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HomeMy WebLinkAbout016-1077-70-100 ;cousin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix rely and Building Division INSPECTION REPORT Sanitary Permit No: 483978 0 3ENERAL INFORMATION (ATTACH TO PERMIT State Plan ID No: Personal information you prpvide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Stodola & Clark, Josh & Kelly Glenwood, Town of 04 - ril -1O -1 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: /OCR id / 6 5Y 35.30.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER g..A, f CAPACITY STATION B HI FS ELEV. /a3.9 ✓� Septic 'Sri. O Benchmark go J F•I 4.., z v_ � t- 3 /a2.5 /CO rinsin Alt. BM F'/a - k.. ee 5� t� ( <.( 660.,..A_, 3 .1 /00 , z Aeration Bldg. Sewer (s % ) 5 7. 7 Holding '.� -- St/Ht Inlet (p.1) c 7./ TANK SETBACK INFORMATION St/Ht Outlet 7.05 TANK TO / WELL BLDG. Vent to Air Intake ROAD Dt Inlet , ov t v.. 4+-z- 514 Septic 6 7 g / 146 41 �(. Dt Bottom , ■ Dosing , , 4 95.9 Aeration Dist. Pipe ‘ 6 ° ..i 79 5 ...1 Holding Q. _____-- Bot. System r1 •/, $ �-'I� � 75 59 -9 PUMP/SIPHON INFORMATION Final Grade 7� 3.3 c i , Manufacturer Demand St Cover GPM ` i 60 .}c -r;_ 3. 7 /ix), 2____, Model Number TDH (Lift Friction Loss r. ad TDH Ft C ---"--------------------"-------__._.-------"-- j - Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width I Length / INo. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 / 6 A S . �_ ` ---__ I SETBACK SYSTEM TO � P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION / ■ CHAMBER OR TA . � • • l04- is.�-/�� Type Of System: / GOJ\0e "► n /(p 4-715 (0 UNIT Model Number: ©u: c,1 4 (, DISTRIBUTION SYSTEM A.J3.1„ 61%,e-A) / 5 f i 5 z 36 4 Header /Manifold /1 Distribution x Hole Size x Hole Spacing Vent to A Intake Pipe(s) %---_. �_ En di c Length 7 Dia 4 Length Dia Spacing 77e., el."- SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only ak (4ea.1s --,„ Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges ■ Topsoil i Yes 0 No es hi No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1221 Rustic Rd #3 Glenwood City, WI 54013 (SW 1/4 SW 1/4 35 T3ON R15W) NA Lot 2 Parcel No: 35.30.15. p F y / �,�,, . d---. L 1 Ctrd 1.) Alt BM Description = I,� dO owS 2.) Bldg sewer length = /4j 0t a.A- /�a r4-1._ - '< - amount of cover = i/ G LE P4— � - Fr. - /l.. e .0 6C E-62.0.- J Plan revision Required? C3 Yes No 0,.. (.,.5,3411.7.5 Use other side for additional information. Z $ /6 VINFAFt• j SBD -6710 (R.3/97) Date Ins- •. oes Sign. 're Cert. No. r commerce.wi.gav S afety and Buildings Division County n f 201 W. Washington Ave., P.O. Box 7162 �� ( r e I ttisconsin Madison, WI 53707-7162 Sanitary Permit . Number (to be t l in by Co.) ' L I L T Department of Commerce State Transaction Number Sanitary Permit Application In accordance with s. Comm. 83.21(2), Wis. Adm. 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 Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide ma be u� sed fo u + +ses in accordance with the Privac Law, s. 15.1' 1 m , Stets. In r a �+ �1 h� I'� i F 2. 2. ‘ I. Application Informs ion - lease Print All Informati Parcel ' r.....4„.„14._ �� ` .f: 01.