HomeMy WebLinkAbout034-1076-30-050 wrssin Department of SOIL EVALUATI N REPORT Page--L
of 3
Division of Safety and BuildingsI b
in accordance mWi Con m 195,Al1Ai;,, 1Adm.
{ County ST.CROIX
Attach complete site plan on paper not less tha 81/2 f 1c ill 'KY cRlan mint �T
include,but not limited to:vertical and trorizontar coon a Parcel I.D. `/ Q J v
percent slope,scale or dirrronsions,north arrow,'an ieeelie road.
Please print al!information. Reviewed by
Personai information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)).
Property Owner l/t/uj Property Location ❑
ROBERT LEAF Govt.Lot ----SE 1/4 SE 114 S 33 T 2 N R 15 E(o0 W
Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# L
2928 C.T.H.DD 2 -- (P �7
City State Zip Code Phone Number ity El Village EVown Nearest Road
Glenwood City, I WI 1 54013 1 ( 715) 265-4964 60th Avenue Springfield
QNew Construd'an UseE] Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD
❑Replacement F-1 Public or commercial-Describe:
Parent material glacial till Flood Plan elevation if applicable AIA� ft.
General commerce Mound System—0.2 loading rate— 2.50 ft.sand fill
and recommendations: ' SEE INTERPRETIVE DETERMINATION REPORT
To be designed by designer or installer
F I Boring# ❑ Boring
a Pit end surface elev. 99.84 ft. Depth to limiting factor 10 n- Soil icatioqRale
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 '1 0-4 10YR3/2 sil 2fgr mvfr cs 3vf-co 0.6
2 4-10 10YR3/2 — A 2fa&sbk mfr as 2vf-m 0.6 0.8
3 10-12 10YR3/2 fl IOYR3/4 sil 2fa&sbk mfr as 2vf-m 0.6 0.8
4 12_17 10YR5/3 m3p 7.5YR5/4 sicl lfabk mfi as 2vf-f 0.2 0.3
5 17-26 7.5YR4/4 m3p5YR4/6 sl If-msbk mfr — lvf-f 0.4 0.7
Some gr; cobbles.
❑
2 Boring# El Boring 98.79 9
0 Pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cori.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
1 0-4 10YR3/2 — sil 2fgr mvfr cs 3vf-co 0.6 0.8
2 4-9 10YR3/ — sil 2fgr&abk mfr as 2vf-m 0.6 0.8
3 9-12 10YR3/2 of l0YR3/4 sil 2fa&sbk mfr as 2vf-m 0.6 0.8
4 12-18 10YR5/3 m3p 10YR4/6&10YR6/1 sil 2fabk mfr as 2vf-f 0.6 0.8
5 18-25 7.5YR5/4 m3p7.5YR516 sl If--mabk mvfr lvf-f 0.4 0.7
Some gr•few cobbles.
Effluent#1=BOD >30<220 mg(L and TSS>30_<150 mg1L 'Effluent#2=BOD <30 rrtglt and TSS<30 mg/L
CST Name(Please Print) Signature CST Number
M Jo Hollister 224832
Address Date Evaluation Conducted Telephone Number
W9875 690th Avenue,River Falls,WI 54022 06-25-05 (715)426-1775
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Parcel #: 034-1076-30-050 04/01/2008 04:15 PM
PAGE 1 OF 1
Alt. Parcel#: 33.29.15.513B-20 034-TOWN OF SPRINGFIELD
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type
08/15/2005 00 0
Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner
CALVARY ASSEMBLY OF GOD CHURCH O-CALVARY ASSEMBLY OF GOD CHURCH
PO BOX 56
WILSON WI 54027
Districts: SC=School SP=Special Property Address(es): '=Primary
Type Dist# Description '2984 60TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 3.320 Plat: 5044-CSM 20-5044 034-05
SEC 33 T29N R1 5W S1/2 OF SE SE CSM Block/Condo Bldg: LOT 02
20-5044 LOT 2(3.32 AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
33-29N-15W
Notes: Parcel History:
Date Doc# Vol/Page Type
02/08/2008 868583 WD
12/07/2007 865269 WD
10/26/2005 810394 2916/125 WD
10/26/2005 810393 2916/124 WD
more
2008 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/15/2007
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 3.320 5,150 0 5,150 NO
Totals for 2008:
General Property 3.320 5,150 0 5,150
Woodland 0.000 0 0
Totals for 2007:
General Property 3.320 5,150 0 5,150
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
' FORAM NCO.99885-A
■'itdrVller
�..,..,.,..... 8 0 3��0
IVE(� Stock No. 26273 VOL 20 PAGE 5044
J„� KATHCEM H. Wi(LW----
REGISTER OF DEEDS
RECEIVED FOR.RECORD
ERTIFIED SURVEY MAP NO. 084u120 05 04:00PM
VOLUME 20 , PAGE 5044 RECTIFIED SUR�VEEY MAP
COPY FEE 3.00
IF-MROIXICOUPITI►- THE SOUTH HALF OF THE SOUTHEAST QUARTIE� :ES: 2
s !aA'S.REcoW) OF THE SOUTHEAST QUARTER,
SECTION 33, TOWNSHIP 29 NORTH, RANGE 15 WEST, East 114
Section 33-29-15
PREPARED BY: TOWN OF SPRINGFIELD, ST_CROIX COUNTY,WISCONSIN Fall Survey Mark Nail
Joet A. Brandt
JB SURVEYING LLC
966 Rustic Road 3 v,
Glenwood City, WI UNPLATTED LANDS �rn
00 91
rJIN
SW/SE SE/SE N89'34'45"E 1323.12'
661.80' I O
220.66' 220.33' 220.33' 625.02' ( O
I!
