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HomeMy WebLinkAbout018-1099-37-000Wisce~n:~n Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buiiyiing 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)] 'ermit Holder's Name: City Village X Township Schlulter, Darrin Hammond, Town of :ST BM Elev: Insp. BM Elev: BM Description: 'ANK INFORMATION ELEVATION DATA TYPE la! ~MAEyI~ACTF~~t ~~Q~• CAPACITY Septic ~Gw?""i-~ I ~ Dosing 1 _ - J +r ~ Aeration Holding B B TANK"SETBACK INFORMATION TANK TO P/L WELL ~DG. w Vent to Air Intake ROAD Septic ~ .~ S ~ ~ ~~ Dosing « .~ ~~ Aeration "'f s Holding Pt1MP/SIPHON INFORMATION ~i 12• 0 Manufacturer /' mand ~~_ ! l~ GPM odel Number ~ ~ ~ 3~ •O J Lift ~I•~S Friction Loss .Z•3~ System Hea ,~o TDH Ft 1 I8.5~' Forcemain Length l ia. p Dist. to well Q N ~ Cf111 ARCr1RRTIR1Rf CVCTFM county: ~ St. Croix Sanitary Permit No: 499114 0 St Plan ID2N.~' ~ / ~ f ~,~ arcel Tax No 018-1099-37-000 SectionlTown/RangelMap No' 09.29.17.847 STATION BS HI FS ELEV. Benchmark .... ~'S' , , Z ! ~~?O. o Alt. BM Bldg. ewer `G ~ a T~+ ~ g ~ p~, ~S! 00. St/ Inlet // pD ! ~. ZS ~ SUHt Outlet ` / Dt Inlet Dt Bottom ~5,~ $'3.25.1 Header/Man. ~ Dist. Pipe .(P~ 2'4' Z.~Qa c~s-.SOS/ Bot. System ~ • r~ ~~ ~S i ~~~aL~rw1'l.~ ~1~~ l2.lt S COJ 00 (iw St Cover Z,p ~ .o • .. r••~+ ~•3~l . l7 ~ tfs' ! BZ'D RENC Width ~ Length No. Of Trenches FIT DIMENSIONS No. Of Pits Inside Dia. Liquid D DIME `~ ~'D t SETBACK SYSTEM TO P/L BLDG WELL LP,KE/STREAM LEACHIN CHAMBER 0 Ma cturer. INFORMATION ~ Type Of System: Q l UNIT I Number: nICTCIQ11T1l1AI CVCTGM /L..L..nA 1___ C,•i ~i'/,. Y/J .1 / Header/Manifold ~~ ~~i Distribution p' ~ ~~ Pipe(s) x Hol Size !~ ~f x Hole Spacing~~ Vent to Air Intake ~•~ th ~ Di L 0 ~ th ~ Dia •~ Spacing rr Len 3Z. 2. a eng g Cllll !'!'1\!CD n..,..._....,, e....~....... n..l.. „ nn„~~.,.~ nr er_rra~lp Svctr?ms Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No 'Yes No COMMENTS: (Inciude code discrepencies, persons present, etc.) Inspection #1:~,b(• ~'~ dab inspection #2: T~ -" Location: 1755 102nd Avenue U`nkAnown (.NnWT1/-4 SW 1/4 9 T30N R17W) Pheasant Ridge Lot 37 Parcel No: 09.29.17.847 1.) Alt BM Description = ~~lh~''~ } ~ 1~ • C.O+~s . 2.) Bldg sewer fengter= ~ ~~~ ' amount of cov ~ ..p..~ ~.. ~~p~~pr,, rQp~, I~ ('~ 3~ [~~aq, ~ ~ ,ti.~ C~-S C.Y. r i .__., ~ - '~~'""^ - Plan revision Required? ~ ,Yes No U,~,(,~ , ~~ ` Use other side for additional information. _ _ _ . -' - Date Insepctor's Signature SBD-6710 (R.3/97) ~~i ~z~ Cert. No. h ~' ~~'~ ` Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County 1 ~ Madison, WI 53707 - 7l 62 ` ~ ~~~O~~ Sanitary Permit Number (to be filled in by CoJ , i l (608) 266-3151 ~~ ~~ Department of Commerce Sanitary Permit Application State Plan I.D. N er 3 ~ 3 y' onal information you provide d d C i e, pers o m. s. A In accord with Comm 8321, W may be used for secondary purposes Privacy Law, s15.04(1)(m) ~ ~ ~~ roject Address (if different thany~mailing ad~ress)11~, ~ ~ ~ ~ N`s ~ ~ ~~~ ADZ I. Application Information -Please Print All Information t _'D ~ y ~ ,,, Property Owner's Name f Pazcel # ~o>~ Block # /%1 Property Owner'sMailingA ress RECEIVED on ropertyLocati ~~ ~ /~ ~ ~ / e y,~l-(J',, Section City, State ~' Zip Code ~~ ~ C Phoge~}llnl~r O 2000 A 111 ~ (c' cle e) I V N; R E W I. ype of Building (check all that apply) ok ~ ST. CROIX COUNTY S bdivis~ n Name CS Numbe Family Dwelling -Number of Bedrooms ~ Pl r ~- 4' I ^ Public/Commercial -Describe Use / / ^Village~~vnship of ^Ciry ^ State Owned -Describe Use _ r III. Type f Permit: (Check only one box on line A. Complete line B if applicable) A. New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System List Previous Permit Number and Dale Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration - Plumber Owner - IV. T e of POWTS S stem: Check all that a 1 ^ ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil At-Grade ^ Single Pass Sand Filter Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic T tment it ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil pli~ n Ral¢(gpdsf) Dispersal Area Requir (s~ Dispersal Area Pro osed System Elevati~ ~o~ ~, ql / ' i p ~a (,~ ~ J i l c ast VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber P Gallons Gallons of Units Concrete Constructed Glass New Existing 1 W 8 ~5 ~ ~ Tanks Tanks Sep[ic or Holding Tank ~' Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I the undersign a responsibility for installation of the POWTS shown on the attached plans. 