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HomeMy WebLinkAbout018-1096-24-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515022 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1) Permit Holder's Name: City i age ownshi Parcel Tax No: Shefveland, Stan e o Hammond 018 - 1096 -24 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: �b 6M t QbT 09.29.17.799 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic O Benchmark Dosing ( 2 1 Alt. BM Aeration n t Bldg. Sewer o`, Z Holding St/Ht Inlet 5.g 9s• i \ TANK SETBACK INFORMATION SUHt Outlet TANK TO L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic , / a Dt Bottom q p Dosing O / Header /Man. / I I - 75 / 8' /8' ? -y y$• (� Aeration Dist. Pipe Holding Bot. System 3.5 Final Grade u PUMP /SIPHON INFORMATION , )• I T7 •Cam Manufacturer r GP and St Cover 1 Model Number zq• !) 9.7 (, O�.TbtJ f� • TDH Lift Fricion Lps System H a TD�� ,- Ft 4J Forcemain Length t Dia. Dist. to Well 3r= ,Z SOIL ABSORPTION SYSTEM 3. ,T S BED /TRENCH Width i Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSI ONS • `o� a, G( .S_4 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: ` INFORMATION CHAMBER OR Type Of Syste : J UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Fistribution ipe(s) x Hole Size— I� x Hole Spacin EVE to Air Intake .. Length �• Dia ength ` Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center 1 Bed/Trench Edges N__-1 Topsoil / Y� es E] No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 5 / 5 / A� Inspection #2: I OIC Location: 1725 109th Ave Ham�smo,�nd, WI 54015 (NW 1/4 NW 1/4 9 1 T - 29N R17W) Pheasant Ridge of 24 arcel No: 09.29.17.7 9 1.) Alt BM Description = � t'� I / � G"`.! A's 0'� C , �)0 e�J LAIAJ �✓5. 2.) Bldg sewer length = ) y - amount of cover = // T- r - -- - _ - -- -- - -- Plan revision Required? ❑ Yes t?�No Use other side for additional information. SBD - 6710 (R.3/97) Date Inse p ci r s Si9n re Cert. No. - I ccwnnVWC*•WI•g0y Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 1- 0 Is Lj ■ ■ Go1 i Madison, WI 53707 2 ary Permit Number (to be filled in by Co.) i sco ■■ 5/5o2Z elparitmerit of Sanitary Permit Application StateTransa / ctionNumber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental b d S unit is required prior to obtaining a sanitary permit. Note: Application forms for state-o' jest Address (if different than mailing address) submitted to the Department of Commerce. Personal information you prov ma / �2 / �t 9 f�•fi / � es in accordance with the Privacy Law, s. 1 S. 1 m , Stats. / CJ I. A lication Information - Please Print All Information Property Owner's Name OCT 3 � 2008 l�l P 1# Property owner's Mailing Address ST. CROIX COUNTY party L01O° ZONING OFFICE Lot City, State Zip Code Phone Number �/�/� /. /�, Sermon '� �leo of Building (check an that apply) ObC LOX J / y Subdivision Name ( or 2 Family Dwelling - Number of Bedrooms 6 - � aA P �a Bloc ❑ Public/Commercial - Describe Use i ' ❑ City of 1 t CSM Num r ❑ Village of ❑ State Owned- Describe Use,! �_ / k/�'`'"" J� — of /fit A . III. Type of Permit: (Check only one box on line A. Complete line B if applicable) t A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) issued B. TO Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date iss s efore Expiration Owner 1 IV, Type of POWTS System/Component/Device: Check an that a I d ❑ Non - Pressurized In -Ground ❑ Pressurized In- Ground ❑ Mound?: 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil a ❑ Holding Tank ❑ Other Dispersal Component (exp ) ❑ Pretreatment Device (explain) V. Dispersal/Treatwfnt Area Information• _ ,� /p Desr Flow (gpd) Design Soil Applicatio te(gpdsf) Dispersa ' � Required �$Z77 1 Pro �V / �� / Li YG VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units _ New Tanks Existing Tanks rj1, All& Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume re ty for installation of the POWTS shown on the attached plans. P��e (Print) Plumber's S' MP/MPRS Number I Business Phone Nurpher Plumber's A ss ( tree[, City, State, Zip Code) VIII. oun /De arhnent Use Ont pproved Permit Fee Da7eI;jedIssuing nt Signature = - ! Re�ml)enial IX, Condit ft -oval ei J ��. 