36,78'I I N
LOT 2 I
I C $ LOT 4 8 = s LOT 1 —��• I .
z rrl $ ,,t 435,020 sq.ft. N aV I
Ib LOT 3 i3 9.99 acres CD I�I r- I
Im rn N rn N incl. r-o-w Cd (.r Id
Rf N !1/� � A f i I rn I
A ` _
Cl I" a °f q� (� 389,788 sq. ft. r++�
8.95 acres
.c �4 t� w not incl.r-o-w NI
L' w �'
rn�
Jui! ing setback line
33.00' 33.00' 33.00' 33.00' $ — centerline ,
1' _ 624.- - _ —
� 1_324.4_7'_ 220.66' 220,33 220.33' a'--r-80th Ave. -(D,O,B,
✓589-28'50"W-\-,7 120.156- _ 220.33' _ 220.33 _ _ _ a?_ 663_15_ _ — r _
_ SW corner 589"28'50"W 1324.47'
SE s.E
South 114 ••• ....
Section 33-29-15 589"28'50"W ............ ............2848.94' .
"" centerline
Southeast corner
Section 33-29-15
Found Aluminum Mon, UNPLATTED LANDS Fd Survey Mark Noii
PREPARED FOR:
(Buyer of Lot 1)
LOT 4 LOT 3 LOT 2 Calvary Assembly of God
310 LaPointe Rd S
145,230 sq.ft. 144,933 sq.ft. 144,850 sq.ft. Wilson, WI 54027
3.33 acres 3.33 acres 3.32 acres
incl. r-o-w incl. r-o-w incl. r-o-w PREPARED FOR:
OWNER: (Buyer of Lots 2-4)
137,949 sq. ft. 137.662 sq. ft. 137,579 sq. ft. Robert Leaf Bruce French
3.17 acres 3.16 acres 3.16 acres RR1 Glenwood City,Wl 3026 60th Ave
not incl. r-o-w not incl. r-o-w not incl. r-o-w 54013 Wilson, WI 54027
Note: There will be no access to State Highway "128".
Note: Each parcel on this map is subject to State and County laws, rules and regulations
(i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing
any parcel, contact the St. Croix County Zoning Office for advice.
LEGEND
.........Government Corner (as noted) c4
o..........Set 3/4" x 18" Iron rebar weighing
1.502 lbs./lineal ft. aceaba�
... soil tests
North is referenced to the SCALE: 1" 250
South line of the Southeast �30 fe
Quarter of Section 33-29-15, O" '
which is bears S89°28'SO"W 01 250' 500'
(St Croix County Grid System) Page 1 Of 2
Vol 20 Page 5044
Safety and Buildings
__. ,�"@"`� 10 SUNSHINE CIRCLE
commerceml.gov CHIPPEWA FALLS WI 54729
TDD#:(608)264-8777
isconsin - www.commerce.wi.gov/sb/
www.wisconsin.gov
Department of Commerce I ,,t)m(;OUN tY
ZONING OFFICE Jim Doyle,Governor
h_-..�.... Mary P.Burke,Secretary
August 03,2005
CUST ID No. 224832 47TN:PO WTS Inspector
MARY JO HOLLISTER ZONING OFFICE
HOLLISTERS SOIL TESTING ST CROIX COUNTY SPIA
W9875 690TH AVE 1101 CARMICHAEL RD
RIVER FALLS WI 54022-4011 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXP�IRIE�S: 08/03/2007 Transaction ID No. 1154255
SITE: ��L"& Site ID No.701810
Assembly of God Church �- 3 Please refer to both identification numbers,
Town of Springfield, St Croix County above,in all-correspondence with the agency.
