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HomeMy WebLinkAbout032-2179-04-000 g r 3rd Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 579076 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 Township Parcel Tax No: Glen & Jamie Owen TOWN OF SOMERSET 032-2179-04-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: d•v0 ldo-04 Am S Gtr / fj/YI 16.30.19.1523 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark W// JX /2,1; l No va.( t av • ov Dosing s Alt. BM / Aeration Bldg. Sewer l) J ~7 ,JJ F ID, 94 Holding St/Ht Inlet (Z) q6. 04 9s. TANK SETBACK INFORMATION St/Ht Outlet LZ S• 9 . TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. ~t goo. ~ /Z- ~l 88. 59 Aeration Dist. Pipe Holding Bot. System 60 Final Gr de PUMP/SIPHON INFORMATION 100.16 17Q (U Manufacturer Dem d St Cover / Z\ 9s s L . GPM fz. Model Numb TDH Li Fri ss System Head TDH Ft Forcemain Length Dia. Dist. to e SOIL ABSORPTION SYSTEM BED/TRENCH Width Length, No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ( gb ~D t SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System:,,// y r / CHAMBER OR 60!/• 7 1 Model G!K STq DISTRIBUTION SYSTEM Header/Manifold P Distribution x Hole Size x Hole Spacing Vent to Air Intake ` Pipe(s) Length Dia l' Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth of xx Seeded/Sodded xx Mulched Depth Over Depth over _TT B d/Trench Center ,rb l~l~ Bed/Trench Edges psoil E Yes FE-] No Rd Yes 0 No N 6f WD D n COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 587 155TH AVE 1.) Alt BM Description = ' f ~p a 70 C~~ re~rs~~ 2.) Bldg sewer length = s ~ 01i~ - amount of cover = j ~H' fD0P I.t/ T r+6! O~~uM Gµd, -p4 1b '7 ~o~ aS aHGj (o ~e a e, Plan revision Required? Fol Yes [ No Use other side for additional information. fo Date nsepctor's Signature Cert. No. SBD-6710 (R.3/97) RECEIVED PA._.L... ) _ ~fjjyisi011 201 W. Wasbitalatoa AVE., y,4. Box 7162 GY A Madismi, W1 5.9'107--716?. 8aaitgry Pump N'""ber (to be filled in »y CO-) <ti7 ~ ~ O %Q State Uansection Number Sanitary Permit Aivucation _ In wc.C.ardanrc with c. comm. alts. Adm. Code, sllbmistinn of this form in rho apptnplrlata governmentai >~rujectAddmaa(ifdifferonttfiw^mw~wdc4ewa) vnii in required prior to obtaining n sanitary permit, Note: Application fhms for 9tete-owncd POWIS Of' nubmined to the Department of Commerce. Personal infornwttIon ym► provide may be used for 9econtlary 5 _purposes in accordance with the Pdvttc Law a• 15.04 1 m Stets 5 , l._Ap ikatlim Inforinatinn Pleaao Print AM Infoir matioa Ptucei II Ptah" Owner'n Name d 3.2-a/79-Dq -0Od Prtntty ()wnar'a Mailing Atkitwws P operRy > tioa , l5 23 (,t1'~, > G=-,`/n, Section Cary, Starr, Zip Code *hon (circle if. 'Cy pp.. of Bailding (check all that apply.) Namc ramily t.3welling Number of no4mom 4t .t or 7 l'nhflcJCnmtncrcial Describe LTae ,____a_~~~ City of O J a .ti _ - ❑ Village of C.SM Number StaMOwned ilesaribeifae.--- Tom 113. T . of rermit! (Check o ,y one Itntt on lute B if applieeble) 3Tr A. ANew S entcm ❑ Repiaccment symem n Treatment/klnlding''ankReplaMMent Only G} Other Modif aatian to ENisting ~YB (exPtaiii} - - 1.iet)'ievimts Permit Number "std Dwte Isatmd . Permit Renewal F1 Permit Revision Q Chanxeof?lumher ❑Permit Transfer to New .4 nefom Rxpiration Owner iV. Type of f'OWM SYstemfCnmponent/D_ cue" Clieek All Out R} "l nn-Prrasud2cd 1nd3rrnmd 0 Pw essurized 1n-t3round D At43rade n Mound ? 