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HomeMy WebLinkAbout026-1302-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572882 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Oevering Homes LLC aka Clevering Pro ertie Richmond, Town of 026-1302-07-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: /dn '! ,C' 64v4LA.— 07.30.18.1584 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ^,f3 CAPACITY STATION BS HI I FS ELEV. i Septic Z Benchmark l a� e 11-N. Go Ong Alt.BM r t /� +�► re, o f �s .Y Aeration Bldg.Sewer �. 7 W Holding St/Ht Inlet �• `95% St/Ht Outlet TANK SETBACK INFORMATION 7'3 9 S TANK TO /L WELL EBLDG. en o Air Intake ROAD Dt Inlet ` �ea�-- Septic + � 35 ' ,_ Dt Bottom Dosing Header/Man. I.7 9L Aeration Dist.Pipe 7. ��•�P 4.7 9Z• Holding Bot.System /6. 9/• �I .'7 W. Final Grade 3.3 /1.3 PUMP/SIPHON INFORMATION l/ Manufacturer GPM nd St Co�, Ga Z.1 /66 Model N er TDH Lift Friction Loss System Head TDH Ft 1� 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 �? �. Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Man ufactur r: INFORMATION CHAMBER OR • �.. Type Of System: • T 2� M /►_ UNIT Model Numbe .!/ r: C0J81/La �T N DISTRIBUTION SYSTEM Soy f-Z3 `/<<o Header/Manifo;d if Disptr(b)tion x Hole Si� x Hole Spacing Vent/D J it take p .1 Pies 7 Z4 Length O Dia•• Length Dia � Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/rrench Center —7.2— Bedrrrench Edges Topsoil � Yes ® No es No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: 7 / 1-,4/ 15 Inspection#2: Location: 955 165th Ave N w Richmond,WI 54017( W 1/4 SE 1/4 7 T30 R18W Nine ty Fifth Stre Sift Lot 7 Parcel No: 07.30.18.1584 1.)Alt BM Description 2.)Bldg sewer length= c3 L� j JAPG LU t3 S J4-L 0 -amount of cover= C�ec r acs. .: �' �.Ot�IG � JI�G•.� --?(Plan revision Required? Yes ® No [y Use other side for additional information. - A-- Date Insepctor's gnature Cart.No. SBD-6710(R.3/97) ?°�w ro C �' rr Cotutt}„ C Vl�_ • � .__ '#at and:Bui'ldings Division '� "( � V-,--201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) 1 S' K —Tvtadison,WI 53707-7162 T s 57 Z 2— State Transaction Number c:I.ck..(54rataryyPennit Application , In cord � .1DEVB�NTubmission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address if different than mailing address) the Department of Safety and Professional Service. Personal information you provide may be used for secondary _ purposes in accordance with the Privacy Law,s.1f.04(1Xm),Stats, 95 S I L 5-La,1. I. Application Information-Please Print All Informat Parcel# Property Owner's Name oa, 6- 1 302- b `7- utTO Property Owner's-ailing Addrrs ( Property Location / /5.� 1 l l/ � ��3 3 �f? ( 1 Govt.Lot City,State Zip Code Phone Number A/��;, ,,,p'/., ection 7 rcle o > Lt.Type of Building(check all that app) Tot Subdivision Name . Family'Dwelling Number of Bedroo \ - �L � Bloc ;��7"'`- s�' 5/ ❑Public/Commercial-Describe Use 1\t,---0 ❑City of ( CSM Number ❑Village of / r ❑State Owned-Describe Use_ ! of "(. I / , z D'�� Cc_k�S ��z3�z3 cl, ,crs _ , BI.Type of Permit: (Check only ne box on line A. Complete line B if applicable) 2 c v.Q� X i A. New System ❑Replacement System I ❑Treaunent/Holding Tank Replacement Only Other Modification to Existing System(explain) ! List Previous Permit Number and Date Issued R. ❑Permit Renewal ( ❑Permit Revision 1 ❑Change of Plumber ❑Permit Transfer to New ! j� Before Expiration ! Owner F� t` t r^- ` . Q, IV.Type of POWTS System/Component/Device: (Check all that apply) '(+ l Le., I a �.. r5 on-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound.>24 in.of suitable soil !I Mound<24 in.of suitable soil le U Holding Tank U Other Dispersal Component(explain) _ ❑Pretreatment Device(explain)�r / /� �l1f�s�ih/-... _ ' _ - V.Design Flos(gpd) ZI ment Design Area Information: / ' Wm Elevano Design Flow(gpd)J Desist Soil Application R/ay�(gpdsn Dispersal Area Required(sf) Dispersal Area Proposed VI.Tank Info Capacity in ■ Total j #of Manufacturer ± Gallons Gallons Units I °. a v ' New Tanks i Existing Tanks c � ? I i 1 h/ e.A.A �j h 1 > = " rr v © d - I Septic or Holding Tank l--- / 6 / ci Dosing Chamber i S1 I 1 VII.Responsibility Statement- 1,the undersigned,aeon .j'ponsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) 1 Plumberature I MP/MPI S Number i Business Phone N, ber �5.�� 3; 72,Q- /5/1 _ j 4'61 ;7Af--mill° 2/A Plumber's Address(Street,City;State,Zip e,�� /V/ 14 / ' ( l p/ 4.VI ounty/Department Use Only -- , ---MI&I I I Permit Fee ' Date Issued Issuine ' it Signature•is roved Approved app r I S / • l�D ',, 3 �� lr� /- 1 III Ow, '• n Reason for Denial I�I / �� �� � IX.ConditiSifsSr71F.#�OAl asons for Disapproval 3) ��\k, , alt a r . '1) 4 Nil• 1." Septic tank,effluent filter and ! ���r^„w�a� , dispersal cell must all be services/maintained w, G.c n-t.tia+tiQ- i as per management plan provided by plumber. 2. AU setback requtements;must be#nalntairiad (' 66 J� ci 1 as per epplicabWcods/ordinances j f!t�zl ht.) c Attach to complete plans for the system and suØthe County only on paper not less n R.12 1 11 aches in sin SBD-6398(R. 11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/10/15 Owner: Oevering Homes Location: NW 1/4 SE 1/4 S7 T30N,R18 955 165th Ave Richmond 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 Specificationet Signature . Ii License nui�•er#226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 95.5/95.0 7.5' 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 .5 ABSORPTION AREA 933 # of chambers 46 BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark A All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. Scale = 1 /4" = 1 0' A op Vent >6" Standard of Cover LQuick4 eaching Chamber ith 20.0 ft2 of Area 315' .6ft^2/pair of end caps Property 4' Lon g Grade at System Elevation Line 34,' Pro 3 Bedroom House ST 30' 101' 103' 5To Slope ;-2 , 30 Po. • 2-3' X 94' cells with>3' spacing 80 B-3 273' Property Line 20' V 7 LI 100' Vents B 10' B.M.* 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 To be >1' above rade 5.6ft^2 pair of end plates g Finish grade elevation Typical Installation 103.0' op Vent Grade , Vent ■ 3' 4„ 3' A30/34 Septic Tank • • 1" 5' 5' Long. 5' Long Grade at System Elevation 3 6" Grade at System Elevation Spacing 5' 2-3' X 94' ' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A_95.5' B 95.0' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer eet)e f1 r, _ ._ y__. . . . . _.._._ Mailing Address_14/33_ C�P `1.6'1 b /1.-2, / /14z/1Z �� , Property Address >5 S / 3---A A,,.Q— VtA--ctiZ-t- I (Verification required from Planning&Zoning Department for new construction.) City/State-____� 1 Marcel Identi;ication Number X02 6 " (� 2'' �' LEGAL DESCRIPTION Property Location l /1 ,3E %, Sec. _, T 30 N R /51W, Town of 1z/ -----___ )�: �'f _ -_, Lot# Subdivision Certified Survey Map#___ V —___—_-----------------r alums---- --- , Page# Warranty Deed# , Volume , Page#_____- - Spec house Lot lines identifiabl }res no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in 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 treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§Comm. 83.52(1)and in Chapter 12- St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the 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. Ifwe,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. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we an/are the owner(s)of the property described above,by virtue of a warranty deed-recorded in Register of Deeds Office. Number of bedrooms 0,es____ _ r • 'GNAT .