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. AN setback mquirwsents must be maintained e system and submit to the County only on paper not lea than 8 in I I i incbes In du SBD -6398 (R 01/07) Valid thru 01/09 PLOT PLAN PROJECT Stan Shefveland ADDRESS W7430 510th ave Ellsworth Wi 54011 NW 1/4 NW 1 /4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 97.6' BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of white wood stake ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark B.M.* 2 Acre Parcel Property Line Scale = 1/4" = 10 Area 15' below system is to remain undisturbed 97' B-1 2% Slope Tank is to be 97'6 B-2 properly bedded and provided with 98' t lockdown covers with approved ❑ d warning labels B -3 0 0 Pro 3 Grading is to be done to Bedroom divert run -off away House from system • Huffcutt Combo Tank Well is to meet all setbacks found in Comm. Property Line 83 109th Ave 140 i , PY PLOT PLAN PROJECT Stan Shefveland ADDRESS W7430 510th ave Ellsworth Wi 54011 NW 1/4 NW 1 /4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 97.6' BEDROOM 3 XXX CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none Ilk BENCHMARK V.R.P. Top of white wood stake ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark B.M.* 2 Acre Parcel Property Line Scale = 1/4" = 10' Area 15' below system is to remain undisturbed I 97' B-1 2% Slope Tank is to be 97.6' B - 2 properly bedded and provided with 98 , lockdown covers with approved p warning labels B -3 Pro 3 Grading is to be done to Bedroom divert run -off away House from system Huffcutt Combo Tank Well is to meet all setbacks found in Comm. Property Line 83 109t Ave Safety and Buildings C0111111 @CC @.WI. OV 3824 N CREEKSIDE LA g HOLMEN WI 54636 Contact Through Relay i sco ns i n www.commerce.W.gov /sb/ epartment of Commerce www.vAsconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary October 29, 2008 CUST ID No. 226900 ATTN.• POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/29/2010 Iden K. ca ori,Nuint ers Transaction ID No. 1605242 SITE: Site ID No. 743951 Stan Shefveland Please refer to:`bot)identificationnuxnbers, a x.4 109TH Ave Maboye .in.all °corres onlence:w th the; enc , Town of Hammond St Croix County NW1 /4, NWl /4, S9, T29N, R17W Subdivision: Pheasant Ridge: lot: 24 FOR: Description: Three Bedroom At -grade System / 2% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1206685 Maintenance required; 450 GPD Flow rate; 37 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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 manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system 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. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A co of the a p p roved p lans, s pecifications and this letter shall be on -site du ^ inspe ction �• T ' �• UV rJU U U � construction an a l�l o ection b authorized representatives of the De artment which may include local ins ector h(j jly p R DEP o w r% c SHAUN R BIRD Page 2 10/29/2008 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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 may be 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS. Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WzS'IvI' ode ?63 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. I I I s 0 0). �E4 c�e Cover Page g Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 10/21/08 Owner: Stan Shefveland Location:NW1 /4 NW1 /4 S 9 T29 N,R17W Lot 24 109th Ave Hammond System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01/01) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature _..vi uF CONM.,EK�.c UIV15�Ulr SAFETY AND BG1I0,AGS License number 226900 cor <�_ poND�n+cF i I i I 'r F ?5 : B � >5 Yt EdRLf.MRii,i ` 2 5 '!.. pesrlcs�uz sb•s ��ss„Rwe. STI►6�it ��D o��g.«•i}se�s �Eii. � 5: 1/68 ; 1l2B A = —L- • I TELL o f L = � • i i . Distribution l ateral h ipepi tab SYU' ;- Fabric Soil Cover well JI 2 fi L lLeWEj> t -wY�rC �. e:5 5` A 2 W ith fiJis oti+sia At•�ad� W ith a p�mra Viev and �xoaa Section Slopin site givele Absorption Urea an a Sti��tA�Yu AIL l For Lateral *tw*rk ' {}isti- fb.ition Pipe Oetli �QCCeS`�' TuRM - UP • - PVC force fain _ ;. • - • - - - •,,, ,.., pVC DistributiOa Pipe P * Last Hole Shw1d Be 1Wt To TLS"- UP Hole Diameter -- P ft. Z tmb(es) a�m X Inches Lateral DietOr - Force Main Diameter Inches of Holes /Pity 4/5 Invert O eVation o L . 