2R in. of ouitwWsail Q Mounds 24 in. of suitable ,soil 1301ding'I'80 0 Other Dispersal Gmuponont (explain)-- L] Pretreatment Detriee (explain) Dispenal/Treat AtArtea InforiyAlloll: _ J d~4 r f~~ S g ~ra on O Dnki Plow d Deai Soil Application ltatc d Dispersal Araa Gi-nlrett of) g> Dispersal Area (sfl GQe) -7 _ S'7 - r~A. 'l'ank Infn^ rapacity in Total #of Manufacturer Gallons Galioms Units , .2 NeN1 TgTanks _F - -Cxi~dng Tanks r , 1 O I U ta era no P, srpiicarilnktinRxank Z~ Y" _ ~•f DnsinA Chsmhcr V11,12as111nnRibiliq Statament^ 11, the undersflined, Rename rata nstbllitq far fglptnllatim of the ti'OW'1S a n the atnneirail plarw. Ph tribm's Name (Print) Plumber'9 9ignsturo Number Business Phone Number t',i $ ~►u yttaf a2 2 gGt 7!S = ~d G-3lal /Q/1 " 1'lunti:er's A.ddT4&a+s (Street, City, State, zip Code) vl l)i. "It fAe Wall at use O~ pprnvetl ❑ epltfet~w $erinit Fee ~ Date ~rl I ~ issu• 8ignatur _ en lteannn for Denial 4~1 • IX, C.oa 11wtaso~s for la1Rappraval 3 0 nk~, a uenf• tmeranii` . 41s{9i mal cell:must all be serytbes I~mairitalrAg r ~ as per management plan provided by plumber. Sf 46 we. GJ 2 AN'se c''egieaeMw is mtlst,ge maiMairisti ' C G Q (,5 Attseh % complete ptaar for the ryrtatn Aud submit to tite County oAly an paper not ten tpan R In I I I incb" in Size Sk31)-6399 (R. 02/09) o ~ 4 a y 4 3 1 ;h ~ Y Z ~c VA •i 1 J rf ,p CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: .:614 6 !L, i Owner's Name: Sr Owner's Address: ® Legal Description: C1 AV S f ! T3 ~3 ,Pa7 l YZU Township: - Z'- County: e P-6 Jj Subdivision Name; Lot Number: Parcel ID Number: c:5 ;2 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 Cry Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber ~;q ~ ~`ah"° License Number: z 7 9 p D Date: ~ 31 Z Phone Number `7l5 Signature Designed pursuant to the In-Ground Soil Absorption component manual for POWTS Version 2.0 SBD-10705-P (N.01101). Page 1 `IN'S r a vo ~ v , d a `d ~ Cb 41 Q. O .H,ien system Cross Section So9! Abso k74-hadulee Fina1 Grade ~ f - ft 'p Leaching Chamber SystemA em Eleuatlon ft ft Sa!! Absat~ntlon S~~~Vtsw . ft i Leaching Trench 9 S` ft Vent Or Observation Pipe Chambers 4" Dia. Trench 2 Header Leaching Chambrr 9D22jf QMffgons Manufacturer And Model Gt u Sail Application Rate _ '2gpdfsq ft EISA Rating ;70. sR ft par chamber Chambers ,3 gpd Design Flow + 7 Soil Application Rate EISA 2 rows of chambers each. Page of W U CL O Za w= U) -j SQN Hwy ~ i o Wp cn:g:v av 4~ pv Z- Z ~Z Q a a- p Q 00 Q 0 CO ~ O ~a ~a O M U O U CT) M CO Cl) u > W O U N U M C7 U CO UC C U.) C'i N J ~ CM u u u n N U LCD CO N u n O U LO r O N u Cl) ~ O Ov 0 LU v Cn U p Z Q ~ LLJ = X Z ~c Cl) C.0 Lj ~ Cn o LU v Y W Z m = S U O LU F- Cl) U Q J O O Z m z W N C/) J N 0 a_ ca a C7 O LO ® CJj J F= W CV O W CD Fo -j o O Z uj LL LL CY) 0- Cl ~ Ia-w O N J LO W Q NF- WU) J pp Q Q O dam=OC6 Dili J, 011111111111111110 0 0 o o 0 III III I C, U O LIQ U r t-- IN [ N V 1~ m U lf) E N U O U~ O N N V N C14 O u N co u I E vwuume -r 1`^~ 1~ m 1'~+vo6 r U r I CO U ~ N CC5 CIO u W O U d' Q c O vi m I IN MI5 HIM" a V 0 cc) N a O co O = X `n Cn in M ii vVi W LU HO O cn LL ~ cn O J Z LU F.