`1O:F APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner t �I_ n Tank Manufacturer > Cu ` ❑ NA (7e J Q r. r CII Permit# ,$(Septic ❑ Dose ❑ Holding Volume: /per, (gal) • Tank Manufacturer: NA DESIGN PARAMETERS • Number of Bedrooms: �� ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: [VA Vertical Distance Tank Bottom(s)to Service Pad: �I �/�(ft) Estimated(average)Flow: '3( (gal/day) Horizontal Distance Tank(s)to Service Pad: /v (ft) Specific servicing mechanics must be provided if vertical is>15 feet or Design (peak)Flow=(estimated x 1.5): I LT (gal/day) If horizontal is>150 feet. Specific Instructions to be provided on back. In Situ Soil Application Rate: • _ (gaUdaytfe) Effluent Filter Manufacturer/ ❑ NA Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model: Fats,Oil&Grease (FOG) s30 mg/L Pump Manufacturer: ,,� r,rA Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA . Pump Model: <`'�� Total Suspended Solids(TSS) :5150 mg/L High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L Manufacturer: -A (BODs) >220 mg/L NA ❑Mechanical Aeration ❑Peat Filter (TSS) >150 mg/L ❑Disinfection ❑Wetland Pretreated Effluent Monthly average 0 Sand/Gravel Fitter ❑Other. (BODO) 530 mg/L _� Soil Absorption System `gyp (TSS) s30 mg/L ANA round(gravity) afQ ln-Ground(pressure) ❑ NA Fecal Coliform(geometric mean) 5510 ❑At-Grade ❑Mound Maximum Effluent Particle Size 143 in dia. ❑ NA ❑Drip-Line ❑Other: Other: NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) hen combined sludge and scum equals one-third(Y)of tank volume ❑When the high water alarm is activated Inspect condition of tank(s) At least once every: ,� ❑month(s) (Maximum 3 years) ❑ NA - ar(s) I At least once every: month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) rY every: / / / ar(s ) / At least once 0 month(s) ❑ NA Clean effluent fitter ryyear(s) ❑month(s) ❑ NA inspect pump,pump controls&alarm At least once every: ❑year(s) ❑month(s) ❑ NA Flush laterals and pressure test At least once every: ❑year(s) Other: At least once every: ❑month(s) ❑ NA ❑year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil 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(1f4)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: 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 5512 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) • . Page of START UP AND OPERATION roducts, solvents or other For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting p chemicals or sediment that mpee the treatment the soil absorption If high concentrations are detected have the contents of the removed by a Septage Servicing damage. (pumper] o use. . Pump tanks not recommended as the excess wastewater ast water will be discharged to the soil absorption syste�mtoonenlarge dose under causing ean conditions is overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents POWTS S of the pump Maintainer assist in anuallyoperat operating the pump controls until normal to ffluent levels are restored within the pump tank.Plumber or POWTS Mainta System start up shall not occur when soil 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 soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the dental treat floc t tanks and soil absorption system: acids, antibiotics, baby wipes, cigarettebutts, condoms, cotton swabs, deg diapers, disinfectants, fats, foundation drain (sump pump)discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps,medications,oils,painting products,pesticides,sanittiory 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 soil 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: P 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 r cult lt in the the rules neen for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. 