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HomeMy WebLinkAbout020-1483-06-000 opuxn f , i County, Safety and Buildings Division 201 W.Washington Ave.,P.O.Box 7162 t ! Sarman'Permit Number(to be filled in by Co.) s Madison,V0 5 2 r "«�"` �c0 ENT ►�:; i � � � _ State Transaction Number anitary Permit Application In atQordaucc with SPS 383 21(2),Wis,Aden Code,submission of this form to the appropriate governmental unit j is required prior to obtaining a sanitary permit. Note;Application forms for state-owned POWTS are submitted to Prnlect A dress(if different roan mailing address) the Department of Safety and Professional Servies. Persnnal information you provide may be used for secon U oses in accordance with the Privac Law,s.15,0411 ro),Stats. q �9 I. A I+cation Information-Please Print All Information G O G 1Ll, Property Owner's ivame c i Parcel k �OL 0�� �u s 3- _ oop' Property Owner's Mailing Address 7 n Property Location City,State yF Govt.Lot �� 7_ip Code Phone Number Section } /9"cle on H.Type of Building(check all that ap � ; 1.ot -----j TZ< _N; R /y g W Family Dwelling-Number of Bedr i i Subdivision Name'7`-' —�Bloc G Pubfic/Cornmercial-Describe t)ne (_.. 0 City of ❑State Owned•-Describe Use P Qom_ CSM Number ❑Village of III Type of Permit (Check only o box on line A. Complete{me B if applicable} A. System ❑Replacement System ❑Treaunent/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) —�— B• ❑Petmit Renewal ❑Permit Revision List Previous Penntt Number and Date Issued ❑Change of Plumber I ❑Permit Transfer to New Before'fixpiration Owner I� IV.Ty of POWTS System/Con onent/Device: {Check all that a iy ?von-Pressurized In-Ground ❑ Pressur zed In-Ground ❑At Grade ❑Mound> , v __4 in.of suitable soil C Mound<24 in.of suitable soil ctll-tl ❑Holding Tank ❑Other Dispersal Component(explain) ED Pretreatment Device(explain) V.Dis ersan eat ent Area Information: _ rgn Flow(gpd) Design Soil Application Rate( sf) Dispersal Area Required(sf) Dispersal Area Frop sed(sf) System Elevti ; 17L3 C t VI.Tank Info Capacity in Total it of ?_ G Manufacturer Gallons i Gallons Units New Tanks Exunng Tanks .� J I Septic or Holding Tank - • 1 v ° i n n (^ Dosing Chamber 1 VII.Responsibility Statement- t,the undersigned,ass ponsibility for installation of the POWTS shown on the attached plans. Plum 7r, Name(Print) Plumb i ature i/-y I MP/MPRS Number Business Phone Number Plumber's Address(Street,C i Y; te,Zip Co ) ZV III. ouutv/De artment Use Only Permit Fee Date Issued I Approved f ,suing nt Signature ❑�' en keason for Denial $ � � 3 /_5 Ix.Conait�iKSa fE: 1AAhFl�pasons for Disapproval 1. Septic tank,eMu*nt fiftr and " disposal cell must all t its as per managamant plan provided by pIuAFt 2. l'! 'tanbfi f�luat t, jl�aihtrd, Attach to complete plans for the system and submit to the Coun Only oa a ' ty Y paper not less than 8 ir_z i I inches in sir S13D-6398(R 11/11) PLOT PLAN PROJECT Travis Waldschmidt ADDRESS 476 Ctv Rd A Hudson Wi 50416 NE 1/4 NW 1/4S 16 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 98.4/98.3 4.5' below grade 3/11/15 3 DATE BEDROOM CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34, within 10' Scale = 1 /4'1 = 10' of tank,piping shall be Schedule 40. L >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area -- - -- -Eft^—ti/pair of-end caps-- - - B.M.