9 g.= '- r- f t I Signed; License Pjdw Date, r CRi}SS SECTI o n s'EC IfICAT1065 SEPTIC •�AN1C � ' °'�3ri�' C�AMB - � y ATN AY�'PRoV ED �gpVE GRADE jUTlflt+i $E3X HOLE COVE �ri GI v T PIPE 1 2 "' 14y" -4R UITH C© IT Vj PADLOCY- 6 rR� . DOOR. WIi WA MING LABEL FRESH: ±�IR : .NT&KE � i Lill! !► E WAS TIGHT S r�xxs � � p PIPE 3 :.P1LTfc.R $ N S-ID SOIL PI?C 3' WO SOLID. Of• rLE € �p y BEDD�PtG UIwER �pi�IC CONCRETE PAD a . APPItov // SPyCIFZCA BOSF.S. PER DAY: rs8 YZ�•- SEPTIC DOSE ! �: DOSE V OLJ�1HE FH�K'- � / TAB TACT ,,.�Q ' Ga�.. �C . SAL - A.. c� ' I.A SIZE SK S? DOSE CAP�I� au J, MC)OC qq �HCBES = /l L V x PER I I.HR 16 -0 W F �ACFJR� s r �: • �� H wsltxIIG AS NI'3�g ?lCl�E= gPtf3ip S hH l D FE£T D £ A ISCMXIGE ' �� � FE£T REiII�fA DZST'R . - FEET g EEN pur�P Of'F FACTOK - vER'lICA3, DIFFER R UpFLY PRESSUR 'T /10 ,£T -' ��Y -IC $� . MIND F � NORC I • �: t�ZgTI d I�iAt'iET LENGTH o r � `. . -4A•iE - :188 Sent By' HP LO SONSt 3100; 1 71b *5Y dt$ZI ; y jr w 1 9EH S ERIES SUMP /EFFLUENT PUMP 0 . islwlarelli. @at SOW » 9a1s as a1w•9 su 91atrA 1tiM9 9► +R Aaarru a u tQ w ` IL Slo 'gym 70 61 E'+ n 82 13.8 2a 24 9.11 st'1.6�1x89 s $O m Wm 4m 1 15 a+ 41 32 tae 21P is e.11 SIUMI191 swo SOW V4 280 so es tom i9 64 � � 32 13.9 2a V 8.11 tfiblt &94 9elnarrs sooaea 11m we +u an ; m IoM to ee 1 11111 27 L1 1111SAXIS car&$" DWPA d— '1Jftsi�ntMgoM awrM a. �aMCanlMoaKarMsb�atKltarrrnMb +i ��� Coatsd Cast Iron FLOW- LITEK/Ham LOW t0oo 3000 �1 Motor Hoosier 0 1-1 tlnFelier Material Cu Carbonate � � • � Closed Vans _. . 3o to ABS Volute Power Cord A6 7Z '� - Mechanical Shaft Seat Nitrils with carbon and ceramic faces s 4 Fasteners Stainless Steel ^ . W S amlClC1C .5M s 10 23 -- - Upper Stem and Lower F;atl Bearings o. 0 0 20 40 60 so FLOW- GALLGn/- "TWJTE cftnt F%=P C 16 PUMP PERFORMANCE CURVE pnW"12si GdmWmCv4p60K 79157 113v 60f12 ramr. MS.IO?.2311.1�a: 4110L3R156e Fern 99b295 -07p3 ww1A.UU1CQ1a ntftmP.00m PLAN Page o • fypNUAs- & MptGEIV[ its POWTS QWN S SYS� SPEC 0 to SQRdc Tank 0 HA F"— owN►'nO S SePBCT O iJA o s p tea LI 30 0 NA perm��- t,�ode Dow NA PumF - C3 HA car comrn I UnD PctmP Tank G� der . Pump #A= 1-6) p Model unit Raw 0 Sol aw= x s3Q mom- o fA °" Q 0900. ��, s o s ) average.. C" �tt{s) ❑ Moon cmd {P�"t�+°dy z'+oos IdA Mortt� p In-9 nd (Q p Mound went Qt�Y Ds :!r.30 m9n- �cad6 D osne� P O nnend (� ) . 530 MWL 0 Ewche 1w Ox °d 50ws cam) s10` c u/t oomt for dons u p 01A ` !1O ` Feoat Cotes j V &kM* p�de she Serv ice FtrQeeesoy s) �Maxtsuain 3 yes -) ce SOHWu� O rnon volume 6M1 Event once every one- (Y„) service Al east and sasc+c► equals s) ( m um 3 Yss) tnsP cond%on of IXnk(s) yynen combined stodge p moss p� out contx�s of tanks) � least once evi" s) ds �csst call(s) At test once every v ic(s) O N Inspect once every s) t3 NX �n souent Attu o p NA I nOP " . I Puff* oontrds a. atsrm JAI ,east apex srerY p r::o Q yearEs) flt�s and Pure Seat kt least once everY C1 ntc+a n O vs i(t) p NA At least Once every pn,.c con's of the f itodw. salwoo p OWTS *A or pt;T[0►HS std be made by s POwins OW to UP Ow" InsPOCISCM p�tpttics ant pwrisbsr of th ley�s IA8sw Pke<nbe t %dude a vwugd onad awe a to duel Ow eff lt u+a tylue VFW', Tank � lure the vOWMe'�� be vis�X .� � Of ate+ sr Y disP --W ttte nd surge- dal reg aware. idae�aY on the $ �s+d WftM d- o f effluent Ors o n of ttse „dome, In ph Of Gft ;" to dock n°r'nd r�equ� ttte irnm dW n M I � Ofd with C t L NR tank 9� std may $ of sludge s� acorn in S OPemo' and dtsP at . Whets the owibkwd aoaun On fY a Sept be antes s of ore tats Cod comP�0• paxrserit �' 113, � �.