- x I- U w W cfl C7 ~ ~ o W w U LL W O W O co co z o `n `n U ~ o~ I v U Iti J CV LO C) LQL 0 D CQ U) y. J _ J i yp O 0 Q l1. LL r Gl u"h Mill J Z J J WOQ Q O¢~~oo 0 1919 I I I II III I I o i ~o 0 0 0 0 9111 II 111181 I II ~ 00 U O lt) ~ U N O M U ~ ~ U N O u1 O O - cp _ N N U u U O M V U pj N G7 - CO CO ~j u u AN i Ln M IvdG 1 O u cD I U I ~jf^AY{n~N I CD U 4F-- N ti CC) N 1-- u W O O Q Lr) LL Y ~ U J O / co N [l) LO N O ~ ~ y Cn U `r ~ / Njl ; t? A / L Cl) N~cfl of x o> r` C', W cnLnM C/) J F- o C) CF) CL ~Z O Cl) x _ LLJ U O W I.J_ U` W LU o 0 2 co W Z O Z::) U J 7 j .`%W W < W Z Lcn v J O C"" ID co `n o°, W E'U J / O Z l.L LL W C) Q Q O a ~ O POWTS OWNER'S MAWAL 4! MANAGEMENT PLAN Page - of FILE INFORMATION SYSTEM SPECIFICATIONS Owner e rJ w ev Septfp Tank Capacity d al ❑ NA Permit # Septic Tank Manufacturer 11 NA ROWE DESIGN PARAMETERS Effluent Filter Manufacturers ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units Q NA Pump Tank Capacity g Q'0 ❑ NA _ ga! Estimated flow (average} coo I/. o PUMP Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) n al/day Pump Manufacturer Qa o NA Soil Application Rate gal/do /ft2 Pump (Model ❑ NA Standard Influent/Effluent Quality Monthly average* pretreatment Unit _ ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sans)/caravel Filter 0 Peat Filter Biochemical Oxygen Demand (BODO) <_220 mg/L p NA 13 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) _5150 mg/L U Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (8005) 530 Mg/4 p ih-Ground (gravity) ❑ in-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L Q NA Q At-Grade ❑ Mound Fecal Coliform (geometric mean} <10' cfu/100m) to Drip-Line ❑ Other: Maximum Effluent Particle Size Yg in dia, q NA Other; ❑ NA Other: Other. 11 NA ❑ NA *Values typical for dornewic wastewater and septic tank effluent, other: _ ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency R 1-1, Inspect condition of tank(s) At least once ever ❑ month(s) y' ~ P.Q ear(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At )apst once every: ❑ month(s) (Maximum 3 years)h ❑ NA X year(s) Clean etfluent filter At least once every; ❑ month(s) j~ 1 pearls) El NA month(s) ❑ NA Inspect pump, pump controls & alarm At )asst once every: El 0 year(s) Flush laterals and pressure test At least pace every: El month(s) ❑HNA Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, 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 to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to chggk 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 tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servioln Operator 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 512 months, shat! be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s), if high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump' tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS 'Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park, vehicles over tanks and dispersal cells. 