SE 1/4,SE 1/4, S33,T29N,R15W / a�
0 341-16�6, v�
FOR: — O
Object Type: Soil Saturation Determination Regulated Object ID No.: 1029637
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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
1. Approval is hereby granted pursuant to s. Comm 85.60(2),Wis.Adm. Code,to estimate the depth to seasonal soil
saturation based on an interpretive determination process. Approval of the interpretive determination negates the
requirement in s. Comm 8530(2)(b),Wis.Adm. Code to designate the ground surface as the higest level of soil
saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon.
2. The estimated highest level of prolonged soil saturation approved under this determination is 6.inches below
grade. At least 30 inches of sand lift on top of 6 inches of unsaturated,in-situ soil is required for adequate treatment
and dispersal.
3. The basal soil application rate for the mound shall be<_0.20 gpd/sf,and the linear loading rate<_4.5 gpd/ft.
4. Chisel plowing to a depth of 12-16 inches immediately prior to sand placement is required to improve vertical
water movement into the soil solum.
5. Landscaping up slope of the mound shall be incorporated into the POWTS design to prevent surface water from
concentrating along the up slope edge of the mound and to divert surface water drainage away from the system.
6. This approval shall remain valid unless the site is altered in such a way that the depth to soil saturation would
change or if saturated conditions are observed for seven consecutive days at depths less than 3 feet below the
infiltrative surface of the POWTS distribution component.
7. This approval in no way relinquishes the use of color patterns to estimate the depth to high groundwater on any
other parcels or portions of parcels.
8. A copy of this approval letter and attachments must accompany the mound system design for this site for purposes
of plan approval and sanitary permit issuance.
MARY JO HOLLISTER Page 2 8/3/2005 '
This approval applies only to those specific areas as referenced and recorded by the CST. Reports dated 7/18/05 for
Lot 1,and 6/25/05 for Lots 2-4 show the locations of suitable areas for mound installation. In addition,the
enumerated conditions apply to all four proposed lots(14).
If the Interpretive Determination Report was accompanied with a plan and an expiration date is shown on this letter,
the expiration date only applies to the plans for the design,not to the decision on the Interpretive Determination
Report.
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department,which may include local inspectors. If plan index sheets
were submitted in I ieu of additional full plansets,a copy of this approval letter and index sheet shall be attached to
plans that correspond with the copy on file with the Department.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 may be made to me at the telephone number listed below,or at the address
on this letterhead.
Sinc rely, Fee Required$ 100.60
Fee Received$ 100.00
Balance Due $ 0.00
Leroy G.J sky,PS . Wastew t r Specialist
Integrated Services Bureau WiSMART code: 7633
(715)726-2544 Voice
Ijansky@commerce.state.wi.us
Jul 26 05 10: 52a owner 7154264827 P. 3
T
c
Mar!j Jo Hollister
W.9875 69o`6 Avenue
River Falls,Wi 5-tozz
(715)+Z6 1775;fax_426- 4827
interpretative Determination Report
P.O.W.T.S.
Conditionally
APPROVED
PropDEPARTMENT OF COMM
ertrJ Owner: Robert Leaf DIVISION OF SAFETY AND BUILDINGS
buyers: Calvary Assembly of God and Bruce French
Location: 5E�/t of the 5E 14-, Section 5 S,T29N, R i 5W, SEE C RESP' EN
Town of Springfield,5t.Croix County,Wisconsin
INTRODUCTION:
i
On 25 June 2005 a site and soil evaluation was completed for four new Private onsite
wastewater treatment system TOWTS)6y this soil tester on a twenty acre parcel that is
for sale. During this evaluation it was determined that there is not a clear four inch horizon
below the A horizon without redoximorphic features. In fact,it appears that the
redoximorphic features are in the A horizon in most soil pits that were observed. The buyers
were informed at this time that the State of Wisconsin,Dept.of Commerce will have to
approve the site for depth to seasonal saturation.
GEOLOGICAL HISTORY:
This area in Wisconsin is an area of the Glaciated Region,which occurred 12,000 to
1 5,000 years ago. This caused erosion,deposition,stream erosion and other processes.