} or psu P be by a o std e � - ShaH sw iwig of ex.0 p#.12 months or. min ZQ of comP�op The ar n+� tV tts r y auvvo* or otter OmermakawwrIc A gNaIItie p rovided TION t 1enf sank (5) =11 Ith conce�W tOO t" tams? r+ennoved by 8 s P� dt _ - �--`` &o� aM **ZW at the in�tive surf the e�es5 s1 uP shaft not ncxwr vtAtarL above aorn bevels. the oWs} . and may in the S3' ocC�lsas �p f t� etse9/ oett{s} in one Urge dose. ovt Ott. p� t nut"ded by a Des t r bC d ties avoid this sifr�on have the or a PhanbSC or PCyWTS m o ff vrJowwaterva bad at,cfoe C r � °`tt power to me et�ctent pump itt 4fte pur asp -. aw SOPWO cos o(s to r nt ai over. or d orcompact }. a oVw gM d1sQ ' s Do �ta> arm Do riot ddW or p moEmd - and PMINS ow g(e OW ate w� �t feet t sbps of me saber sbwm mad, irn 09 elan or- ln* 9 btmii . condoms; t0an swabs; K gwoe S t� bio6ta� Y v�aber: � and v99SWAe P bate. °��� P pes< s5, n'r tamao'" scram >d irtscn�e thatthe service the tnffa sbeQe ...lase P'owrS fags andlot Per in oomPf Comm 83.33,11 C.od i is Proper s c soorutec� and the abandoned P Pe �n a Ail P to t� and pits ate - reraov acct properW emposod of by Sege VOW spabe ttas The eonLer+ W e) a ad and removed or tUW ors n'°ry'°nr.�i AtEerp mataftL Mad re1ttt sue. ! °r aEtt� in8rt sow . C,DNTwGENCY PLAN the *'10wln9 measures have if must be U10% tiD Pie a code if the POD � � �'l" be r t tent and assay be u�ezed for the k1mWn of a r�t not begn n3A sine Est a es s be P d � flw 1 0 be and a oa sysNeri- s from a dStin3 an t� a ralw upon by need for a new soli and site' * � &� area w7t'"M& 'n mist c omplY at 8tat time• with the rotes in eifeci adV In POWTS tis�� S' ent ble'du to setback aadlor 5011 forms• is D A suAabfe ,up n wed as a fast resort to replace the fazed &a PO>� a sod .and a t�otdittg s m identify a suitable eptacenwnt a ` � failure area is available a . Sj',.e,=vEjuf=afion s not been a suitable repiaoem oc aft how tank tray be as a last resort in the faiYn� PO of the biomat at sM won Symms Gte w1th the rules in of such sys eite�attltattittte. sxtd and at -91st �g st d L i°rn GASSES ANDJOR WSUFFIC TENT OXY�• <<WAPJw4t>y TANKS MAY CON T/4tN LE THAL 4oEM aRC:11A115YANCES. DEATH MAY SEP71C, PUlfRP AND OTHER 1•RF�► A=REA MENT T ANK tat�toER AI�CY L.T OR 9JIPOSSIBLF DO mar E ffER A SSSMC v PUMP FRON< THE MNrM - MOR OF A TANK h%y BE DIPFiCD RESULT_ RESCrlE -OF APERSON ADDtF OKAL- OoW POWT•S MAiHT > PO%WTS INSTALLER Name Name Phone Phan" LOCAL LlLATOW A€JI'HOMY SEPTAGE SAO OPERATOR Agency Nary ^v = — ];:: � Phone ?,t, — D Phone °-Z . dLts. t taf<e. w t:°ur'ty' Z°'tlt'g aad s na rt+is Qrd�d ell f and 835�(l). M & (3)• WaWnsln A� COW POI ) tt�e re+i�memn+ rt�gta�e�C of dt. t:oltlRt a3.7�}( )(a�'1 . guararAes 9+e pa anuaw of the POW S Wisconsin Department of Commerce SOIL EVALUATION REPORT Pafle or Division of Safety and Sukfts in accordance with Comm 85, %Ms. Adm. Code c«,rty� j ral �L Attach complete site plan on paper not lass than 81/2 x 11 inches direction mus Parcel I.D. include, but not limited to vertical and horizontal rererence Poi M ( ), percent slope. sole or dimensions, north arrow, and location and distance to nearest road. Date Please print all information. R° Pasonar i ftnnstion You provide nay be uMd for M WIdWy purposes (pmMY Law. s. 1 5.01(1) (m)). Ply Property Location cJ 1 G �� v GOB tOt/V4J 1/4 /4 S T Z N R - 7 E (or Owners g Addrr�ss Lot # Block # J Name or cSAA# _ ZT R a G Phone ❑ CRY ❑ Village Nearest Mad MY ZKM ZIP Construction U Residential / Number of bedrooms Code derived design flaw rate GPO ❑ Public or commercial - Describe: -- ft. ..� ' Flood Plain elavadon If applicable 7=comments and reoarxrrer+dations: ®� System Type_ System Elevation 1 _��� sod g 9�� �. F I 1 � # Pit Ground surface elay. �"=-�- u. Depth to knidrV factor _ �• So ll A Rabe GPDff Horizon Depth Dominant Color Redox Description Texture Structure Consistence BotudanY Roots in. Munsd (1u. SL Cont. Color Gr..SL Sh. `Etf#1 'Efgf2 Sul r Fd—, Boring # - I Pit Ground surface elev. . ft. to I�rridrlg factor in. Sop Rate Horizon Depth D Redox Description Texture St uct" Consistence Boundary Roots GPDRE In. Munsd Qu. SL Cont. Color Gr. Sz Sh. 'E1f#1 l D�� Z 31z. Z l r • Ettkrant #1 a WD > <_ 220 m 30 yL and M >30 =150 ` Etikwit #2 : SOD S 30 mg/L and TSS <_ 30 mot CST Number CST t emu w_ tie P(W 226900 Bird Plumbing, Inc. Shaun Bird Address Date Evaluation Conducted Telephone Number 715 - 246 -4516 1008 192nd Ave, New - Richmond, WI 54017 sue_ Ila ` Soil Test Plot Plan Project Name Stan Shefveland Shaun B' Address W7430 510th Ave Ellsworth Wi 54011 CS. #226900 Lot 24 Subdivision Pheasant Ridge Date 10/21/08 N W 1/4 N W 1/4S 9 T 29 N /R W Township Hammond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of White Stake System Elevation 9 *HRPSame as Benchmark B.M.