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018-1096-06-000
iJ ~ 0 ~ ~ " c ~ ~ ? n 3 '* ~ ~ ~ ~ ~ ~ ~ ~ ~ .a E. ~ :. ~; x~ d ; ~ 3 ~ ~ ~ p ~ ~. ~ ~ ~~ ~ y O O N M N O O 'e~ tlt~,'I • '- 7' ~. N .' ~ O fp 7 N ~ ~ F.y ` l1 ` 1 •P ~ ~ O N ~ ~ C) ~ TI ~ ~ ~ ~ o 7 C O U1 ~ N fl. N C. O 7 ~ V ~ d .J "'! I ~ ~~ ~ O o~ `< o u~i uyi 2 ~ ~' ° ? C ~r o I m ~? m y ~ ~ `° 4 ° ~ ~ N m c`o N c 'o d 3 l 0 W~ ~,~ N ~~~ o N N (/~ I W N O ~ C ~ y f ~D * ~, ~ Q • _ ~ ~ lll ~~~1)1 I 'Y , o ~ '0 0 0 0 O O 'D '~ ~i I n N~ N vi v~ -°- m I o, ~ ~ vcg 3 o ~ a ~ ~ ~' eo , , ., ~+ ~ o N 7 ~ ~ ~ f~D a ,,,, Z O C p) Z =i ~ 7 ~ O ~ ~'. o I o' 7 ~ ~ ? a ~ ~ i ~ ~y : N N '. C ~ _~ N. ~ I w C ~' d a I ~ p Z N O ~ C ~ ~ I N d _ A~ 3 O_ •~ Z N ~ W ~ < < tD I a 3 ~ I ~ z ~ ~ C :'* 3 ~ Z -' ~ ~ I ~! Z ,~ ~ w ~ I I o w~ ~ ~m ~~ ~' a N ~.~ ~~~ ~ ~ m a m ~c m • m N 7 ~ W ~ f~D .y' ? 7 d O _ 71 ~~ Q d N C m m y ~ a . ~ a~-•o o w m a I o~ N~ v a~ o m ~ ((~~ ~ ~ ~ y 0 (n N fD 'O 'O ~' m oa •o ~ ~ tOn ~ ~ ~ ~- 0 0 n 7 7 = f?o f?~ -w .~ A ~ Oi ~ ~ ~ N ~ N O i I ~ w m~ 3 w s ~~ c ~ ~ ~ '' ' n O fD ~ I _ ° m ~' m ~ ~ ~ v c ~.~ ~ m a roc o e I Hamm x ` ° a~ o • • wv • ~ ~ N ti 0 ~ j b ~O I ~ m ~ o I ~ m ~ w : ~, a I . ~ ~ ' ~ n.... ~ ^ I N W E A7k>z K Pf?L~F i.~JCiC~N3 Cpn/CR 3UNGTlOr+ ~ !~/~iysN~ t ~Bg.C . ~CF+~ 411+~cK a~cwr'.~sc~y--1 s Cr r-•-~-c :1a.., ----~ ~ ~ ~'~'~ ~..k '~T11?~!7 i ~ PIPS 3' Y t0 ND~STURBEA ,,, $81 L /~K.i r ~~~ K~~rc (~T ~ba.tr'S P~ NEG.TIOKS LQv. >7v 5CPTIG f aos>< E3AFFl.ES r, .4hF'~ ~^~C `~t~. ~ tQ da '(~ ~ ~ri 1 Tie : r. t7.r.-'t-~ a..~ E G I l= !'t A 7l b-J S ~ v~ ~ i ~- ~I t ~~ 1 4Y17-~ ~~. S,t ~YV~~t~~.irr~ ~i..r~ ~4l r, T ~~ ~Z. ~~ b.. CONa~~'~'~; . 4t0 CSC ~,. I+ ~~` ~ ~x Q o -, Yf~+~tT r ~i. ~~ L 1r.`1 40 3' o•+To w~r:.r~ G~uKC T'/~1J~.5 MA-JUfACTUft~R: `~ a-r• IJLtM6CR Of DOSES: ~~ PE Y~NI{ s-zc ; t `~ " G~ ~ ti~raaus S ~ L~lti~v AL /10.Y'1 !'lA- ~ K D1.~ ~ .eos¢ vo~~rME ~1 IAJCLtlDIrw U~' d, . .iU ACTL3R[q, JCa B.~GKFLOW: GALLONS MQO~ L u+al~tl~: - ~ d ~ ~ `~ CAPACITIE5: ~-: ~ ~3 SWtTLM 'PSIPL; ~'~` wtb wtHes Qk G~l!_ ~4 5 _ a g Z ~"'~'~-'r ?UMP /'~Jr-JUfACTURCR: U /'d ~1r~`~~r~^ 8: sUGxES OR~ ~ (,A~Lps.,;5 , C ~ ~IUCHC6 ~' f ' MpOEL AJUMDLR: ~F .3y QK _~ ~ G~LLOs.;S r t ~R~ V ~Q~' ..~ v •~ S W I T C H T t! P!C : 0~_.., ? 1N4NE5 OR GALLGu; ..,. ...r AJOT PUMP g1J0 ALAR1+1 ARC 7a 4G _..~yr MI-JIMUM D1SC1{~ll(,-C RAT --r.....~i..: .._G-N rNSTAi.~CO pu SEP~q~rC CtkCusT; ~ERTIt^L ptFpERfu{f OE?W[tIJ PUI"~ pcF Ayp ptSl'ts~JTi 0A1 PIpE.. s FEET t ~"1i1JI1~lLlM AIETWOftK SUPPi.`~ tRCi~uRE ~ ~ ~ FCGT ~ , ----.."~ '{- ?d ~EE7 OF FOaGC MAIN X ~.~.~r "~ ~OPILirRICT10-J 1•ACTOiI. r FEET ~ p ~""~y ~ ~~1 y+~.rr.~.~ "' TOTAL L7y~-IAMIC NCAb nc ,3 F!<CT J'P[R~.t^~, oih~[A14tCIJA •OF T~11.jK: LEA,tC.TM ;WIDTH , 1 Rw~ ~ ~, t~ Zd WdL0:60 Z00Z ~Z 'hpW 860 5=5=Z ST Z 'ON Xdd JNIlSSl BIOS QBI~IldSJ WObd b'~ - 24" x,'A. t~uo~ _. a 1J Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM,,.,l' Safety and Building Division INSPECTION REPORT GENERAL If~tF~:ikstAATION (ATTACH TO PERMIT} Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l~ Permit Holder's Name: ~ ^ „a Y~ ~ 1/ V' ,City Village X Township Hammond Tovrnshi CST BM Elev: ~~. yo Insp. BM Elev: ~'6• y. BM Description: ~~" ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic , / ~~~ L / i '1,•,~ (/ J Dosing w `-~ ~~ lY Aeration ~` ~ _ _ Holding ELEVATION DATA county: St. Croix Sanitary Permit No: 420560 0 State Plan ID No: Parcel Tax No: 018-1096-06-000 STATION BS HI FS ELEV. Benchmark /D . Z ~~ Alt. BM .S Tt Gv ~.- t9 L . Bldg. Sewer ~/ Q ~S~ S t Inlet )/. q , ~ Ht Outlet .~_ ~ Dt Inlet / ~/ Dt BottArt9 ~ ~ ~/~Lyl< / ~ ~ G~ ` ~~ Hea 2 ?' Za~ ~" ~' ~O- 3 Je^ ist. Pipe Bot. System ~r~.C z ~ 2.3 `~~' ~ Final Grade I .2 `j-S St Cover Z. ~D .~ Bf~IL~ 5~ is~e3 3.S D'7.~ /G'~! Z TANK SETBACK INFORMATION TANK TO , P/L WELL ..