1NIPRS Number Business Phone Number Plumber' a (Print) Plumber' re ~~6 l~ ~a ~-yam Plumber's Address (Street, Ciry, Sta~Zip o ~~` _ ~-1JL~C.// / se Onl VI . Coun /De rtment U Sanitary Permit Fe (includes Groundwater Da Is ed Issuin ent Signature s) Approved isapproved Surc111rge Fee) 55 D . Db $ ~/ bllJ J en Reason for Denial I1C. Conditions of ApprovaUl2easons for Disapproval a~ S ~~` ~ t 1. Septic tank, effluent, filter and dispersal cell must all be services / maintaitleg 4 fit. Q e 5 e r ~ , a ~ r.~, as per management plan provided by plumber. 2. Aq k retluiremeMa must be mairltairled ~ ~ ePP ~ / o~narlas. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size 7 SBD-6398 (R. 01/03) PLOT PLAN PROJECT Darrin Schlueter ADDRESS 1238 Hwv 12 Roberts Wi 54023 NW 1/4 SW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 94.0' BEDROOM 4 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons HOLDING TANK SIZE LOAD RATE .55 ,BENCHMARK V.R.P. Top of Steel Fence Post ^ BOREHOLE O WELL * H. R. P. Same as Be B.M. AIt.B.M. LIFT TANK SIZE DOSE TANK SIZE 765 ABSORPTION AREA 1100 # of chambers none ASSUME ELEVATION 100' Filter Za ,,-~10~0-- nchmark ~a~/~ Property Line 230' Property Line i ~ (, ( Plea a note: system is being size larger than required, 91 ~ I us d a .55 loading rate and Scale = 1 ~4ii B - 29 94' 93' wou d have gone longer, but - the ite did not permit this. ~ QI Ur1~eSS Sys em is about 10% larger tha required. otherwise ~ca~,~.~- stated . ~ , -- ~~ 18% lope Area 15' below system is to remain undisturbed Grading is to be done to ^ B - 3 divert run-off away from system Well is to meet all setbacks found in Comm. 83 B - 1 Tank is to be properly 376' Property Line bedded and provided with lockdown covers Huffcutt with approved warning Combo Tank labels Pro 4 Bedroom 386' Property Line 102nd Ave • ~ ~ PLOT PLAN PROJECT Darrin Schlueter ADDRESS 1238 Hwv 12 Roberts Wi 54023 NW 1/4 SW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 94.0' 4 BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .55 ABSORPTION AREA 1 100 # of chambers none ,BENCHMARK V.R.P. Top of Steel Fence Post ^ BOREHOLE O WELL *H.R.P. Same as Benchmar B.M. Alt B M ASSUME ELEVATION 100' Filter Za )) -100 k ~7~1 - 230 Property Line Property Lrne ~ ~ , ~ Plea a note: system is being size larger than required, g 1 ~ I us d a .55 loading rate and 95' ~~ Scale = 1 /4 = ~ ~ wou d have gone longer, but B-2 94 93 the ite did not permit this. 1 O~ Unless Sys em is about 10% larger tha required. otherwise ~cati,~.~ stated . ~ , -- ~~ 18% lope Area 15' below system is to remain undisturbed Grading is to be done to ^ g _ 3 divert run-off away from system Well is to meet all setbacks found in Comm. 83 B -1 Tank is to be properly 376' Property Line bedded and provided with lockdown covers Huffcutt with approved warning Combo Tank labels ~ Pro 4 Bedroom Hous L 386' Property Line 102nd Ave commerce.wi.gov ^ ^ isconsin Department of Commerc® Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 09, 2006 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC 1008 192 ND AVE NEW RICHMOND WI ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/09/2008 Identification Numb'ers' Transaction ID No.1308339 SITE• Site ID No. 716546 Darrin Schlueter _ Please refer to both identification numbers, 102°d .Ave above, in all comes ondence with the a enc . Town of Hammond, St Croix County NWl/4, SW1/4, S9, T29N, R17W Lot: 37, Subdivision: Pleasant Ridge FOR: ' Description: Four Bedroom At-Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1090610 Maintenance required; 600 GPD Flow rate; 37 in Soil minimum depth to limiting factor from original grade; System: At-grade Component Manual, SBD-10570-P (8.