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HomeMy WebLinkAbout032-2153-30-000 • COUnIy ve,o~~,,m:rr.;neertarcar„r.,e-PRIVATE SEWAGE SYSTEM St. CFOIX Safety a nd i;m 7i`q liwisi"" Sarear: Perttu' N0 INSPECTION REPORT 605047 GENERAL INFORMATION (ATTACI I TO PERtAIT) sta,e Plan 01 Personal in'crmaY.;u yus arc, 1, ,,-y rr usei br x3tnrCarv Gu C,^,Sei [P'r:acy La',. 5 C4 'I::',, 1l rermdHolder'sNonr, Cdy "'Ill IC",,01 Pane lax NJ David & Colleen Odegard TOWN OF SOMERSET 032-2153-30-000 C, ST BM E ev Ins(;. D`.t I hr" BIA Descuotprr. # - _ Sectic'v luwnrRangeAlip Nu 15.31.19.1326 TANK INFORMATION ELEVATION DATA TYPE MiWUFACTtIRFR CAPACITY STATION KS HI FS ELEV. Septic Kenchmalk r Dosing At Btvt Aetat.on_ Aldg. Sewer t% r r: Hofdrng- SL'Ht Inlet St-Ht Oallel TANK SETBACK INFORMATION TANK 10 PrL L':'F. I BLDG 'derv n: Ar I-tzre ROAD Ot 191et - Septic Dt Bottom Dcsirg Header.-Man Aeration D st. Pipe Ho olno Bot. System r Final Grade PUMP/SIPHON INFORMATION Mavdaclurer 0ea•ard SI Cover cl 7: GP!j Model Nerd;rl TDH I A Fi ct'on I uss System Fici IDII Ft Fcrcemam Length D'a. n;l 41Vve SOIL ABSORPTION SYSTEM BEDJRENCH 0:49' LeuyC ; Nc. Of TCm es VIT DIMENSIONS N. O' P is :11.i11 e tls ..qr..i De pCi DIMENSIONS SETBACK SYSTPA TO l R:. U3 WEI.I LAKFiSTRCAM LEACHING 1.lanIficturer INFORMATION CHAMBER OR type Of Sysb_rn UNIT IAocel Nr:r`b, DISTRIBUTION SYSTEM I•rtake 1-leace•~PAen 1 1,! DisCrC.;b[:° w Hau See JA Hole SpaCmA Vert s AiT Pours; Ic^.gth rim Lcrn; t', Ga Sp.acinc SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only OVA, 0,Qf CcG:lr C^pBr! I b,ertedrSOd7on xv IAu chco Bedtl,"'o :lenre• BedTv"UhU;ac, lapse. - yr Nc Yes Nc COMMENTS: dnclude code discrepencies, persons p•esent etc i Inspection 01 Inspectior #2 NIR.. WEU ~dh inS}~'.`s~. v Location: 586217TH AVE fR$~Q Lt~~.~I' p I ~ r- urp, Ah HM Descril = V 2 Bldg sever lenglh = . amount of cover ° ✓ 1 ~(A la, 'J ) rvr'f T J"' Plan revision Rcqueed? Yest I Noy Use other side for additional information ro ~k Cate I scp.doYS Signaluw Ce 7 Safety and Buiidngs J:vtstor. , ~ ~ xtt-U~ 201 W. Washington Ave.. P.C. Box 71o2 Sammy Permit Namba(us be fiLcd m by Co)P g 2~}8 Madison VA 53707-7162 - ) State 7ransecnon Number ~3iIITaR' ] ermlt M)4 lv arwrtraaa wtth Si'S 3R33I (2i, Wis. A;1m C'ude, subn:i.sLo ..f t;us ! ~ to the aflprupnat< g>veuaa:lul umt is rm:ired n:im N c+talaing a sa:titCy, ravt. VOtt. .A,,,, fount f, rate-ownc^. PON ; S are subm:rcc so Yroje,:. Adless (tf di$amt lhac maiiino eddressl the Dcpmtm= of safe? md''rofm>mrml Sasi•s. Pas.Inat Ietonutioa rco piowide ma. br ed for se:a:dan A Fu:poses io acwrdan:.c r.icb E'nvaq I~w c. i c.(:41 I i m Sr:¢s. LA hcatloaloformanon_-Plesse Print /Ult~ufoma ~LK o ?"'Pet r,' s N anon In L fTe t-~--`- V * ` ~,-a~> 3 Yt m Owns s Nlaiiu +uiba5 1 - .-J ~p > g: -Y-1L I?mpeT,•Iacaanon 1Z ,i q. ~4 t Gott L>t ~ City. State ! Zip Code Mon. Numbv CC r' t"I C-1 C -4. Swim IL Type of Building (check all that ap ) T-- y T V; R~ or N' aniiiy Dwdhrzg-Number of E4.;:r . ? Subdivtslon Same i : Yuoiictionunacud - Ths<i.be .ac O JY~~-0.