- BLDG. Ve~Air Intakes ROAD Septic ~~' /~- ~, ~ .q,~ s~ Dosing ~' Aeration Holding ___ PUMP/SIPHON INFORMATION Number I ,d ~ For~n Lengthr~, ~ Dia. Zy C SOIL ABSORPTION SYSTEM Z i BED/TRENCH Width ~ ~ Len th~~„ DIMENSIONS ~ SETBACK SYSTEM TO INFORMATION Typ~Of System: ~ ~ DISTRIBUTION SYSTEM ~~, ~-~- Demand GPM die c~ TDH to WeII O~6S ~ ~~ ~I~~ ~~ No. Of Trenches 3 rL BLDG WELL ~'_ sv' '7 !0 CHAMBER UNIT Header/Manifo d ~ ~~ a Distribution+ M~L Pipe(s) Z'r L/, /Y/1 l / x Hole Size ,/~ x Hole Spac~ / ! > Length Dia .' Length Dia_L pacing ' SOIL COVER S(,tht(L5 t/~~ S >~r~'ssure Systems Only xx Mound Or At-Grade Systems Only (,Cjgt-~ ~' e~.- Depth Over '~.S Depth Over xx Depth of xx SeededlSodded xx MOlched BedRrench Center ~ . ~ ~ brJ V ed/'1"rench Edges Topsoil _~,~ ~~ Yes [~ No ~l Yes ICJ No COMMENTS: (Include a iscrepencies, persons present, etc.) Inspection #1: r__ ~ ~O~/ b-~- Inspection #2: / ~b~ Locat[on. 1091 173rd Street Hammond, W 514/0_15 (NW 114 NW 1!4 9 T29N R17W) Pheasant Ridge Lot 6 / ~,P,_arcel No. 09. .17. 1 1.) Alt BM Description = S J "~~ ~ !"'~ ~ldlG / I wl ~ f ~~I/ ~'O ~ ~til`' ~y/S~~'~` /~~~~`°~~ ~'Z - ~ G~~~ 2.) Bldg sewer length = ~ f ~~ ~ ~~ f~R(/7'" dry S~i-~ t KS~[ ~~Et'~ "' ~Y spn 1 ~~ - amount of cover = ~~ Q - ~ ,~i( /,b /~~""' S ~ „ ~~/¢~~,firf'y~ -f- ~~~ 0""- o t~ h~.t/~( sr' Plan revision Required? I_:, Yes ~I No , - "3 ~ ~ ~~ Use other side for additional information, ~ ~ ~. J -.-- _ - - ~%t~(L~•~- ___-__1 !~ _~__. Date Insepctor's Sig ature Cert. No. SBD-6710 (R.3197) nn ~ ~~ ~~ ~~/An` / C~~ ~ /) ~~ ~~ ~~~ Depth uer / q -~ Vent t it Intake ---~ s ~ j '• °~ . ~ ~ r ~f o~~ U~ ~~e~ 5 ~ ~` ~~ -Te~sT IUI~I~lJ OF ~~~~ p ST ~0~~( (. 0. I~0 T (O ~E W-~ ~ ~ i `~ i ~ ~ C , ~ DD'"' ~-~/E ~~ ~, '` ~0 ~0 s ~~ ~ a~ SE 95 ~9 ~. / ~l3e/pw C'vvr~~ti m ~r.,s~-~~1 ~ ~O 5h~ t~..z.1 A rcr; ~'~ ~u,lk~ o~z5' I..c~~ Gti~~nb~-+2S ro~-v~~t, S he ~- 3D P~m~ ~ ~~, ii~~ /r o t'(,tJ ~ ~c~.w~ 10~X1~-l ~7 yr( TWNk , 3 a°~ j r°' / ~ ~.. '~ 4~ c i~ ~~ ~e ~ t ~,,fL ~ ~,~' ~~3~~~~ ~ ~ ,moo ~ \ , ~ P ) / ~'~ _ ~/O 'r ~~ W B~ ~ = -~ ~0 1 °P of 1" re~~ F~ ~E w ~,~,,~ P,~vE Sanitary Permit Application eatery ~c tsuttatngs Liv-s~on In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. PO Box 7302 i `~ See reverse side for instructions for completing this application Madison, WI 53707-7302 n scons f c personal information you provide may be used for secondary purposes (Submit completed form to county if not ommerce department o t l -Z [privacy Law, s. 15.04(1)(m)J ~0.~ a p ,p'Z ,~ state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County/~ State Sani ~~tt Number Check if revision to previous a lication State Plan I. D. N~~mber _ _ ~ !,~ r °-' I. A pllcatlon Information -Please Prlnt all Information. Wi=t ' Location: / . S 9'. Namc P rty ner perty capon • ? g ~ r f Z / ~ ~~S f' ~;~~ ~ ~,Q~~ ~ 1/4~~/4,S T N,R~ r)W re s s perry Owners Mailing Add Lot umber Block Number - ~ ~ ~ tri ~~si C~ ,State Zip ode • P Su iv-ston Name or SM umber ___._®~ II. a of Buildin check one /, ~ p~~ ~ C'ty e ^ Vill 1 or 2 Family Dwelling - No. of Bedrooms : ag f~" Town of Public/Commercial (describe use):_ /mss ~ ^ State-Owned 3 ~ / Q C ~~1 3 ix ~ ~, s Nearest Road ' -~~ Parse ax um s III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) p) 1. New 2. Replacement 3. Replacement of 4. 5. 6. Addition to Existing System System System Tank Only ate Issue B) ermit um er ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 5-{-pl ~n 'y 3b 1 g(I'Non-pressurized In-ground ^ Mound ^ San Filter ^ Constructed Wetl d ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade D Aerobic Treatment Unit D Recirculating D Other: V. DispersaUTreatment Area Information: Design Flow gpd) 2. tspers Area 3. Dispersal Area 4. Soil Application 5. erco ation Rate 6. System Elevation 7. Final Grade 1 . Required~~ Proposed ~ Rate (Gal sq. ) (Min./inch) Elevation t a ror ~ q7 ~ .3 ~ ~s~ ~ 933 8 - ~ , VII. Tank Capacity in Total # of anu~'acturer Prefab Site C Steel Fiber- lass Plastic Information Gallons Gallons Tanks Con- on- g N i E i Crete structed ew st ng x Tanks Tanks SG,OT ~ Ooo - /oo a ~ ~iiG,G~i~7 ^ ^ ^ ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement the undersigned, assume responsibility f 'stall a POWTS shown on the attached plans. I , Plumbers Name (pant umb ign re stamps : MP o. Business Phone Number D L ~jvz <~ /396 v ., 715 Z~S= Z~ ~ Plumbers Address (Street, City, State, Zip C e IX. ounty/Department Use Only Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued •( suing A ent Signatu o stamps) Approved ^ Owner Given Initial Adverse Surcharge Fee) ~ 22 S ~ /t! ~ Z ~~ ~ ~ Determination i D . „ X. Conditions of Approval /Reasons for Disapproval: , „ w_ f~~d ~d ~~j oz G~~snS~'fl~t~r, r"'a~ Sa~''`°~ sys-I~-- ~ ~.