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); 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. L,03t1 • Per manual cited above,.limited activities are allowed in the area 15 feet down slope of the component area. ~P~' Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and p ARTME dispersal are prohibited. N OF G • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption SEE COR area. chs. NR 811 & 812c • 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 POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions bf Sec. 145.20(2)(d), Wis. Stat SHAUN R BIItD Page 2 8/9/2006 • Comm 83 22L71 A copy of the approved plans specifications and this letter shall be on-site during construction and omen to inspection byauthorized representatives of the Department which may include local insuectors. 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 shall 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, ~~L~~ ~~~~~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin.gov Fee Required .$ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART code: 7633' cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 ~~c~l~ ~!~r 3 Fp SAFES - ~ 106 ~ e~~`di Nis Date: 7/28/06 Owner:Darrin Schlueter Location:NW1/4 SW1/4 S 9 T29 N,R17W Lot 37 Pheasant Ridge Richmond System type: At-Grade Manuals Used: At-Grade Component Manual version 1.0 SBD 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81) ~~ +~~~ 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 Contige y n ~»~Ily 9-11. Soil test ,~~D 1F COMMERCE Shaun Bird -Y iNCs Signature ~PONDENCE License number 226900 } ~i S P1iG FaRE.E.MA~ ~i ...~ ~t ~ 2~ _ ~~'t'UR~3- ~?S" ____ t - • - - ~-- LitSTltc~.~.iT;a.~I LAt~[ZAL -~ STASt~-i Z` £~ 0~~~~*Ttaws VJEi.c. ~~ _ ~O ~~~ ~~~ > gt l~~ S~ ~/6B s = ~ ~{. ~B~R.a,tEa Sxus'ii~~c. ~'abr;~ -- ST~Bsti~~D ~}bStrva~~t3n----.-.._ Vote ~ t ~ .,~ t > ~I ~ v c es __~ ., , T CE~t o~ lL - Z/Z l~6~t£,C-s~T~E D~is~ribu;ion La#eral ~- Soso COVQr ~. >_5 2" t A ~2 .•• ~L6Nt~D ~;,.AYfR. > 5' ..+ p3.an Visw and ~ress Section of pi.scor-sia At-gr'ada u~-t with a Slagle Absargtian Area en a Sloping Site Slbr3A~1U fL~. Page Of i#istribvtian Pipe €3et~i~ For Lateral network ..TuR~t -uP!• ~GL~t~touT~ * Last dole Si3ouid ~e ~fext To ?i~ttt3- UQ _.~_ P~tC ~nrte Mai n "t'~"t ~- PVC ~istribation Pipe P Ac ~e s~' 3~x ~~ ~ Ft_ hole i3ia~eter ~~~~ Inth `~~ X ~ Inches Lateral i1ia~+eter ~~-- Inch{es} ~ Y~ ~ Inches Fore Main piamete~~ Inches ~ Of Notes/Pipe ~__~___ Invert Elevation Of Laterals ~ • J Ft. ^ Signed; License lamer: Date: \, o ~. ~u ~~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings rn accor~anc;e wnn t,omm ao, vvis, r~arn. ~,vue ~^ County ~ ~. ~` Plan must Attach complete site plan on paper not less than 8 1/2 x 11 inches in size J . r . indude, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. -~ ~ ~ ~~ D ~ ~ '~ ~ 9c percent slope, scale or dimensions, north arrow, and location and distance to nearest road. f J Please print all information. Review by Date Personal information you provide may be used for aecondary purposes (Privacy Law, s. 15.04 (1) (m)). $ ~ ~ ~~ Property Owner Property Location Ct ~' l~ /U ~ ~ (~_~L/ ~ Govt. Lot N(,~ 114 S (,J1/4 S T N R E (or W Property Owners ailing Address M Lot # Block # ame or CSM# N Subd l ~ O ~ ~ l l ~l.C c City State p Code Phone N m ^ City ^ Vill ge Town Nearest Road ~ ~ ~ ( Cc New Construction Us Residential / Number of ooms Code derived design flow rate O?J ^ Replacement Public or oommer ' - __._____ ___ ___ Parent material Plai elevation if applicable /f//~ General cornrnertts and reoortwnendatrons: A U G 0 9 20 06 System Type X COUNTS~ystem levation ~ d _~___.__ GPD ___ ft. Boring # ,y~~yyy Boring Q' Iii Pit Ground surface elev. ( ~' ~ ft. Depth to limiting factor ~~ in. Soil lication Rate Horizon Depth Dominant Cdor Redox Desaiptitm Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Z t ~-`f ~ °-- i y ~ ® ~~ # ~ Boring ~, _ ,/ Pit Ground surface elev. f ~ ft. Depth to limiting factor ~ ~ in. Soil Iicatron 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 3 ~~~~ cz ~ ~ ~~,.- ~~ ,,~ . a • Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) a CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~-- !