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HomeMy WebLinkAbout030-2126-00-000 Jsconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 572854 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Mattson, Robert & Kari St. Joseph, Town of 030-2126-00-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: GS 25.30.20.1024 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER.,'S CAPACITY STATION BS HI FS ELEV. Septic Y. S Benchmark ` ~i etc./` a•5 160 (D G. ~Ol,►`r /~d Dosing Alt. BM n Cov~ b b ~l. s~ ~;•i ~fl 3. t 3 1 Pd !a ~j Z S Bldg. Sewer S `A Ano I -7 Holding St/Ht Inlet Ste. 7 TANK SETBACK INFORMATION St/Ht outlet ~.l9 cm S 1 TANK TO P/L WELL BLDG. Ven to Air Intake ROAD Dt Inlet G Dt Bottom Septic > / /,V fT ) /t _ Y -2 J Dosing Header/Man. 4 - (P 9S\+ /0. V Aeration Dist. Pipe ; ~ 4 Holding Bot. System V 9; Final Grade ~e,,~ PUMP/SIPHON INFORMATION Manufacturer Demand St Cover Z GPM ; .3 . ( d.3. J Model Number TDH Lift Friction Loss System Head T)H Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 4 3 / jcl.ck;rA SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ( I INFORMATION CHAMBER OR -V d~ Type f System: AM UNIT Model N ber: DISTRIBUTION SYSTEM OC / 8x3 Header/Maniflld Distribution x Hole Size x Hole Spacing Ven too j I ake Pipe(s) ^ Length Dia Length Dia Spacing 4e-- C S SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth. Over xx Depth of xx Seeded/Sodded jxx Mulched Bed/Trench Center Bed/Trench Edges Topsoil No Yes ~g ]No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1355 Birch Park idge Houlton, WI 54082 (NE 1/4 NW 1/4 25 T30N R20W) Bi/rc Park Lot 20 Parcel No: 25.30.20.1024 1.) Alt BM Description = I G o✓ ~ V ~ 44,I., S /z° o-,,- 2.) Bldg sewer length = Jy n I A-~ - amount of cover = I! G Ou) Q, IL 6 V1_ ci h,a ~..tt~., (vol. ~-a Plan revision Required? Yes Vo ~Z ZZ ' / 7 Use other side for additional information. SBD-6710 (R.3/97) Date 4rInse ctor's S ature Cert. No. 7*S leo 33 N i l ~.T la e II 4 tau 4~t ~ ~ Gear r~e~~ S c ~ KNUOTSON PLUMBING Es CONTRACTING, LL O 927150TH ST. 648447MPRS fig, W{ 54023-8526 CELL 651.470-1737 )COPY - County / Safety and Buildings Division J va o= 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be lied in by Co.) ' ! 6 Madison, WI 53707-7162 5 7 State Transaction Number RS ermit Application 1111 11! ~ In accordance with Pety 2~is. Adm. Code, submission of this form to the appropriate govern mental unit ILI, is required prior to a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Ad dress than mailing address) the Department oo d Pr ofessional Servies. Personal information you provide may be used for secondary 1315-5 purposes in accordance with the Privacy Law, s. 15. 1 m , Stats.j, - 1. Application Information - Please Print All Information w~ e Property Owner's Name / Parcel # , 6 v~ 2 26 Property Ow/ner,s Mailing Address Property Location /r L ce Govt. Lot f10 2 X City, State Zip Code Phone umber Section (circle one 61-3 T3e)_N; R~Q E II. Type4ft uilding (check all that apply) Lot I 4A, or 2 Family Dwelling - N ber of Bedrooms Q o Subdivision Name 54 ❑ Pu lic/Commercial -Describe Use _X1L,0-- %7i►-. ❑ City of CSMNumber El Village of El State Owned -Describe Use -rown of ~~7.. 3 w /1 III. Type of Permit: (Check o y one box on line A. Complete line B if applicable) .7o n~e A. ®w System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal El Permit Revision ❑ Change of Plumber El Permit Transfer.to New Before Expiration Owner al IV. Type of POWTS System/Component/Device: Check all that apply) [won-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil a. El Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaVYreatment Area Information: Desi Flow (gpd) DesignSoil Ap lication Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (s System Ele on mod= . o 1 In 'o cs -1Y y~r VI. Tank Info Capacity in Total # of fact