* 4' Long - - -- 45' Pro erty Line 34" Grade at System Elevation 10' 101.5' B-2 45' 45' B-1 30' 102.5' B-3 2% Slope 45' 2-3' X 66' cells with>3' spacing ST 15' Pro 3 Bedroom Property Line House McDonald Lane Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/11/15 Owner:Travis Waldschmidt. Location: NE 1/4 NW 1/4 S16 T29N,R19 986 McDonald Lane Hudson Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications She Signature License numb r 226900 PLOT PLAN PROJECT Travis Waldschmidt ADDRESS 476 Ctv Rd A Hudson Wi 50416 NE 114 NW 1/4S 16 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 98.4/98.3 4.5' below grade 3/11/15 BEDROOM 3 DATE CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34,within 10' Scale = 1 /4" = 10' of tank,piping shall be Schedule 40. j4' Long ent Quick4 Standard Leaching Chamber with 20.0 ft2 of Area " 5.6ft^2/pair of end caps B.M.* Grade at Syste m Elevation 45' Pro ert Line 3 4" 10' 101.5' B-2 45' 45' B-1 30' 102.5' B- 2% Slope 45' 2-3' X 66' cells with>3' spacing ST 15' IF Pro 3 Bedroom House Property Line McDonald Lane Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Vent / Typical Installation 102.5' Grade Vent 3' 4„ X30/34 Septic Tank 3 1" 5' Long 5' S' Long 1„ 3 6" Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 66' ' Cells Same on other end Observation tubeNent At end of cell A 16 chambers per cell B System elevations: A_98.4' B 98.3' �r, CROIX COUNTY SEP]7C 'I'ANKMA ANCF /LGREBMENU` AND UWP4F-RSHIP FU]]M (}vm/crqBuyer ' ` Mailing Address roperly Address Ion required CT-()f[I planiijIg LEGAL Property Lo vY, 1o`vz o/ Subdivision ------ — Lmi # � CmrtifiedWtirrey Map # __^— ---- Puuc# ~~--- Warranty U�emd # ~ ----- - --- ' \/uuomc __�______� f`����___________ SPe(`houve o" io/ lbx.: idmuibmk]x ��^ oo Iog/n!y«ruawuodmab»oiao«e»fyuuzsrpdcsyotel"cou}dn:uud/iuio- yrnmkoofaibueiokuuJ cpa»as P'«n"^uubrouau:xv000mmoryuoipi-lignut tile Septic tank nv°cy three yrmnor,umlur— h needed,h y alicensed p«»pc'. What you upmiuxmr«ya�u/can«fl�»t the tunc«»nofthoxoy6cmukaou �ca�o^/u»�8cIod/o °m g»mxy»salsynteuc Owner iomin{enaocv responsibilities are uPunifi»dill 4( ootin, 031(1) and nCbayux|2 St� ('e z . cnuruyu��turyU,diounc: The property Owner a&o'".sm submit m St. 0^ixComity p|ulmil/A`s Z^u�S «pa'/un"tacu,ificudvntvn/ d owner and»y«mea�rplozq6e�j«»zueyomon�o�ocn:xft�wdlvh � n ;dhxy'by r Wastewater«�P�u y}e��ia� " � p��c mdf�u&dm�(1)U�m�xi��o�zo7���condition uud/o(2)xdo/o»pnci»uaudymiripiog(d'nc'oxouoy). dboocpdctukilemnthuol86Jlofs|udgo. ;,"uu�uz^°"�h°'nucr�nuva�nezvad�ea»ovr'o9v"vuvu�,xujuo/no/^�ai^�,o //�w"va/� suwou"diqpoud°yuvu,"dbd Cu��6c�vou�����yo�x 'c - -�~~'�" ,�����:u/d �eD�»�»»�m���tm� kc;mu"u�Sm�vf���*�u �r ,_ ,'~.^.has been omzmu u 6 3»o�gD«Pa�«�u,v,i within [d�od000yourvxp/odomd om»/ ccvnq`l'm'|«ndn:uo/ue6mtbuSL 'Croix 'u'~~`°""^/Z,� DWe certify that all statements prupur�described above, 6yv ofx~^ uu cb h�»/vfa�«x`buowl»dge. Uvvcao�acrdmvvm�rx)oyU -- `' ^""`x deed zvcocueu/nKug/o�zo/Dow|a (�Dce, � /r 1101 0 �iir�|f�|U1{� ()� )---'-- *+*Auyjuthrroa/iouzdmtm,zdm.e7ucxoutedmxy result ill`tile omn�nq'poud/boivg»*nkcJky the Y1,uuduX &Zou �cludcvidd�uapp�^u�uouzocordvdnmono/y deed/�ro8zeKnD^xzv'uf0oo6x[8 �~l)e,—^^~~~. 'c�o�nn�o�dein�enmoo:{y6�ej ' o auJ acuyyofrord( vd«uivry map /f *** POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 0 r. "s— ,, Tank Manufacturer: ❑ NA Permit# Septic ❑ Dose ❑ Holding Volume:lCno (gal) DESIGN PARAMETERS Tank Manufacturer: NA Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: RNA Vertical Distance Tank Bottom(s)to Service Pad (ft) Estimated(average)Flow: �-� (gallday) Horizontal Distance Tank(s)to Service Pad: (ft) Design(peak)Flow=(estimated x 1.5): V,3J L> (gal/day) Specific servicing mechanics must be provided if vertical is>15 feet or If horizontal is>150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: —� (gaUdaytW) Effluent Filter Manufacturer: