HomeMy WebLinkAbout020-1404-10-000' 1
i
I
O O O N C}
p 3
N n O Q Q N
C> .Ca c C n
O
d
ra
N J? V
CD s ? '^
c O W
v 0
CD z
CD O
CD
0
N CD
I c
a
z
o z rr3- 0
(D
N ~
( Z
O
v 0
0 3 CD
D
C
(D
W (D
Q
Z m
O_
N
M
9
O
I
f m m N n
CD c rn o =:
d _
D) CAD A z
(D .0 m O
CD (D <D
N
X U) O
N r m
N C
O
I � (D 3
I - m
�0 0m
(nno Q
Z
(a C 7
F N N 0)
CD
N m 0
m m
0
O
CD
(D
O 0
O n
0
o
ai
d
O
3
c
- 0 n
d o
7
DOf
#
CD
M
O
W
CL
'. CL
N p
A
N
7
p
p O
O
O
A
CA �
O
�
N
3
N p
3
N
n
O
O
N
d r j
C. W
w '
c Cp
m
_ 0
N 7c'
7
N N
O O m
w W
m
a
w
N Cl) co 0
M v v
m
CD
3
M
D M 7
N �
O (p
y
y
(n C
N N
7 (D
CL a
N _
a 7
(O
O
C
C
CL
W m
a
0 3
o
3
�? z
CD
A
T
C
C.
y O CO)
m
o �
CL
(D
0
C.
U)
i
-4 N
�i Z O
C) 3
N
Z
z
A .Z1
A
I
I
I
I
I
m w O
p O 7 N y
N G o�
ro
3
I �
cn Z D
m �o D •'
I � o. W
3 O
CL Fp
o
I
I
0
_0
3
c ?
M
N
C
CL
Z
O
ah
y Q
° m I �
o m
I � C
W � N
a
Z Q 7
3 in
I � m
0
I > >
C
CL
I w
U3
m
I �
1
I
o a
ry
a
I r.
0
I H �
07
n 0
I - �
S
I x
CD
C
I <
N
I
A
I m
I
I
O
N
� 2
o s
O . `
c � ?
W
O A �
O CL
A Ul
c
a
Z,
N N
O O
W W
T v - 0
000
a
y C
• m o
fT
C 2 Z
D 0
0
y
y
C
W N
i s
(O
C
CL
W T
0 W
a
° O
m
A
C
7
CL
3 m o
� c
d � �
G Q N N
CO -+
O O
s W �
7 Y O
•, D b
? o
v
0 O C
C
CD
o �
n
3
pl
A z W
A m 7
m N w
m
Z
M
i.
d
�n
o
A7
O
a
A
fi
A
ti
rA
N
O
O
i
A
H
Oq ti
f0
I
I
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
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
Midwest Construction Hudson Townshi
:ST BM Elev: Insp. BM Elev: BM Description:
qS,.q c Z - -�► 1 t�
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
w 5 _
( Z GV
Dosing
i
System Head
Aeration
Forcemain
L th
Holding
Dist. to well
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
i
System Head
/
zd
Forcemain
L th
Dosing
Dist. to well
Aeration
Holding
SETBACK
SYSTEM TO
P/L
PUMP /SIPHON INFORMATION
Manufactur r
Width t
Demand
Model Numb
xx Mulched
TDH
Lift
Fn oss
System Head
TDH Ft
Forcemain
L th
Dia.
Dist. to well
ELEVATION DATA
County: St. Croix
Sanitary Permit No: 430004 0
State Plan ID No:
Parcel Tax No: ow-
020
Section/Town/Range/Map No:
29.29.19-3&4A—
r
ti.
SOIL ABSORPTION SYSTEM (2-4) i c
BED/TRENCH
Width t
gth
No. Of Trenches
xx Mulched
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
DIMENSIONS
Z
3
SETBACK
SYSTEM TO
P/L
JBLDG
IWELL
LAKE /STREAM
LEACHING
Manufa,t rer.
INFORMATION
CHAMBER OR
Q
UNIT
Type Of System:
M /
�_.
Model Number: 1 2 11
J'
(0
DISTRIBUTION SYSTEM (to 64i_P1 .)