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 life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. 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 chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits 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. • 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 that time, ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. El 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. I~7 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> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name y _ Name Phony t 3~~' Cpl Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone 7 /5 - 39(o-A4 6 0 - This document was drafted in compliance with chapter Comm 83.2212i(b)(1)(d)&M and $3.64(1), 12) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK NUANCE AGREEMENT AND O'W MSHIP CERTIRCATION FORM OAmeaBuyer L men/ Mailing Address ?goner i Address-k5 8 A G -<m4c✓SL W L. Yd ZS y - (Verificaion required from Plamring & Zoning Dgm=eW for new emstruction. Cityl Staxe e J ~L T tJ~(~ Parcel. Identificalim Number D 3 2 - - M -A.L DESCRIPTI01N- Property Location r/< ; S F jl4 ;Sec. 6 , T ,7P_N R w, Town of J d YVI P t~se t SubcH ision Plat: ~ G t(N t l y & P Lot # : R Certified Survey Map # , Volume . Page # Warranty Deed (before 2007)Volume Page # Spec house On yes kno Lot lines identifiable kyes no SYSTEM MALM1 NANCE 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 ou.< 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 disposd system. Owner maintenance responsbilifies are specified in §SPS. 38352(1) and Chapter 12 - 5t Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zonimg Department a certifcation form signed by !be owner and by a master plumber. journeyman plumber. restricted plumber or a licensed pumper veriffing that (1) the on-SrGe, wastewater disposal system is in proper operating condition and/or after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree tO maintain the private sewage disposal system with the standards set fornk h=in, as set by the Department of Safety And Professional Services and the Department of Namral Resources, State of W sconsm. Ceroficaton seating that your septic system has been mamtamed must be completed and returned to the St Croix County Planning & Zonis? Department widdn 30 days of the three year expiration date. Uwe certify that all statements on this f are true to the best of mylonr Iaowledge, I/we am/are the owner(s) of the property described above; by virtue of a w deed recartled in Reggistea of Deeds Office. ~4 ut~2 r flf flfl212S i~ SIGNATURE OF APPLIC-kNT (S) DATE s ny information that is misrepresented may result in the sanitary perxait being revoked by the Plaaui ag & Zoning Department include with this applicaliion a recorded warranty deed from the Register of Deeds Office and a copy of the c mt fied survey map if reference is made in the warty deed. nKEV. 0411?,) Parcel 032-2179-04-000 03/28/2008 10:56 AM PAGE I OF 1 Alt. Parcel 16.30.19.1523 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/03/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NEUMAN, KIMBERLY