Wisconsin is divided into five natural regions,which are related to land 69 the use of plants,
animals and by man. Also the boundaries are determined by soil texture and
structure in the underlying rocks. 5t.Croix County is located in the Western Uplandi
which is underlain 6.9 Ordovician dolomites. (Martini L.(1.965). ,T-6 Physical Geologg of
Wisconsin. University of Wisconsin Press, Madison,Wisconsin.) This part of 5t.Croix
Jul 26 05 10: 52a owner 7154264827 p. 4
Page 2-LEAF,Robcrt
County was formed 6y ground moraine deposits from the Wisconsin stage of glaciation.
The parent material at this site is loess overglacial till and the topography is gently rolling.
LOCAL AND SITE.HYDROLOGY:
This land area is located within the Lower Chippewa River hjasin which includes rau Galle
River,Wilson Creek,Cady Creek and several small creeks. (5t.Croix County
Development Management Plan;Physical]=eatures Analysis pg.2-1 i.) This site is near
the headwaters of the Wilson Creek that flows northwesterly and near the headwaters of
the Cady Creek that flows southerly. (Sec attached copy of 5t.Croix County Soil
Survey,page 72.)
The attached topographic map from the state of Wisconsin Geological and Natural
history Survey shows the site to 6e two feet higher than the surrounding land area.The
slope drainage at all the sites are linearand convex which isgood for moving water away from
the site. All surface waters drain from these sites and there are no wetland areas nearby or
areas of ponding water.
SOiL MAPPING
This area is indicated on the copy of the Soil Survey map as a Santiago series which are on
ridges of ground moraines or on pittedglacial drift that are gently sloping to steep and well
drained with moderate permeability and as a Frecon Series which arc of gently sloping and
sloping,moderately well drained soils formed from sandy loam till. Well drained soils removes
the water and does not have redoximorphic features and moderately well drained soils remove
the water somewhat slower and are wet for only a short period of time. This would imply that
the site appears not to stay saturated for a long period of time.
As indicated in the Soil Survey of 5t.Croix County,Wisconsin published 6.9 the
National Cooperative 5oil5urvey the area tested is mapped as Santiago silt loam with 2
to 6 percent slopes and Frecon silt loam. Both of these soil series belong to the soil order
Jul 26 05 10: 53a owner 7154264827 p. 5
r
Pagc 3-LEA1=,Ro6crt
Alfisols and are further classified as Typic Glosso6oralfs that have properties of tongued
and cool. These soils are formed mostly under broadleaf deciduous forest and where
drainage is not restricted from the waterta6le with an udic,ustic,orxeric mositure regime.
(Keys to Soil Taxonomy(Soil 5urvey StaM USDA-NRCS.)
SOIL CONDITIONS AND 5(. K ACE.WATE-R>=LOW:
The soil evaluations completed by this certified soil tester encountered an A horizon of 9 to
12 inches of silt loam with redoximorphic features starting at y inches in a few pits to 9 inches
in most of the pits. Root and worm action was present in all pits to depths of 3 6 inches. This
indicates that there would be greater than 6 inches of in-situ soil to accommodate a properly
designed POVV-r5. The subsoil colors are more of a grayish brown than a gleyed color
that is associated with wet conditions. In the lower part of the A horizon and into the glacial
till recloximorphicfeatures are observed. The E)horizon consists of a sandy loam with
gradual heavier conditions and had some sand and loamy sand pockets With many sand coats
present.
Many other pits were observed that were similar as far as rccloxiphoric features, texture,
structure and consistency. Afew pits had few,fine, faint redoximorphic features in the A
horizon at4 to 6 inches. These areas were not considered for that reason.
Surface water does move into theA horizon which may be perched in the g horizon as
indicated 69 the redoximorphic features and some water having to be a6sor6ed into the A
horizon due to tension saturation. The redoximorphic features in all the pits were few,fine,
faint then becoming common,medium,distinctive or many,medium,prominent. This indicates
that perching does take place, but not fora long period of time. It also indicates that it is
wetter longer atgreater depths and pro6a6ly not so wet and for shorter durations near the
surface.
The surface and su6surFace drainage from the site appears to flow away from the site in
three directions as indicated on the topography map as this area is the highest elevation.
Jul 26 05 10: 53a owner 7154264827 p. 6
c
Page 4-LEAP,Robert
An existing dwelling,approximately 400 feet on the west side of the 20 acres has a
replacement mound system. According to the soil survey map,similar soils exist at this site.