--" Property Owner's Name O� VVVV • a I i 3 Ili / p Location d• arrr�ra� -- RW /# Property Owner's M;'f ng Address / ST. CROIX COUN L _ L t . l Zip Code Phone , . " ...or '/<, d ' /•, Section C ity, / i _ State ^� ,+� le o L .. l l ' _ Li) 1 A i( 3 Tl __ s'_ N ' R '/ E ` % II. ype Building (check ) L ot # t apply) Subdivision Name 2 Family Dwelling - Number ofBedrooms — ` ' %,,`_ Block ' ❑ Public/Commercial - Describe Use / - ❑ City of CSM Number Awn of of /� / 0 State Owned -- Describe Use �� ' own of (? lew CA. 0 at, III. Type of Permit (Check onb, one box on line A. Complete line B if applicable) ❑ T reatment/Holdin Tank Replacement Only 11 Other Modification to Existing System-(explain) Aw System _ ❑Replacement System g List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber 0 Permit Transfer to Ncw r'; ��� Owner Before Expiration h c IV. 1, . e of POWTS S stem /Com . onentiDevice: Check all that a' 41 II ❑ Mo > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil r� . n- Pressurized In -Ground ❑Pressurized In- G roun d ❑ At -Grade ❑ Pretreatment Device (explain) ❑ Holding Tank ❑ Other Dispersal Component (explain) 4 NAM', I V. Dis ■ low ersaU (gp rest nt Area Information: t Dispersal Area Required (s Dispersal Area ProposeditBf! Design Flow (gpd) Design Soil Application Rate(gpds sP f 0 .0 a• Capacity in Total # of Manufacturer 0 VI. Tank Info Gallons Gallons Units /) (" t c U I k Existing Tanks 11,..ti , New Tanks Ai ItI�J' k V A 1 I w i Septic or Holding Tank f/ f t f Dosing Chamber y VII. Res s onsibility Statement - I, the undersigned, assum f /onsibility for installation of the POWTS shown n o the a C Business Phone Number Plumb ' 3�;r. _ Plumb is Name (Print) I � � A /�) ' - yJ AI t 1 Plumber's Address (Street, City, tate, Zip Code y / P t /�D J 2 VII oun /De l artment Use f nl / Permit Fee Date Iss. ed Issuing/ nt Signatur J ►` ' PProved ❑ D'<appro $ APS' e>6 7 v it) - A Oft ❑ O - r Given Reason for Denial IX. Condit'tisitAgyfygMeasons for Disapproval 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained in pyir appartlai rode / 1lnapr4s r not less than 8 112 x 11 inches In size Attach to complete plans for the system and submit to the County only on paper (R. 01 /07) Valid thru 01/09 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 9/6/10 Owner: Kelly Stodala Location:SW1 /4 SW1 /4 S35 T30 N,R18W Lot 2 Rustic Road #3 Glenwood System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4 -5. Maintanance and Contingency Plan 6. Filter Specifications Sheet Signature License ber #226900 r • PLOT PLAN PROJECT KeIIv Stodala ADDRESS 1223 Rustic Road #3 Glenwood City Wi 54013 SW 1/4 SW 1/4S 35 /T 30 N/R 15 W TOWN Glenwood COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 9/6/10 BEDROOM 2 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 800 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 611 # of chambers 30 ■ BENCHMARK V.R.P. Top of Concrete slab ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL * H.R.P. Same as Benchmark SYSTEM ELEVATION 97.1/96.9 2.8' below grade Plans Designed Using Conventional Powts Manual Version 2.0 Well is to meet all A setbacks required b q by Vent WDNR Rustic Road #3 >6" Quick4 Standard -W Leaching Chamber of Cover with 20.0 ft2 of Area 5.8ft ^2 /pair of end caps 4' Long Grade at System Elevation Scale is 1" = 40' 34 unless otherwise noted 206' Property Line Pro 1 or 2 =_ bedroom structure