~,.. ~ ~.-~. ear ,~ /~~~' 1 , ~ - c% s~cJ ' `~'° ~'` ` /~h~ Z Ui i ~e~ s ~ ; ~~ -re~sT N~ ~~~ /U~'~~ ~q Tag -~ ~-z. _ ~u~rJ O F ~ pp ~ /~/E ~~ 1 '` 1 ~~ ~ g~ 7i a~ `~ ~~T~r 3 - 2, ~~ (~.E~L ~Ni ~ lfr,4.D,ErL ~iFFr,~ ~ i ivao 9~. s~Prcc- -~r~ t~ Rio Tilk3E ~~'1t~2. ~~'-' /~[ q 3~0 `fyse~/~~4 ~ ~ '~ ~ ~~ ~ ~~ ~ ~ ~e Z~, ~ s ~~ ~-l ~- ~- v~,~d z ~ ~~.--~ ~Z ~~ ° ~ ~3 polo ~ ~~~ -~ ~ ~ ~ / ,, , ~ ~ so ~ 8~ ~ =i~'o -rop of ~" ~Qo~c P~~vE Wisconsin Depai~ment of Commerce SOIL EVALUATION REPORT Page _! of 3 Divisbn o#-Safety and Buildings rn accoroance wren Comm tsa, vvrs. Aam. ~.vae County m t i Pl i h i n s ze. an us nc es Attach complete site plan on paper rat less than 8 1/2 x 11 include, but not limited to: vertical and horizontal reference point (BM), direction and le or dimensions, north arrow, and location and distance to nearest road. percent slope, sc a parcel i.p, ~~~~~ O (p - ~L ~"~ o '~yy ..,, ~(~ -(/4i Please print al/ infortma>rfon. ,3 T v ~ ~~ Re ~ Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 75.04 ( (m]). Lc~YY/t• ~ ~ p Q Property Owner Property Location ,l -E (or)OOy ~ S T N R ~ ~ ,e ~ - 1/4 Govt. Lot ,b~ f 114,// t Property Owner's Mailing Address d~>` Lot//--# `F~ Block # Subd. Name or CSM# CG ~~ City State Zip Code Phone Number ^ City ^ ~Ilage (~ Town Nearest Road v~nvYl ~ (yam 7G ~ - I ZG ~~ S~ [~ New Construction Use: ~ Residential /Number of bedrooms 3'~_ Code deriv design flow rate `y~'SIJ~ _ d -__ GPD ^ Replacement ^ Public or commercial -Describe: ~_-__.- ~ ~ , -- leva 'on if ap icabl~ a t~ !~! ~ ft• d Pl i Fb ~ ~ ~ _ ~ -- p n e a o -_ __ -- __ PareMmaterial __- ~/ General commerrts S yST PI,~ Pi` C (f r I v • ~ ~ .. _ and recommendations: I! '_ p ~Q~ ~ y'j ~ "' // n -~ ~ . ~ 1~a~..'n w ~ ~, -F~P i ~ G ~ t G, rt I'VI M ~Ciy1GiA Boring ''~ Boring # f Z ~ [~' pft Ground surface elev.1Qr<-.~ __ #t. Depth to I'rmiting factor _ in. Sol ication Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIf[~ p in. MunseU Qu. Sz. Cont. Cobr Gr. Sz. Sh. "Eff#1 'Etf#2 I a -// y -- S; w-a r G v~ S ~ Z /-3Z -- S:r./ C ~ . G a Boring # ~ Boring 2 - ' pit Ground surface elev. ~~'~?~ ft. Depth to fimikng factor /Z~-__ in. - Sod A ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Raots GPD/flz in. Munsell Qu. Sz. Cunt Cobr Gr. Sz. Sh. 'Eff#1 'EtT#2 1 0 - / 3 L - S ~ orb m-~-- ~ ~ •s • 8 Z // 3/ ~ S%~/ ~'fsl try r c • ,/ ~ o ~ ~~ ~ - ado / 'Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mg/L ' Ertluent #2 = BOD < 3v mg/L ara r SS < ~u ngfL CST Name (Please Print) ature CST Number w~ ct., X5.3 a' Actress Date Evaluation Conducted Telephone Number ~ ~ ~ 510 ~ s~. So rv~r ~~~ w~ S~~zS /a -/ ~- ° Z- 7/s = ~.y ~ ;Y~~~ ~~~;'~ d ~Q ~~ >~~ ,, ~ ~ ~ ~ P of ~ ~ QQ /~~ J7 Parcel ID # - _ -``` `-"'-"----- age _ _ - - Property Owner __ -_ _ o Boring # ~ Bonng nd surface elev. ~- G ft. Depth m limiting factor f ZS in. ~~ lion Ra rou Pit - Horizon Depth n Dominant Cobr Redox Descriptio Texture Structure Consistence Boundary Roots GPDIf~ •Eff#1 `Eff#2 in. Mansell Qu. Sz. Cont. Cobr ' Gr. Sz. Sh. ~ U~ 3 ~ .S' ~` r- ~ I Z ' ~ Z IL- 0 / - S, r .... !/~ ~ ,c Ong # ^ Boring - Ground surface elev. ~ ft. Depth to timfing factor _ in• ~~ ication Ra ^ Pit Horizon Depth Dominant Cobr Redox Desorption Texture Structure Consistence Boundary Roots GPD/Ftz Gr. Sz. Sh. ~1f#f 'Etf#2 in. Mansell Qu. Sz. Cont. Cobr Boring Boring # Ground surface elev. ,~ ft• Depth to limiting factor __~ in. Pif Sod nation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfl~ Gr. Sz. Sh. 'Eff#1 'Eff#2 in. Mansell Qu. Sz. Cont. Cobr Effluent #t = BODS > 30 < 220 mgf t. and TSS >30 <_ 150 mglL `Effluent #2 =GODS <_ 30 mg1L and TSS <_ 30 mgll. 