„~ R ~--~ ~ 715-246-4516 Property Owner _ ~ ~ ~arcel ID # Page of Bori # ^ Boring ~~ ~ ~ Ground surface elev ft. Depth to limiting factor [ ~ in. Pit 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 ~ 3 ~ 3l z ---' S~ ~ r- ~'~'' , ~' I3~`f 2 ,-s' -~- G ,~- ~ 3 Na-~o ~ s" ~ ~ '~-- ~~ ~ ^ 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 Ong # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon ')epth Dominant Cdor Redox Descxption. Texture Stn3cture Consistence Boundary Roots GP D/fl= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 720 mglL and TSS >30 < 150 mg1L 'Effluent #2 =GODS < 30 mg/L 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 format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB0.8330 (8.6/00) ~• ' Soil Test Plot Plan Project Name DarrinSchlueter Shaty Address 1238 Hwy 12 Roberts Wi 54023 ~, Lot 37 Subdivision NW1/4SW1/4S9 T29 #226900 Pheasant Ridge Date X28/06 N/R ~ ~ W Township Hammond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 94.0' *HRpSameasBenchmark Property ine * Alt. B.M. is top of Survey Iron @ Scale is 1" = 40' AIt.B.M. 94.5' 91 ~ unless otherwise 9 S' B - 2 , 9 3' noted 18% Slope B-1 B-3 230' Property Line Scale = 1 /4" _ 10' Unless otherwise stated 376' Property Line 386' Property Line ~' ECT~CN AND SP€cLiICATIQN~ SEPTIC TANK ~ P~}Mr C~,RMB~ CRASS 5 ,+ i~Ii~. ABOVE GitAD~ ~ £ ~r£AtHERP~f ~i1NCTIt3I~ $~X ApPROV ED LE CBYEit ,~++ CI ~ ANT PIP£ ~,~ NI30~ 4R ~ ~~~ C4I~33U I T THO : FR£ar»' "?IIt ;~tTAiCE ~~ ~n . WARtiIItG iA$E ' ~---~ ,z, a. --, ~" ~-~~- { _ 10 n ~iY ~ ~ _, f a w~~- ~ ~. INLET i4 G ,5r- ~` i a. : ~ u ~ i+iA1'ER TIGHT SEALS T A Y T i LSJ~+ 1 SEAL { HITQ~i ~~p~~S ~~ T ~~ ~ F3LT f.R "- .~--- i ~~ '!~ F,~ 3 ~ 8 ` aW ~,I OII AppRF1YEiI Pik 3` 3lID ,,~ ~ F? ~_ C '"~ + z FF • . ~ St 5ElTL - ~#~fP t1FF ELEV -~_.-•- ~ 3n ApPRt3~tEi7 ~3EDDIHG Ui~DEK '~;C ~ C~DNC~TE PAi) SPECZFICATI4335 B~ DOSFS ?LR 3?AY = ~C~ ~ 3'i SEPTIC t noSE j ~ ~. GaL_ ~ ~{35E y{y~t+tE Z1~CS.UUII+iG Tl~NK MAi~Fi1I'ACZVRFR: S.S~ GAi.. Fj~$AC1C: `-•-----" SEp'FZC ~". ~}I,, r ~ j ,~NCt~iES = ~1,y~~AL- TANK sZZ£S = i~USE jv ~~ ~~ ~yyt,K1 C~iFRCITI£S' Ay - _ =s=,F---_~14L• $ _ ~ 2 IISCHES ALARK nAt+R~FAC2[3REA;= ~ ~ ~~~ .~ ~~'~GaL -"-""" MODEL li[~1"18~~- ~, ~g•PC1# TYPE: C i ~~NCf1E~ = ~~L.--- ~nF ~~ ~ 1 _ I LHR ts. zs WA J KoDE~ ~8~ _ - ~,, ~~'`.." ~ ~zR~~ As PER SWITCH ,~ ~ G°~ PUnP £ ALAR FEET DISCHARGE RATE ~•,! -- ^FgIBUTIpN FIP~- ~~FEET REt~IiIRE3 - }' ~ FEET ~ EEi~t PU1''~P Oi F .ANB I3ZS - - - - - dER'fICAL DIFFERENCE $£TW ~ - ~g FT_ "FRICTTai3 F14CTOR - - ~y~~.~---^FE£T + MII~~ `Jet NETWORK SHFFLY PRESSUxZET> j N ~£ H£AD ~ ~ ' Jf V FEET F4RCEM~IN X~ ~OTIiL DY ~ PtJMC TAit3c: L£KGTH ~" I,IQi3ID FNT£RNt~L DIi~E3~5ZONS flF f..ICENSz. ~Ii1I'iB~ = S IG~tED: _ -4ATE x, :t8$ Sant By: HP lasarJat 3100; 1 715 552 8827 ; May-5-O6 2:56PN1; Page 2/3 9 EH SERIES SUMP/E F'1-LUENT PUMP t Specifications E~IAIfl Cl+l SIIIIt>9E E~E~i 1BHIHAICE~w~E~ > lRtD. wad E0>EOE~ MI. ME, tBA1C M/ IBtti ~.k1 Ai11iiNRlf p tI ti' lp p1.1 ~ RI A1a1 DEslt~ 9EH-gM 5(199330 UUCS+- u'0 115 314 13A 1000 70 54 55 41 32 13.8 2D 24 9.11 x11.64xB.94 8131-DM 509340 L1/CSa 41'0 230 3d 1i.5 1000 70 64 55 41 32 13.8 2II' 2t 9.11 :11.61 x A94 9Bi-t7l4tffS 5093.50 UI~CSA 4"0 115 314 •.3A t00D 70 6d 55 41 32 13.8 20' 27 9.11 x 11.64 x 8.94 9E4-(IA~AfS 50996U__ _ INlCSA 4Y0 230 3ra 6.5 1000 70 fi4 55 d1 32 13.8 20 27 9.t1 x1t.64x9.94 Cor4inuou5 DutYN>~A-"1i11k Gi7MNfit1-PUmDSareraeCcoAimwusOutYdsbnpaslh4yamtunwiMintnet>U>GShalrrinpsforN~estputnps.' FLOW- LEPERS/HOUR 10 Motor Housing Itngeller Material Epoxy Coated Cast Iron Poly Carbonate Closed Vane - ABS .. ... 1 ~g'p ~ ~~ ~~ l ~ s W Power Card _ W Mechanical Shaft Seal 5 ' -- - ... .. ._ a Fasteners Shaft 2.5 - ------~- ----• Bearings D .. ... .. r e L Nitrite with carbon and ceramic faces Stainless Steel Stainless Steel Upper Sleeve and Lower Bail Bearings Little Giant Pump Ca P() Bet ]ID<10 • t)klsUooa CSty, OK 73157 P4one:1Y5.y4'7.25l1 • Fu: 405.22&1550 FrmaB: euxlo~~ner.ie w+'tuaslme,com ~3 Form 995235 - 07/03 rLDV- GALLONS/MINUTE PUMP PERFORMANCE CURVE 115V bOHZ ~~.~ www LfttleGiant.PVmp.com _ ~ ~ UAL & MANAGENtEMT PLAN •-~ PUWTS (~1NNER S ~~ ~v~,rcwt SPPCIFICpTIONS t~urriber of Number of Commet~ Units fbw (anral'age} (Estimated x 1~ p~gn ttow (p~• soil Apps Rs~ E uerrt t2ua~ly Fatar O~ ~ Grease (FOG) BiOcftiem~ OzYB~ Demand (BODs~ Tots[ susPiend~d somas {TSS) Effluent QuaFdY t+lA P BODE Biadtemicat Oxyger'd~ ~ ~ (TSS) Total Suspen metric mean) Fecal CoGfottn (geQ Maximum Efiluerrt Particle Size Service Event inspect ~pdrtlon of tank(s) Pump out contents of tank(s) Inspect disper~ cell(s) Clean effluent filter tnsped p~unP. Pump oontrots ~ atarm Flush (abecals and pressure test fVA Monthly svB~3e` 9a mg/L . QZp mglL Monthy average" Si0 mglL ~a mgn- 51t7' cfullQQmi incridiameter SePtrc' Tank Ca1~Y $eQtic Tack Manufr u Effluent Filter Maw C-ft9ueat Flfet~Model Pum.