Gallons Gallons Units 1P0*9 1, o y / New Tanks Existing Tanks a ° ii C7 Q Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for in llation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's i ature MP/MPCRSS Number Business Phone Number ,//t~ d ~ 7 ~1 cr T3 ~ Plumber's Address (Street, City, State, Zip Code) Cpl - 2 ~U _ 4~ 6 VIII. Coun /De artment Use Onl Permit Fee Date I sued Issuing ent Signature Approved 175 - Db erGivnReasontbrMimil- It Condi easons for Disapproval 3' ~ ~t? L Z O~ Septic: nk, effluent filter and . J .dispersal cell must 811 be services / maintained 1 as per management plan provided by plumber. 2 A1,v0d sck fequitoments mtrl t betnglrl a#* ~1 t O~ r as per. apo"Ift pd I o►owww", N~ p Attach to complete plans for the system and submit to the Co ty only n paper n t less than 81/2 z 11 inches in size SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Mattson Sewer Owner's Name: Robert or Kari Mattson Owner's Address: 967 Inspiration Way M Bayport Mn Legal Description: NE 1/4 NW 1/4 S25 T 30 N R 20 W Township: St. Joseph County: St. Croix Subdivision Name: Birch Park Lot Number. 20 Parcel ID Number: 030-2126-00-000 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber. Keith Knudtson License Number: 648443 Date: 11/19/2014 Phone Number (651) 470-1737 Signature - L_ r/ Designed pursuant to the In-Ground Soil Absorption Component Manual for POV TS Version 2.0 SBD-10705-P (N.01/01). Page 1 ~~D f P~a /f ar Rd ~e.+T i~7d1-2 1 TQ~ Z- r 7J- 7p a -75~2 _Jk 6 v. I /oo e.~ l Q 163 U q"7 \ e - , A w loc 7-e 1 Gran ~c.~ s O KNUDTSON PLUMBING & CONTRACTING, LLC 927 IWM ST. 648447MPRS Wi 54023-8526 CELL 651-470-1737 i S ic,~l Absorotlon &a-tam Cross $ection 104.75 ft 103.75 ft V Sc loduie 40 Final Grade PVC Vent Pipe 99.75 VYM Vent Cap ft Leaching 98.75 ft Chamber m sevation ft 3.00 5.00 ft Soil Absoration System Plan Vlev- ft 3.00 ft 1 teaching Trench 1 5.00 ft Chambers 4' Dla. Trench 2 Header Vent Or Observation Pipe Trench 3 Leaching Chamber Saecificatlons Manufacturer And Model EISA Rating 20.00 sq ft per chamber Soil Application Rate 0.70 gpd/sq ft 750.0 gpd Design Flow 0.70 Soil Appi'iawon Rate : 20.00 EISA = 54.00 Chambers 3 rows of 18.00 chambers each. Page of o Filters r. 25 EFFLUENT FILTER ?t.--525 Filter is rated for 10,000 GPD (gallons per day) 1116" Filtration Slots „W„ f` Ong it one of the largest filters -~s Mass. ft has 525 linear feet of 6" filtration slots. Like the ,,~lok PL-122, the Polylok PL-525 has an automatic shut ball installed with every filter. Men the filter is removed for awning, the ball will float up and WmPoranly shut off the system so The effluent won't leave the tank. sURW Ft of VW other filter on the market can ^Sim make that claim. IOAMGM AMVM,r& 6' ~'L-525 Maintenance: ~--SM4OPW -e PL-525 Effluent Filter should Aerate efficiently for several years under normal conditions before. 10 requiring cleaning. !t is recom-~ Trended that the filter be cleaned y every time the tank is pumped or at least every three years. If the " installed filter contains an optional } alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank cover pumper or installer. AuMneftShu"M U.S. Patent No# 6,015,488 BA Wh wFiAw is 1. Locate the outlet of the 5,871,640 RONOWd septic tank. 2. Remove tank cover and pump tank if necessary. _2 Installation: 3. Glue the filter housing to 3. Do not use plumbing when the 4" or 6" outlet pipe. If filter is removed. Ideal for residential and com- the filter is not centered 4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening 10,000 Gallons Per Day (GPD). use a Polylok Extend & 5. Hose off filter over the septic Lok or piece of pipe to tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page back into septic tank. septic tank. 19-21 for Extend & Lok 6. Insert the filter cartridge back 2. Remove the tank cover and information. into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter the filter is properly aligned into its housing. and completely inserted. 