Header /Manifold
Distribution x Hole Size
Hole Spaci
Vent to Air Intake
xx Mulched
Pipes
'
Bed/Trench Edges
t
7 90
Length Dia
Length Dia Spa
SOIL COVER x Pressure Svstems Only xx Mound Or At - Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded /Sodded
xx Mulched
Bed/Trench Center
Bed/Trench Edges
Topsoil
Yes g No
Yes No
CnZo {jl S :�Insa uco iscrepenci �sl sent, etc. awl 6 S 7
Lo43 Jack P ine Drive Hudsbn, WI 54016 (NE 1/4 SW 1/4 29 T2
1.) Alt BM Description =
2.) Bldg sewer length
- amount of cover
Plan evislon qulred? Yes No , Zp ?At
Use of r side for diti apn I information
ection #1: . l 03 Inspection #2: - —
W d gods Lot 10 1 / .334A
. �• �`+� �l � S'b 1 O. i0a = g `f'• boo �
04
Cart. No.
M
Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162
County
C PO I
iscons
Madison, WI 53707 — 7162
Sanitary Permit Number (to be tilled in by Co )
Department of Commerce
(608) 266 -3151
c. 3
Sanitary Permit Application
State Plan I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal infor vet nrnvf ±n-
Project Address (if different than mailing address)
may be used for secondary purposes Privacy w, s15 N j(n ��
E CG �°
evr
I. Application Information — Please Print All Information
' UO3
Property Owner's Na me
Parcel N Lot H Block N
ND (f 0JV5 -� ,1 <<� ���� �
I.
oz.0 -/cV
Property Owner's M ailing Address W:
Property Location
0 w
) C — 'J "y ' /a,Sectiou
City, St e
Zip Code
Phone Number
(circle one)
T N; It�B 0(2:)
II. Type Building
of (check all that apply)
Subdivision Name Comber
1 or 2 Family Dwelling - Number of Bedrooms
❑ Public /Conunercial - Describe Use
L rl C- t A- C, 10 JD�
❑ State Owned - Describe Use i
❑City []Village%'�l'ownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
New System �.. y'
❑ Replacement System
❑ Treaunent/Holding Tank Replacement Only
❑Oilier Modification to Existing System
B.
❑ Permit Rene Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
a ✓Ob -Z7-
W.
-.�-
Type of POWTS System: (Check all th apply)
AA
K Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter
❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filte
❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain
V. Dis ersal /Treatment Area Information: s O 'R
Desi n Flow ( pd) Design Soil Applic riot Rate(gpdsf) Dispersal Area Re (so Dispersal Area Proposed System Elevation J
9 s
O 30 �`� 1 rt� '{"r 2S'g S
T
.
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site reel Fiber Plastic
Gallons Gallons of Units
Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Ilold[ng 'I'at>,l•
Aerobic'heaunent Unit
Dosing Chamber
_
-L _
VII. Responsibility Statement- I, the undersigned-, assume . esponsibility for installation of the POWTS shown on the attached plans.
Plumber's Na me (Print) - 's
1 Plwnbe Si gnattu MP /nom Number Businesses Piione Number
tt/ Z_ 1 6
Plumber's Addre ss (Street, City, State, Zip Co
L(�� c9 87"� -� c,v 510
VIII. County/Department Use Onl
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuin / Agent Signature o Stamps)
Surcharge Fee)
El Owner Given Reason for Denial
IX. Conditions of Approval /Reasons for Disapproval
'- S <.w. ^
to xll s� s t �1.� -.te e --t —rg *-C
CJ -
&_V11 �) U
ee v+ sc e_t„ 4o tv4 : ,.c,t„ n i 94 Q +-e- a& . y csTa A J W1.9 -t w.
Attach complete plans (to th County only) fa the system on paper not less than 81/2 x 11 inclies in size
SBD -6398 (R. 01/03)
I -/ -"-kcK p ( � j 6
r l
V
�l
D (Z P kJ 6
LL
M
If 6f- ^"
walf
cy t-
L Z /
lzsro
S
k � - CtPzz,b��7
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Dj of Safety gnd Buildings
in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 8 112 x 11 inches in size County s-
. I
include, but not limited to: vertical and horizontal reference point (BM), dir Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distanc o neares oad. O Z O - u� - 1 - C) O
Please print all information Reviewed by Date
Personal information you provide maybe used for secondary purposes (Privacy Law, 15.04 (1) (m)).