-- p--Ta=k CsPat~Y pump T$ttK Manor Pump IVlanufadurer ~ ~. Pump Model Pceae~auc.a.•..,•Ft[ter - p Peat Fitter ~~ n O Wet3and D Iyechanicai Aeratia p Other. - ^ Dlsinfec~on i'age_ ct ~ai ^~ NIA s , Q IVA Q NL4 '- ^ 1VA - ^ t~iA 5persai ~K~~ ^ [n-ground {pressur¢ed) jn~round {gravftY) p Mound At-4cade ^ Other_ --r----- values iy'P(d ~ domestic t~~ wastarraLer and ~~ ~nfc efrtuent. •+ Yatues types for ~e~ests4 ~- Service Frequency ^ rnontfis r(s} (Maximum 3 yrs.} At feast once every oats one-tt-TM (~} of tank volume d scorn eq itVtten combined sludg e an eaRs) (Maximum 3 yn;-) p month At least once every ~ C3 mon r(s) At least once every ~ s) p NIA At Ieast onc8 every ^ mo s) ~ Nw At feast once every ^mon ^ months 1:I yearfs) O NiA At least once every ^ months ^ yearns) ^ NIA At least Once every KltAtl~t't'E'NANCE iNSTRUCTtt3N5 one of the foitowing ficertses or tnspee6ons of tanks and d"4spersal setts sr,au be~ made by an individual carrYirt9 fir: PCyWTS Mamtarner, Septage ins: Master Plumber: Master Pturciber Restricted Sewer, POW'rs inspe ~ a rsirssing or broken up ~ must include a visual Inspection of the tank(s~ to en~Y. nY gang pperator. Tank insp cracks or leaks. measure's volume of combined sludge aced scatm and to sheds r any nardrnraria. identify any io check tlt'e eti4uent levers of etttuent on the grosmd surfaae_ The disl~~ Qell{s) shall be visually inspect ~~~ of efiuent on the °r ~~ for any ponding of effluent on the ground surface. to fire observation PIPS and to check uir+es the immediate npilficafion of the local regutato% ~°~' ground surface may indre2te a fa+Ting condition and req or more of the tank volume, the When the combined acwmtriation of sludge and sctrrn in any tank equals ~ and isposed of in aacordanoe with ch- NIR entire ooMents of the tank shall be femoved by a Septage Servicing Opera . 113, Wlscansln Administrative Code- - t t~mponents; and any POVYTS Maintairtet- Ttle setvidn9 of effluent . rnedaanicai ~ 2 months ooe~ss shy be {>Zrfennsd by a nt othermalntenanae or monitoring at inter~r3ls oratory aufharity within tQ daYS of campielron of any semce eve . q selvk;e repast short •be pm~~ to the loco[ reg STARTUP ANO OPERATION reerua; of palming Qroduds or other For new a~nstruction. prior in use of the POtM-S chedc.treatmertt tank(s~ fa ~ cell s if h canoenira6ons ate ctremicais that may impede the treatm s) eased ~ a s P 9es ~~ g ~ ~ p~ ~ _ detet~ed hate the oQnt+ents of ih ~''` , Page of~_ !' S sfart up wait not occur when so'i'condifions are frozen at the infiltrative surFace_ fill above nomlaS highwater ferrets. y~then power is restoc~eci the excess Dcrrtr-9 p °~e' p~P ~~' rriaY ceii(s) in one large dose. oyerfoading the ~(s} and [nay raesuult in the ~~~( tie discharged m the d'cspe~ p ar s~irface deseharge of eflicrent Ta avoid this sifuation have the contents rff the primp tank removed by a Sig Sees ~, p~-~ ~{ng p~ to the effluent pump ar contact a Plumber or POWTS Mafitainec to as5i5titt Lnanualt~+Ope~'~ ~ p~P c7D~t1'IQIs tlJ restate normal levers wittti'n the pump tank.. do not drnre or panic ve~tlictes over tanlc.~ atsd dispets2l taells_ Da not drive or p2r3c Duets or oflierwise drsturb or compact the area within 15 feet down sklpe of any mound of at-grade so[1 absorption area- Pram the wastewater strum may imprt~ve the perfortTra[tce and prolong the life Reduction or-eitminatton of the following ~ butts; condoms; ~tton swabs: degre-asels; dental fiCSSS; drapet+~ of ttte POWI"S: antr"bio6Cs; ~babywtp~: ~~ fir, fruit and vegetable pe Ss: S~ne% fl~;~ herbic,~es; meat eGn drsinf: tat; fouriida~on draft {sump P. F3 des: saniia na tans; tampons: -and w~ saf6ener brine. soaps medx~ons: o$, ~ainSng Products: pes~i ry p ~ - gB`e'Nt30Ni~it:NT taken out of service the fot[owirTg steps shah ~ taken to Insure that the When ttte POW'I'S fails and/or is permanently- system is PmPeny and safiely abandoned in oomptrance with ch_ Comm 83.33. V~esconsin Admhtlstzat6ve Code: All piping to tanks and pits shat! .