I KIMBERLY I NEUMAN 305 WILLOW ST APT 4 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 587 155TH AVE SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 6.640 Plat: 10-050-NARNIA NOOK LOTS 1/5 032-05 SEC 16 T30N R19W PT NE SE NARNIA NOOK Block/Condo Bldg: LOT 004 ('05) LOT 4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 16-30N-19W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 02/28/2005 788465 2756/469 QC 02/03/2005 786540 10/050 PLAT 2008 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/05/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.640 66,200 0 66,200 NO Totals for 2008: General Property 6.640 66,200 0 66,200 Woodland 0.000 0 0 Totals for 2007: General Property 6.640 66,200 0 66,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 RECEIVED Ift. Dept. of Safety and Professional Serves SOIL EVALUATION REPORT Page of 3 Division of safety and Buildings SEP 0 4 L 0 in accordance with SPS 385, Wes. Adm. Code Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must D C R U NCY/ 0 include, but not tirnded to: vertical and horizontal reference point {BfA direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parn~t tA. 02Z Z 17,170 P510 Please print all information. D ate Personal kN ffnaum you provWe map be user ~ secondary PUP- (Privacy taw. s. 15.84 (1) (M))3 J~by Pm?po,gwnw / Property Location Z. 'l 0 6AJ e" Govt. Lot 114 .:114 S T400 N R l 111 { or W Properly Owner's Mailing Address [ # Btocl # Subd Name CSL4# S~'7 ~ ~S.j` ry Cl vc / Cl~hlR6? ~Cl~~ city state 2p code Phone Number 0 City ❑ VMage ®7'own Nearest Road [8. New Construction Use:0 Residential / Number of bedrooms Code derived design flaw rate GPD 0 Replacement ❑ PubGc or cornmendal - Describe: Parent material 6 C9 'r a 1 Flood PWh elevation if applicable /V iL Generals ~7G~In`aC5~1 3 h/~r ~d Scc.rd?Gu~t•a. t~rn.'ta.a 5~ and recommendations: g (0-r L" i f wry S* t l I I Boring # ❑ Boring I F Ph Ground surface elev. r fL Depth to uniting factor ~7o in. Sod Application Rate Horizon Depth Dominant Color Redox DewAAa r Texhue Structure UwAstence Boundary Roots GPD/& 2 in. Munsell Qu. Sz. Cont Caior Gr. Sz. Sh 1 Q`S j®i % 3iy IVA %ths~k /77p/ c w 2 F O~ 7 A/A rl-p C-3 O's 3 1/0- Iff 7, ;-7W i XiA 4S~' //h c 1 v 0,7- 6 z IVA r" S Z- 0, 71- 4 IWO 14 L • F2-1 Boring # 0t Boring tLY Pit Ground surface elev- ft. Depth to finding facto; in Soo Rate Horizon Depth Dominant Color Redox n Te)dM Structure Roots GPM z in. Wnseti Qu. Sz. Cord. Color Gr. Sz. Sh. Z CS" C~. •f ~ f. 4 -16 '/aY / rh Gs PIZ. - 0,7 010C I 4AA Effluent #i = BOD > 30 <220 mg& arw TSS> < 150 mgtt. * EtiWnt #2 = BOD $ <30 nftL and TSS <30 nVL ~S T ,+iar ( Sign atufe /J rker anti t✓ e =t* ,y g Address f~ Date Evaluation Conducted Telephone Number property t G le, 6 w n,-, Parcel lo# 0.722 t Of 3 Boring knft Bodng# D M ® pit Ground surface elev. l J . ~tt. Depth to tacfAr LS s Sol Appkabon Rate Horizon Depth Dominant Color Redo)( Description} Texture Structure Boundary Roots c z in. Muni Qu. SZ. COVIL Color Gr Sz.. Sh. z1 ~g~ "r° IvA Osf m 1, .010 Boring ~o Pit Ground surface etev_ it. Depth to nrr}}iting factor in. 8th lion Rate 6 tea...... R _ vsrrx~s z Redo, s r - - D yih - ~int3}sZen vL1t4F-- x- 2Sius^#iss I 5 c~liisxc = iis3£ie3i8 Ss'Ss~a'svc * £3rnaaty, ots z € z . - } t Boring _ Boring # ~`y Ground surface eiea. ft. ~ to =g taet:r a:. C1 Pit Soo Aqa gate £ s-?nren 3 : rin~.