Property Owner "" Irvp" Location
hE -f�Kz) � Vs
1/4 SW 1/4 S� T Z � N R �R E (or W
Property Owner's Mailing Address _ Lot #' Block # Subd. Name or CSM#
City State Zip Code P one Number
❑ City ❑Village I5q Town Nearest Road
C�R:�2l5P�1.�
MN I SS 17-8 ( .__1 � `-�LS� - IZM12 P)NN
[K New Construction Use:2 Residential / Number of bedrooms --Y_ Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material 6 \1 � LhA- O%J \ (JP --!i Flood Plain elevation if applicable ft,
General comments
and recommendations: �'j CL1.�_S tf 3 �X (, Z. S' Ut-Jl- rS OF )fv R �rZ �u2 L�ReN
t3 01' ; � M OF
Boring # [] Boring �p
® Pit Ground surface elev. S ft. Depth to limiting factor 7 -1 1 in.
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
v.. r.yNuwuvu �a c
GPD /ft
'Eff #1
'Eff #2
o \z
s Lt Q Z.!5
-
` h 1 s
� s �
m 1
c, �
��
--�
�_ , z
Z
S - 1
-S Lar
—
S
0 ac)
yv
Cw
--
-
Z
3
y�
to - L/
J
a t - 5V
? -.
I
Boring # LI Boring 2- 12 Pit Ground surface elev. ft. Depth to limiting factor in.
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft
'Eff#1
'Eff#2
-S
Is
L
\j:� sbk
�nv�-
�s
1�
. 4
S - 1
I S4 R- VA
—
S
0 ac)
yv
Cw
--
-
Z
3
y�
to - L/
cnwon► n I = ovU - oU uu mgrL ano I s5 >3U _< 1 OU mg/L - emuent vz = Bvu < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Sig tore 3 _ 1 Z� CST Number 4
Arthur L Wegerer 220254
Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number
421 N. Main St. River Falls (dI 5 40 22 715 -425 -0165
Property Owner y Parcel ID # U zo C) —00 0
pnna
Z r,r 3
r
Z Boring # ❑ Boring C
® Pit Ground surface elev. ` 3 ft. Depth to limiting factor ;� C t Z 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
. Depth
in. -
C)-)
.3LiP - Z 34
-
L
-�:- -; k
m v��
Ckv
1-
. S
- e
Z
)q 3
`1 .3 `12 3I y
--
S
� 0-S Z
h1 V
CW
—
y
. 6
3
3Ll So
- ,s -j 2`/Ii,
_
S
U s3
1
Cw
,
1, - e
Ll
log 2 sal
70.
cc� S
30
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Horizon"
. Depth
in. -
Dominant Color
Munsell
Redox Description
Qu. Sz:" Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
,7v11 r,�JFrlll:d llUll RdlFr
GPD /ft
'Eff#1
'Eff#2
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
r
r
Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 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.6/00)
PLOT PLAN Pace 3 of
Scale
Wi
J
i.
r
X13 X52 P1�1 b Z.
f �
J
3
V
I�
z
ZD
J
ZS - o3 715- 425 -0165 220254
CST Signature Date Telephone LTo. CST No. Job NO.
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building pivisign
r INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name:
Midwest Construction
City Village X Township
I Hudson Townshi
CST BM Elev:
Insp. BM Elev:
BM Description:
TANK INFORMATI
MANUFACTURER
C
ing
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Friction Loss
System Head
TDH Ft
Forcemain
Length
Dosing
Dist. to Well
29.29.19.
Aeration
SYSTEM TO
P/L
JBLDG
IWELL
LAKE /STREAM
Holding
Manufacturer:
INFORMATION
PUMP /SIPHON INFORMATION
Manufacturer
St. Cr oix
Demand
GPM
Model Number
Vent to Air Intake
TDH
Lift
Friction Loss
System Head
TDH Ft
Forcemain
Length
Dia.