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 fom-at, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-&33U (8.07100) a . ~ PAGE .3 OF 3 1tiTA1t~F J~ n~ ~. TOT# ~ LEGAL DESCRIPTION~1 ~A-N1 t4 ,S q T 11'~ N R. /~ E(or~ SCALE: 1"= y0 BM 1 ELEVATION X00 • d BM 1 DESCRIPTIONT -~ l S ~Ovt (~ .'P t BM 2 ELEVATION 9G ~ y~ BM 2 DESCRIPTION ~ o c~ ~ ~~ .zQov` ~iA c SYSTEM ELEVATION 9(0. L ~ SYSTEM TYPE_ ('on u c d~~.'on.a ~ CONTOUR ELEVATION /gyp. ~ - /QZ, p r-'~ 1 N - ~' ~ s cc. ~ ~~ 0' ^ b-~' ~ ^ r ,~.v Zvi, v ^ -3 rv2~o SIGNATURE ~ ~~ DATE ~G r~l~ - ~2- I - (~~ ~~e~ s i L~ T2-~ST ,~~ ~(~{ N~ 'rte ~~ Ta9 ~ I^Z i __ . _... w~ iM a ST ~if~D -~ L° o. u~ ~ ~ F t~ ~ /~D~t'lf .. /oo~ ~~ ~~ ~, p' ~ ~° g~ ~ a4 ns T~,~ _ s~o 3 Z,7X ~~,5-- ~d FFW t / lODU a~ ~4-L 5-cPT-i ~- 7-.~.~t, !L i3~ ~ -rv~ E Vii' I tie. M,ti ~w~ 3~ `f yse~/~~4 (v I ~ `~ °~~., ~~ ~~ m~ of 1 a~3p~~~ i'' .~o ' PI S~ - = l~'~ Tip ~ r ~" ~2oK P~ PE pg 6wl Z- ~=~ q V '~ ~ T~~ o ~ ! " ~`'" Pi of ST CROIX COUNTY SEPTIC TANK MAINI'ENANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~l~ T~S~ ~~m m~~ ~ IA~T ~ ~ Proparty Address ~~ ~ ~ ~ ~ ~~ r--~'" / (Verification required from Planning Department for new construction) (7..h~, r~~ l~~ Parcel Identification Number ~° ~ ('~ °' ~~~ ~~~ A~Q City/State _~___ -.--t---- ~,~ s„T.. DESCRIPTION ,,~~ff Property Location ~ '/4,4'' ~ '/,, Sec. ,/subdivision ii avrnr~a~ '~ N-R I ~ W, Town of _, I,ot # _~• Volume ,Page # Certified Survey Map # ~~,~~ a3~ .Volume ~ ~ Page # 'Wstrranty Deed # Lot lines identifiable ~l yes ^ no Spec house ^ yes ~l no SYSTEA: 1!'Ls nvTFNANCE em could result in its premature failure to handle wastes. Proper maintenance Impropar use and maintenanceof your septic syst b a licxnsed pumper. What you put into the system consist of pumping out the septic tank every three years or sooner, if ncedod Y can affect the function of the septic tank as a treatment stage in the waste disposal system. errt a certi5cadon form, si®ed by the owner and by a The property owner agrees to submit to St. Croix Zoning verifying that (1) the on-site wastewater disposal system mastexplumber, JourneyasaaPlumber+ restrictcdplumber or alicensed ~)+ ~ septic tank is Less than 1/3 full of sludge. is in proper operatuig condition and/or (2) aRer inspection and pumping the vate sewage disposal system with the standards t/we the undersigned have read the above roquiremeats and agree to matntam Pn State of Wisconsin. Certification ent of Natural Resources, Office ~~ 30 ent of Commerce and the Departm set forth, herein, as set by the Departm stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning da of the three year exp~ .~ date. ~ /~~ /~ _ DATE SIGNATURE OF APPLICANT OWNER CER'TIF~CATION our knowledge. I (we) am (are) the ownei{s) of I (we) certify that all statements on this form arc tru~rod~ ~ ~gistor of D~ Office pcrty 'bed abov , v' a of a warranty decd ~~ /a~/ ~~ DATE SIGNATURE OF APPLICANT «««««~ s.ss«« Any Formation that is axis-represented may result in the sanitary pernut bcuig revoked by the Zoning Department. wam~aty deed from the Register of Dads office «* include with this application: a damped ma if reference is made in the warranty decd a copy of the certified survey P ~ /# ~ // ` POWTS OWNER'S MANUAL & MANAGEMENT PLAN.. Page ~ of ~ FILE INFC~RMATiON Owner L~$~~ i~~ BUST Permit # DESIGN PARAMETERS Number of Bedrooms ~j ^ NA Number of Public Facility Units .B'NA Estimated flow (average) ~01~ al/da Design flow Ipeakl, (Estimated x 1.5) ,~D al/da Soil Application Rate . ~~~ al/da /ftZ Standard Influent/Effluent Quality Monthly ave rage` Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (RODS) 6220 mg/L ~"NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly ave rage Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L I;~NA Fecal Coliform (geometric mean) 510` cfu/100m1 Maximum Effluent Particle Size Y$ in dia. NA Other. /i~'NA "Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~~ al ^ NA Septic Tank Manufacturer ~L/j~~%~ ^ NA Effluent Filter Manufacturer ,~jp J'- ^ NA Effluent Filter Model ~B~`ty0~ ^ NA Pump Tank Capacity al ,0'NA Pump Tank Manufacturer .6'~VA Pump Manufacturer ~'NA Pump Model ~ ~0'NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection - ^ Peat Filter ^ Wetland ^ Other: ~ NA Dispersal Cell(s) ~'fn-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: NA Other: ~' NA Other: ~NA ^^ w,~,TC~, A \II~G C/~LI Gf111t C ~nr~u• ~ ~nr~nv~ vv~,wva.a. Service Event Service Frequency - Inspect condition of tankls) At least once every: 3 ^ month(sl (Maximum 3 years) ~ ear(s) NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) o _ ^ NA Inspect dispersal cell(s) ~S /~ ~~ At least once eve ry' 2 3 ^monthls) (Maximum 3 years) 'yearls) ^ NA Clean effluent filter At least once every: / ^ month{sl ear(s) ^ NA Inspect pump, pump controls & alarm At least once every: ~ ea~ls-(s) Y ~NA Flush laterals and pressure test At least once every: ' ^monthls) ^ yearls) ~' NA other: At least once ever y~ ^ month{s1 ^yearls) NA Other: ~ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals o>kQ-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and' disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. -„ r ~ Page 2 of '~ • ;START UP AND OPERATION For new, construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(sl. If high concentrations are detected have the contents ` of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist~in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN !f the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: ~J A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption ' ` system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. site ha nod ben evaluates), to identify a suitable r~lacement area. l! ilure o OWTS a so' and site ation ust be d rforme~ to I~ate a suitable repl'acemerlt, area: If replacement area is av ilatrte a holding tank ma be inst Iled as a I~st resort to replace the failed POWTS. ~' ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~. 7r/~t/7~ ~v/~lit/ i(/L Phone (~~ ~3~~ snorts ~AAl1UTAl1UGR rv~• ^v ,..r Name ..... ~(~SliIJL PL.13e5- /itJL Phone S - ~r.~~ SEPTAGE SERVICING OPERATOR (PUMPER) AL REGULATORY AUTHORITY Name Phone LOC .Name Sj C f l/l~ Phone This document was drafted in compliance with chapter Comm 83.221211b)111(dl&(f) and 83.54111, (2) & (31, Wisconsin Administrative Code. O_ct 28 02 O1:25p Bonte Excavating [7151796-2519 ~.~~ Real Estate {St. Croix County, Wisconsin) ' f Northeast ~ Quarter (;dE 1/4) of Section Ei ht i Nine {29) 27orth, Range Seventeen (17' West_ {~)' Township Twenty AND; J West Half {W lf2) of Section Nine g North, Range Seventeen ( 1, Townsh.~p Twenty Nine (29) Southeast corner of said West Halftaf Sect on ~ommencin g at the quarter section line 342.8 feet; thence N82°W 340tQefeetNothence 582°F7 170.4 feet; thence S39°W 170.0 feet; thence S56°W 263.7 feet to section line; thence East on section line ?92.78 feet to Place of Beginning. i AND; South Half of Sauth~est 4uarter of Southwest Quarter (S I/Z of SW 1/4 of SW I/4) of Section Twelve d12); And Northwest Quarter of Northwest Qe:arter (Nw'' 1/q ~,f xw 1f~) of Section Thirteen {13); All ir.'~ownship Twenty Nina 29 ~ west, ( ) north, Range sixteen (1,6) Real Estate (Pepin county, Wisconsin) Lot Five {5), $Iack 7wa (2)r Iilampe Subdivision to Town og Pepin Pepin County, Wisconsin. r AN~; Lot 4, B:Lack 4 of the Klampe subdivision in the Town of Pepin, PeAzn County, Wisconsin; AND Fart of iot 1, Block 5, First Addition to 1Kla:npe 5ubdivisio;~, described as follows: Commencing at the Southwest corner of said LOtt which is the Point of Beginnings; thence NJofith 46°8 ~ £ast, 135 feet ~ thence South 43 52' East, 91,40 feet; thence South $0°~;, West, 263,03 feet to the Paint of Beginning. Located in Government Tot 2 of Section Twent I Ono PEPINy pQ=Pe (23) North, Range Fifteen (15) West, alI)in TOWAihpF pin County, Wisconsin. I r { p.2 .~ Oct 28 02 01:25p Bonte Excavating [715)796-2519 p.1 !,~ °`~. ~~ DOt;UMENT NO'. tt ~ ~ -P 11If QUIT CLAiM D&ED Karl M. v]ferta and Katherina d. I7lferts, elk/a Katherina G4. Ullerta. alkla Katherina Vlfarta, a/k/a Gate Dlfarta, elk/a Katherina Vlfar ts, husi. •nd sad ~dife :olding as sur~ri •:orsh ip x~a rital p-opercy, quit claims to R~rl M. Vlferta and ?