O��A,� Standard(Domestic)Influent/Effluent Month/ averse ❑ NA Y 9 Effluent Filter Model: Fats,Oil&Grease (FOG) s30 mg/L Biochemical Oxygen Demand (Boos) s220 mg/L ❑ NA Pump Manufacturer. „^ Total Suspended Solids(TSS) s150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L , Manufacturer. (Boos) >220 mgA_ A ANA (TSS) >450 mg/L ❑Mechanical Aeration ❑Peat Filter Pretreated Effluent C3 C1 ❑Wetland Monthly average ❑Sand/Gravel Filter ❑Other: (GODS) 530 mg/L (TSS) 530 mg/L Soil Absorption System Fecal Coliform(geometric mean) 510" Ground(gravity) ❑In-Ground(pressure) ❑ NA Maximum Effluent Particle Size '�in dia 0— NA El At-Grade ❑Mound Other. . ❑Drip•Line ❑Other: ❑ NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) hen combined sludge and scum equals one-third('f,)of tank volume ❑When the high water alarm is activated Inspect condition of tank(s) At least once eve ,❑months) ry: ear(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: ❑month(s) ear(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: month(s) ❑ NA Inspect pump, pump controls&alarm At least once every: ❑month(s) ❑year(s) ❑ NA Flush laterals and pressure test At least once every: ❑month(s) Other: ❑year(s) ❑ NA At least once every: ❑month(s) Other: ❑year(s) ❑ NA Cl NA MAINTENANCE INSTRUCTIONS Inspections of tanks and sal absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (' )or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper)and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: 9' All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of<12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005(02/05) START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process'and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will bedischarged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when sal conditions are frozen at the Infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade sal absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and sal absorption system: acids, antibiotics, baby wipes, c1garette`butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps,medications,oils,painting products, pesticides, sani4ry napkins,solvents,tampons, and water softener brine discharge. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s. Comm 83.33,Wisconsin Administrative Code: • All piping to tanks, pits and other sal absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator(pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or sail (imitations. if the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LiFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. Name Name �'� r Phone 1 l�! J— Phone SEPTAGE SERVICING OPERAT PUMPER LOCAL REGULATORY AUTHORITY Name ZX, Name Phone l Phone This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code. 1 FILTER CARTRIDGE INSTRUCTIONS Installation STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3i4-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. V STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter , l cartridge into the case, pressing down until the filter locks into the bottom of �lij 1 the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 90 Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. rr 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. a P� ,w � i ltll 4. Once the effluent level has been lowered below the invert of the �? outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. :'+ >. Slide the cartridge up and out of the case for cleaning, ` 5. If a VRS switch connected to an alarm is present, the switch ; should be removed by turning counterclockwise 900 and cleaned with water only. 