Dist. to Well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County:
St. Cr oix
Sanitary Permit No:
No. Of Trenches
Vent to Air Intake
430004 0
State Plan ID No:
Inside Dia.
Parcel Tax No:
DIMENSIONS
Length Dia
020 - 1083 -10 -000
Section/Town /Range /Map No:
29.29.19.
STATION BS HI FS ELEV.
Benchmark
Alt. BM
Bldg. Sewer
St/Ht Inlet
St/Ht Outlet
Dt Inlet
Dt Bottom
Header /Man.
Dist. Pipe
Bot. System
Final Grade
St Cover
BEDITRENCH
Width
Length
No. Of Trenches
Vent to Air Intake
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
DIMENSIONS
Length Dia
Length Dia Spacing
SETBACK
SYSTEM TO
P/L
JBLDG
IWELL
LAKE /STREAM
LEACHING
Manufacturer:
INFORMATION
CHAMBER OR
UNIT
Type Of System:
Model Number:
DISTRIBUTION SYSTEM
Header /Manifold
Distribution
x Hole Size
x Hole Spacing
Vent to Air Intake
Bed/Trench Center
Pipe(s)
Topsoil
Yes [� No
n Yes No
Length Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At - Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded /Sodded
xx Mulched
Bed/Trench Center
Bed/Trench Edges
Topsoil
Yes [� No
n Yes No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 433 Jack Pine Drive Hudson, WI 54016 (NE 1/4 SW 1/4 29 T29N R19W) Walden Woods Lot 10 Parcel No: 29.29.19.
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan Use other side additional Required? ' Yes L] No 1 EL information. ;
SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No.
-3 � ? h tom ete la ( he t t only) fort syslept gn pajter�ot less h t S1/2 x ll�te i
SBD -6398 (R. 01/03) 0 �J } / GG�L UUU
Safety and Buil ngs Division
County
�_
Im. 201 W. Washington Ave., P.O. Box 7162
ifSeonsin Madison, WI 53707 - 7162
Department of Commerce (608) 266 -3151
Salutary /Permit Number (to b. filled to by Co.)
11 3000 —_
Sanitary Permit Applica _
State Plan I.D. Number
In accord with Cotton 83.21, Wis. Adm. Cod , ers= rovid e may be used for
J mP
�
Address
secondary purposes rivac
Project (if cf rt than mai:in address)
I. Application Information - Please Print All Info at' 1 9 2003
F33 � C _ OR -
ro Owner's Na me
ST. CROIX COON fY
Parcel # O _ /aQ�Lot #�� Block #
%
P� ZONING OFFICE
_ / Oea —
Pro rty M ailing Address
ovatio
h Owner's
IL 4)
/n` J
4pe k, U,Section �
City, e Zip Code Phone Number
`
Ark ✓
(circle
T o�
N ' R
H. Type of B that apply)
—� — -1;
�1 or 2 Familer of Bedrooms
Subdivision Name CSM Nu r
\Ichec
❑ Public /Comse
L( fl � w El
State Owned / /� olvG�� —
❑City_ ❑Villageownship of
III. Type of Permit: eckNO& one box on line A. Complete line B if app ble)
A. New System y ❑ Repla nt System Treatment/Holding Ta eplacement Only
❑Other Modification to ExistingSy n
B. ❑ Permit Renewal ❑ Permit Revisio ❑ Change of ermit Transfer to
w t Previous Permit&tmb nd Da •sued
Before Expiration Plumber wner
IV. Type of POWTS System: (Check all that a
X Non - Pressurized In- Ground ❑ Mound > 24 in. of sut e soi El Mound < 24 t able soil El d i igle Pass i
El constructed Wetland El Pressurized In- Ground El Holdi ank ❑ Peat Filter El erobic
Trea U _ R circ datin t : r
El Recirculating Synthetic Media Filter ❑ Leaching Chambe ip Line ❑ Gr vel -less Pipe