[a the rina G. U1 lerta Family Trust, Dine M. e~nte, Trustee, P.o nald C. 3ont e. I~t Alternative Trustee, having full power to sell and encumber, *_he tnilawinq descriUed real estate in St. Croix and eepin Cnur.cy, State of Wisconsin: Ste attached Exhibit "A^ £cr reai estate description. The purpose oC this Oust Claim Ceed is `o terminate that occupancy r: ~tiC as originally re s!+r•red by the Gran[orc by rlnad as originally dated September 1, 1995, rec.:+rded in ut. Croix County Register eE Decd3 .:n November 1, 1995, at 10:00 a.a. in volume 1257 of Recordv, 8agaa 2~- ~e, as tocu:nent ~fumner 5356'9 and re~:orded in eepin County Register of Gccda ar: LLr: amber 13, 1935, at 4:OG a.m. in VolvTe 206 0£ Records, F,•ges 39:-295, d9 Document Nu mbec 095145. EXDKPT PER WISCON~~N STATUTE 77.21{i) Skis is homestead~r7petty. Dated this ~ day of Augv sC, 1948. ATJTAEN2ICAT10N sr. ~c~c;x ca., w, p.g'~ :N he..•d i AUG 1$~~9$ 3:30 Rp^ Regli'ar at CaeJy~~_~~ LJAME~A,VD RETVRN AODRESg Leo A. Beskar, Attorney RODLI, SESKAR, BOLF5 & KRU£GER, S. 219 North Main Street, P, p. Box 1 F2iver Falls, rvl 54022 Pepin County Oi0-484-0000; 010-510-0000; 010,507-0000 St. Croix County 002-1426-$0; D02-1G25-40; 018-1018-20; 028-1018-30; 018-101$-40; OI8-1018-50; 018-101$-60; 018-1018-?0; OI8-1018-SU; :arcs 2 entlfl^.d Cicn Number (PZtJ1 O1$-1018-90; 018-1015-£~; 018-1015-70; 018-1015-80; OI8-1015-90; 018-10iy-00 ! , " fS£.1L) ~~ -.. '~,C ~i. `)/7:L 4 ~ r L- ]tarl M, IIl~erta ~' _ r ~ tC6A*_,~ {SEAL1 `~L i tiL~Wi T7 ~"' ~~-'' .T ''1 1 ~ ~'V {,(€it~1 Kathacina C. Vlferta ACANOWL6DGMSNT STATE PF WISCON51[l ) 1 ss, CO[fNTY ) Personally came before me this day o! 29 the above natnec to me known t~ be t"re peraonts) who e!tecuted the foregoing instrument and acknowledge the same. Signatures of 7tar1 M. Olfazta and at arina G. D1Ce rte _ authentic 's da• of August, 1998. 1,P4 A. sea kar TISLE: MEMBER STA'Iff @AR OF GISCONSZM (IE not, authorized 6y 570&.Ofi, Wis. SC at s.) T8I8 SNSTRIMSNT PJ71S DRAPS6D 9Ye Lao A. Saakar, 7~t tOrnay RQDLZ, BSSiCAR, 8PLE5 ~ )CRUELER, 6.C. 219 North M.tin Stzee*., P. O. Sax ?38 River Falls, iiI 54022 Notary 2ublic County, Wi ~. My commi3sien 18 permanent. i na€ t; expiration date: } .. - .. ~:°' s .: L ,.". ~ 1, 4 `ai a• ^.a' ice, aK ..t .p ,rp -.~~.,... .3y~r-IT: . ~-•-~ ~. ~ / ~~U ~' h~ r ~ LFE" 1064' % yFir~ ~ ST i ~'• ~ '~~2 ~~ ~ ~••• LOT 29 -~ '~°~ `0 r mc. ' ~ ~ " ~~° 1.67 ACRES 68, 524 S0. FT. i~ ~~i Sao LFE J064' r `~~ -V %. ,~; ~ ~~ Gtr ~:<• ps ~ f P`~P , :` ~ 2 TOP OF, 1 :..1R~. ~. PIPE 106f.~30 .~. ao~ - 6 ~23q ° ~ ~ ~ 28 ~ ~2~s ~ 2 ~~~~ zs~s oi~a :RES ~ 6s, 0. F T . ~ ~ ~ `~Q•' `~ $T~ CROUt" CO.OVIS~ " J „ ~• ~~ ~'~• of ~~an . ~ ~, ~P ~QY• , ~ •, a'cloc'~ M::R+ooordodin J ''vim ~:,~ _ ~ O "`~ o ~O• 2 Q~e~M. e~T~de ' ~p .. j ... ., UT I L 1 TY ~ EASEMENTS NO.POLE`OR.BURIED CABLES'ARE_?O.BE PLACED:SUCH ~ THAT THE .1 NSTAL L AT I ON. WOULD D I S7URB ANY, SURVEY STAKE, OR OBSTRUCT VISION ALONl3 ANY LOT L-NE OR STREET L 1 NE. THE' D I S,TURBANCE OF,'. A SURVEY STAKE''`. BY ANYONE . I S ~' A VIOLATION OF ` SECT f ON_,, 236.32 ` OF . W I SCONS 1 N.. STATUTES. UTILITY EASEIYENTS AS; HERE IN;; SET,~FORTH ARE•:FOR ..THE USE OF PURL IC BODIES AND PRIVATE'UTlLITlES'HAVING THE R 1 GHT TO SERVE `THE AREA. 0 SET 2.376" 0. D. X 30' ' 1 RON P 1 PE` WE f GH f NG 3. 66 LBS. PER LINEAR FOOT. NOTE,: SET 1' O. D. ~ X 24' :; ; I RON.~ P I PE WE I GH I NG::.1. '13 LBS. PER L' I NEAR FOOT A T ALL OTHER LOT CORNERS. • UT 1 L I TY EASEMENT f TYP ~ ) S. li4 CORNER OF SECTION 9, T29N, R 1 TW. (FOUND AL UMl NUIN MONUMENT ). - ~ - • ~p~ltNkpp ~ ~ ~ it •••••••••••••••• ROADWAY SETBACK `~ JAMES" M. :., ,. ® -PROPOSED DRIVEWAY LOCATIONS '' ;`..WEBER ~ :. 1. ~. :. • 1804 . •DRAINAGE AREA ----------'-'-- ,r 3PRIN(3 VALLEY. wls.. ~ GOVERNMENT CORNER AS NOTED ~ Q, HWE HIGH WATER 'EL EVAT ! ON , ~' ~ ~~ LFE • LOWEST FLOOR ELEVATION ~~~f~~teON~~~o` ' THE PARCELS SHOWN ON TH 1 S "MAP. ARE." SUBJECT.., TO ', COUNTY AND TOWN LAWS, ;RULES.AND REGULATIONS WETLANDS, MIN 1 MUM LOT S 1 ZE, ACCESS : TO, PARCEL, ~. BEFORE PURCHAS 1 NG OR DEVECOP.1 NG ANY.:°PARCEL, ICT THE ST. CRO IX COUNTY ZON 1 NG OFFICE' AND' THE Wisrsonsjn Department of Commerce Division bf ~afery and Buildings SOIL EVALUATION REPORT Page ~ of III PVW/YO..