~~ Redux r~Luan ~ I eq1ure ~ Structure ponsMence ~ I S r S s i s d * Ef juent #1= SOD > 3C :5220 ng1L arW T'SS >3L' t 150fflWL E($S ent #2 = BOD ~ < 30 mg& ar`A TSS c 3t} mQ!? The DepL of Safety and Professional Sen'ices is an equal opportunity service provider and employer. If You need assistance to access services or need material in an altaernate format, contact the department at CPOS-266-3151 or TTY through Relay. SBID8339 tR1 i:I I) Property Owner 6 lei Parcel ID # 0-7 2 Page of ~J J= _J B... Q -g ® PR Ground surface elev. / ft. Depth to lirm- g factor/ 7I ~ S in. Horizon Depth Dominant Color - Redox Description Texture Structure sistence Sol Rate Boundary Roots GPDiB in. Munsell Q,t Sz. Cont. Color Gr, Sz Sh. ® M S°~ r s m Syr C du -O q 8 7s' i S Xc n2 yIt. L G e v l v i> ..7rq I F L( I IvA- TM I ~ I ~ x I ~ l i 1 1 ~ ~ ~ # Il 1 { l 1 I i i [ ~ i I I ! t 5orinR i._I L Li Pit Ground surface eii:v_ ft Depth to iimifing factor in. S~ fip~~ r s3 +a i . t •t_3~ ~,.=rttr es.,crrsa..:rti -s~,i._s; : i ~yesr= r..aiir~xr';nr i -i ~'~X'it~~ 's 'vTsi~~iJiz >ver5~srix~ i•s"!.'vixuar~ . av~ t v~`s~rs~s•.` ~ , i- s - i } g s i E ~ I 2 i ttt 7( i i I ~ 7 ! i ~ i ! t 3 ice} } .j Pit Ground sm-ta `ie C--.^..v.' gj alft.ing t 2 r S -.mod. as:. i ~;t~ =.LGGUE•a~ ~'?at l - 3 Ha_ € _oty, s`OD, sA s ec? x_ L i ors i ~ss~ r ,t -Ida s l I I i ~ I Ef#t!ferd#1=BOD ,>30<3?_xingi :^K-SS >,..=f ,I^ii'! `DTIJL'YL~»- BOD ni.i. Tt~`c ,W .r m - <,r+- ~ri,r and < Rai t he Dept. of Safety and i'rcfessiortal Ser:-ices is an equa ag~rtunitT service pdtir and erttpicyer. if toiz need assistance to access services or need material in an alternate format, contact the department at 608-266-31:51 or TTY tlrQUt k, Pke;a-,-. SBR%339IP.3 2.II; OWNER Page 3 of 3 Name C=/ j Brian Parnell Address_~;-,?7 /Ss rn ¢ CST 231314 5o/ft-&rs- .e t 1S Date - A Benchmark 1O/~ /%y~vc~~,`nc EL, /DD,U A Benchmark 2 floe lYevc e"fe q Soil Boring _1 Suitable Area 1 40' Scale F 44T L I ; ,4 ' 7, 72. 1A q-F f 3iq 92n F- i ~ r r t wieoot 15h DepWbm t of Commwoe SOIL EVALUATION REPORT pme/ . of 3 Divtsiot of safety and Bps n a=ftm v*l& Comm 85. Adm. Code Attach cornptete sole plant on paper not teas ome 1/2x11 him in see. ~ rrurst ' ' T G/POt' 1C inchrd% but not flnutedlo vet and trorWmW reflaemae poled (BAS, d nmUm and - . Po ifo.Psmwtstope,scaeor ,norbarw,andkxasonanddstanotonearestnoad Pkese print aH Wbrmath Pbrta"iq yavMVlean err9WWdfW8GcmaW,p (P&m Law.&ISMM(a*. P"ot" Pro)etyEor.~n Y 'a Address GGK W tt/lA~ Ira 5f 19 S T 30 a R /f few S 15 5 La # t3lodc #F `u' tbd gloms or CSW /ll n cue l PM* t oa 11-z ~MERs~T- ~vl Syaas ?f5 ~y~-s9Gk ©so S ve NOWCOr>sbtrcOM timoResidergWl ofbedroomm 3- Codedetmdd tSowMe 45'O COO 0 GPD © Rq*wwnwt 0 Pulft orooewnercFal - Desc ribm Patera maindmi SftNo y 4U7 -G/1t.S1s. Flood Plain elevation if Mate Gen"ammuft andrecornomxboons. .0 -;4 4V 7,e ov/uo 0-nu t/AF;U 7- CO -F. S Pit Qoestd surface etetr. ~t Depth iolknMQ favor in. sa Role fftt on Dfl(o Dor+alment fiedaocDesaksm Tere<re Sbucture Coke El msdary Roots G~ MurIit QL Sr- Coat Color Gr; Sz. Sh. 