B.M. % —� • 20' 45' �. G 2.8' Below grade, any deeper S ' , will require a additional B -2 20' boring dug deeper c 60' 100' 1 ■ Vents r , B -1 24' - d 2 -3' X 62' cells with >3' spacing -16' B -3 T• 30 %AT. V, 30' C()VI 600' Property Line • J PLOT PLAN PROJECT KeIIv Stodala ADDRESS 1223 Rustic Road #3 Glenwood City Wi 54013 SW 1/4 SW 1/4S 35 /T 30 N/R 15 W TOWN Glenwood COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/6/1 O BEDROOM 2 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 800 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 611 # of chambers 30 BENCHMARK V.R.P. Top of Concrete slab ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 97.1/96.9 2.8' below grade Plans Designed Using Conventional Powts • Manual Version 2.0 Well is to meet all setbacks required by ino Vent WDNR ustic Road #3 >6" Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 5.8ft ^2 /pair of end caps • 4' Long Scale is 1" = 40' Grade at System Elevation 34 unless otherwise 206' Property Line noted Pro 1 or 2 bedroom structure B.M. % 20' 45' 2.8' Below grade, any deeper S%.44 will require a additional B -2 boring dug deeper 60' 100' Vents *, B - 01- 24' 2 -3' X 62' cells with >3' spacing 30' B -3 T. ►T 30' 600' Property Line y J Cross Section of Quick 4 Standard -W Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard -W Leaching Chamber with 20.0 ft2 of Area per Chamber 5.8ft ^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 99.8 Vent Grade ► a, Vent 4'11 4" 4' X30/34 Septic Tank � Oft 4' Long 1" 5 ' 4' Long - Grade at System Elevation 3 4" Grade at System Elevation 3 4" Spacing 5' 2 - 3' X 62' Cells Same on other end Observation tubeNent 9.5' B 20 chambers per cell System elevations: A__971 B 96.9 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 ontinge cy Plan Option #1. If system fails, determine cause of failure, use alternate area and install new - N. ' tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 -246 -5148 Shaun Bird #226900 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwOwner/Buyer k e - • uyer 1 c . ; y , ,� Mailing Address 3 �_,! _ - . _ Property Address / 2 3- I 4.d `mac.. ' ' for new construction.) (Verification required from Planning & Zoning Department I City /State Parcel Identification Number 0/ 6 fo . 7 - 2 - - 2 G ' oU ' I r DE S ON / Property Location 5'c V4 ,�() 74 , Sec. 3S, T , N R /J W, Town. of 4 4 zyt, :c.; , Subdivision # � / 7 C :� , Volume ‹7 , Page 4 57/0 . Warranty Certified Survey Map f Deed # h g , Volume / 4 0, Page # 2- D 3 . Spec house yes no Lot lines ide'ab - COP no • S Y S T E ; , 0 O ' 1 CATION Proper spar use and maintenance of yam septic system could years ' re to e wastes. mahrtenance consist) three a lice sed pummpe r. What yon into the system can affect out t3te aepasc in the waste dlisposal �� Ow oOw= the aftiae septic teak as a treatment stage maintenance responsibilities are specified in §Comas. 