•T n.Y. VN.Y.. , ~N. ~W.... wVCa County f'01 Attach complete site plan on paper not less than 812 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal reference point (BM), direction and Paroel I.D. ~~ ~ Q b ~ v percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q ~p,- 6 U Please pti ,' vie by Date Personal information you provide may tie u ed for '(Privacy w. s. 15.04 (1) (m)). ~j ~ Z Property r Property Location ~ ~UI~ ~ ~ 2~~2 Govt. Lot N 1/4 N~1/4 S ~ T 2~ N R ~`1 E (or W Property Owner's Mailing Address ~ ST. CROIX COUNTY Lot # Blodc # S bd. Name or CSM# " `O~~ 1 ~ ZONING OFFICE City State Zip Code one u e ^ City ^ Vllage 1~ Town Ne st Road ~ ~ ~ (~1l ) -I~Op-ll2~0 ~ ~ ~~ ~~~. New Construction Use: ~ Residential / Number of bedrooms 3-~-{ Code derived design flow rate 45U Lo C~ GPD ^ Replacement r ^ Public or commercial - Descxibe: Parent material l i ~' Flood Plain elevation if applicable _~ /~ ff. General comments S~s~Pn~- t?f'~ U ~ ~OC~'3~ and recommendations: ( r ~ 2~i % °~ - Dbrer~Kd aru.e~ lake~laerrv~ `j(,t,_ c~`Z~l~n,ctll ~--Sy~`.~ Boring # ~ lJ ,Boring Q c/,\ Pit Ground surface elev. ` ~ C~V fL Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ ip 12 ~-- ~i 1 ~s 1.~~ ~ 5 - 8 2 l~- l ~~ `~ Sf L~ ~ r ~ l(~ J C 1. LI ~ icl Z ~ , y , Cv Boring # ^ Boring Pit Ground surface elev. ft. Depth to limiting factor 2.. ~ in. Soil Application 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 2 ~( ' c 2ms~~ tr~r ~ - ~-[ 3 l 5 '~ C ~f (v ~ cl ~m ~~ - .' ~ ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L Address Date Evaluation Conducted Telephone Number alb ~~~~ ~~~' ~ ~~ 5`~aZ ~ -s - c z C~ /5) z ~7- yaa~ r .: Property Owner Parcel ID # /"'V Page ~ of Boring Boring # ~it Ground surface elev. ~ ~ ~ ~~ ft. Depth to limiting factor 2 in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfftz in. Mansell Qu. Sz Cont Color Gr. Sz Sh. 'Eff#1 'Eff#2 ~ ~ 10 I z ~- ~i 1 2 c (u . 5 . S 2 ~ ~Z Iv ' ~1 r ~ ~ ~- ~ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Sol Appliptron Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft2 in. Mansell t2u. Sz ConL Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Bonng ^ Pit Ground surface elev. ft Depth to limiting factor in. Sal Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Mansell Qu. Sz. Cont Cotor Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =GODS < 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. SBD-8330 (807/00) r PAGE~OF NAME ~ /1 r ~ LOT# ~ LEGAL DESCRIPTION tiw ~ ~tl~ la ,S ~ T 29 .N.R. / ~- E(or~W'~ SCALE:I"= <D N BM 1 ELEVATION /G~ • O BM 1 DESCRIPTION ~p~ Q.~ ~ ~ QUG ~~ BM 2 ELEVATION `~ / ~ ~~ BM 2 DESCRIPTION ~dQ ~ ~ ' OyC ~r~ P SYSTEM ELEVATION IOCJ. 3 O SYSTEM TYPE 1'l~t ov mac( Sy ~~evy1 CONTOUR ELEVATION q 9 S~ ~ ~U~• - + - ~ s~~.9 B z yf s ~'on~avr ~ ~-ley. G.._; ,~ e 9.9.cy Y9s o ~3 SIGNA'I~JRE „2~~ ~=~ ~ ~ ATE G -~ ~Z T.L. Sinz plumbing Inc. E5609 ?08th Avenue Meaornonie, WI 54751 Date: [.~ ~' l S ' D '?~ Phone: (Z 15) 235-2644 Fax: (Z 1 S) 235-2592 FAX 7'RA-NSMI7TAL No_ of Pages: (including cover) To: ~~ ~D t X LO ~ /~/ 9 Attn: ~/f~v1 (,~'~ i nJ ~J From: D~[~ -S! N Z- Subject; ~ T (o ~ff J~/~-1~/ T /Ci o~9~ Message: ~ D ~ ~ T~-P T ~ ~ C. L U u~, Signature: To ~ 911i~11'IdZHI5'I,L Z69Z5CZ5TLT XV3 85 ~ oZ ZooZ/~T/TT rV ~ V ,~ ~ C~~ h~~ wieaoshoapisen.neacon~ SOIL EVALUATION REPORT vim, ~ a_~ DhMaion a sMen- ene o..re~wgs b aoeorew~e ~ Comm eo, ws. wam, wa. O~f- __ b d Pl st m. ert wnu Atrs~A mniplee ait v~ ~ rarer nor 1.es dv~ d 12 a 11 i~d+es hdae_ bur ~ ('indld er: ~ ed ~ p~ (Baa), akasoe eerd xaM or dle~enerene, norm error. end baMon an0 o~slance b nwrest res0. prrosre elope p~1 in, , Pl~s+r pffilt aI inlbellaOoll. we'"""'d °jr Deis MifenN rMnlr~ ~ p~w~s ~~r w rpM M wasrlnJ pMp~~ (P~•a~~ ~~. a ~e_e~ ~ ~~ CIF ~~ 4r Praprl~ Looria~ eon. 4or 1MI~ Ir111d 5 T N R E (er~ Prapenyo.~r~ weeng ='~ 3 ~a r ~. ran. ar c~ L,:{ (P 7i Go - /2G Q ~ry ^ ViNepe Taon Naeresl /~ ~f7• F~ rrer caietur~ Usa: ~ flstlerrUal- w,nioer a eedraonn ~ _ Carlo a.rhed a~elyn Ao.