~ dis°_ °nneded and the abandoned Pipe openUx3s sealed- . Ths contents of tilt tanks and pits shall be removed and properly disposed of by a Septage •Servicing Operator. After pumping, tilt tanks and pfis shaft tae excavated and removed or tYierr covers removed•and the void spate fitted with soft, grave! or another inert solid raateriaL CONTINGENCY Pt.At~i if !fie POW'["S fads and Carulot be repotted th$ fo[[ow[ng measures have been, or must be forcer, in PNvide a code compliant replacement system D A suitable nrpiacement'area has ~~ evaluated and may be utilized far the location of a replacement soil absorption system_ The rep[acemerst ariea should be protected from disturbance and compar~lon and should not be infringed upon b}r required setbacks from existing ar~d proposed structure, rot &nss and wel(s_ Failure to protect the replaeernent area will result in the need for a new soil and siteevaluation to establish a suitable replacement area- ReptBOeraent systems must comply with the rules in effect at tr-at time. D A suitable replacement area is not avai[abie due to setback and/or soil timita5ons_ Stirring advances in POWCS technology a holding tank may be installed as a last resort io replace the fazed PDYVTS_ ~T~,e site has not been eraiuafied tb identify a suitable replacement area Upon failure of the POWTS a soa.and s//-"~ evaluation must be performed fo locate a suitable replacement area.- if no replaoeraent ont=o is available a [ding tank may be installed as a last resort to replace the faired P011YTS_ _ Mound and at-grade Sor7 absorption systems may be reconstructed In place fe[towtng ramovaJ o€ the biomat at the tnfittrativs surface.. Recaonstructio'ns of suctr systems must comply with the rules in effect at that tirrte_ ccHftARIriIN{~> SEPTIC, tsUMP AI+ID OTHER T!'tF.ATILTENT TANKS MAY CONTAIN LETKAf.. GASSES ANDIOR INSUFFICIENT OXYGEN. Dt? PLOT ENY'ER A SEPTiC, PUMP QR QTFiER TREATMENT TANK UNDER AAtY CIRCUMSTANCES. DEATH MAY RESULT_ ,RESCUE OF A PERSOt+I FROM THE INTERIOR flF A TANK MAYBE DIFFICULT OR IMPOSSIt3LE. AoomoNAL conr«'s POYYTS JNSTALI.ER Marne „~// ,~..JJ Phone /~frj"/ ta" 7-~ . POWT'S MAINTAINER tr[ame .~ Ph~rre ~ ~/-S-- ° ~..5~ Ea SEPTAGE SERVICING 4PERATQR PUMP i.flCAL REGULATORY AtJ~NORITY ~ . t~ Name ~ :~'rr- ~ Agency ~' Phone r Phons '~fJ ~ "~ 'rtes aoaune~ was drattod by Ore str~ of the Glean I.a1ce, iVlarquette and Waustrara County ZaaIng and Sanitation :Qe ThTS doasaent meets uee a+inimcan requite of dr. Comm 83_?7CIl(b}{il(dyd~{fl a*rd 83_S6(1). C2) &. f3J. Wisconsin Adh7[rtts7t'atm Cede, the of fE~ls QoCttment d005 t-ot guarantee the perfotmaaoe of flue Pt?VYTS_ ~ t?1011 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~~ Property Address City/State d~ (Verification required from Planning & Zoning Department for new construction.)G ~ f ~~ Parcel Identification Number ~ ~ ~ ~ l ~ L ~. ~ ~~~" ~ " LEGAL DESCRIPTION Property Location~/~/a Subdivision Sec , T ~N ~2~~ Town of ~~' '~- ,Volume ~- _-, Page'# Certified Survey Map # ~Varruty Deed # S ~ , Volume Z ~ Page # J Spec house yes no Lot lines identifiab yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could resultvn 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 trea p ent stage in the waste disposal sys~m~u~~~ r~ntenance responsibilities are specified in §Comm. 83.52(1) and in Cha ter 1_ - St. Croix Count Sanitary The property owner agrees to submit to St. Croix County Planning & Zoning Department a certifi~caatil> ifhorm, si~d by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper ve~Y f necess the se tic tank is wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (' az'Y)* p less than 1!3 full of sludge. Uwe, 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 statements on this form are true to the best of mylour knowledge. Uwe am/are the owner(s) of the property, described above, by a of a warranty deed recorded in Register of Deeds Office. ~ ID n / 1~ SIGNATURE OF APPLICANT(S) DATE & Zoning Degaranent*** *** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning 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) u. 26osQ oss STATE BAR OF WISCONSIN FORM 7 - 1999 Document Number TRUSTEE'S DEED Dine M. Bonte as Trustee of Karl M. Ulferts and Katherina G. Ulferts Family "[Yost for valuable consideration conveys without warranty t0 Darin I.. Schlueter and KerY~ T. _ Srhl irPtPr~ Husb nd and wif Grantee, the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 37, Pheasant Ridge 1st Addition. St. Croix County, Wisconsin. 