8352(1) and in Chapter 12 - St. Croix County Sanitary Planning & Zoning Dot a cerlific�oa form, signed by the The property owner agrees to submit to St Croix County or a licensed pamper that ( the can -site owner and by a maste= p � Plambe r, restricted phmirer P (if Y)� septic tank is wastewater disposal system is in proper o on aud/ar (2) after inspection and less than 1/3 full of sludge. with the 1/we, the undmersig ed have read the above requirements s and agree to of Natural private R State o stem i - Certi on s o as set byte temp m u n st be and. returned to the St Croix County Phoning & won soling that your septic system expiration date. �g matt witma 30 days of the tree year Uwe certify that all staff on this form are nue to the best of nxy /etE knowledge. Uwe am/are the owner(s) of the property described a bove, by virtue of a warranty deed recorded in Register of Deeds Office. N � r b �. / Lis 4r �- S ATTIRE OF APPLICANT(S) • SATE „ Any informatics that is misrepresented ek Department may result in the sanitary permit being revoked by the Planning & Zoning D Include with this application.a recorded warranty deed from the Register of Deeds Office and a copy of the cerdfied survey map if reference is made in the warranty deed. ( -08 . co rn ill IIL�_ a ‘. - \10 ". ii * ( � 3 1 r v F m g ‘4i‘#p 4 a Is. r _ i Q .P 0 Y\ I VI ) ch C� 0 1., , (iiii............... \. , ` ( ,, � 1 , r .) ,,: ii, J Atfl ....., 7 .4 , ' ,, __ __� �; ,rte / N O y /r /li /� /�li �; /r�[i /r si i, fir• /i 1J w�r , �i� Lf.{ i�lirlirh�li�rli����li��li�lir�i�j ji�l,�� ". h ti r im � elvet \ F \ \ \ � \ \ � . �' _ _ AL(( ((\ I I1(i�\ • JII • I_ - f 1 t ! . I l..l_I I I velvets* 6_I'_I � ��irr�r• � . r ��rr�l T j ������ ��(\(\r\� r \(\�f i 1.� 17 '17 di . I E al t l t l a l a i 11 a � a l 1 1 � � , i � � r � �� i r.�.� � I1�ai� a ll all z 1 111i lI I ( . . � 1 I (li i l l I ■���• , o l atio•frEgii-e•-iimoormialmia.mrf.1, iji#11.011)110)1.010 t � 3 , -� V J a ' I 1 r a �� _� irit � �k �i tI ll Wit �� sI 4 :� ��' z aril lislii r iiliiiiliil ■ 0 rn - -- -a �.� o0o O it it i■ is .r it r is it it is is i■ it it rlirj 0 -I- I-I_LLi_i_LI-�.I-I - ^' a' o 0 0 tolotoixotoOgir70 1 _..„3,37._ ww®s ® r .eawr•�sw� 0 o 4i JJ i i���i� ifil �Ililillilf I { I` i I I I t i • IV 114111 till; Alul III 111 .2 • 9175E6 • BETH PAST • REGISTER OP DEEDS • ST. CROIX CO., WI RECEIVED FOR RECORD CERTIFIED SURVEY MAP 15 17/201 5 010 P PART OF THE SOUTHWEST 1 \4 OF THE SOUTHWEST 1/4, EXEMPT *:. SECTION 35. TOWNSHIP 30 NORTH. RANGE 15 WEST, R PEE: 130 #: COPY FEW 3.Q0 • TOWN OF GLENWOOCI. ST. CROIX COUNTY,WISCONSIN. • PAGES :2 West 1/4 Corner Section 35- 30 -15y V' Iron Pipe r ' O 1 _, UNPLATTED • c�3 l tai LANDS c�1 v N Iv � 1 -I • • NW Corner. • 1 S89'35'55 'E 800.20' north I'rrle of SW7SW Y ' c . o - -- 33.01' ; c 567.19' 'of SW /S w tn a , 131,144 sq.ft. . vents N ' o . o u w m 3.01 ocres 124,724 sq.f a -- 1 * :R incl. r -o -w • Z. excl. r 86 acres o N a I l = o -w' to • N w • u 33.: Q' 13 - S •E . ` 1 ✓ 57.,47 603.67' UNPLATTED j 33' 33'1 50' -c L-'�d- .c i LANDS LANDS A N Nl T 4 - 4 . she =E�, o .`N' x ! LOT 130.512 sq. . • � N w1 0; 138,948 sq.ft. 3.00 acres g+ 5 .3.19 ocres excl. r =o -w u l ' ind. r -o -w soil centerline l l vz l Y 3401' 1 567,19' ' I., l l 1 N89'35'55 "W 600.20' I g 1 P FOR: 1 a 1 UNPLATTED • Kelly Ctark . t ° r;:',6 1223 Rustic Rd 3 � • • LANDS .Glenwood City, WI 54013 1 .. NOTE: . Southwest .Corner Hatched area is a 33 foot wide ingress- egress easement -• • Section 35- 30 -15- to serve Lot 1, being the north 33 feet of Lot 2. 