'tit Im /0 V / 0 - /o R 3/ SSG a f Shk ' An ~ k/ 3 • S. 8 3 - ~Z /a 7/ - 5 D i >YD t - ~ ~ Pit L~undsurboeNev ft. _ Depth is ~m9 talc ~iE Rate Ftorimn Deft Doodnam RedoKDescription TOO." SM10 re CAffmisunce sotxsdoy Roots CIPM +1m- Munsell QtL Sz. Cott, Color Gr. sz. Sb. 4E M1 2 0-5 /0 YR313 L- / s 6~ /hr f~' ccl .3-f- I( • ~ 2-- 5-4:3 /0 Yy e Y11 /I 5Z, /M -fA C5 yye fl? d6 A C / 7S G z G t Z ' l#7 = BoD > 3t1 <220 rr~t and TSS >3t3 < i5D rt>,~t. ~ _ $pp 30 < ~ ~i. . Atl*m Dole Ew.rhr"Conducted Telephone mmter ~l/av • s3 - aoa 3 Its-'77a • 3yfc 2 Private Sewage Consultants 2812 10th Ave. Spring Valley, wi 54767 4AJ4 G s8y f3y r /4d j -may 14 o.~ GZA ~av L Svc` ~f~15o~N 03a'©5G~. 74` a~ ParcdlD# axsw paw VeP6 to *nag ad= 2 5a. ~CWLCk, tx sz sn. . , SL- 47 L p"t ~stsae R - Degm ib f sore fb" Redvx Ts a ~r ROM GPt 3rs C.aeAae IrL munses t S7- CAM £(k)r Gr: sr- sue. f o 16 iaY2 y/~ - 2 sG i shy~~ w, y Z D z5 - siL Z f s re CS , s JD V)P"71(. S DDS l.~ LJ- 0 soft Pit OW& b. Sol - T~ munsea sr- Cwt 001W rg Pit G R 'DirL E S Im MunsO cap. Sx C* colm fir, sh i I ~~t ~1 = $f3~is 3~1 <~j mgt. 8t!$ TS.i >3t1 < i.50 - " ~ ~ = 3Q tnglt. ~xi 3SS < ' 11'e}s"mmt ftf £omm"€e m w t off "ftinw seam P-1m f "Joyff if Wos affsta la w access s"Ces c amd e~a€e~iai i~a as a%"aw f , $i react s [teW"eM at Mg-2f&315i ar T ff &W Z#,r '3. sets-a3~~t,s~ap 3 r O.RIG ~ ~ I INAL ~hs~- GoT` CAI 30 • - ,t3~c~ ~~'r5 , s ~ 'S up Q - ~•v Y~ ~,e s -covoQ . GaT try f ~L C 3 d` ~ A7 yob I a t 0 4P 113 T0r OF /o 0, 0 A15 /,OX y n Mell ~ la lop f-~/A A~ 5 P~ 6Io 7 / For issuance of permits and designing DD TTGN jj**rr Contact: Ulbricht & Associates ~1~AL Registered private wastewater consultant and plumbers ZV S l D ~ 2812 10th Ave. Spring Valley, Wl 54767 - 7. 715-772-3442 a r %Msoor>sM Department of Cam w ce SOIL EVALUATION REPORT pa of 3 Division of savvy and Bu kkW in accmdance with Comm 85. Wis. Adm. Code Attach c«npwe site plan on paper not less than 81/2 x 11 incties in size. Plant must County S inducts. but not Crruled vertical and hanzontat reference point (BM), direction and percent slope. scale or dmumnions, north arrow, and location and distance to nearest read. Parcel l Q. 03 2 • - 76 - evo Z Please print all RevterNed tYy, P-Ond id&n-bM y«, pwide mry umd . s is os tA+)t• / N ~~iVSCJ Propei`Y°" nf:r 2003 GovL Lot AIA) 1/4 5f- 1/4 S T30 N R `4 1 &4w) W Property Owner s Nogg Address lot # 8lric # Subd: Name or CSKW 52 (55 - 4+ ST. CROIX COUNTY A/dpuI A_ IV Cky `~M E R $ i; T -State S cope ~ y 7 s y~ ~ ° ~ ° Village N~®1 [Town /T" Nearest ~ /~{-V-e- . AV/ yd ) oMER SE T New Cor Wucrion tee: Residen6ai / Number of bedrooms 3 - Code derived design flow rate 5'O ❑ Replacement ❑ PuWc or comet rrdal - Desire, GPQ Parent material _ AI V 41/7- LGir kf,. f=lood Plain elevation if appGcabte _ W1 11. .General oortrrtents arid recommeridations: 4A) f e ,OVIUD OV U Ulu 770,t..;4 L Imo. O . -T. S . Boft P/1 # 0,1 > Pit Ground surface elev. it. Depflt to 6mi ft factor ~ in. S(A Applicalim Rate Horizon Depth Don*mtt Cokx RedoxDescription Texture Structure Consistence Boundary Roots GPD/ff in. Muntsell Qu. Sz. cont. COW Gr. ft IC 'El l1 '£ff#2 / o-& io R 31511- 21f She /m / 4J 3 . 