* 2 Acre Parcel Property Line Scale = 1/4" = 10' 97' B-1 2% Slope 97.6' B - 2 98 ❑ B -3 Property Line 109th Ave Soil Test Plot Plan Aroject Name Stan Shefveland Shaun Bi Address W7430 510th Ave Ellsworth Wi 54011 C11T, 226900 Lot 24 Subdivision Pheasant Ridge Date /08 N W 1/4 N W 1 /4S 9 T N /R1 W Township Hammond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of White Stake System Elevation 97.6 *HRPSameasBenchmark B. M. 2 Acre Parcel Property Line Scale = 1/4" = 10' 97' B-1 29% Slope 97.6' B - 2 98' ❑ B -3 Property Line 109th Ave I �WiisconsinDepartment ofCommerce SOIL E LUATION REPORT Page � of 3 bivision of Safety and Buildings in accordance with Comm �is. m. Code Attach complete site plan on paper not less than 8 1/2 x 11 inche County size. P include, but not limited to: vertical and horizontal reference point (BM), ' eation a parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance earest Please print all information. Re 'ewed by Date Personal information you provide may be used for secondary pun es 1 m). Property Owr cation T C4 ,�./ S (� Govt. Lot / t/ 1/4,f/4J1/4 S T Z N R ? E (or Property Owner's Mailing Address o Block Subd. Name or CSM# c'.J l7 -/ // Z city State Zip Code Phone Nu r �df�VTy illage own Nearest ad ZONIN OFFIC � AL 44 ew Construction Us Residential I Number of bedrooms Code derived design flow rate �{J"Z7 GPD ❑ Replacement ❑ Public or commercial - Describe: _— Parent material ,[�1CJ Flood Plain elevation if applicabl ft. General comments and recommendations: System Type — System Elevation 1 �� Ong # Boring L F Pit Ground surface elev. /• 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. •Eff#1 `Eff#2 .3 Ong # ❑ Boring 77 Pit Ground surface elev. l- 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. •Eff#1 •Eff #2 • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 ' Effluent #2 = BCD < 30 mg/L and TSS < 30 mg/L CST Dams (Please Print) S' re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �'Q� J 715 - 246 -4516 Property Owner _ Parcel ID # Page of Ong # Boring j� Pit Ground surface elev. _ � • - ft. Depth to limiting factor 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 Z z - ! ----- < rn 4-a . Z/ Z 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 E] Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 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 altemate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD4330 (8.6/00) Property Owner — Parcel ID # Page of 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff #2 Ne - 0 1, r F-1 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 GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD, < 30 mg& 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 (8.6(00) L C 'o s 0T 1 1.04 ACRES g 00, 906 SO. FT. N S 7 7 7,5t 6 7 LOT 4 , 3 O'1 ' I 1.56 ACRES LOT 9 14 67, 804 SO. FT. /. ^� 1.60 ACRES gp 69, 654 SO. FT. w l ® �I O I co I W 1 ( IN _210 mi 33 33' , S ` �. gyp: -, � � • � _ _I/' � .' '1'S °� 30T - - -- - - - - - -" L OT 23 L OT 26 3 1.93 ACRES W N° o° 1.64 ACRES 84,262 S0. FT. L OT 24 N I o o. 71,367 S0. F1 1061 cv LFE 1063 1.69 ACRES p= L OT 25 Q- 73, 459 SO. FT. o HWE 1 061 ' 1. 71 ACRES o LFE 1063' 74, 417 SO. FT. y ---- ---------- 2 W l o N c O DRAINAGE _ N I ' RA - s' - � D _ o _ cA EASE 0 0' 1 35- 0 41 4'N 6 'GOLF TT � 90. 0 , 0 , °p; o cb O 3 20 0 4 26a�/' - SOUTH LINE OF THE NW 25� 86 1s� 00' lb ----------------------------------------- - - - - -- - - -- NOTE : THIS PLAT IS LOCATED IN AN i AGRICULTURAL AREA. HOMEOWNERS SHOUL EXPECT TYPICAL FARM RELATED i ACTIVITIES THAT INCLUDE SMELL, NOISE, EXTENDED HOURS OF OPERATION, 300 ETC. i r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP I CER CATION FORM OwnerBuyer �`f - � 5� � "!'