1 " Survey Nail. .. . . Note: Each parcel on this map is subject to State and County laws, . rules regulations (i.e. wetlands, minimum lot size, access to ...".. parcel, etc.). Before purchasing or developing any parcel, contact N . - 5t. Croix County Zoning Office and Town Board for advice. ' e'' „ ' %. . LEGEND . * 4/ 1. Found Government Corner (as noted) .. . (� w. r, o Set 3 \4” x 18" Iron Rebar weighing a i . minimum of 1.50 lbs. per lineal foot • s.... Seta "PK" Nail DRAFTED • . Joel A. Brandt J8 SURVEYING LLC • • North is referenced to the • - West line of the Southwest SCALE: 1" = 150' Quarter of Section 35 -30 -15 • Which bears N01 °05'23 "W 0' 150' • . 300' Sheet 1 of 2 • (St. Croix County Grid System) Vn1 In Ds..e >:•1A TOO /t000 NOISOntiJSNO3 SncNI4 658E 489 StL MT LZ :OT EMS OTOZ /LO /60 .. sa, • . • t 4.,0. f . aows _ ...A.,........ Ts 3 . 41, ,� 1 ' , I. 01 4 rr.su' *C 3 ." �' . P •4" , - I �eer ' `S 6 G ttar ! e k /o ff I 6 • e I . g �M� le i ii.....p_ .6 . , E r ? , r.i �r.�.... . � • a . ?k 1 !!!! II 1 t •'.o• , •.c• , -o' 1 I i1 ; i 1 li 1111 1 qq j i I C E d d 1 1 1 1 II 1 1 - mawwrm /� � der '+ moo enno °N' .wmm.anan W � � Arrow Bunding colter Ii � .. LINDUS CONSTRUCTION °*'° a .. 1eias IINIIIIILLOOMINIIII Nnnuo o.wawir+ owea FAX g� °"" "' a s • ■ . £00 /Z00 J NOISAAlIZSNOA SIIQNIZ 658£ 689 ---- XVA SZ rOT SAIL OTOZ /L0/60 1W • NA 8 ,..... z I IV.0 _ 11%0' ■ .1 7a• Et e a 1 1 b i .,., I 4 4 £ ii E 1 --I s t I 1 6. g to, r b I '---] .., . ,, 1 , tix ,1! ;f111$31 .it g4f4 lil . 4 i o t 11:1 i jIk g� -41* 43 71 1 II b'�Q" I - 6 = 0 � tt It II . Arrow Building Center saw n y .no IN b. LI:7US CONSTRUCTION cur R«. STODOLA Eafgenel .,,, ' °"^" s « . NIMPAMilmein • • .Ss y .� ,..v,4", ! i r4r r' .�F.F; ;.4 !11111 IIIIIIIIIIIIII • f. V,F 9 F r: F r: F r: F r fi r- } r, F r ;F r, , , V,r >f - I. - r .F i V r,V f. I ,F r Fr,Fr;Fr W ; ' -,:}),... F y 1.7 1.1; 111 si , .1 ',41-,4f,:l.i,4t, i ,..,, }t �; illlll{HIIII _ r r r " F r ' I 1 ' r F r }r r r 11111iI�IlII IC it r` Fr`Fr ��• I � t -....0.:,111:t : Fr I i 11111 I i �f o 1111 LEMMIL 111111111111111111 t t' t' t' ' � II N111IIIIIIIUIIIII '� • F•F•F V f f ff li .'\ % r .1 A . ee �""� a "i � �. ►n Mow Building Ginter ». ' imp ' LINIDUS CONSTRUCTION �° .., °: • — '"`" STOPOLA ''" �` MAIM. , a } • ____..••..•+ nnI1 74 ail b99 5TI. ICVI SZ :OT 8tls OTOZ /L0/60 l VOL 1 6 70PAGE 203 STATE BAR OF WISCONSIN FORM 3 - 1998 t64�3653 SH N.ATH1-EEN H. WAL QUIT CLAIM DEED REGISTER OF DEEDS (>ocumcnt Number ST. CROIX CO., WI This Deed. made between Josh Stodola and Kelly Clark, both RECEIVED FOR RECORD - - - 06 - 28 -2001 9:30 AM QUIT CLAIM DEED - — •' -- . _ _-- --'_..__. ----- - --- - EXEMPT A 3 Grantor. and Josh Stodola and Kelly lIy Clark, both single, as Joint Tenants, CERT COPY FEE: with Right of Survivorship _. ._..- - .' -_ " -.. COPY FEE: TRANSFER FEE: _ _ . -._ -' - RECORDING FEE: 10.00 PAGES: 1 Grantee. - - -' - - Grantor. quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Arca Name and Return Address James H. Krave, Attomey P.O. Box 304 Glenwood City, WI 54013 -0304 016 - 1077 -70 Parcel Identification Number (PIN) This is homestead property. (is) (is not) Part of .the SWI of SWtx of Section 35. 