❑ Othe i
V. Dispersal/Treatment Area Information:
Desi n Fllo ((gpd) Design Soil Applicatio dst) Dispersal Are lire (s ispersal
Area Proposed (st System Eievatio,� jdv,
VI. Tank Info Capacity in ToC Number ai u rer
Gallons Gallon
Prefab Site Steel Fit
of Units „ /
Concrete Constructed G14 o
/
New Existing W
Tanks Tanks
Septic or Holding Tank ap
Aerobic Treatment Unit `��
— - - -- - -- --
Dosing Chamber
- — — - -, —
VII. Responsibility Statement I, undersigned, asswne respot ibility for installation of the POWTS - ho n the a p.
lumber's Na me (Print) Plumber's Si gnature MP/MM Number
Busine,:: Phone Nur.ibei
Plumber's Addre ss (Street, City fate, Zip Co
(-0/ col
VI 1Y County/DepartrrjFt Use Only
- - - -- —
Approved
❑ Disapproved
Sanitary Permit Fef (includes Groundwater
Surcharge Fee)
D• sue ssuinl;, Age Signi::ure o tam )
❑ Owner Given Reason for Denial
��// l/�
d
IX. Conditions of Approva Reasons for Disapproval 3 4 -
6 _6 - C� 0 <<f -5 c�c ir,
JYe,0UUJ_.A 1, Ita- -nZ,(,J (AY ; �ourr3 Aaf, . 6
- �� N • � .sue �-
Zy
#�,_
77P
,. f,
4 F
N
I
Sp
Zd ,
i ,L
AA
f $2.
l A � `-- `s' /N tip �-• �C�
O%
/DO
fo
6y
.10
R
f
v
COPY
0
T--� `t sc6y-)l`
S�
At _ _�3
Ol,e6U ir'� C�P (\.) -- 1(-
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Tnhla I - SvQfpm nASian Specifications
Sanitary Permit Number
Septic Tank Component
Number of Bedrooms
Design Flow - Peak (gpd)
Design Flow - Peak (gpd)
Inspect once every 3 years
Estimated Flow - Average (gpd)
D v
Septic Tank Capacity (gal)
a
Soil Absorption Component Size (ft')
220
Type of Wastewater
Domestic
150
Tnhip 2- Steil Absorption Component - Limits of Reliable Operation
- r -
Septic Tank Component
Soil Absorption Component
Design Flow - Peak (gpd)
Soil Absorption Component
Inspect once every 3 years
Maximum Influent Particle Size (in)
1/8
Maximum BOD (mg /L)
220
Maximum TSS (mg /L)
150
Septic Tank
Inspect and /or service once every 3 years
Outlet Filter
Inspect once a year and clean at least once every years
Soil Absorption Component
Inspect once every 3 years
Table 3: Mai ntenance Schedule
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
ad
LU
m
u m
o
JI
LL
Z
Q
� Q
W
U �
ch
z
0
m
�s
n
N
D
t
C
E
a
G
a
D
0
_J
LL
.L
� 1?J3zN1 "�
n
^^
Q Q
s
U
x
m
0
Na
Ln
�
0
x
N
M
CD
Y--
C
L
,v)
�
Z
E
0
C
t
C
E
a
G
a
D
0
_J
LL
.L
� 1?J3zN1 "�
1475
Wisconsin Department of Commerce SOIL EVALUAT 1 RT P age 1 of 3
Division of Safety and Buildings in accordance with Comm �,+ A.C.E. Sal & Site Evaluations
Attach complete site plan on paper not less than 8'/: x 11 inches in size. st St. Croix _
include, but not limited to: vertical and horizontal reference pant (BM), and Parce(,a.
