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HomeMy WebLinkAbout026-1121-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 578919 0 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: Halle Builders Inc., c/o Wes Halle I Richmond, Town of 026-1121-07-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: ,r� Q 5 05.30.18.722 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic l> �`r AZ Benchmark 3• �f /asp /al �( Alt.; L.— d . L �I Aeration Bldg.Sewer ► 162 . / (p Holding St/Ht Inlet 4-. Z -J61 3 y f 10 St/Ht Outlet 5 ( 1�� TANK SETBACK INFORMATION 'T Y' TANK TO L t WELL BLDG. entto i intake ROAD DtInlet Septic 72— Q Z 7 Dt Bottom \ Dosing Header/Man. .(v Dist. Pipe G' 9Aeration ?• �- ,�Holding Bot.System Final Grade ?.Z. �d PUMP/SIPHON INFORMATION r Manufacturer Demand St Cover // Z• GPM 7 Model Nu TD Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No.Of Trenches 'L n IT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS � 3 Ce _e, SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer, l�,Q INFORMATION CHAMBER OR Type Of System ^ 3 L 9 J �� UNIT ModQj N']n`Qr: _ / Ca w eat, 'e n-csl'IL. 6 T olo Fc y DISTRIBUTION SYSTEM /06 1741— Header/Manifold/ Distribution \ x Hole Size ` x Hole Spacing Ve^nt�o Air Intake L Dia P Length *,— Di a Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only kZ S Depth Over Depth Over xx Dep of xx Seeded Sodded xx Iched Bed/Trench Center 3 Bed/Trench Edges Topsoil Yes 0 No Yes E] No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 1714 106th Street New Richmond,WI 54017(SW 1/4 SE 1/4 5 T30N R1 8W) Partridge Run Lot 7 f Parcel No: 05.30.18.722 1.)Alt BM Description= ` '�m GaJ�– e., 25 CA, 2.)Bldg sewer length= .-7 -amount of cover= f 3 � _ r Plan revision Required? Yes No Use other side for additional information. 51 L — Cert.No. Date Insepcto Signatur SBD-6710(R.3/97) PLOT PLAN PROJECT Halle Builders ADDRESS 1113 Hiahwav 64 New Richmond Wi 54017 SW 1/4 SE 1/4S 5 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 99.5/99.1/98.7' 3' below grade DATE 4/15/15 BEDROOM 3 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 •4 ABSORPTION AREA 1 156 # of chambers 57 IL BENCHMARK V.R.P. Top of survey pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 55 107' B.M.* 99.5' 101.5' 102.5' Scale _ 1 /4'1 = 10' 100.5' 5' B-2 B 5' Vents AD Ac A 35' B 3-3' X ' cells with>3' sp ing r 5 � 5% \\ . IF Slope �s Z1 ! Pro 3 B-1 50 /a / Bedroom 0 f ST House 201' Property Line Sts 25' `Pro\~1 t Line L34" >6„ Quick4 Standard of Coeaching Chamber ith 20.0 ft2 of Area .6ft^2/pair of end caps 4' LGrade at System Elevation 171' Property Line 106th St. All piping shall be SDR 30/34, within 10' � of tank,piping shall be Schedule 40. Y rlC O county Safety and LtltviEiin ffJ� 201 W.Washington Ave., P 0.Box 716' 'Sanitary Permit Number(to be filled in by Co.) Madison,W17477t6Z, State Transaction Number Sanitary Permit Appli="y,l11 + L��` ,.l uni In accordance with SPS:83.21(2),Wis.Aden Code,submission 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 Servies. Personal information you provide map be used for secondary _ / purposes in accordance with the Privac l Law,s.15.04(1)(m1,Stats. I. Application Information-Please Print All Information i parcel# Property Owner's Name '? 1 Property Owners ai ling Addr s Property Location ( �� 6 Govt.Lot ` + City,State Zip Code Phone Number './., Section (r/ /L I 1 cRCie o T �N; RE H.Type of Building(check all that apply) Lot# Subdivision Name 2 Family Dwelling-Number of Bedrooms 3 SQ Block# I El Public/Commemal-Describe Use G �� I ❑City of b fw ?