'Township 30 North, Range 15 West, St. Croix County, Wisconsin deacrthed as follows: Beginning at the IV Corner of said Styli of Ste; , said point esatn d to be in the centerline of the public is highway: thence South on the West line thereof assumed to be the centerline of the highway 450 feet; chance East parallel with the North line ttereof 600 feet; thence North parallel with said west line 450 feet to the North line of said SW} of SA; thence west on said North line 600 feet to the point of beginning. t Together with all appurtenant rights. title and interests. Ir st' Dated this c n 1 day of .tune 2001 , Josh Stodola .... _.. —. . Kelly Clark -- ... A1ITHI:N1ICATION ACKNOWLEDGMENT SianaWrcts, Josh Stodola and Kelly Clark, STATE 01 W1bC,ONSlN > both single, ) ss' -- - County.I Personally came before me this day of au th- nticatell this 2 • a f •4 2001 - __- .. -,. -. -- -- — the above named _/ • * - .la nes H. Kravc, Attorney I 1 .1;: MEMI3ER STATE BAR OF WISCONSIN (if not. to me known to be the person(s) who executed the foregoing :nuhurired by 706.06. Wis. Stets.) - instrument and acknowledge the same. Y'I IIS INSTRUMENT WAS DRAFTED RY - - - -'-' -- - - -- -- .lsttnes H. Kravc, Attorney at Law . Glenwood City, WI 54013 -0304 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. (If not. state expiration date: ncce ,1 .> • \anres n1 persons .signing in any capacity should be typed or printed below their signatures C;1I'r CLAIM DEED , STATE BAR OF av ISCONSIM FORM No- 3 - 1998 INFORMATION PROFESSIONALS COMPANY FOND nU LAC. W1 800 - 055.2021 1 1 c/a/#s PAID Wisconsin Deperbnent of conmrerce SOIL VALUATION REPORT • _ ` Page / of - I Division of Safety and Brings i in accordance f Co 85. Wis. Mm. Code Court Attafi complete site plan on paper not less than 81/2 x 1 inures ` size. Ran must -.5 erg iX indude, but not xmited b: vertical and horizontal • point : direction and Paoel LD j (a J � � --- v percent � slope,scaleor t•., : 0 to nearest road. ' l C 7 Please prr ti �_ Date , • Personal inlennabion you provide rasa be (PriSeey a 15.04 (1) (m )). / 7 4 ,Ghvr� 6.-,6 /6 owner MAY 1 I : • . . _ Location iec.F4t/ GLfrL'/ . [ nUNl Lot s /i„ 114 >' 114 Sys T 3o N R /..r E (r • ) PropertyOvaiw's MaiingAddress ST. C ' /.21 .�usrS'� A. - PIANNIN(3 & r ONING OFFICE 4 . # I �odc # �Stbd. Name a t z 6, Zl.�"' it'C�' . Ica'- ' - c..ej i-° City State ZIP Code Phone • - city ❑ @town / - - Newest Road d Gz y i z4m lc-Ye/3 1(7 /S' 6s - ?Ftr- tagNsvic Gz 1 RH.r7re. Ra. 44.3 Tr-New Consbudbu Use:13'Residendal / Numberof • • ,. / code derived design now rate / S GPD ❑ Replaesment ❑ Pubic or commerdat - r ,, : • . Parent maternal 'tOK.1.4440 a/ Plain elevation if applicable n /P/1,- 8. General aornmeNs 5- 21G on c'r a it S i 744 ct 7 o t • " •• c a7" p 7�1' Q' / 4 /era r' and ' 1 " ? fie .4, -.41, 111111 o ✓ h 6-c /L :, ∎ ■ Yl h fit // y �,/� ler v , t� a �i e �� otiJ,r r re N.C • s"gc,7Zem e% v . 7 6C 9t G ' --►> se^e sr•PAr el, �ap e 3. i Boring # ❑ Boring © pit Ground surface elev. PP s- ft. Depth to erg factor 47 in. sari Application Rate • Horizon Depth Dominant Color Redox DesaiptIon Texture Structure Consistence Boundary Roots - GPDIW in. Mansell Qu. Sz. Can. Color Gr. Sz. Sh. *ELM •88/2 / P -33 7•Sy 6/L s - m/ rs /F -7 / 2 - 37 - ^ .s -- �, ®4 A" 1 _ — . 7 -3 .35'• ---1 7S yr 4// -- cS s'G- in / es — . 1 /. 