percent slope, scale or dimemsions, north arrow, and location and dis nearest'` pj_ 08 - -000, ID #29.29.19.3340
Please print all information. pi L �
Personal information you provide may be used for secondary purposes (P 15,040).j
Property Owner Property L ,
Midwest Const. &Development O Hudson„ INC. _ 1;o Lot SW 1/4 S 29 T 29 N R 19 W
Property Owner's Mailing Address , Btor t k Name or CSM►�
P.O. Box 932 _ 't0 _ Plat Of Walden Woods
City State Zip Code Phone Number _j City I Village 0 Town Nearest Reed
Hudson WI 1 54016 715 - 760 -1149 Hudson Glenna Drive
JIM New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flaw rate 600 GPD
. Replacement ,I Public or commercial - Describe:
Parent material Glacial outwash Flood plain elevation, if applicable na
General comments
and recommendations: Install 2 trenches using 29 high capacity infiltrator chambers five feet below grade at elev. = 100.0' & 99.0' on
105.0'& 104.0' contours. G�tu
Boring # Boring
11A Pit Ground Surface elev. 105.14 ft. Death to limkinq factor > 104" in. Sal Application Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD/ft
"Eff#2
1
0 -18
1Oyr3/2
none
sl
2 fs bk
ds
cs
2fmc
0.5
0.9
2
18 -30
1Oyr3 /4
none
sl
2msbk
ds
aw
2f,1mc
Z0.4
0.9
3
30 -54
Oyr4 /4
none
gr Ifs
1 msbk
ds
aw
1 fm
0.4
0.6
4
54-80
10yr5 /4
none
grs
Osg
dl
gs
1I'm
0.7
1.2
5
80 -104
1 Oyr6 /4
none
grs
Osg
dl
-
-
0.7
1.2
o�C� W
L
/
j_
r ��
� Horizons #3, 4, & 5 contain oximately 5 - 10% gravel & cobbles.
1,9 L le Y
# AM Boring Sal >93" in.
AM Pit Ground Surface elev. 101.55 ft. Depth to limitinc] factor Soil Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD/ft
"Eff#1
*Eff#2
1
0 -23
1Oyr3 /2
none
sl
2fsbk
ds
cs
2fmc
0.5
0.9
2
23 -30
1Oyr3/4
none
Is
1ms
ds
aw
2f,1mc
0.7
1.2
3
30 -58
1Oyr4/4
none
Ifs
1msbk
ds
aw
1fm
0.4
0.6
4
58 -86
1Oyr5/4
none
s
Osg
cil
gs
1fm
0.7
1.2
5
86 -93
1Oy /4
none
s
Osg
dl
-
-
0.7
1.2
o�C� W
iCiC O
/
j_
r ��
Effluent #1 = BOD ? 30 < 220 mg/L and TSS f3O < 50 mg/L t #2 = OD 30 mg/L and TSS <30 mg/L
'ST Name (Please Print) Sig ure: CST Number
James K. Thompson 3602
Wdress A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane Osceola WI 540 9/15/01 715- 248 -7767
a
tip' S �NF��f
-
L \ ��
il
property Owner ' Midwest Const. & Development Parcel ID # 020 - 1083 -30 -000 ID# Page 2 of 3
I - I Bori # im B oring
t Ground Surface elev. 101.9 ft. Depth to liming factor >94" in. Soil Application Rate
�LJ. L
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Rood
*Eff#1 *Eii#2
1
0 -19
1Oyr3/2
none
sl
2fsbk
ds
cs
2fmc
0.5
0.9
2
19 -28
1 Oyr3 /4
none
Is
1 msbk
ds
aw
2f,1 me
0.7
1.2
3
28 -50
1Oyr4/4
none
Ifs
1msbk
ds
aw
1fm
0.4
0.6
4
50-62
Oyr4 /6
non
Ifs
1ms
d l
gs
1 f
0.4
0.6
5
62 -94
1 Oyr5 /
none
s
Osg
_ dl -
-__
dl
0.7
1_2
0.7
1.2
IV
Horizon #4 contains apprcudmately 20% gravel & cobbles.
yt� ado
F v v I Borinn (J U
Pit y Ground Surface elev. 100.85 ft. Depth to limiting factor >86" in.
Soil Application Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
*Eff#1 *Eff#2
1
0 -27
1Oyr3/2
none
sl
2fsbk
ds
cs
2fmc
0.5
0.9
2
27 -36
1 Oyr4 /2
none
Is
1 msbk
ds
aw
2f,1 me
0.7
1.2
3
36-60
yr4 /4
none
Ifs
1 msbk
ds
aw
1 fm
0.4
0.6
4
6 72
1Oyr4 /6
none
grs
Osg
dl
gs
1 f
0.7
1.2
5
72 -86
1 Oyr5 /4
none
grs
Osg
dl
-
-
0.7
1.2
IV
Horizon #4 contains apprcudmately 20% gravel & cobbles.