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water n only, making sure all septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 900. d. 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case. 10.Replace and secure the access opening on the tank. - BEAR ONSITE,'FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY BEAR ONSITE'"Filter Case-Lifetime Limited War-anti •:l. J .:il!�i S:'.2r..:`CSJI C.!'."i r1- t,.c..:): .i. � _:)" •i .,i_.. y i ..> a„ rr_ha3, ,,is na< ale. M,21, v ? 945x1 � Q I I � Ai !.z♦ fjrr O � � I O-L59MMY 327-56) -�.- ' S89°I1;25';E 3.27.39' �" z g� - 15Fr P &rf��e Pie NR IS112(5Xn) _ Nenico N�r4wO I � tom,' W�+. �/ � • 1 I I V�� QrW h � W W°• W W .W�� ,-�;�`i a ,2.008 ,�9c eES I �. � LLB- .� fT —— WWWWW WJ I � �''�•�� h �N89sS�,Zyf1E 30618' _�••� i SM �rl ELEY. 911 _ � TOP OF IVN P40,c i I ' I h b 510.73'---- O ,Z?.D1/3 A�+c�,eesT q I - _ �_JJ 33' II I Illl IIIIIIIII l 111111 I 8062130 State Bar of Wisconsin Form 1-2003 Tx:4044888 WARRANTY DEED 959010 Document Number Document Name BETH PABST REGISTER OF DEEDS LRecording ROIX CO., WI THIS DEED,made between Diane Beckman and Darrel Rothe 2012 3:07 PM MPT#: N/A ("Grantor,"whether one or more), FEE: 30.00 and Travis Waldschmidt FEE: 669.90 AGES: 2 ("Grantee,"whether one or more). / Grantor, for a valuable consideration,conveys to Grantee the following described real !estate, together with the rents,profits, fixtu res and other appurtenant interests, in St. Croix County,State of Wisconsin("Property")(if more space is eturn ddress needed, please attach addendum): River Valley Abstract&Title 1200 Hosrford St. Suite 201 Hudson WI 54016 SEE ATTACHED LEGAL DESCRIPTION File: 2808790 020-1028-70-000 Parcel Identification Number(PIN) This is not homestead property. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: Easements,restrictions and rights-of-way of record,if any. Dated May 31,2012 (SEAL) I (SEAL) *Diane Beckman *Darrel Rothe (SEAL) (SEAL) * AUTHENTICArAL \e1-. DE?N*% ACKNOWLEDGMENT Signature(s) ��'y • t STATE OF WISCONSIN ) ,L authenticated on - �►- ST CROIX ss. COUNTY >. �G Personally came before me on May 31,2012 , TITLE: MEMBER STATE BAR R/ (A �}�` the above-named Diane Beckman and Darrel Rothe (If not, rrrnn t►►� authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed he'�regoing instrument and knowledged the a THIS INSTRUMENT DRAFTED BY: Doug Berg j*Lorrie . eMars/*" 1200 Hosford St. Suite 201 Hudson WI 54016 71 Notary ublic,State of My ommission(is p anent)(expires: March 20,2016 ) (Signatures may be atithentrkwarAror acknowledged. Both are not necessary.) NOTE:THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ©2003 STATE BAR OF WISCONSIN FORM NO.1-2003 *1'�pyame below signatures. i I ATTACHED LEGAL DESCRIPTION All that part of the NE 1/4 of the NW 1/4 in Section 16, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin, lying North of the public highway running over and across said NW 1/4 of said Section 16. All that land lying between a line which is 33 feet North of, and parallel to the South line of the NE 1/4 of NW 1/4 of Section 16, Township 29 North, Range 19 West, extending West 500 feet from the East line of said NE 1/4 of the NW 1/4; and North line of the old town road right of way. EXCEPT Part of NE 1/4 of NW 1/4 of Section 16, Township 29 North, Range 19 West described as follows: Commencing at the North Quarter of Section 16; thence N89002'1 3"W, 198.00 feet along the North line of said NW 1/4 to the point of beginning; thence continuing N89 002'13"W, 155.04 feet along said North line; thence S00 057'54"W, 453.12 feet; thence S89 002'13"E 327.36 