4 ' , sY- i7 S s /f/ , ►uS _ .nsG ••r/ — _ — , .7 ‘ /, 6 • Boring # ❑ WEing 2 © Pit Ground surface elev. 91'% 8 it. Depth to baling factor 7 f in. soh Application fawns Horizon Depth Dominant Color Redox Desaipeon Tore Structure Consistence Boundary Roots GPDrfL in. trawl Qu. Sz. Cont. Color Gr. Sz. Sh. Vitt 'Etil2 • / O -2 / T s / r G / 6' "5 e f A S � - , i ( 5' / • 7 /.4 z_ ay _.Zy` 7.S 7r /y cS _ o , of cs -- . 7 /. L 3 .2P -/ 7.i yr L ## — /YrS S , dSF- or ( S -- Y c • 2 /. 6 V ¥/- 7v .a yr 5'`Y — GS +?Sec- Hi / c S — ` • 7 I• �v Nvr #5/ is AS Z 6V1/0_, 1 - - Bert #f = BOD 30 < 220 mgt and TSS >30 < 186 mgit. tw • Effluent 82 = BCD; < 30 mg& and TSS < 30 mgA CST / CST Number Name Meese Meese in) r" � �? /bpd 4 > /r l3 . rl c / / 3 y, Address j ... y � ® / i Barbia6on Conducted Telephone Number 2973 ,Co tzar A / 4 a w, v /C Sl4PX 4aZ usr cat w_ s---y/1-049.90 Property Owner 1Eu7 • Z Parma ID # Page 1 of _ 0 Bating 1 Bwing# ® Pit Gintutd surface elev. 9 r1 fl Depth to Baffling factor 7 7 in. ( Sod Apphcation irate Horizon Depth Dominant Color Redoxbesaiphon Iodate Structure Consistence Bouda y Roots GPDItf in. Munset Qu. Sz. Cont. Color Gr. Sz. Sh. 'B1 'Elf/2 L /O - .72 7.5 9r- yi r+ . s oSta Art I cs — - 7 /- 3' 22-3s 75yr vf ni , o,SC 094 f C5 _ 7 / -` ` ss = ya T S syA irrS , oss- rr* l r s -- - 7 , /- $ t /8 7Z 7.sp r 5/Y i s R er -a' vn / -- ,? / -4 I # ❑ Boring Q Pit Grou O d surface elev. ft. Depth to inning factor in. , Rate Horizon Depth Dominant Color Redax Desaip6on Texture Structure Consistence Boundary Roots GPM! in. Munsel tau. Sz. Cont. Color Gr. Sz. Sh. 'GNI 'E##2 • ,art L pre ; > s ,, so nil:. ‘ A7 e® - I - f t c 7 1 0 ,i, r_ i "Is i LS. / �,$m' - r* .r re 4 .d vs , 7 / * + f. G ✓ / 7‘ h. %fit 7 c r Baring / 7 Gcarid surface alai/. fit- Depth to limiting factor in. ❑Pit Sal Appcon Raise Mignon Depth Dominard Cdar Redooc Deacr ipdan. Texture Structure Consistence Boundary Rods GPDIIf in. Morsel tau. Sz. Cont. Color Gr. Sz. Sh. •E1fil1 'Efflf2 . . . . • Emuerlt #1 = BOD 304220 ngll. and >30 <1E0 mg/l. • Effluent # 2 = BOD,< 30 mgt. and TSS < 30 null. The Department of Commerce is an equal ity s provider and employer. If you need assistance to access services or need material in an alternate forma please cct the depattznent at 608- 266 -3151 or TTY 608- 264 -8777. seoa tc m r N x 1 � to ■ vo k (v � 1 I i o. L A ti tt 4 ro r. L1N v 13 W is k -. .k . ..''g ?Ni a v 88 z O - :v A k 5.c x 4 u N ; * A P-• ■ 1 J 1 h I . n icy e, n n ^ r 4 0 1 Y :. ... i 0 . ,..••••••• 4 - ' t . -'s ID ,0" WEST o.' ;EST .. .a - . wrs k hk 4 s � L JL \) „ i. . > . j �} ':tea. .x . _ „ „�a . l 7 . �.� # 1 t�� l' ' 1i 'it'''' : ,_ . , _. , t ,,,..A9'" Ill . :I, ' ., ; '''L •. ' • . . , t .: ...-.„°;,',i: ,.„..,,,...,, �b F.d� " rot_ I. „:4i,,,4,,, ,,, - - , ,,,,,, ',,,,,:i,.7 7, , ,, , ,,.,, , r , ,, ,,,,,,, , ,, , ,. „ i ii, .3,!_i..,: : 4, a � a e 1.05000 FT JOINS PANEL 0295 Wisconsin Department of Comore' SOIL E V A L U A T I O N REPORT P a g e / o f 3 ' of Safety and EkAdings in accordance wall Comm 85, Wis. Adm. Code County . ST L'ro /'X • Arch con** site plan an paper not less than 8112 x 11 inches in size. Plan must , include. but not limited to: verbal and harinantal reference point (BM), diecdon and Parcel LE/ ,� percent slope, scale or dimensions. north arrow, and location and dance to nearest road C ea' h� Please print all lnfn�i Reviewed by J Date Punnet intonsation you provide rosy bsused seconREGEmiNificpsw• s. 04 (1) (fon. Prope Owner Location KAELL// GLAZA SAP U 6 2Qn Lot 1/4 , 114 S 3s T 3o N R /S` E i40 ,w Soled. w Nanecrt Property Omiw- AMatiingAddress # f 13 �.