\ CSM Number 11 T page of ❑State Owned--Describe Use j Town of III.Ty (Check only one box on line A. Complete line B.if applicable) A !_.' Other Modification to is-ting System(expla ) j System ❑Replacement ❑Treatment/Holding Tank Replacement Only �� 015 ! K IJ D1�( CG L�-S w (JN l,�Pc C� 3+>r R- ❑Permit Renewal ❑Permit Revision I ❑Change of Plumber ❑Permit Transfer to New List Previoru Permit Number and Date Issued Before Expiration ` y 1 ty'a i U 1�`- nr,T• stem/Com onent/Device: (Check all that apply) Non-Pressurized In-Group ❑Pressurized In-Ground ❑At-Grade El Mound>24 in.of suitable soil ❑Mound<24 in.of suitab e soi] 5-Rolding_Tank__ Z}Other Dispersal Component(explain) [I Pretreatment Device(explain) V.Dis ersal/Treatment Area Information: Design Flow(gpd) esign Soil pli oa Rate(gpdsi) Dispersal Area Reed(s Dispersal Area Proposed s System Eleva on / J �U Z i J qi VI.Tank Info Capacity in Total #of Manufacturer v Gallons Gallons Units New Tanks Existing Tanks VV p�l 0✓ Septic or Holding Tank Dosing Chamber VII.Responsibility Statement-1,the undersigned,assume re, s' ility for installation of the PORTS shown on the attached plans. Plumber's.. ame(Print) Plumber's Si e MP/.MPRS Number Business Phone N er 276/ 74f'—ol Plumber's Address Street,City,State,Zip Code) l VIII.Countv/De artment Use Only Permit Fee Date Issued �Issuing Agent �Approved I ❑ a S ��.OD ' Zo l ❑ Owner iven Reason for e ' IX.Conditions of Approval/Reasons for Disapproval 0 O e Ve I DP err SYST M OWNER; s eulpio/apoo algeoi!dde lad se I 1.Sep is tank,effluent filter and pave;ulew aq; s;uawaapibei�0 � l�d.z A-L,4j (1ew�e ot�sri� w dis rsal cell must t�@ serviced/_maintaineclagwnld�(q papinoad d;uaula ew gad se M�•� feAAA bt P as r management plan provided by plurnbel?awe;uleul/paaul'1as a w l 01esiadslp 2.All s tback re uirements m as per applicable code/ordin�'°eompiete plans for the system ands i-to the Cq os a els�ss than 8 11x 11 wlhal in siu SBD-6398(R- 11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/16/15 Owner: Halle Builders Location: SW1/4 SE1/4 S5 T30 N,R18 1714 106th St. 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 Co tingency Plan 7. Filter Specifications S t Signature License numb r 226900 i i II _ I PLOT PLAN PROJECT Halle Builders ADDRESS 1113 Hiahwav 64 New Richmond Wi 54017 SW 1/4 SE 1/4S 5 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 99.5/99.1/98.7' 3' below grade DATE BEDROOM 4/15/15 DR OM 3 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 .4 ABSORPTION AREA 1 156 # of chambers 57 BENCHMARK V.R.P. Top of survey pipe ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Sameas Benchmark 55' 107' I B.M.* 99.5' 101.5' 102.5' Scale = 1 /4" = 101 100.5 5' B-2 B 5' S' Vents 35' B- 3-3' X 78' cells with>3' spacing 5 5% t\\� Slope IF Pro 3 B-1 50 Bedroom 01 ST House 201' Property Line 25' L34" Property Line >6„ Quick4 Standard of Coeaching Chamber ith 20.0 ft2 of Area .6ft^2/pair of end caps 4' L Grade at System Elevation 171' Property Line 106th St. All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 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 Typical Installation x/ 102' Vent Atel Grade Vent 4' 4" A�30/34 Septic Tank 4 4' Long 1 5' 4' Long 199 ' 34" Grade at System Elevation 34„ Grade at System Elevation Spacing 5' 3-3' X 78' Cells Observation tubeNent Same on other end To be located on end of Cells %A B System elevations: C A_99.5' B 99.1 ' 19 chambers per cell C-98.7' ST. CROUX COUNTf SEPTICTNN,KMA[N1EN ANCT /�GRFTMI'17NT AND OWN ENS811' CJ/0T1-0C&1'l--'N FORM ()noDerfBUycr � Mailing Address,--///-'3 � " ~ � PrnnodV (Verification required fromPlannitig&Zoning.Drpartd1011t Jot Ilewo/uml nctioll) Ci ty/State �~� |�un��c�uo �oz��mr L— I7\ LEGAL DESCRIPTION Property ' /|''-------- ------ ------------' — '--- ---' Location (�' ) 11/1" '5F 1/4 ^ Soo, ]� ls� » VV, I0oYoO[ Subdim— ' Certified Survey Map #_--------- ___ Warranty Deed #_______ uyn }»,Uoc idmxiOuhlo / vou/ nu SYSTEM MAINTENANCE AND OWNER CERTIFICA110N � � Irriproper use and maintenance of>ourxeptic systemmLild result m its�.