5. Replace and secure the 7. Replace septic tank cover. septic tank cover. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page FIE liliFDPd"TION SYSTEM SPECRRCATKM Owner s 106-, Septic Tank Capacity 0 NA Permit Septic Tank Manufacturer E3 NA DESIGN PARAN FrERS Effluent Filter Ma 0 NA Number of Bedrooms AC: 0 NA Effluent Filter Model Q NA Number of Public FaaTtty Units A Pump Tank Capacrtl+ gal -Act" Estimated flow (average) gal/day] Pump Tank Manufacturer Design flow (per, (Estinumed x 1.5) ' - galiday Pump Manufacturer &A AppGcedon Rate / Pump Model `NA 9WC niA Monthly average{ Prstreatrawt: Unit Standard irufluerutJEffkuerR Quaky Fats, 08 & Grease- (FOG) 130 mg/L 0 Sad/Gravel Filter 0 Peat Filter Nocherldcai Oxygen Demand (BODJ <220 mg/L 0 NA 0 MecluMcal Aeration 0 Wetland Total Suspended Sol'ds (TSS) <I50 erg& 0 Disinfection 0 Other. Pretreated Effluent OualitY Mond* average 0 NA Biome Oxygen Demand (BOD j 530 mglL )(W Ground (gravity) Lt in. Ground (W ) Total Suspended Solids ('i'SS) 530 rnglL 0 NA 0 At-Grade 0 Mound Fecal CoRtorm (gam mean) 51 O` afu/1 O0m1 0 Drip ! ine U Other: Orher Mawnum Effluent Particle Size put ilia:' 0 NA ❑ NA Other: 0 NA Other. 0 NA -Vakues typical for domestic wasbwater and septic tenik effkuec& Otfiec DNA MAIiN'FOiiAN( SCHEDULE Service Event Service Frequency Its) yews k>spoc[cordition of tank(s) At least once every: 0 ear(s) (Madirymn 3 ) ❑ NA Pump out co nbdrm of tank(s) When combined skulge and scum equals one-third W of tank volume 0 NA Inspect dispersal cell(s) At least once every: 3 0 ith( S) Udedrown 3 years) 0 NA (s) 0 NA CI? QC effluent filter At least once every: f year(s) 0 month(s) Inspect pump, pump controls & alarm At least once every: 0 year(s) 1~= ' 0 month(s) ANA Flush laterals and pressure test At least once every: 0 year(s) ~ i Other. 0 month(s) 0 NA At least once every: 0 year(s) O NA MARCI'I NANCE 91STRUCTl(MS Inspections of tanks and trapetsal cells shag be rade by an individual carrying one of the foNowMB licenses or ~f" reams: Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector. POWTS Manntauner: Septege Ssrvmm Operator Tank inspections Fnust include a visual inspection of the tank(s) to identify any ri g on broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to dum* for any back up or pond"eng of effluent an the gad surfaces. The du- ;ersad cak(s) shaft be v ► inspected to check the effluent levels in the observa ion pipes and to check for any ponding of eff io nt on the ground surface- The pondurg of effluent on the ground surface may indicate a fa7ang condition and requires the immediate notification of the local regubenry authority. When the oombirmd aocuinulatiot of sludge and scum in any tank equals one-d" NO or more of the tank vokrme, the entire cxmtents of the tank be removed by a Septage Servicing operator and disposed of in acoordi nce with chapter NR 113, Wisconsin Admatisd'ative Code. AN other services, including but not limited to the servxAng of effluent filters, nucharacal or pretso[u¢ed aomponerds, pretreaUTmit tunas, and any servicing at intervals of X12 months, shall be performed by a cerdfied POWTS Maintainer- A service report shall be provided to the kcal n e pAnt ory aurthonty within 10 days of cornplation of any service event. t5 i"Of w- 7r SIM" 1*1 i ~ ~ PIP 7 Z IV ~ l 7D j ~ y A, CA2 101% 1 1 ~ %Y K co )M -1 k t A t. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Robert or Karl Mattson Owner/Buyer a~po ~ 363 5~ ~ Mailing Address 1 ?Ivy r rs u N- 72-Property Address 1 Birch Pack Road 3 5 (Verification required from Planning & Zoning Departm far new construction.)' Flou~lton Wi. 030-2'126-00-000 City/state Parcel Identification Number LEGAL DESCRIPTION Property LocationNE NW 25 T30N R20W, Town o.I`t. Joseph . , 'fa_ , _Sec. , . Subdivision Plat: Lot # Certified Survey Map # , Volume , Page # Warranty Deed # q9 7 a( O (before 2007)Volume , Page # Spec house OyesEkno Lot lines idaiifiable yes[Ino SYSTEM MAINTENANCE AND OWNER CERTIFICATION: } Improper use and maintenance of your septic system could result in its premature~'Iurc to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383,52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning: Department a certification form, signed by the owner and by a master; plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. Lwe, 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 Safety And Professional Services 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 8c Zoning Departmejaan-anty in 30 days o thethree year expiration date. Vwe certify that all statementis form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described shave, by virtue of deed' recorded in Register of Deeds Office. Number of bedrooms n dG2 ! ! U1^~ 1>/7 SIGNAT OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the'Planning „cot Zoning Department: t** Include with this application a recorded warranty deed from theRegister of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12)___ 994018 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI State Bar of Wisconsin Form 1-2003 RECEIVED FOR RECORD WARRANWDEED 03/27/2014 08:00 AM EXEMPT # NA Document Number Document Name REC FEE: 30.00 TRANS FEE: 204.00 THIS DEED, made between Birch Park LLC a Minnesota limited PAGES:. 1 liability eom an **The above recording information ("Grantor," wheth one or more), verifies that this document has and Robert B Mattson and Kari L. Mattson, husband and wife been electronically recorded & returned to the submitter ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Recording Area needed, please attach addendum): Name and Rerun Address + of 20, inch Park, Town of St. Joseph, St Croix County, Wisconsin Burnet Title 5151 Edina Industrial Blvd. #500 Edina, MN 55439 Attn: Post Closing . ~'%30-2126-00-000 Parcel Idemiftcation Number (PIN) This homestead property. 000o._ Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Any easements, restrictions, reservations or declarations of record, if any. Dated March 9G , 2014 BIR L C (SEAL) (SEAL) * * Jams Waters, Its Chief Manager (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF Rrnr0TS'1N M`'ni esoiy,- ) ) ss. authenticated on Hennepin COUNTY Personally came before me on March 21, 2014 , * the above-named James M. Waters, Chief Manager of Birch TITLE: MEMBER STATE BAR OF WISCONSIN Park, LLC a Minnesota limited liability company (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) ent an knowledged the same. TBI C aFTED BY: p{{ y o t~n5 * G P~efil~.r't}I~. NoNry Public, State of cousin 4Nvoma_65SWEEx0res Notary public &t, W R t My Commission (is permanent) (exp sAinnmcma 1 X300 4(o 5w _S- 30D Jww% 31, 2015 w M NJ 55j '3 9 4natures may be authenticated or acknowledged. Both are not necessary.) LbDOTE: THIS IS A ANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDEN'TIFI'ED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. St. Croix County 994018 Page 1 of 1 ,cousin Department of Safety an~ofesioll'dl .rvis~'io~n o~Jadu FP 0 2 ZO14 SOIL EVALUATION REPORT Page 1 of ►f 1'f ST Ci ""C@*" rPth SPS 383, Wis. Adm. Code Attach complete site plan on~hp County ST. CROIX ~i ' rYlo#le WIW~ >ri'~~1149ies in size. Plan must eiss include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 030 - 2126 - 00 - 000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Date b Please print all information. Reviewed Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). " l1 Property Owner Property Location /0 0 ROBERT B. & KARL L. MATTSON Govt. Lot ----fiG1/4 ntW 114 S 25 T 30 N R 20 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 967 Inspiration Way M 20 Birch Park City state Zip Code Phone Number iiy Village own Nearest Road Bayport, MN 55003 ( 651) 955 - 8400 Birch Park Ridge Or Code derived design flow rate GPD Q New Construction Use Residential / Number of bedrooms Replacement Public or commercial - Describe: sandy outwash Flood Plain elevation if applicable *TA ft. Parent material General comments Conventional In-ground trenches 0.7 loading rate and recommendations: ,~G~ (J kd - • S04 _ System elevation to be determined by designer. 