�l l�' (C1 Mailing Address _ �u —� t) 3� n Property Addres C P T (Verification required from Planning & Zoning Depart went for new construction) City /State Parcel Identification Number I — 1 0 7 41-0 LEGAL DESCRIPTION property Location �1/4 �"/1'` 1 /4 , Sec. , T N R ` / � W, Town of le Subdivision Lot # a Certified Survey Map # _, Volume r , Page # Warranty Deed # 17 I -r , Volume , Page # Spec house yes Lot lines identifiable 6 no S YSTEM MAINTENANCE AND Proper OWNER CERTI Improper use and maintenance of your septic system could result in its premature failure to handle wastes 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 §Com aL 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 v that 1 the on -sift owner and by a master plumber, journeyman Plumber, restricted plumber or a licensed pumper erifying ( ) wastewater disposal system is in proper operating condition and/or (2) after inspection and Pumping (if necessary), the septic teak is less than 1/3 full of sludge. to maintain the vats sewage disposal system with the IJwe, the umndersigned have read the above requireaxente and agree private of Wisconsin. standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, Certification stating that your septic system has been maintained must be completed and retuned 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 a warranty deed recorded in Register of Deeds Office. Number bedrooms SIGNATURE bF A,PPLICANT(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. 08 105) Iillll IIIII IIIII IIIII IIIII 11111 Iill !I!I!I Ilil lill * 8 8 1 5 9 6 1 State Bar of Wisconsin Form 1 -2003 881596 WARRANTY DEED KATHLEEN H. WALSH Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 09/18/2008 02:30PM THIS DEED, made between HomBuilders, LLC, a Wisconsin limited liability WARRANTY DEED company — EXEMPT I ( "Grantor," whether one or more), REC FEE: 11.00 and Stan Shefveland and Suzanne Shefveland, husband and wife TRANS FEE: 150.00 ( "Grantee," whether one or more). PAGES: 1 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 needed, please attach Name and Retut>w9ddxts ! e,� N addendum): �m dLo" . .1l��Q G `+a.,.,,. 11 Lot 24, Pheasant Ridge, St. Croix County, Wisconsin Hudso N �7CA�OM 018- 10% -24 -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: easements, restrictions and reservations, if any, of record. Dated l I �j v HomBu l rs, LL (SEAL)By: Vr 64 • (SEAL) * * William Pletcli, member (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) HomBuilders, LLC, a Wisconsin limited liability comnany bv William Fletch member STATE OF ) authenticated on ) ss. ., COUNTY ) *Kristina O land Personally came before me on TITLE: MEMBER STA E BAR OF WISCONSIN the above -named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: * Kristina Oeland, Estreen & Oeland Notary Public, State of 304 Locust Street, Hudson, WI 54016 My Commission (is permanent) (expires ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. INFO -PRO— Legal Forms 800. 855 -2021 www.infoproforrns.com 1 Of 1 Parcel #: 018 - 1096 -24 -000 10/28/2008 03:52 PM PAGE 1 OF 1 Alt. Parcel #: 09.29.17.799 018 - TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - SHEFVELAND, STAN & SUZANNE STAN & SUZANNE SHEFVELAND W7430 510TH AVE ELLSWORTH WI 54011 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1725 109TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.690 Plat: 09- 026- PHEASANT RIDGE 1/32 018 -02 SEC 09 T29N R1 7W PT NW NW PHEASANT RIDGE Block/Condo Bldg: LOT 24 LOT 24 1.690AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 29N -17W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 09/18/2008 881596 WD 09/26/2003 741523 2420/625 TD 08/06/2002 686239 9/26 PLAT 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/19/2007 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 1.690 200 0 200 NO Totals for 2008: General Property 1.690 200 0 200 Woodland 0.000 0 0 Totals for 2007: General Property 1.690 200 0 200 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 .sw•e +o saouw vaw :,o,w woy 6SOS- SEZ(STL)XVJ fiwn,e sefiewmos+yeV+W M111Nnua4a ®wimze ]fill U7 saaw>uswwaoa saw,a (¢,o wwwv��m, re+w�,u 995E-Z49 (008) 166E -SEZ (SIL)Hd & vawb �u t :- nw,e�eN,wiw i�w r, :tawe 3JN34I53b L£-80 �(p�� ■■ w ,i mwu�w+aamoa�wen... �auwiw.