CON CW5ION/R)=.COMMENDATION5:
The landscape at this site,gently rollin& shows the water movement away From the tested
areas with drainage to the south and southwesterly. Mere there are slight depressions in
the topography where surface water can collect,there will be redoxiphoric Features Forming at
shallow depths which were observed at Four inches in some of the pits that are not being used
fora POWT5.
Redoxiphoric Features in the lower part of the A horizon are probably due to the tension
saturation above the saturated subsoil. Bascd on the lack of the redoxiphoric Features in
the upper 7 inches of the topsoil,these soils will properly accept and treat the wastewater
with a long and narrow mound system as per Comm a 3.44(3)(6)1, and 2.,Wis.Adm.Code.
Based on all this evidence the recommendations shall be.
1.)The depth of the approved sand be at least 2.50 Feet for adequate treatment.
2.) The mound system be designed long and narrow with a maximum linear loading rate 4.5
gpd/ft and the basal soil application rate shall be 0.2 gpd/ft,Z for adequate dispersal into
the natural soil.
3•) Increase the downslope area around the mound system to increase the basal absorption
area.
4.)Surface water is to be diverted From the mound system with either a grass diversion or
upslope area of mound system designed with a greater side slope.
jZ/cs�ectFully subm�it�te/d, o�J_1�.
Mary,10 ollistcr,CST 224832
Dated: 6 july 2005(Revised 26ju1y 2005)
Jul e-b U5 l U: bJa
KrYFIKENCE5
.) Martin,L.(1 965). The rbsical Geol2gg 4 Wisconsin. university of Wisconsin
Press, Madison,Wisconsin.
2.) Soils. university of WlSconsln E,ducatlon Courses: .
3.),5t.Croix County Development Flan. Volume Two;background Studies. Fhysical
Features Anal9sis.
4.) Soil survey of`jt.Croix County(I 975). Unitcd Statcs Department of Agriculture
Soil Conservation service and}Zesearch Division of the College of Agriculture and
Life Sciences,university of Wisconsin.
Jul CO UC7 11 :eba owner 7154264827 .
P. 1
P)/Zz_-:LJ Jq"',11V Acle
CERTIFIVY SURVEY MAP NO.
VOLUME PAGE .
THE SOUTH HALF OF THE S 0. 60 `E'AST QUARTER
OF THE SO'67HEA5 UARTER.
SECT!QN 33, TIWNSH' 'P•29 NORTH, RANGE 15 WEST, East 114
TOWN OF SPRINGFIELD; S'T'.CROIX COUNTY,WISCONSIN Found Aluminum Mon,
PREPARED BY: 4!�
Joel A Brandt ,�c
JB SURVEYING LLC ti `s
966 Rustic Road 3 ` UNPLa,XrED, LANDS ,� S" o!--
Glenwood City. WI — w 50�� )J'C*
N89'i34'45"E 134.12 .�Oi
661.80' u7
0
220.66' 220.3 ' 220.33' 628.80' / ( C!
N
4 �
33.00) I I to I o0
sat lasts ..1
Z "' SOt1 CPS CS Ix N
sn,a tas•s Z z LOT 1 —10a� Io r+i
1 'z $ LOT 4 N o LOT Z 43s,o2o sq-ft. lip Iw
T �' I
Itn I� rn N w U N Incl. r-o-w r*.
14 cO rn w 92. 574 sq. ft rn !Q
wLIN
u -
:sot Incl. r-o-w
v 6
NI I CSM i -
33.00' 33.00" 33.00' 33.00' t f center.{re
_t_.,_- _ — 630.08' _ _ L
1_324.4_7'_ 220.66' 220.33' 220.33' rn
/1-S89'28'50"W 220.66 ^ _ 220.33- _220.33_ _ _ 663_15' 60th Ave.----� - 0 8
Still co•ne, 589'28'50"W }324.47 �— — r _
South l/4 SE/SE I I
Section 33-29-15 S89'28'50" 2615.91 cen(erl:ne
W � � Sou#heast corner
Found Aluminum Mon. Section 33-29-15
UNPLATTED LANDS Found Aluminum r4or.