~ U C7ry of_ n State 0%1" Desmbe Cse_ _ _ (r CcR{ Vmnb-r Village of _ _ _ ,'own of 4~ r~ rn P (t AL'fy of Permit: (Cbeck only o box on line A. Comple(e line B if applicable) - - ~ _ - ~rr Ives. S}•slan D itcphezmen[ i)x¢-n I '.ramrnL'nw::iug T•wii Rrpia:cowt Only Ofiter Modifir4 wo w ex'utiag $yst® icxpjau" B. CYnrnit Keaex al ~.-'YCmlt h-vuicn bm:gc 'If PIna :aus:et ;o New List ~n umber an4Dalr Laued Aetsnc Uotratwn i•, IV _'pe of POW"I:S Svarm/<'omponenT: Device (Check all that a Is't- Ja'.._t~yy,7I 1,r. -Frei si>ed la G mt I F1es i v In.iimund .1iLra;, _l lfuuod _ ?4 u:. 01 suitablesoil - Mound <24 at M ssauble wit ~b N ~S ❑fiolcu.y Tzok fxua Lfi,~-tss: npangtlezpnonl Prenrmnent Devix (expLvn) _ Dispcroal 1 reat el) Ares luformsuou: .L F F~to'w~rtj :.p}l[ au m Rn' gpdsf) Insyersd iVra R[ 7u'ved islj I):spcsnl Area ho d (SD inn Elev o /-lL [ (7J V1. Tauk Info I Capacity m Tow • of _ _ _ tdmufaawtx Cntlws Callom Omts ' g c j ~Z, s, 5 _ I F' iz Nen raik~ V >epac a Hot:Ly; '!'znk - ~ T VB_R_ expomibility Statement- L thr undersigned. asxu eaponubdoy for immilanno of The PON"1S shown on the attacbed plans Plussbex's Name:?riatl P'.umbe:'s _aue ~41'~Atr lt)ntt➢bv Busmcm l'bune Nuvba Yas 1. cr.. L Cny Suit. Zip _V ouub',De ariment WOnT} . {vpprmed -37T.3ppY <~r~~ Pe:raIt Fm IDIs* Issuia ems:pWir. i A% s 485. oa ~LzO / S y3w~f`ivrn i(eason ,u :Xnnil~ / IX- Coudi ' sons ffor Iyi pproval g f t. ter.IL ttOb(a+: tYtm l`n. 3' Ln 4e- ~J S ill o54ar w erg -List dll b~s^ - r nt=-eC p/r .nV.3yNmPn' pin p. ~IU nbe . 2. M tbrrcw,- em m nt- 1: C : 4\ , I d na+!`- fJF^ ~j .r~ O ~OT1'K.. / I 11((~~1L,.. M per pplatcnble rprS f rrt:ii ~fa1,~.~..sTt1 -A[ucb m rvmpkre Pian+for m [ w.uJ :ubmif to the C:onnn' only on pryrz ou: M. r b [z 11 iuan in w< ~ / r C!i-yJt~Nnt~ ✓vl J~j I- I72- SBD0358 t)Z 11:1 I ) System PLO I' PLAN PRO•IUC-•1• David Odenard ADDRP:ss 6160 48th St. N Oakdale Mn 55128 SE 114 NE 1/4S 15 fT 31 NIR 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 90.4/90.3 4' below dradC 6/8/18 BEDROOM 3 DATE CONVENTIONAL XXX CON TNTIONAL LIFT HOLDING TANK NIOI NU SEPTIC TANK sl%E 1000 gallons LIFT TANK SIZE DOSE TANK SIZE. : HOLDING 'TANK SIZE. LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of nail in oak troo ,t ASSUME ELEVATION 100' Filter Lifetime Filter ❑BORE11OI.6. DWELL "II.R.P, SameaSbenchmark 507' Property Line Scale = 1/4" = 10 vent >6" Quick4 Standard of Cover Leaching Chamber 80' with 20.0 ft2 of Area 5.6ftA2/pair of end caps 4' Loner 12„ Grade at System Elevation 34" Vents 120' B-5 31, 34 2-3' X 66' Cells %kith >3' spacing I3-3 2e/v Slope 75' 35' ~4J 30' 13.2 r 64 4 Found by I 10' B-1 tC-~-~► B.N.W All piping shall be ASTVi SDR 30/34, within 10' of tank, piping Shall be ASTM F991 S.I. 15' Pro 3 Bedroom 301' Property Line House 17th Ave Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Dale: 6/8/18 Owner:David Odegard Location: SE 114 NE 1/4 S 15 T31 N,R19W 586 217th Ave Somerset Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chambjandigency 4.6. MaintPlan 7. Filler CrSignature License n Sv,icm PLOT PLA\ I'RU.11 (-.I' DE:vK, Ooecard ADDRESS 6160 48th St. N OaKdate [An 5,5128 S E l ! a NE 1 ; l s 15 ; T 31 1t 19 LS TOWN Somerset COC\TT ST. CROD'. SrSff:Pot VLEN ATION 904190.3 4' below (Jraoc 6.81'18 3 LATE BEDROOM CONVENTIONAL, CO\A'EMIONA1. 