795464 KATSLEEN B. NALSEt REGISTER OF DEEDS ST. CROIX CO. , kI RECEIVED FOR RECORD 05/20/25 10: 30A![ TRUSTEES DEED EXElWT # REC FEE: 11.00 TRANS FEE; 216.8® COPY FEfi CC FEE: PAGES: 1 Recording Area Name and Return Address fHE RIVER BAAIIC PC Box 188 Osceola, WI 54020 Part of: 018-1099-37-000 Parcel Identification Number (PIN) EE ~ Dated this I ~ day of NIaX 2005 * Trustee AUTHENTICATION Signature(s) Dine M. Bonte, Trustee of Kart M. Ulferts and Katherina G. Ulferts Family Trust _ authenticated this ~ ~ day of _ ~__ _ _ , 209 `~~ ,- -- - __ ~C- ~~~ * Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Hudson, WI 54016 * Dine M. Bonte Trustee ACKNOWLEDGMENT STATE OF ____ __ ) ss. County ) Personally came before me this - _ day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Notary Public, State of _ _ _ _ _ _ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) .) ___ _ -._-__-------- --- I * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, W[ STATE BAR OF WISCONSIIV 8Q0-655-2021 TRUSTEE'S DEED ~ FORM No. 7 -1999 ' Parcel #: 018-1099-37-000 08/11/2006 02:34 PM PAGE 1 OF 1 Alt. Parcel #: 09.29.17.847 018 -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 Go-Owner O -SCHLUETER, DARIN L & KERRY L DARIN L & KERRY L SCHLUETER 1238 HWY 12 ROBERTS WI 54023 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 1755 102ND AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.540 Plat: 2300-PHEASANT RIDGE 1ST 33/54 '03 SEC 09 T29N R17W PT NW SW PHEASANT RIDGE Block/Condo Bldg: LOT 037 1ST LOT 37 (2.540AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 09-29N-17W NW SW Notes: Parcel History: Date Doc # Vol/Page Type 05/20/2005 795484 2806/055 TD 05/06/2003 720313 9/59 PLAT 7(1f1R CI IMMARY Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 0 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.540 69,100 0 69,100 NO Totals for 2006: General Property 2.540 69,100 0 69,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.540 69,100 0 69,100 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 Jam. ti / ? ~° 32' 4 / N N 13 ° 23' 49" Y ' LOT 38 43'8'' / / 1.87 ACRES / 85, 753 S0. FT. ~ ~ LBO 1080' / ~ , i N ~ ' 53" _,_ , F-- ' i ~~' - __ Oqq /NA ~ 4. ~ f ~ ~ ~~ ~ ~ ti O / ' ~ i~ I , ~, LOT 3 7; ;~ ^ ~ ,~ ' 2.54 ACRE5 ~ ~ti / ry. 1 10, 470 SO. FT~ ti ~ ~ , LBO 1080' ' ® ~, ~ ; '~ BEARINGS ARE REFERENCED TO THE _ \ a~et ~ ~ ~ ~ / Fl-SOUTH QUARTER SECTION L 1 NE. °D \ ~ I ~ ' ~;~ ;'~ ~~ CR01 X COUNTY COORDINATE SYSTEM). ao \ 3 ~ ~ ti RECEIVED AUG 1 0 2006 ST. CROIX COUNTY ' JAMES M. ' WEBER Y11~10VW1EIf, WI REws~J 3 -ZZ-~3 S87°26' Ol"E ~ ~ ~ 386. 02' ;' ~ ~ o \ \ ; _ / \ ;, \ _ _ , \ 3 ~ c~, / ; \ I W I O i Z 2 tijr © , , , ~ \ ~' ~ ~ ' i \ I ~ i ' r \ ~ ~ .~ ~ •~ ., \\ LOT 6 go! :3'I 33' :; •~ cA \ 2.09 AC ES ~ '' :~ ., CV \ 91, 199 SK). FT. ® ~ •~' P- ~ \ ~ $` _ 1 ~ ' ~ ; ~o~ ; cfl M ~, ~ ~ \ i ~ ~.. ; \ , ~ ~ ~ 3 ' 001 \\ ( 303' 6k. ` ', 7 { ~ \\ , 36~ E ~~ Q ; ° g ~ ~ , ~ H66 \ I ~ O _ N_W 1 i4 -_ SW I i4 N \ ~ p ~ ~ ~ '~ SW 1 i4 - SW J i4 ~.. - - ~-~- - - - - ~ ~•~ z \\) LOT 35 •® ~.~. \. \~ 1. T2 ACRES .•' ~ . i+` ~\ 74, 967 SO. FT. ; ti I \ ~\ ~ to ~ \ ` ~ ~ \ I \ •E 302'' ~` ~ ~ \ 4' -6~ ~ Z i N74 O \. :~ , ~ \\ ~~~ LOT 34 ;, ~, ~ \ 1.87 ACRES ~~ ~~ ~'• uQ~ 81, 268 SO. FT. I ~, ~ ~~\ h hh 0 ~• ~O / / 15' I Z ~\ DDC 'T~ Q ~ l oj. •Q ~~, ~ Wisconsin Departmer~ of Commerce SOIL EVALUATION REPORT Division of Safety and t3uikiings Page _ I of _~ In accoroance warn Comm ao, vns. Hum. ~,ooe County ~ ~ - Plan must ss than 8 1/2 x 11 inches in size t la er n t l h l it Att l X Y . n on pap o comp e e s e p e ac include, twt not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. viewed y Date Personal information you provide maybe used f t'bttd2rypmpvses{Pri~yJaw.s.i5.04 (1) (m)). C(/Y~': (,(~(y~y~ r! g Q 3 Property Owner(r'_ 4 ` ' ~ - - 'Y~ r~ ~ ~Gm i I (r l.a 5T Pr party Location G~vt. Lot N ~ 1 /4 5~; 1l4 S 9 T z`~ N R ~ 7 E (or~ Property Owner's Mailing Address y ? `' ^'7 ~` ~~ L t # Block # Subd. Name or CSM# . Q ~ ~ l(~i 11 ~ ~ n~ ~cl ~ City State Zip Code PhorNe Nurhber ~ °` ~ City ^ Village '® Town ~ Nearest Road ~~ ~ l~ t _~... --_ -y .._ 1--Iammorl a mrr,~ rid I ~ [~] New Construction Use: ~ Residential /Number of bedrooms _~-1__ Code derived design flow rate __ ~ SO_1 ~~ ~ __ GPD ^ Replacement ^ Public or commercial -Describe: __________________ __ _--_~__ Parent material ___ T t_~ (______^___,__________ Fbod Plain elevation 'rf a~pA.licable ____~/1~___~.