�rmittire failure m�ndle wastes. Propm- uaintenaucxuvuoistsvfpuopingoot the septic tank evvzv three ycarsor,"mux. J needed,hyu licensed ru`up,". What you put i^m the system call affect the ffinction ofthe septic tank as a treatment stage lit tile wasie disposal SyStellL Owner maintenance responsibilities are^yocifindivgC0000. 83-52(l) and mC|iuvux 12 3t, C",ix County Sanitary u,di,anc,. � � � Tb property owner agrees to Submit to St. Cmi^C'nuvtyYlmuu`i2 &Joom&uvpm`oco`it ccz,dimdoofnuii, signed hythe � owner and by a master plumber, journeyman plurnl)ei,iestiicie(l plumbL-l-or a licertsed purripei yet ityltig that(1)the 011-SiTe wastewater disposal system ioinpcnyoroperating coudiiiuuuud/nr(2)after ioxpcc,iouuudpmoipog(if'iecessury). the septic tanl� io less than {B full oisludge. 1/we'the undersigned have read dio above requirements uud ux,�c x, ��iu�u,o/l�vzv/vuto o`wag,dixp./oal,yot"/uwid`U^` o�oumruvomhnub'b�e/o`^xx�u»ydmI)upu/��o`o�CoonuxzcxuudUiel/qpurtu`nu^v[Nutvna] Koxooueu, Smtuo[Yvjscouoiu / Ce,d§cu6omnmdug that yoar septic system has been inainiained must be C0n1j)1et0-I and.I.-etUrned to the St. Croix Comity I'lallill1q, & Zvowig Department vrid^h/30 days of-tile three year expiration date. ]hp:certify that all statements uodixboouu^^ truvmd`, h^nto[u0/oo,buvwhdgu. l/n/eaovaro the uvmuz(s) ofthe property described above, by virtue ofunmoanoydovdrucoo|ednzkvgmwrofDoo.isUUIuo ' ~~ '{�(x ------------------' �1`u~��TlT�|� ()� ��]»T.ICAN]-(S) 1)A'TI-' ***Aoy information that uu`ierupzcverted may result ill the sanitary puouithuiugowvobcJhy the nhoovg, 8 Zoning Uepu/bliow. ^*^ Include with this application u recorded waoao{y deed from file.Ke&iozc' uf])ood;"'ifi ouriJucepyufthu"mtiflrdoon'rymxyif- reference is made in the warranty deed. POWTS OWNER'S MANUAL 8t MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner IE Tank Manufacturer: ❑ NA Permit# *6eptic ❑ Dose ❑ Holding Volume: o-o-v (gal) DESIGN PARAMETERS Tank Manufacturer: -XNA Number of Bedrooms: 3 ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: NA Vertical Distance Tank Bottom(s)to Service Pad: Estimated(average)Flow: 3oz?(gaUday) Horizontal Distance Tank(s)to Service Pad: Specific servicing mechanics must be provided if vertical is>15 feet or Design (peak)Flow=(estimated x 1.5): Jv (gal/day) If horizontal is>150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: (gal/daytW) Effluent Filter Manufacturer./ 142 ❑ NA Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model: Fats,Oil&Grease (FOG) 530 mg/L Pump Manufacturer: ] NA Biochemical Oxygen Demand (BOD5) x220 mg/L ❑ NA Total Suspended Solids(TSS) 5150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L' - Manufacturer. NA (BODS) >220 mg/L NA ❑Mechanical Aeration ❑Peat Filter (TSS) >150 mg/L \ ❑Disinfection ❑Wetland Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other. (BODS) 530 mg/L �/ Soil Absorption System (TSS) 530 Fecal Coliform(geometric mean) ric' /L A Ground(gravity) ❑In-Ground(pressure) [I NA '`❑'At-Grade ❑Mound Maximum Effluent Particle Size tX 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(%)of tank volume ❑When the high water alarm is activated Inspect condition of tanks At least once eve ❑month(s) (Maximum 3 years) ❑ NA p ( ) n'� ear(s) Inspect dispersal cell(s) At least once every: J�ea�(sjs) (Maximum 3 years) ❑ NA Clean effluent filter At least once eve ❑month(s) ❑ NA every: � � 9-year(s) Inspect um ❑month(s) ❑ A p pump,pump controls&alarm At least once every: ❑year(s) ❑month(s) A and pressure test At least once every. ❑ Flush laterals p ❑year(s) Other: At least once every ❑month(s) ❑ A ❑year(s) Other: ❑ A 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 (1f3)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<_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) Page of START UP AND OPERATION 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 be4scharged 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 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 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 soil absorption system: acids, antibiotics, baby wipes, cigarette 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,sanitary 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; 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 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 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 Phone J — J Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name yyj Name Phone —72-f— l�� Phone 7 JJ; -- 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. FILTER CARTRIDGE INSTRUCTIONS m Installation STEP I 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 tnrough 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 314-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. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of 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. 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludgeJ;* layer on the bottom of the tank and not just the scum and effluent. A ' 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. u �� 5. Slide the cartridge up and out of the case for cleaning. ' 6. If a VRS switch connected to an alarm is present, the switch _ should be removed by turning counterclockwise 901 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 -; 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 1. N 91 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 L METED wA RRANTY " 'te,I' SEAR ONSITF-Filter Case-Lifetime LimiteC war�arr v I, 4F .rl i C 1 f 11 .. .. _ .. w � ul _ O0. z4 N � u O D U1 N � z0 � 0 U 3: emu_ z Qom u�i z� I I � I N � o EZI lu I 04 [Inn Qw W lu 6 id m w „9E6-,6 "o-J, ";Iip-v cl 1-1 m 9 Go ---------- -------------------- ---------- IL - ------- ul 0. --------------------- ---------- -------------------- "Ohe IL -------------------- 0-.Zl X .0-.9z 0j, w r 3:31:= 13 0 d) uu, IK :1 @ 0 lu 0 rL.3,a%9 w w EE w %q9 O H er :N I ` I t N 1 19 N N x • � O O) 45,370 SO. FT. r- - !M N89'55'31'T 341.43 T� W w , 18 UNFLATTED LANDS 1.090 ACRES -- ------------------------------------ Q 47,496 SO. FT. to N89'55'31"E 339.53' S 89ro6'47" w 660.00' 1 ; 162,19 323.3 I 220.00' 627,00 1.024 ACRES S89•Q8'47 W 705.56' 44,582 SO.:FT. I 1. J � N ' j T M WA T& ~\ y �` r RETENTION AREA t w 0� °' N89'S5`31"E 2 0.2 N. 1.014 ACRES ti I MINI t N Ic 44,147 SQ. FT. k. I ELEV. 978.7 ,ib ) R r, I 0 -- a !— — N 1.017 ACRES , yrb�O 4Av- fn f/ .v 44,277 SO. FT. e? 2� $ : C, ;. 16 0 1.004 ACRES Ln ty7728'p 43.714 SQ.,FT, 1.617 ACRES ! / 70 430 SO. FT. ! y 9. N89'55,31"E 260.21 ' 80' 15 1 I ! 1.009 ACRES ; \\ /f 1.061 ACRES 6 43,948 SQ. FT: N89'55' "E 220.02" �' 9 I 2 12 .00 b+ / 46,217 SO. FT. 10 6`1,-'•K, 1 SEPTIC SYSTEM- cv / 0) `. Op• I d1 EASEMENT '� 1,028 ACRES \` I ' ,! � Z TO LOT t N 44,779 SQ. FT, i r S89-55'31"W 204.54' n 1� ; EP�TIC SYSTE Tr I : +-------- s 50" 50'+ EASEMENT 1$"i r S89'32'S7"W v W in TO LOT 10 I t 100" 100,00' 'd W r) 0+ - r °� cv CC, CV I N 9` 1 E 2 . t kn 2 N S89.55'31"W 208.68' N V) ��" 1 a w L - 1.019 ACRES I " 3 a, I— — — — — .