Horizons #4, & 5 contain approximately 30% gravel & cobbles.
U
F 5-1 Boring # 4M Bonng
Pit Ground Surface elev. 105.62 ft. Depth to limiting factor > 108" in. Soil Application Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
_ GPD /ft:
*Eff#1 *Eff4Q
1
0 -11
1Oyr3/2
none
sl
2fsbk
ds
cs
2fmc
0.5
0.9
2
11 -26
1Oyr3/4
none
grsl
2msbk
ds
aw
2f,1mc
0.5
0.9
3
26 -56
1Oyr5/4
none
s
Osg
cil
aw
1fm
0.7
1.2
4
56 -70
1Oyr5 /4
none
grs
Osg
dl
gs
1f
0.7
1.2
5
70 -108
1Oyr6/4
none
s
Osg
dl
-
-
0.7
1.2
IV
Horizon #4 contains apprcudmately 20% gravel & cobbles.
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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.
/ an.0
��Ia ce 1 Iii ✓c
■ 50; I e✓al u&6 , e , -)
P'&
/d, (J,4 56. ceozk
1oz .D
ez
w�
W
v
B-?
8r
t �
`
■
cr
/(a; !i Oc - ce.
Assu , mc.d B /i _ /ca o9;
01.36
P.3 a {3
/�o
STATE B? 0 0r- WIQ E 05a - 1998
Document Number I WARP—AMY
This Deed, made between JoAnn E Neuharth and Betty M. Evlen
Grantor, and Midwest Construction and Development of Hudson Inc. a
Wisconsin Corporation, Grantee.
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin
(the "Property"):
654704
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
08-24 -2001 12:30 PM
WARRANTY DEED
EXEMPT it
CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 1800.00
RECORDING FEE: 10.00
PAGES: 1
Recording Area
NE 1/4 of SW 1/4 and the North 66 feet of South 495 feet of the NW 114 of
SW 1/4, ALL in Section 29, Township 29 North, Range 19 West, St. Croix
County, Wisconsin, EXCEPT the South 429 feet of West 203 feet of said
NE 114 of SW 1/4 and EXCEPT part described in Vol. 461, Page 421,
Doc. No. 300625 and EXCEPT part described in Vol. 477, Page 588, Doc.
No. 307501.
N and Return Address
dw Construction and Development of
H n, Inc.
17 industrial Blvd
n WI 54016
020.1083- 10.000 and 020 -1083- 50-000
Parcel identification Number (PIN)
This is not homestead property.
(is) (is tat)
SUBJECT TO the rights of ingress and egress for an access roadway as described in Vol. 461, Page 421, Doc. No. 300625 and
in Vol. 477, Page 588, Doc. No. 307501.
Together with all appurtenant rights, title and interests.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
easement and restrictions of record.
Dated this 23' day of An" 2001.
AUTHENTICATION
THIS INSTRUMENT WAS DRAFTED BY
_William J. Radosevich, Attorney at Law
Second Street Hudson WI 54016
(Signatures may be authenticated or acknowledged. Both are not necessary.)
J__oAnn Neuharth
e:r
• BettyA . Evjen /Z'
ACKNOWLEDGMENT
STATE OF WISCONSIN )
) ss.
St. Croix County )
Personally came before me this 23' day of
Aut?!ust , 2001 the above named
JoAnn Neubart h and Betty M. Evlen
to me Mown to be the person(s) who executed the foregoing
instrume d l edged the same.
Notary Public, State of Wisconsin
My ommislion is pe t. (If not, state a rati date:
of persons signing in any capacity must be typed or printed below their si Information Professionals Co., Fond do Lu. WI
STATE BAR OF WISCONSIN 800455.2021
WARRANTY DEED FORM No. 1.1491
TITLE: MEMBER STATE BAR OF
(If not,
authorized by §706.06, Wis. Stats.)