+woavww+eww TSLbS IM'31NOWON3W ONVl3/(33HS 'ON NVId 3nN3ntlHtloTZa sia4uaD 6 mno Pam w G S N W 9 N u � � p ®O � �i wOs� � —�'�� �i I >Luiu 9map�a� o0 0 m9Q�ei�w �d LSO uQ� Lu O D Q 0 4 Z LU o mz w l w ^' L U O N ® ® T 3 z Z Q z M®®® ® ®E c ME: 11 lill Jill ............ EV J" U-1 ----------- MA LU ---------- lab, L 1 61 W T am I Li d 1 � II n .......... . ----- wl --------- m ------------ . . .... .... .... ..... ........................ --------------- ------------- u ----------------------- ........................ Z 4 J Zp O ,P,ZI Q IMF Ti'n mOONIm Ti3m rtOaNlm YoGm9 „4,91 „4,SI gp .S L a s Y L+ g 8 4 Ill A - - - - -Al ................... LU Q 0..• '.4 3 � � �I Q Woq qR � Q a a to § m m i Q m .................... 3 A 9 Q Q „P.Zf Q m u �Li WLL' I gF� Q I �O i S'ro O� ,PSf i i >J� zru O r U LLa Jrc �� Z m >} _ o p az o N t LU S 0> 30 N N W O W J N N R' W L ' V a ��a, at tj N F ^ r O G} I m0 _ O z iLb Q !I Y II I � w�zn L Q N == LL W a a J 2 'U Z W J Z F a 11 r aN U u Za900 ZZ O a O ►MMf --- = 8 ro z NO LU ��LL > W41O� m�a LL n asia awls viol m � Z � r N N L a J W a rch z O LU V/ u7 N ;lconsin Department of Commerce SOIL EVALUATION REPORT Page Of ` Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C �! Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must Include, but not limited to: vertical and horizontal reference point (BM); direction and Parcel I.D. t percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0/ `a7 W 2 — da _ Please print a i F ( r ' by ^ Date Personal infarriiaQon you provide may be used TP IP Law. 15.04 (1) (m)). Q/pvv_ G� J Property OwnerLocation n (IM k JUN ] Q 2002 ovt. Lot I\jbj 1/4 Nt()1 /4 S `l T 2� N R E ( W Property Owner's Mailing Address of # Block # Subd. Name or CSM# + I � ST. CROIX COUNTY 2 Lf r 1 � City State Zip Code ❑City _ ❑ village o�.Town Neares Road d S (_7 l 5 ) ?tQD _ Z(' N 11 d vie - P-New Construction Use :'® - Residential / Number of bedrooms _. * �- 4 1 Code derived design flow rate S 0 GPD ❑ Replacement / ❑ Public or commercial - Describe: Parent material " f � I n elevation if applicable ft. General comments ys � 2/ t'_ U, S So (X N7�t4J alit- OX 4 and recommendations: e o r el U- 9 .�, O ct / ,L' �0 T k/!�� n _ � � , C',►i°- / B / 2 / ° c:4 K -e Boring # . Boring ` ? vv C C ® pit Ground surface elev. '"lR .M IL Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ In. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. q-7 'Eff#2 I O -t 2 t S. I 2-n-� t-y ' c g t v Z f 2- Si c1 2 k r-4r m -�' — — . 1 Z. Al o �Lr� �c Y t — YX Boring # Boring 5 pit Ground surface el ev. ft. Depth to limiting factor 4 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 0-1y to }z S; -I Z ry-gbk I 5 S Effluent #1 = SOD > 30 220 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 2 9 Address Date Evalua on Conducted Telephone Number (115)2q7-`/GUS I Property Owner l LJt )'1c . Parcel ID # / a / Page of © Boring # ❑ Boring pit Ground surface elev. + ( o• too ft. Depth to limiting facto 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 eS v-Q Lx- i Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. c o il Application Rate Horizon Depth D-xninant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I _ - F-1 Boring # C] Boring Pit Boring Ground surface elev. ft 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 Color Gr. Sz. Sh. 'Eff#1 'Ef1#2 • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 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 - 2648777. SBD -8730 (807100) PAGE OF 3 NAME SO O 1 LOT# y LEGAL DESCRIPTION AM X1JW l a ,S 'I T _ q .N,R, E(or) SCALE: I "= Z/O BM 1 ELEVATION U BM 1 DESCRIPTION (0 4 BM 2 ELEVATION BM 2 DESCRIPTION , "pvr A'D� Q SYSTEM ELEVATION 9 7, ,5-0 SYSTEM TYPE 44 - (9-ra cl -e- CONTOUR ELEVATION 97 00 g o 0 0 DATE SIGNATURE — �� i SAFETY AND BUILDINGS DIVISION Al Field Operations Bureau 13 East Spruce Street INSPECTION REPORT Chippewa Falls, WI 54729 NVsconsin www.commerce.state.wi.us Department of Commerce Scott Mccall=6Governor Philip Edw. Albert Secretary Date of Inspection: July 18, 2002 Plumber Name and Address: Project Name: Pheasant Ridge Use: New - Residential Legal Description: NE, NW, 9,29,17W Lot Number: Lots 25 -26 Subdivision: Pheasant Ridge Certified Soil Tester Name and Address: Municipality: Town of Hammond Henry Grote CST 222774 County: St. Croix E 4366 353` Ave Plan Transaction Number: Menomonie WI 54751 Sanitary Permit Number: Owner Name and Address: RECEIVED Ron Wastewater Flow: 450 -600 gpd 70th St Persons Present: Jon Sonnetag Hammond, WI 54015 JUL G 4 X002 Rod Eslinger S T. CROIx COUNTY ZONING OFFICE This onsite investigation was conducted because of conflicting soil and site evaluation reports by Henry Grote and Adam Schumaker. CST Schumaker felt that the contrasting soil colors of the substratum might be indicative of seasonal soil saturation. >+ 41t'and it is my opinion that the bands a streaks of contrasting color are depositional in nature and not pedogenic redoximorphic features. The contrasting colors were likely deposited by water from different sources and thus there are different colors. Convolute bedding often overlies horizontal bedding as was observed in the soil pit on Lot 25. The high chroma streaks noted in the horizontal bedded sands are like due to uneven weathering of minerals in the sand rather than contemporary redox feature formation. tifltlorllrlill>rilir! . Nfta* `:I!tQtto Sizing example: If there are any questions regarding this report, please feel free to contact me. J y Le y G. J sky, ast ater Speci ' t Ljansky@ mmerce.state.wi.us E- it 715/726 -2549 Fax 715/726 -2544 Voice cc: Excounty ❑ Plumber ❑ CST ❑ Owner ❑ Other ' CUPIN REPORT Pag 1 of 3 1665 Wisconsin Department of Commerce 9 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. 8 O percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. �A 6��S�r?D O Please print all information. R sewed y g Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). r e L2 Property Owner Property Location Bonte, Ron Govt. Lot NE 1/4 NW 1/4 S 9 T 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1011 170th St. 25 Pheasant Ridge City State Zip Code Phone Number City j Village YJ Town Nearest Road Hammond WI 1 54015 1 715 - 796 -5240 Hammond 110Th Ave. I New Construction Use: j6 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement ,_ Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 2- 2.83' x 118.18' (St'd- Infiltrator, 38 shells) stipulation 1099 chamber trenches @ system elevation of 99.2 FT] Boring # .J Boring Pit Ground Surface elev. 104.1 ft. Depth to limiting factor > 80 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 1 0 -8 10YR 2/2 - sl 1 c sbk mvfr cs 1f /m .4 .6 2 8 -36 7.5YR 4/6 - sl 2 m sbk mvfr gs 1 m .5 .9 3 36 -80 7.5YR 4/6 sl 1 c abk mvfr - 1m .4 .6 horizon 3 has occasional 10YR 6/3 fs coats on peds Fil Boring # Boring Pit Ground Surface elev. 101.3 ft. Depth to limiting factor > 84 in. p 9 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 1 0 -10 10YR 2/2 - sl 2 f sbk mvfr cs 1f /m .4 .6 2 10 -40 7.5YR 4/6 - sl 2 m sbk mvfr gs 1m .5 .9 3 40 -84 7.5YR 4/6 - sl 1 c abk mvfr - 1 m .4 .6 I horizon 3 has occasional 10YR 6/3 fs coats on peds; occasional 5YR 4/4 scl inclusions (3" x 6 ") below 72" ' Eff luent #1 = BOD 30 < 220 mg /L and TSS > 0 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mgr CST Name (Please Print) Sign to e: CST Number Henry F. Grote 222774 Address Certified Soil Testing a Eva ion Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 541751 11/16/2002 715- 233 -0398 Property Owner Bonte, Ron Parcel ID # Page 2 of 3 37 Boring # Boring Pit Ground Surface elev. 102.2 ft. Depth to limiting factor > 84 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10YR 2/2 - sl 1 c sbk mvfr cs 1f /m .4 .6 2 10 -32 7.5YR 4/6 - sl 2 m sbk mvfr cs 1M .5 .9 3 32 -84 7.5YR 4/6 - sl 1 c abk mvfr - 1 m .4 .6 i horizon 3 has occasional 10YR 6/3 fs coats on peds F-1 Boring # Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I I i ❑ Boring # ._.j Boring LL ,f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i i ! i I Effluent #1 = BOO 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 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 (R.07 /00) certified Soil Testing t r O ZS SAO tile � r ( -� 3 o�.10 f w s ;�„� e� -•nom@. .�lX•N.4 �� >` >` >` >`» � a� 3 so p � t N CD ' •: 867 44' 260.0 , NO2° ' 27 E to -Ato Q f ¢ ....... /O " w o 881 .s 'Los 0) o• .3 Z , C s �� ni s A 0 20 �y A p s s\ s y n, C$ 0 � V 0� S � ti . O I