-�44,389 SQ. FT. w L C-4 � N d O 0 14 M y < 1.047 ACRES P I : I o O P I 45,612 SO. FT. g N �` T— 5 I 0 $ I 1.034 ACRES 45,033 SO. FT. i BENCHMARK USGS N 1.127 ACRES i DATUM 1$29 vi 49,112 SQ. FT. 1 ' 204,54' N89'55'31"E 261).20 1 Ei_EVAT1061 a 982.34 ,ts N 1 w� Property Owner HA lk ayi l aces Parcel ID# Page 9;C of F31Boring# ❑ Boring pit Ground surface elev. G a.17 ft. Depth to limiting factor /DD in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 1 0 -9 lo-►R'la SL- al-&R ash, as d .s -9 a q-so -I.svR yl SL a i:n lay, d aW i F .5 .9 3 so-)00 FSa K 6sl,\ Boring# ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor /00 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 0-9 ►oyr}/a L F&R cts a .5 .g a 9-4 ►oyg414 CL a msaik dsh cw I F .14 . 6 3 a3- -1,5`19 41q SL IFSa k ds� aw J jr 3a-Ia 5 4R 414 �- SL Irstl4lAsk IS YR 111 ❑ Boring# ❑ Pori S 19 Pit �Ground surface elev. 101.Uft. Depth to limiting factor /00 in. Soil Application Rate Horizon Depth Dominant Color Redox Description iture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 d- 100/2 a (0- S F .a� 101010 alMs�. s�• I F W— ots G 1A.� OF a Ig V14 o\16, . J *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<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-8330(R.07/00) RECEIVED Wisconsin[epartmentofCommer a SOIL EVALUATION REPORT Page--Lof� 6ivision of Safety and Buildings FEB 1 3 (� in accordance�with4Com 85,Wis. Adm. Code c Attach complete site plan on pap Pr notVsM",8(i) b IIThnche County in size.Plan must `��• C— rd include,but not limited to:vertic ),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 01q/0— 1 l;d 1 -0-7 Please print all information. Reviewed b Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). "� 6 Property Owne Property Location G►le eull a Govt.Lot sw 1/4 S 1/4 S 'S T 3Q N R j E(o Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# I I I I qw4 6y -7 1 1 Par�rIA9Q Ru'" City State Zip Code Phone Number ❑City ❑'Village ®Town Nearest Road New l�A ,o.,d w 54011 (-t%5 )a146- 813 k►c vv\OVN� I I b to",k S+. [X New Construction use:®, Residential/Number of bedrooms .3 Code derived design flow rate q50 GPD ❑Replacement ❑1 Public or commercial-Describe: Parent material A 0.G i�►«1 T o Flood Plain elevation if applicable ft. General comment n,, u�cJt Fo �' e&C LN � 11*je and recommendations: 7.3 ( 97.7' -r. 1 ���•Sib � .� '� T.3 97, L T.S ?(0.321) hee «. Boring# ❑ Boring Pit Ground surface elev. , ft. Depth to limiting factor D 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2 I 4-1 104R 3la L ) ):& k JS O-S F ,b -1- 13 10IR31`1 - L IFPL 6sk C F 3 13-19 io 2 sl q L 13,rSag 65k CvJ NF .s , 5 X-S6 `7.54R yjq ail. 13K 5k aw h loo Y Iq Boring# ❑ Boring Leo I? Pit Ground surface elev. /O 3a ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 o�$ 1oy�31a L a ter dst as a •s 1%-love '7•-SA 414 SL IF58K lisle% C vi -- ,,q .6 s �R ylq SL Il:Sri d�� *y .6 4z.. 14 Ew �IqT LS *Effluent#1 =BODS> _ T > < * 5<30 mg/L and TSS<30 mg/L CST Name(Please Print) Signature CST Number �orVN� -: s tkc\< U��L L dal-N6 Address Date Evaluation Conducted Telephone Number o??(a Z004\ S.+ S+Ckr* prA;tie° w( sgoz(o 10-Z4-0 2442-3ST9 SBD-8330(R07/00) 4a 1 ` t3v, iSelr, Page 3�.3 N Sca� 2 : I ',- V ' ' 171/ l tat tooth let 1;.,C:) of aIt 13 D r o N� _ q s N J 3 o-� 7 Ft M 100 . Do V r"�"► D �'� , 1{ Ll l bd,70 4- /oa,-77 ' o ° a o ° N a N O E n a m a? 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