PREPARED FOR:
LOT ¢ (Buyer of Lot 4)
LOT J LOT 2 Calvary Assembly of God
145.230 sq ft 144,933 sq It 144,850 sq.ft. 310 LaPointe Rd S
3 33 acres 3.33 acres 3.32 acres Wilson, WI 54027
Incl. r-o-w inct r-o-w incl. r-o-w PREPARED FOR:
OWNER: 1.8u,'er of Lots 1-3;
137,949 sq ft 137.662 sq. f t 137.579 sq ft. Robert Leaf Bruce French
317 acres 3 16 acres 3 16 acres 3026 60th Ave
not rncl r-o-w not rncl r-o-w not incl. r-o-w Wrtson, WI 5402?
Note: Each parcel on this map is subject to State and County laws. rules and regulations
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Jul 19 05 09: 33a owner 7154264827 p. 2
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings
in accordance with Comm 85,Wis. Adrn_ Code minty ST.CROIX
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.
percent slope,scale ordimensions,north arrow,and location and distance to nearest road.
to L
Please print all information. Reviewed by /►�/� �1.n Datte f
Personal Information you provide may be used ror secondary purposes(Privacy Law,S.1 5.04(1)(m)), 1,{J — / o V ICS /I�//'1✓
Property Owner Property Location El ED
ROBERT LEAF(Buyer. Calvary Assembly of God) Govt.Lot ---SE 114 SE 114 S 33 T 29 N R 15
Property Owner's Mailing Address Lai# Block# Subd.Name or CSW
2928 C.T.H.DD �1 5T/ l -- - �)
City to Tp Code Phone Number ally ❑Village • Town Nearest Road
Glenwood City, WI 54013 ( 715) 265-4964 60th Avenue Springfield
E] New Construction UseE)Residential/Number of bedrooms Code derived design flow rate GPD
Replacement 0 Public or commercial-Describe: church
Pared material glacial till Rood Plain elevation if applicable_ �N A h•
General cornments Mound System—0.2 loading rate— 2.50 ft.sand fill
and recommendations: SEE iNTERPRET1VE DETERMINATION REPORT—on-site w/Leroy Jansky,State of Wisconsin Wastewater
Specialist
To be designed by designer_or installer
Boring# 0 Boring
a Pit Ground surface elev. 100.14 ft- Depth to limiting factor 10 in. Soil i DM Rabe
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
1 0-4 10YR3/3 — sil 2fgr mvfr cs 3vf-co 0.6 0.8
2 4-10 10YR3/3 _ sil 2fabk ds as 2vf-m 0.6 0.8
3 10-13 10YR413 m2d 10YR4/6&l0YR6/1 sil 2fabk ds — 2vf-m 0.6 0.8
Some gr; cobbles.
2 Boring# Boring 100.14 10
0 Pit Ground surface elev. 11. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary j GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'EM *0102
1 0-4 10YR3/3 — sil 3fgr mvfr cs 0.6 0.8
2 4-10 10YR3/3 — sil 2fgr&abk ds as 0.6 0.8
3 10-14 IOYR4/3 m2d 10YR4 16&l0Y1t6f1 sil 2mabk ds — 2vf-m 0.6 0.8
Some g;few cobbles.
'Effluent#1=BOD >30:S 220 mg/L and TSS>30:5 150 mg/L 'Effluent 92=BOO <_30 mg1L and TSS 130 mg1L
CST Name(Please Print) Signature CST Number
Mary Jo Hollister 224832
Address Date Evaluation Conducted Telephone Number
W9875 690th Avenue,River Falls,WI 54022 07-18-05 (715)426-1775
Jul 19 05 O9: 33a owner 7154264827 p, 3
Property Owner LEAF,Robert(Lot 1) Parcel ID (Pending) Page 2 of 3
Boring
a
Boring ❑ pit Ground surface elev. 100.74 ft Depth to limiting factor 9
• in.
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Chi.Sr- Cont.Color Gr.Sz.Sh. *M1 'Eff#2
1 0-3 IOYR3/3 — sil 3fgr mvfr cs 3vf-co 0.6 0.8
2 3-9 10YR3/3 — sir 2fa&sbk ds as 2vf-m 0.6 0.8
3 9-13 10YR4/3 m2d java,4fbi sil 2mabk ds — 2vf-m 0.6 0.8
tovR�r
Some gr; cobbles.
F-1 Boring# t-1 Boris
pit Ground surface elev. ft. Depth to limiting factor in. Sri ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfg
in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'E111#2
Boring#
H Boring
Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary boots GPDff
in. Munsell Qu_Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
Effluent 91=SOD,>30:S 220 mglL and TSS>30<150 mglL "Effluent#2=BOD,<30 mg1L and TSS_<30 mg/L
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