______ ft. General comments s ys~.e~ ~ It J •ll',S", S'v / /a ~~Sa.-.d-~/~~ and recommendations: ~~ ~, y. S G P~ r~ ~o ~ ,~ e 9 ~ ~ .~6, ~-no~d%4.acu-~~vn Boring # ~ Boring 2~ ~] pit Ground surface elev. ~.5 _._.U_ ft. Depth to limiting factor ~`{ in. Sofl A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ 0-IZ IU r31~ - ' '1 2 ~r c S lv-~ . 5 2 I2- 2 I O r 4I3 -- s ~ ~ I 2 -~-,~ Irjk v~-4'r e ~ - . ~ 3 Zy-- 4 t D r S/`~- ~- 3 P 1 ~~J - r `III i c I sb k f i - - . `I Boring # ~ Boring C~ pi( Ground surface elev. ! 5_.~ ft. Depth to limiting factor 2 ~ _ in. ~~ ~~ Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft2 in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 `Eff#2 ~ 0- y (0. 3 r" Z -- S i I k Yr~-~'r c s 1 v~ 5 - 8 Z i~-ZS I 4~3 St~~ S yYr~'r ~5 - .'-( - ~ 3 25 -~ )d 5~`l 3~P ~•5 r`f/ef Stc'I Z 5bk v~~ - - . L/ . ~ 'Effluent #1 = BODS> 30 < 220 mglL and TSS >30 <_ 150 mg/L ' Effluent ft2 = BODS < 30 mglL and TSS < 30 rngll CST Name (Please Print) ature CST Number ~dGm S~h~>~ket- -r Zs3 30`'1 Address Date Evaluation Conducted Telephone Number 2l t 3 ~Sb ` 1' S~". .Sv m ~°r~~c -~- , (~S I 5 5~ 2S" /z - S-o z ~~i5~ 2 ~f l - `/o D~ ~ h ~. Page _ ~_ of _ ~-! Boring # ^ Boring ~Z Pit Ground surface elev. ____• ~~ _ ft. Depth to limiting factor _~_~ in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDi'ftz in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 •Eff#2 ~2-3p 1~ ~ - ; ~ 1 2 ~ c - ~ ~-l00 ~ `I C ~1 • 4 /cc 5 ~ c 1 2tn5 i - . `-1 ~ Property Owner ~L~r_~ 5 ~O.l~! ~t~Tr ~-+5~- Parcel ID # ^ Boring # ^ Boring ^ Pit Ground surface elev. _________ ft. Depth to limiting factor ______ in. Soil A lication Rate Horizon Depth Dominant Color Redox Descr~tion Texture Structure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring Boring # Ground surface elev. _________ ft. Depth to limiting factor ______ in. ^ Pit Sol A licadon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/flz in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 •Eff#2 'Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent i12 = BODS < 30 mglL 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 format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.0)I00) ., ~ 1 PAGE .3 OF~ ~T a ME ( I ~-~ ~t S LOT# ~ ~ T EGAL DESCRIPTION rtiw ~ Sw 1 a ,S ~ T Z `~ ,N R. 1 ~ Etor)~ SCALE:l"= ~~~ BM 1 ELEVATION /O(, . U i " BM 1 DESCRIPTION~o fJ o -~ /N S~-e e l ~o TT BM 2 ELEVATION ~~, ~U BM 2 DESCRIPTION~p cf-~-%ti ~ S~-~ ~/ ~o~ SYSTEM ELEVATION `~~S . S~ SYSTEM TYPE Yh y v n cf CONTOUR ELEVATION `~ ~/ ~ Sy N Sec. f ®t - 1 ~, ~ 9J. 5~ ~~ ~ 93.5 ~ Cow `' ~ ~ ~ ~ 6~~ a B z ~lS~ S _ /' DATE /-~~ a3 r PAGE~OF~ ~JAI~~ (~-~ ~~ S T OT# 3LEGAL DESCRIPTION ~w ~~r'~ S 9 T Z Q N R/~ E(or)~ SCALE:l"= ~/O BM 1 ELEVATION /OU - ~ ~ „ BM 1 DESCRIPTION~o~~Ly Sac/ ~oo~ BM 2 ELEVATION ~~, xU BM 2 DESCRIPTION ~o„~ e'~%ti S~-e ~/ ~oa' SYSTEM ELEVATION 9~- S~ SYSTEM TYPE YY~ u ,~ n ~ CONTOUR ELEVATION ~ ~/ ~ S~ N c_ f ~t _ I con $_ z 2g ~_ 3 ~ 9/• 5-z~ T- ~ 20 93• S° n ~~ -~ I ~ Zd' ' / ~°~ ,~ ~~ 1P5` ~rav-. Co rruar ~ DATE /-~~ a3 3~' ~ ~ ~ t an ~ la ~- p l~ - `f ~~ ~ ~o ,; ~ X ` f ~O ~ / l 1. ) ~ 1093.2 ~ T ~ 1 78 ~ ` ~ • 1093.3 X l 1 LF 1 ~ ~~ ~ ~ ` , ; ~' ~ ~ 0 5 313 8- ' ` _ _~ ~. a, L ~ 6 , ~ '~ ~ 97 CRE • ~ ~ H 1.30 8' .'~ js'~_y7;` ~ LF 108 ' ~/ / ~ X i ' a D/~ NQG ~ ~ ~•' 1.092.6...., ~~~. Q 4~ 3 ~, ~ , ' e LOT 8 / ~ i 1. S2 ACRES ~ 2 O CRE i, ! O , ~ ~ O ' , ~ S7 )~ Jr ~ ,' M ; • 3g ~ 6 E 346 9• ~ ---- -- - ~ ~3 ~ f' h ,~. ,, ~T3.3s. -f ~ / ~° , „~ A .~ ~` ~ Y I. ~ ~ ff ~ ~ n a~~ l~ ~ f ~ ..., .., Z. , yr. 0 / f M ' ax , ~ M ~~ _ ~} ' ~ ~ L O? 84 ' ,.-...~-~ ' ~ ,~" ~,~ ~' ~` ~ ~ i J a 1.'S8 ACRES i D 0 . --~ .~. ACRES I q .3 ! i 1. 3 ACRES "'~ ~ ~ • B 62 ~ ~ -h w , - • 1103.3 •~ ~ W~ ; c ~ ~ ... ~ ~. 1 ~ ~ ` O f o ~ ` ~ f 1 `~ \ ~ t 103.4 ~ ~ ~ r i ~ ~ X f a tr \ ~ ~ ~~ ~ ~ _ ~ N ~ a' ~ ` 182 ° 38' 27" Hr 1 • 68' i `' ` s ` f L 65 ~ ~ ~ ' CA 1. T4 CR£S ' ~ ~ ~ A ,~ i I ~ N ~ OT 81: gf ~ ~ .f cA / '• ~ N ~ ~ ~ `~ ~ `~ 1.68 ACRES Ni ..~ O ~ f ` '~ f / ~ ~ f ~ ~ i -- ~ \ ~