7` iL,2 1 j C Y, s ' ' ? a 1Z l tk t c -k h ~121~a ~'rt d1 ❑ Boring # Boring Pit Ground surface elev. 103.75 ft. Depth to limiting factor 111 in. Sal A ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPDt'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 2fabk ds cs 2vf-m 0.6 0.8 1 0-7 7.5YR2.5/1 dsh cs lvf-m 0.4c 0.6 2 7-14 7.5YR3/3 sit Ifabk sicl if--mabk dsh cs lvf-m 0.2 0.3 7.5YR4/4 - 10YR4/6 m2d7.5YR4/6 sl lmsbk mvfr cs lvf-m 0.4 0.7 .6 10YR4/4 s Osg dl aw 0 7 1 tI47 0.7 10YR4/4 s Osg ml l 2 Boring # D Boring 97.65 100 F Pit Ground surface elev. ft. Depth to limiting factor in. Sal A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#l GPD/PFE in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 0.8 1 0-10 7.5YR2.5/1 I 2fabk ds cs 2vf-m 0.6 2 10-17 7.5YR3/3 sit lfabk dsh cs lvf-m 0.4c 0.6 0,2 0.3 3 17-32 7.5YR4/4 - sicl lfabk dsh cs lvf-m 4 32-42 10YR4/6 f2f 10YR5/6 sl lmsbk mvfr cs lvf-m 0.4 0.7 psg d1 0.7 1.6 5 42-100 10YR4/4 s some gr. Effluent #1 = BOD > 30 _ 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 30 mg/L " 220 mg/L and TSS >30< CST Number CST Name (Please Print) Signa 224832 MARY JO HUPPERT/Hollister's Soil Testing & Design Date Evaluaf Conduced Telephone Number Address W9875 690th Avenue, River Falls, WI 54022 07 - 23 - 14 715-426-1775 SBD-8330 (807/13) Property Owner MATTSON, Robert(Ben) & Kari Parcel ID # 030 - 2126 - 00 - 000 Page 2 of 3 g Boring 3 Boring # E] Pit Ground surface elev. 96.45 ft. Depth to limiting factor 120 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 1 0-7 7.5YR2.5/1 l 3fabk ds as 3vf-m 0.6 0.8 2 7-14 7 5YR2/2 I 2fabk ds cs 2vf-m 0.6 0.8 sil 2fa&sbk mfr cs 2vf m 0.6 0.8 3 14-26 7.5YR3/3 4 26-40 7.5YR4/6 sl If--msbk mvfr cs lvf-f 0.4 0.7 5 40-120 7.5YR4/4 s Osg ml 0.7 1.6 some gr; horizon 5 has a broken layer of 10YR4/4 cos. ❑ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. SOiI 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 L S Boring ❑ 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 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30:5 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L SBIM330 (807/13) JF`7 Plot Flan for Site and Soil Evaluation Page 3 of 3 Property Owner &crrr B- K~AAI L . M Ti-5014 I40ft Legal Description -or' z.-at (except where noted) 3 0 = Backhoe it or- T On) Lo W N ~ -r+t w Yq, s zs ~ 1 R =PATS N~ use TO WSJ o F sr Toseptt~ sT c~o~ cowuTy {,tl~oNS~i+~• 3, ©zo North Off% 01P loo 4- T u5'~ s- ite Lf,cation: ~T,fI.F ~ 7G a~ - CY 110,) Y Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. 0 3 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. a4l -W e Please print all information. Rev ed Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ❑ Quest Development, Inc. Govt. Lot E 1/2 1/4 SW 1/4 S 25 T 30 N R 20 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Suite 150 10700 Old County Road 15 20 Birch Park City State Zip Code Phone Number ity []village ■ Town Nearest Road Plymouth MN 55441 ( 7¢3-595-9512 County Road E a New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD n Replacement Public or commercial - Describe: Parent material Loess over out wash sands Flood Plain elevation if applicable ---I J T' General comments and recd mendations: This site is suitable for a mound system r C" fi UV o 1❑ Boring # El Boring JT GOUt4V v Pit Ground surface elev. 101.96 