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 RESULT.ESCAPE PE OR RESCUE LIFE. NEVER INTERIOR OFRA ANY TANK TANK MAY NOT STANCE. DEATH MAY OT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. n• n Name S� ���, I/ Lame s/ 'JU/� /t/ / /` Phone �S-c727' � 7 sl Phone 7) �-�- U X.57, 7 SEPTAGE SERVICING OPERATO PUMPER) LOCAL REGULATORY AUTHORITY Name %�' f/j7G���l Name�74 //�/� (! w ' Phone 3 t 16,0 Phone 7 /� ot•V - 5j Y'g �J 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. ;�P °, j w FILTER A " Installation , STEP g Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then eit additional insert p pipe more the outletthe tank through the outlet or solvent weld (glue) 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 31a inch pipe onto the filter case. If side support method is not „; , utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter h§ cartridge into the case, pressing down until the filter locks into the bottom of z the case. ) `' STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning '. -'_r clockwise 90 Maintenance 1. The effluent filter should be cleaned every time the septic tank is s k v serviced. 11 ' - " 4' 2. Open the outlet access opening to inspect the tank and filter. ::.,,,,,:,,,,i, �N s �,� dam makin sure to remove the sludge _ t.3. Pump the septic tank completely, 9 layer on the bottom of the tank and not just the scum and effluent. '4. Once the effluent level has been lowered below the invert of the i;, outlet pipe, firmly pull up on the filter handle to dislodge the ; cartridge from the case. g ' "" 5. Slide the cartridge up and out of the case for cleaning. i�'., N +Ss � ..L � dun .4ji 6. If o a VRS switch connected ed by tturnin a counterclockwise 90° and'cleaned k should be removed by turning *rte , with water only. �.,; �� ' ,n0. K m 4- .R' 7. While holding the cartridge on its side (large flat surface facing �� ��. * � down) over the access opening, rinse off the cartridge with water ., $ 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 90°. 9. Insert the filter cartridge back into the case, pressing down until , the filter locks into the bottom of the case. F 10.Replace and secure the access opening on the tank. BEAR ONSITET'FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY , BEAR ONSITE`"Filter Case-Lifetime Limited War ,r v ' n .7 i' . r -...-^ ; a ' ` ',,, �4"a+ ',:7 '0'77i,`,47',' i x ` V tin' d «. ? a a � e 5 cxt�: ` YrA 0' ` a �T t y . m r� . - a 1 N _ w i " dy, * � ` a 4'raT`'1:° d r ' Ali� K ' 4 Y r § . ':,z. ,.,�,Th"X'° Ali .. :..,: I UNPLATTED LANDS , 1 0S 00'35'17" E 1384.52' 66.00' Thl. 302.62' 315.45' 300. 7' – .?„, --- iv –918.64`– 6 1 28 IS 110 10) \oy 1 ,;:).. zt..' ....: 4... 1 3 :0 in IN Cry . co co 1 1 – co co cb ' z Cl) (3 ,..) • N- 00 b °O 1--• 1 .0 aL , cz. Q cr, 't ..1° 4 43 er) ..to f. (Ng • t() 1 N 4,... •rss,..... . 06' . ... -•. I* 4 ..■•••••'*" ^) \ N\, N, •.....•.••••''' v*'. \ N . •a. S.....(Z) N‘ , . , N 0 7.77' ....". '...—...""." —•"..•'"'... . (r) E, 215.55 o„, 'N. ... -. \ et) , .., 0 SA C2'3 24 ....---""----------' ...."' ......--- ' .......... J •..\ A \ -.. .., 1•01 t'.3 cr) II -.... •ct-r,,• •-•-• N -..";;',...,......N, 0 N '''"----- L,------- , "... 215.53' o... ........_ , 43 \ • (ri c\i N'e6 1 . 4`11 Ac,23 2 __.—... , -"""'",N. '\■:,. 10 \ ■ 14 N, ".. •,-,...„ \0 .--..--"- --1-86–•46r N ......,„_ s, \ \\ ,, N •... N, .. ‘.\\., \ , N . • ID 1 ..,. ,, \ '-•.. -....: \.-''.....•... \o \ '',.\ .,.. '•.0) ........... •. N N N csi . N _.....—• • ■ kr) •K'L4 a , „, ............. ,r, ,t• co • ,A 1 „ .11 - : kt ze u L. co 18:ii 'o #37 : cs ply - co cry t. °O kr) ..:1- • Cl U3 C.) 6 I 238.23 1 7 02 8 z •••4- t $\...i ci 2 c.1 • 600'42'29"E Cra • (\,1 ' N ••••.. 03 b. I en ,-55 co r... I cl) • 494.73' 53.48' • IA ",..4- ••■•• ``I a 5"W 660.00' 1 I CZ) N Q 7ERTIFIED SURVEY MAP FO- 1'0 VOLUME 79, PAGE 4992 tillicR ...._ 1 . ,war - Jr 1 0 I I rwr� � ...