~ role 1/s~i/_ ° 0 GpD p R~ra 7' O p+tlc w - Oaoiba: Panosm~riy ~ •' ~ ~ -- __ FbvoP~n.rrrdonr.pv~ ,._ ~~ ~ ~~*' ~,~ syS~e,~ u~ yr 96 • j ~ ~' G~-~, yU ~ ~ ~ "'~'° "~ 101.3 d ~9 ~ ~ PN Otound sukeoe Nev. LO /~sO ^ IL aPm p ~+~+91e~ 12 dd _ 1n. ~ R~ Melly OrapA~ OsielerntCa~ ImrpeOaOCiiDalon Tosses SbWlee Cwrsislerrae B0~/losy fi4o4t tl. 1MIfIYIA GY. $ CsI1L 6obr ~. 3t• .~1. ~ ~ ~- -- ,z/ ~ ~ . G 3= - /n / ~ - 8e,;~g ! a ^ 9erNg ~ Ph G-wrdeula~do+ ~_~R . _ ~,~~~.,zd_~. Merhsr upper e~. Omrnenl ~, ~ T.~. ~~~ ~~ ~ ~~ Nv~sA Qr. ll:. Core; Ook~- 6r. Sz Se. 'El•1 ~ o-~ s ~ ~ ~ 3/-i s _. ~ ~ ins es ~ I -- - ~ 2 2 <. • E~IiaR s1 • BoD ~ ~ = 2ZO n911 end T$$ s80 s i6r mr1L ' Ellenrn ez: sivv ::w rnon. ono ~a6 ~ 7Y n!~ g~y~,,,,~ ~. C9T r~eber C8T Nenw IPlees orYlq ` - -- 1. ~!~.+~ ....s~~ , _ _ -• 'J. C' 2 ~ ~ 9 I ! ? SI~J ~' _~..~. .s. ,~ ~~- ~d WdTZ:66 2e0Z Tz •a~p 'Ul Xti.~ 4021 Zo ~j 911Iti~f1'IdZ1QI5'I,L Z85Z5CZ5TLi %~73 85 ~ OZ ZoOZ/bi/iT f Ploarly Owner `~._=1-~, ^_ PMaM 10 ~ ^_,~ ~- P~ L d ©~ a ^ eore~a ~z,s ln. aeea: vszuia*n T.seure °°"r,~..".' w"'ea~' Raeor 6P0~ liorleo" Deitn ~~ ~al0r Cr. 8z. sn. -eir, •Ef1 in. Mum Qu. St. Carl Color ~ ~L I - ~ S"~ r- C s~ r _ Z ~- - - y~ ~ l4r S ~ SQ l' ~ ~ . ^ O~~Y i ~ 9orip __ R DeW~ o fin~r+p fecbr e1- Q Pit tsroYnd sufe~ eMr. Ted swave Caredee~ Earidar7 ~i t~rL'[oP OeOer ~~ p°0°r~ Oeo~a irL Yyea~ll GY. 9L CoM Gobr Gr. SZ. 8h. ^ ~~ ~ ~ ~~ l3rC~wa sUAaO elw. _-Il. QlYY11o ~r11~ir1Y r~or _. "_' Y' ~ Rfl ^ Pit ppm FDA! Florae" ~~ Qar~~ll Gels fisai7~ Oea~ Teesee rRruollMe Cam ~~ ~~~ ~IQ u...~ ~. Si. Coal. Color Gr. Ss. S~. ~ < 15D • Fin a2 R 900~:'~ ~9-~ ~ ~ `~'"~ Eire f t =BOO, > 30 <_ 7.?~ mpll. and T5S ~C _ ~ Tde D~e~nent of Gorey is m equal appottuairy 9erriae provider ee8 employet. 14yvu +~ ~staece b accQii oe.ico of sod ~~yial ~n nn el~erosee fmnu. P~~ ooucaCl lire d~etm~o~ ai 601L26A-31St ar TTY GOS-71~I.i77y. ~o.ura~u+ 9d WdZZ:80 Z99Z TZ ';'0 'Q~1 x~i~ ~ 4:0f~J 9HI~f1'IdZHI5'IZ Z65Z54:Z5TLT %V3 85~OZ ZOOZ/~T/TT Joy ~ ~ I ~~ 'lam ~`~ Tay ~ 1-1 N t,.~ (~ N Town) ~ r, ~ ~,t.,,,,,..., ;t,, o S.T C~ (~~ ~,~ P o. I' i~~ I'; ~~" ~ ,, O~ D ~~ ,~ ~' i g~ ~ j a4 ,~ ~~ _ 3- i ~/ II f-kirF rrJ i r I~vG 9~4t st PT «. T.rn ~ I , ~ V'. v TiJ3 E ~ / t-cF .'~ ~~«_~ c~,~;,~ ~/ / ~~ So R 8~^ - =1UO~D Tip ~r 1'~ tE~n PIPE ~ o l~j 9Hi~I1'IdZHI5'I,L Z65Z5CZ~TLT %V3 85 ~ oZ ZooZ/bT/TT r f ' PAGE .3 OF~ w~~ ~E._~o.,n~.C~., L.C~'T~ 6 FGwr DL~'BIPT~~1~(l~stliLMW /A .l~_'j~ ~ -N-g- !~ E(or~ scup: I^- 1/0 HM I ELEVATION !00.0 BM I DFsSCAIPf'ION m e n ~. l StOII ~+ : p G AM ~ F~EVATION 96 - y~ $M 2 I~PSC:R1PTTnN~~ s~ I ~~ =Ee.~ ~S SYSTEM ELEVATION !b. 2 O SYSZ`BM 1YPE ~n ne ~: e..~ j CONTOUR FlE~ATION /oa. ~ - ~Z, d ~ ~ __~ I ~ I -e- I s i ~~ ~W ~~ ~~ ,~ ~ ~ti ~ o C~j ~'~ SIGNA ed WdiZ:86 ~80Z iZ 'sop axls~nzazxlszs S5` ~~ 3 h`' ~oZ•O •art xti~ : lvzl~ Z65Z5CZ$ili %V3 85~oZ ZooZ/6T/iT NORTH L /NE OF ] ' SB9° 4 I' 59' E 2627. 77' w - - _ - _ - ' Ss' E AVENUE `" _-- P06o. zs THE W -- - --------24P.64' -------- ------r /7~. --- -------- ~ -------- -PURL i I e' ~ 253, O /' g N g `°° • QN I •i ~ 7 $ ~ .... ..~.i ... t ..... .: w. o~ ......... ........................... ....... ' ~T, 3 L OT ~ 7 ho' L ~ 69, 386 90, FT. ~ 7Z, ~pAg r ~ LOT 2 ~ I 9 Y•s8t sCOREF - o ~ '~ • p'L ~~ ,~+ J~~ S54' S9' 54" E ~ ~ I , ~ E 108, 14' ~ ~ E. .. . ~. age ~~ >? 's 9/, ~a ~---- • ~ LOT 5 ~ Fm. '- ® ~ ` I ~ 1.80 ACRES 6~ ' r, 98, 716 SO. FT, `` ~~, i ~ ~ ~ I ~ ~ ~~ I 1 ~ ~ ~ , .9 . .~ ~ ~ LOT 3 - ® .3 a , r. ~o acRES ~ ~ ii : i ~ ~ ~1g~ 63, 409 SO. FT. ~,' ~~ " ~g• ~~ ~ ~ r~ ~ W 3. g3. .•39 .•. 1 N t. 6T. T5 9• i• 4 .' ` , 1 ~g ~ ~ ', 6 Oq'.E ~ e '~ " ~ F ~~ / do'~~ .'CP 1.53 ` ~ ~ `'~ ~' .~ ,~h, s 1 61.7g ~, ®® I; s~ (~ LOT 4 ~ moo. °~•'~,~ tie ~~, ,- ® ~ 9 ~ ~ ~, I. ~6 .CBEs - ,- ,. 0 , L O ACRES - ~ ~ ' ® ~ ' ~ 67~ eo4 SO. FT, - S\ /' ~ I 68, 634 SO. FT, soy I i I ~~- 5 a~ \~ '~- 6 _ A, °° ° i s ~ ~ , ~ ~i. • 1 • •~ . ® ~ ` ' 1 i - 7 I - •1 •/' -/O, ~~ 3333 I .:- ' • ~.' ~,,.. .~ ' s9, _`- I _ .-~' -f , ,-'~ LOT 2T _-, I -~-. •/~ 1.33 ACJPE! -~ - 3 ~ i .3 _ _ 6' O - o~ - ~ ?3 ~' -• ... ~......... -~• z ~ r' gyp. ES W ` :~ ~ r . 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