feet to the West right of way line of a town road; thence N00 002'22"E, 187.18 feet along said right of way; thence N89 002'13"W, 165.12 feet along the South line of Certified Survey Map recorded in Vol. 2, Page 400; thence N00 003'53"E, 266.00 feet along the West line of said Certified Survey Map to the point of beginning; and EXCEPT a parcel of land located in the NE 1/4 of the NW 1/4 of Section 16, Township 29 North, Range 19 West, Town of Hudson, described as: Lot 1 as shown on the Certified Survey Map recorded in the office of the Register of Deeds for St. Croix County, Wisconsin, in Volume 2, Page 400, Document No. 340973. Parcel I D:020-1028-70-000 2 of 2 (715)24&MlO 05 NOTE MugNOTICE A-0: Oevering Homes 13-24 ELEVATIONS FT Al BRACED WALL LINE PANEL DETAILS (715)248-3010 -------------- GQ --------------------- -- -------- Fe ---------------- 12 NOTICEI L------ --------------\-------J, Oevering Homes 13-24 FOUNDATION A2 BRACED WALL LINE PANEL DETAILS WD6- (715)248-MIO (JL ---------------------- --- ------------------ 0 0 ---------------- !_NOTICEI 933 SQ.Fr. M VENTRY A N LEVE _gOevedng Homes 13-24 MAIN LEVEL A3 E-:1 �an t, E ►,,� g�z/� 3 Wisconsin Department of U91" 201! SOIL EVALUATION„�EPORT Page of Division of Safety and Buildings 14 " in accordance with Comm 85,Wis. Adm. Code ZnNIN UFrr.,- County Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must �' to 1 include,but 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. �t Please,print all information. ev,e QDate Personal information you provide may oe used for secondary purposes(Privacy Law,s.15.04(1)(m)). 0 3/13 Property Owner Property Location _ Govt.Lot /r 114 14 S TL N R E(o W Property Owner's Mailing Address Lot# Block# Subd. CSM# y` �'�l r� &j -/ W iLt-4 t / k&3 City State Zip Code Phone Number ❑City ❑Village n7rown Nearest Road 04,4ewConstruction Use:%-Residential/Number of bedrooms_J _ Code derived design flow rate GPD ❑Replacement jL ❑ Pui;lic commercial-Describe: --------.-_--_----------------------/---_.___-- ----._----- Parent material Flood Plain elevation if applicable General comiTients and reoomrnendations: System TypeZ�y /V �1 --- ---- System Elevation - � - —- Boring# F_/1 0 Boring r 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 2 YJ IM, ' 3 �a- Boring# El Boring F1 Ground f 0 pit surface elev.,�l(/ 61ft. Depth to limiting factor//�in. Soil "Cation Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 b •? 3/Z if /�7Ft' M/ lo-32- r- o 3 d //6 -A Zo n IA 7 Effluent#1=SOD >30<220 mg/L and TSS>30 VW#2=BOD <30 mg/L and TSS<30 mg/L CST Name(Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, 54017 � %� 715-246-4516 Property Owner— + Boring# ❑ Boring Drcel ID#— Page _ of / spit Groui id surface elev., — _ft. Depth to limiting factor 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 I o- /a r 3 ( a Cs a•,� .� ,� z Q-3a 3 C( F-1 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/ft in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 F] Boring# ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 Effluent#1=BOD5>30 220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 nUt The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD4330(8.6/00) i • Soil Test Plot Plan Project Name Travis Waldschmidt Shaun Bi Address 476 Cty Road A Hudson Wi 54016 CST 226900 Lot 6 Subdivision Date $� p NE 1/4 N W 1/4S 16 T 29 N/R19 W Township Hudson ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD *HRpSame as Benchmark i r,� F ^ �j ' Property Line ?d d r l0' 101.5' B-2 45' 45' B-1 30' 2% Slope �-3 102.5' Scale is 1" = 40' unless otherwise noted Property Line McDonald Lane