5 . Y - ra /o YR 1116 51- If M l?- /Z3 0.17 7-5 ,o LS i/M /10 Y/e /2 56 0 > Yo R -Pit Grand surface elet ft Qe0h 1o ntg factor in. Sofl Rate Horizon Depth Dominant Redox Description Texture structure Consisferxe Botatdary Roots GPM In. Allunsell Qu. Sz Coat Color Gr. Sz Sh. 'EM 'EIM / 0-5 /o y2 313 L / s6) E f -k,, 6f w ~f . I( . c 2. 543 /o Y12 Y1, q L', 17-_15W 4" f2 CS /76- y 61 S/ C / y 4 3 75 W G .7 Z 5 39. q1 o 97 s ' Elifuentt #1= SW, 2-,30 < MD rm& and TSS >30:5 150 mgr. - Mxw& #Z = eoo j .W aW_ wd-M < 30 mgr. csT T?o -uLBFiC-4T .27- Co 3 '7 5; Dale Evatualion Condtxted Telephone Number ' /!/tw• /3 - aoo 3 7~S•77a • 3Y~2 Private Sewage Consultants 2812 1 Oth Ave. Spring Valley, WI 54767 t - f: , L.. 0 f t1 Parod 9) s~C ~~ws®ti 03a- ~~s~• 70• 01~e' Pam 3 &)MK- > SIM R Texwm struett" consmw" Homey Roots wM 2 • / /G 5z- f .4 pt GrotmdswIawetev. it. Depth to &-Mwv f Kkx In. - soy ~ t on Depth DW& OM&Md Redox 0eser"m Tex" SkfMve COMWOxM t3udary anal:-GPM tbs. SF. Cara. Cdw car. s=, sh. -t -Ew El 00 opmuft G"Mawedev. A. owl tK*jr- in. Rat t•tort wr; O Dofftwit Redwc [Jss rt_ Texk" Cbnstderree 8cxadary €aaras G-Ppff Ir Munses Qu. Sr- Oont. Cokx Gt. ~z SYt. -owl -am .,z A { 4 F-I pit Raft# t nourtdsta eetev ft Depth 6 fac%r in Sol Appkafpn Rat Hort wn Dep1h Dm WnraM Color c TothAM Structure CwAbhnw t +ctecy Rests GP[DO kL LAUFMA Qu. SL Cdor Gr. Sz. Sk 'Eff#2 OEM " EMuer8 #f = BODt> 30 <22D vioL 8rrd TW >30:5 150 MWL " EPAwnt #2 = BODs < 30 trKA and'SSS a 30 MWL The Deprftwrat of Commeree is an equal opportunity spice provider and employer. If you nwd assistance to access servtees or E7`Y 6tf8-264-8773. need sttatetial in an alternaw fotgnA please contact the department at Eft-26&315# or seeanorca+nat i . + s cAsT L>oT" Ll ivy 5CAt E: / jr! 30 . qPP ~o„~ D • ~ r LoT Lh~ s~ c r t/0 ~o 16 Ian V, 4 z -ro p eF 4f 0, 0 M p", sPEw sF,T, ~ + , I , 61o 7 ~-b For issuance of permits and designing Contact: Ulbncht & Associates Registered private wastewater consultant and plumbers 2812 10th Ave. Spring Valley, Wl 54767 715-772-3442 6 5 a„ kQl00, 33 Lot 2 3 , 0 t • J'~ j~jQ 1 i `s r `s `5 ~ `fi`r ' _ _ ~ ~iVIT~] f~ s= ® •e z tt^s L3 ~r . j ~^41 w c • m '4EL:954.9' ' E ` g, oint Driv wa a nt - • for Lots 4 an s E u ? Gonti uouS ) r•» t•"~ ~s 12.46 ! Buildable ores. a CL:953` • EL:983.0' EL: 964.5' I e •-e LOT 5 19 16' 5.564 Acres or 242,368 Sq. Ft EL:951 a''(C1:9sx. N r y 1 u us • ;e tour m~iab t~a61e S'ructur o u, 3 ti U) lcres Ficod Proof Elr vatiot; 858. F ,ww ,.3 y ,.~s•••~ 51~ E.1:956.5' ~ r rv ti / ~ O ~ r ll e '4,r ,,•s'. 10 Sq. Ft. ` BENCHMARK s nc g Fop f kan P Elevation B.05 g$` ' e • ti . % ~iruct Ya .e... EL: 958.2' E1:959.8' _,i `~S ,d•'•+w GL:958.3' tz 01, q1'~ ~ 6.640 Acres o~ Sq. Ft. + - 2 'T_. XEL:974.9' '0 'r+uresut~ liA4#able ~ Q f X EFop f"levation =Iron 959Pipe.89' 2,48 Conti ous EL:978 2~ "x1:950.6 •r 1 Buildable eras , . w JIU tiro \ 'E1: . r«. ? rt ~ EL:976.8' X e~ ~ EL'943.4' S n} Q . ~r ~ - a +~y EL:941.6' ~ 1 ~ • .;yEL:9s6.T •1R } ~r VIL:941.