ft. Depth to limiting factor 61 in. FF►CE oil lira ' a Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary is in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#2 1 0-21 10yr2/1 sil 2msbk mfr cs 2f .5 .8 2 21-48 10 r4/6 sil lfskb mfi cs if .2 .3 3 48-61 10yr4/6 is lmgr mfi cs - .7 1.2 4 61-98 10vr5/4 f2d5yr5/6 sit lfskb mfi - - .2 .3 F 2 Boring # ❑ Boring 99.84 36 Q 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/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 j i 1 0-20 10yr2/1 sil 2msbk mfr cs 2f .5 .8 2 20-36 1 r4/6 sil lfskb mfi cs if .2 .3 3 36-50 10yr5/4 f2d5yr5/6 sil lfskb mfi - - .2 .3 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent - BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 10105101 715-246-2454 Quest Development.Inc Pa g 2 of 3 Property Owner Parcel ID # 9 ❑ Boring # Boring g 0 Pit Ground surface elev. 110.94 ft. Depth to limiting factor 34 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 1 0-17 10yr2/1 - A 2msbk mfr cs 2f .5 .8 2 17-27 10 r4/6 - is lm r mvfr cs if .7 1.2 3 27-34 10yr4/6 - sil lfskb mfr cs - .4 .6 4 34-56 10yr5/4 f2d5yr5/6 sil lfskb mfi - - .2 .3 ❑ 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 Q Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Pit 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 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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-8330Test (R.07/00) fzc~ TOOn ~oac~ z `V1- c ILI Nou \ a ~y T I lot S to ~ G Q(`l i °4 a~ Co.,c~t.r too TOP (,31 lU ~.`~b as gj.aq ~o.9y ~ 30 to 4- PEti!' / N (J- 1-07- To B& 19-S-SY(-v6-D + Netu iAvD i I/%z2UIIfL p,'/V iSSv,f-,v c~ Vic 67X% s'Ti ) G- 6930 - 2-03 Z0 . or v (5eN rite, 7- WI:5. 0 30. 2 o,3 50 • &ov M,9-S7 -&-k 030 - 20 3~ . /0. 6-raV gal O 3& • Z v ! v . 70 - OOD Ulbricht & Associates Private Sewage Consultants 0 3 D . Z a yd ~ ~Q . 655 O'Neil Rd. Hudson, Wis. 51016 -715. 3 SG . 91g S - - - 7 i 5 77 --2, • 3 yel'Z- Parcel 030-2126-00-000 09/09I20P14 AGE 15 F^1 Alt. Parcel M 25.30.20.1024 030 - TOWN OF SAINT JOSEPH Current C'I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - MATTSON, ROBERT B & KARI L ROBERT B & KARI L MATTSON 967 INSPIRATION WAY M BAYPORT MN 55003 Property Address(es): " =Primary * 1355 BIRCH PARK RDG OR Districts: SC = School SP = Special Type Dist # Description SC 2611 SCH DIST OF HUDSON SP 1700 WITC Notes: Legal Description: Acres: 3.020 SEC 25 T30N R20W LOT 20 BIRCH PARK 1354 BIRCH PARK RD Parcel History: Date Doc # Vol/Page Type 03/27/2014 994018 WD 04/23/2002 677006 1877/91 QC Plat: * = Primary Tract: (S-T-R 40% 160% GQ Block/Condo Bldg: * 09-003-BIRCH PARK 030-0 25-30N-20W LOT 20 2014 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/11/2011 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.020 68,000 0 68,000 NO Totals for 2014: General Property 3.020 68,000 0 68,0000 Woodland 0.000 0 Totals for 2013: General Property 3.020 68,000 0 68,0000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charg00 Total 0.00 60 i ~§@$ !g~dgppeal~ ~ ~ ~ js~ ~ 4➢~ay ~l~61y6 99 ~;y~ ~ ~ VZZP-6S9-a9 NVYJ SY9H00?ISSQ VHL a a a- ~ d~@544 9 NOSJJVM IWVY N98 :909 9,9MVuIs9y ti U a 0 U P4 0 _ w o w 4 R ~1 I ~i Clw ~ U s~ I a m m is O~ am ~FCr : F °m i Ellx ~04 c ~y Fo I aa6! w U f ]oNW a~~ f ; 4' I C , 1 I •..1__-__- tt i E ~S ~ z~a9 4.L ae~~ep~p~~66e6§k' ~ ~ ~J g~S22q~8i~Sq EEE~fe i _ ~ # say =6 @ !9}€ $ £bb~-ASS-%<9 KV91 S9,YH00XS9U YHJ o$~~~F 93 .4 VOSJJVH IXV3I 7 M99 909 90AZ$QIS9&T ti c.~ D ti 0 0 w 0 h w A - s ~,I Yl,~u Fug lxt 9-L H °L o - ~q aom~ o ~ n h ~ r ' . d Vhf $a II &3 gr O a 44 d 8osg o°'yz qM em ~.vau qee~ € i i ti z-ozozrun ~R L-®a..v ct i i ~ aY 4 ° + CUf-P99-9/9 RY91 SY3HJOwsffQ 9HL 1 ~ el a €~~P la ATOS,L LVW IXVX -7 AT99 :&TOJ 90AIgQIS ~?I g M 0 U EN, O U f11 PA I ~ A pMry Y 0`01 pp u ! ~ . ~ o~ @i ^1 y y tl 3 i 1 ~ 4 ~ t ~s~~{ y pypy 4 ~ ~ R!!! ~~9>: i 4~ i ! qI Pf J