��� . • fjli - `" AVM/ ywn t. 11 li li 7.\..446+► . .r., 1 .a-A i �� � � die�.�...�..�._.�...._._.....,�..�.� . . i e 0 1 gill I I-.. I hi 1 04 it 1615013 th ., ., ,. III s+r 7, ! ill r �' I r 1 .• la Y I II ( S I? gIt Pr i. • 7 ) «, 1 .11-Nit I 1fI ....w ., . - I I t 1 '4, i MI • _. . 1111 111111111111111114 ,--4 , Iji i CP 1Ella i ,_ .......t, 9...-.... B I 117._-_.!! -IS- ''''' '' r 1 1 1 . • WNW . Wisconsin Department of Commerce ;; OIL EVALUATION REPORT Page / of - pa Division of Safety and Buildings )1 ance with Comm 85,Wis. Adm. Code K..))1 County 5.7i% Crrp! 7( Attach complete site plan on paper not s than 8 1/2 x 1 in - include,but not limited to:vertical and horizontal referen inttr� Parcel I.D. -7 percent slope,scale or dimensions,north arrow,and loca on and distance to nearest road. L7 "�t,_ / -/ !-. I 0 t--ot-C 1 Review y / Date Please print all informai,on. AUG 2 5 200`i I /2-1"82.0_5_ Personal information you provide may be used for secondary Pu ••-es(Privacy Law,s.15.04(1)(m))- Property Owner ` ST.CROIX�ERSPI5fIocatl / ' ,1 „, epAv� /`„j ZONING Q:F�F,IIG p t,� 1/45 1/4 S / T UN R I ' E(.,�]'�'/ (' is Mailing Address /i�/L,Q Lot# Block# Subd.Name •/CSM# �� o, 50><- / 9 1 — _t'sel‘s , .5 . ee-- City State Zip Code Phone Number ❑City ❑Village Town Nearest Road -Co/Pr e/S-L. (Ji f•S$/DoZJ'I (-7/-311/7-.77 3'- /2 i.e. n•d 1�S5/X.r • New Construction Us Residential/Number of bedrooms Code derived design flow rate --y� -_ -M GPD ❑Replacement ❑ Public or comm��l-Describe: ----- �j� Parent material t-G a�� ..) Flood Plain elevation if applicable ft. General Z and recommendations: 5 s,'e.�- Cie L's ,, ?s' '/9s' 0 , 5 5 PX/ ���t 0,° y ) .0' S e,-,,f to e, C6. oL,0-/ -, Ong# � Bonne 1 Pit Ground surface elev.,/12/,' Dft• Depth to limiting factor 3._.]G2.in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 I G- ? M F3,01.,.- MIMEO ^ c 1. 3 5 - ITINSPI ______ rAa Os MEP 442- M ir, 16' .4,1111 IIIIIII NM Or 1.1111 ❑ Boring 2_ Boring # Pit Ground surface elev./ / . Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD Eff#2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. I a- , S 1 IIMIIMININ cs _.. , ,o SC-I , __ t , r) 62 4U' •Effluent#1=BOO,>30<220 mg&and TSS>30<150 •,Ar Effluent#2=BOD5<30 mg&and TSS<30 mg/L CST Name(Please Print) •*;r re CST Number Bird Plumbing, Inc. Shaun Bird / i 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5417 8 --/3 t� 715-246-4516 l Parcel ID# f//Page of Property Owner_ Z ❑ '.ring ] J �# .i Ground surface elev.� . 03 Dep/o limiting factor ` d I Soil Application Rate ► it Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 V —3 A 3/L S 1 2t. an c 2 .b /•O 'Z fril cr I m$ L' , m ri-- I cS I MINI . 5 / O 11011111111111.111111111 11.1111111111111111. INIIIIIII I— _- Boring# ❑ Boring Ground surface elev. ft. Depth to limiting factor in. I Soil Application Rate ❑ Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ifE in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. , 4 ❑ Boring Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Pit I Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Roots GPD/tf. Boundary *OW 'Eff#2 in. Munsell Qu.Sz. Cont.Color _ Gr.Sz.Sh. > < *Effluent#2=BOD,<30 rrtg/L and TSS<30 mg/L •Effluent#1=BOD >30<220 mg/L and TSS 30 150 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. 5804330(R.600) Soil Test Plot Plan 1 Project Name P.C. Collova Bldrs. Inc. Shaun B' l7 Address P.O. Box 489 Somerset Wi 54025 CS t#226900 Lot 7 Subdivision 95th St. Site Date :/8/05 NW 1/4 SE 1/4S 7 T 30 N/R18 W Township Richmond 0 Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 95.5/95.0 *HRPSame as Benchmark Alternate Benchmark Top of 1/2" pipe @ 100.3' A 315' Scale is 1" = 40' Lineerty unless otherwise noted 101' 103' -2 30' • 5% Slope 80' B-3 273' Property Line 20' • B 10' 100' 20