d~s 6~ref' 54.. ~C~ecdr_ a.G4litC~, Edi.$~aans:i.n, Darcra~nr C+.a.• 7`2;5, +~;uE a.~@~d.cia €6a~~rd :fs n~+ aLu~ ~~~_~??.~.:5{, iih~r s.ai-c1 grtstet:~~e~ ascusgx~: .axnrd ~~ro~ Ca ggq ~ ~~ ~~a'~ ~i' t=ilt; ~7a.ft<];i).a-cul..i.aan a~a,r ~~ ai+ur~ie~ss uL sn~~ areal ~~tat~.. _ ~: ~_' ~ia3 tea-j. ~se~,a~~ E~ ~cui:~ti+<~ s~ la~.u~i.eF~~l ~e~~ :son~n~ c>•ar~#:i.~s.vanca'`sq ~a3~~~='s of re~aat•~ anJ ~~~~w~~,~:ie. :a€a~1 aai.r~~?ar~it r1g8~aes c+m~~r~-s:: in €hae decd rsacaaCSired i,s, E9cslc~ 235, ~~Sa i~: lra c:~i.~ ~' x~i"i•t~~ ~Y' ;cir~ ~3at~~r of D~+~al.~ r9r s~Ici ~G.+urety+ _ Ti:a-i ~~ ~~$~-f ava~r,~sQi3 +A*R'~ft'd~~tq,. - ~ ~i/. V its a~?eee+~t ~tss~w _ _.- ~fc+r,4. ~.R,,.. ~v ~~ -._.-_-.,~ryri,.l~.,. ~...~.. . f~ -.e~f1_ . . €Lrlc~er ~. ~l;Lli+er __~ ....~ _~,____. iSEA~.p -'~~- ._.. 5~ . - ' .. ~:- ~ + :.~ `a '~ , !' . t' L. A- (SEAL) Susan. `$_ ~.;! i.er. Ali-iiilEt~7lCd TiflM ~e,~ ant. g}, vfS an:%raf A4f IFer. _-,._,__. -,.-_~.._ F'tttE Fat~r~a s:c~: ~gta'sF~615P.:aF ;•.tSCJNSv~i- K- cc r - -..._~_. _~_ ._ ~ --'-------- ACKAAOMlLEOGEMEAIT day a6 STF+ iF QF VNFSt.QI`15EN ss. _ -- PerEOna!!y camcs lseture r:+e, t3tFy 3rd -.-.` Gay of -- _---°- -_---. the atsave nz.ned _--- __.__~ _Zognr •1. i•tillc-r aZ~_Susan ~!_'.?i21~r,_ husband ancf .z :EEc , as joinz_te.nants,-_-_-- kerES :";9e ._--r,~r:,; tax *~~a(ec+7 n-r _ _ €9?.'o~d J. Olson, rSCC,:. _-_- ----_~.__..-.~__ ~.__.~- Ba LGi,j I10 , 6; Es . S 1 ~JL - - -_ :.? [rim Ke:a+^in 10 GB iF e po:yon -S v.ho e:~ec ~:::c! tt:e tc.ee~binE1 :n' t _-...._.__ _... ._ - __ .__ -----. _._._ .._._. ,._ ~ i - sfrumenf and ,~+%nfvrFE:Bgfd the sa~n=_. ~/" i ~.5~z ' ._.._ -=~• ~.1: 3, -an:carednfac~~wte4yect_Sat~a:ryne~t' ftarold t7- Olson . ... - h%Ota!% ~ uC1EG -----3.e_~._J.r'+'i -r _.__,~_... Ccjunt,y. {:'1$. .-' .~..."- . ~.I ... Z~:.-::t[~._..t ...r... t'ITi&G ~Fn^lE L'ekrm ilk: i i~"~~E`'~ iviy irmrnis5a4t9's Rerman~nl.{M- ~-~~!rr-°-=~=2~*d~te: ~, a._-. .-s "r .. c-z . vav n, ~" . .~prls.:, wLtX t 4 2 -_ +3.': - ..