<- # ST. CROIX COUNTY ., . c Slate Al Code Pb8N 1888 r NtNO °Fri ❑ image EKovel . Nearest Read CIty [ 7y i RH1 rre- , / b. '*� ��D 1 GO i syoi3 1 Pill a6S = 2.7f-s L�0 / &New Construction Use: arResiderdial t Numberof bagmen / Code derived design Aar rate / So GPO ❑ Replacement ❑ Pubic or commercial meercial - Describe: R Parent dWK,. 7,- "A/ /''�''' Plain elevation if appica r. 4 T • ' i " G s.7` i •`P 9Ycet /Yew r' Cameral comments ..5 14� C.rre.{ it S u � and ?ai/c Zor.+6 ` / /� fir v i to a J7 ir, APR A' 7)r rec rrested as(I v, l e • sys>4u v . , e - . ^P 3.. Itt ,vAt • 1 I Ifting # © Btidlig Ground surface elev. 79 r ft. Depth b knifing factor if in. sou 1e Rate - Horizon Depth Doneinant Color Redaoi Desaipion Texture Sbiz*xe Consistence Boundary Roots - . GPDIW are. Mueiael Qu Sz Cont Color (3r. Sz. Sh. *BM 'E8#2 0 - 33 r — .4. ©SS m / — . Z 3 S T J — �� V c « / . 3 ` -s S S — Mi — 7 1 ❑ Boriig Z ' e«i<g # D Pit Ground surface elev. f 8 . R Depth to timAirg factor 71 in. I Sol Application Rate Horizon Depth Dominant Color Redaoc Desaipthm Texlue Shcacfue Consistenoe Boundary Roots GPD/WE in, Qu. Sz Cont. Cdor tar. Sz. Sh. 1 'E1#2 A 7s / r - LA. ins es nil T 1 • 7 44 S 0.2g- Pfd cs .? /. �S/ J" 7.S 7r VI/ , 3 .2f- W 7..i yr tfi . /HS DSO Hy ( <5 e ? 4 t; , . Y Y/- 71 Syr Y� — Cs CStr- "pi i c3 — • 7 /• Nvr #Y' is /S 1 6' 66/ • - - • Effluent #1= BOD > 30 ^ 220 agA. and Tss >30 =150 ngk #2 =e00 <aoigk and TSS <30mg& tT Number CST None Print) c /) .� ,- ..7.2.,y," Add • (1 5. ,r ,�T-� Sy � / '! Evaluation Conducted Telephone Number 7y7.g go g'4' at_ A.P., Sfoovenriz, cu.� aril 7.1.C-W mil Property Owner /¢ &L5 Parcel ID # Page 2 of 3 I f 1 Baring it ® a°ring Ground surface elev. 9f. / ft. Depth to Mining factor 7 7 kn. Sol Appficaion Rate Horizon Depth ' Dominant Color Redox'Descdplon Texture Structure Consistence Boundary Roots GPDIIt In. Morsel Qu. Sz Cont. Color C1 sz Sh. '21111 13f#2 / ,*-111111111 7 . i /4 rn r A msC 3 i 14.1 1 7 /. ‘ z r 7Syr ',/6 -- "I 5 oSG .+, r cs - • 7 / G 3 -22 -3s 7.i r '/ // mt 0S .r./ C.S. '_ 7 /- y 3s -- y 9 7S- yr s76 i„s oS - _ r.,. cs _ 7 / ( S <// 7.Y r y • .?,S R Os-Pr YD! 1 — - _ 2 f - *arc= 3 h A-r /3' I coaA 1 I Boging #0 Beneg Q pit Ground surface elev. It Depth b fprr8ing factor, in. j salt Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDVIf in. Mined tftu. Sz. Cont. Color Gr. Sz. Sh. - 'EMI 1 'Eif#2 !"AE - ,t}PTE ; .4,.[.Tic9 .4s' trss D ,f7.,.1, y - >/i%/, 71;1474 .1<.7C r4s4 rtw .ti.r�i, Pn.,' EL/ / '9, r ba,J m Ls_ r4�srn - e w < t‘ vs - ,�/� % 44' / 7f ;.77�e ,.ice` 7'0 4 s' � e , ❑ Boling . 1 B odrg # opt Ground surface elev. 9 2, 7 R Depth to liming factor / , o g in. Sol ADpfication Rats Horizon Depth Dominant Color Rector Description. Iodise Structure Consistence Boundary Roots GPDltf in. Mimed Qu. Sz Cont. Color Cir. Sz Sh. 'E1r#1 'Eti#2 i o- tog /r1-`t/,4 5/rs Q .5 m / A / 14- N ip • - 5---- I 0 • . d�7 - , : # 1= BOG, > 30 < 2 2 0 mglL and T S S >30 < 150 mglt. 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