1,111 HOLDt\G TANK \1UUND SI 1000 galions 1.111 'fA\6 SIZE DOSE 'IA\h SIZE. 'IlC T A\6 SIZE: 110LUTAG '1':AAI: S[%F: LO_',ll RA'fF: A1tSORPTIOA AREA 651 # of chamber, 32 -IL Rf:\CIINIA RK C.R.P. Top of nail it oak tree ;%SS( Ntt: CLI:\ V1 ]O\ 100' filter Liteume }'lll'f 71 SORHIOLE N'I31.1. 'II. R. P. SORIP. 85 bCil C'1 n',ari; ~,0-' pronen_r Lin- V Cnnl~ - 1 1A ° - i n' _ VVaIu - I/_r - 1 V >6" 10ifiA4 Standtu'd T.eachmL Chamber 50 of Cover vvith. 20.0 IQ of Area ~.6ft'`"pair o' end cans I ' Lone 4 Ci-a(le a: Svstcm Elevation Vens 13 i B_q X 66' Cells with >3' spacing g-3 "i SIDne ..5, i' 1-' lfi Found by o~kncr! 10' 720 B-1 PRO B'TM,i', Al' nipine shall he ASTIM SDR Wm' 1, within ST 10* o tank. piping shall i)e ASTM F89' 1 Pro B,,-J11111,11 01' Properly Line llousc copy 21 -ti: ,~~t Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with ^ 0.0 ft2 of Area Per Chamber To be >1' above grade 5.6ft 2 pair of end plates Finish grade elevation Typical Installation 94.4' Vent AGrade Vent 3' 3 A/30/34 Septic Tank 5' Long t 5 L,on I . Grade al System Elevation 36" Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A B 16 chambers per cell System elevations: A 90.4' I B 90.3' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page - of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity gal 0 NA Permit # Septic Tank Manufacturer O NA 1-)ESIGN PARAMETERS Effluent Filter Manufacturer DNA Number of Bedrooms FJ NA Effluent Filter Model y/ NA Number of Public Facility Units - NA Pump Tank Capacity J al NA Estirated flow (average) al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) i Pump Manufacturer NA Soil Application Rate gaUdaylft Pump Model NA Standard InfluentlEffluent Quality Monthly average" Pretreatment Unit NA Fats, Oil & Grease (FOG) <_30 mg/L 0 Sand/Gravel Fitter 0 Peal Filter Biochemical Oxygen Demand (BODs) I s220 mg/L ❑ NA ❑ Mechanical Aeration O Wetland Total Suspended Solids (TSS) .150 mg11. 0 Disinfection O Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) s30 mi Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 7~NA U At-Grade O Mound Fecal Colifonn (geometric mean) <-10" cfu/100m1 0 Drip-Line 0 Other: Maximum Effluent Particle Size in dia. [ NA other: 0 NA 'Other. - - - A Other- 0 NA 'values typical for domestic wastewater and septic tank effluent Other El NA MAINTENANCE SCHEDULE r Service Event Service Frequency 'inspect condition of tack(s) Al least once every: ' earls(s~ (Maximum 3 years) J NA Pump out contents of tank(s) When combined sludge and scum equals one-third (5) of tank volume - 0 NA Inspect dispersal cell(s) At least once every: L~.moanth~s) (Maximum 3 years) ❑ NA Olean effluent filter At least once eve 0 oath(s) U NA - - - ry: Or(s) nspect pump, pump controls & alarm At least once every: D month(s) 0 year(s) NA =lush laterals and pressure test At least once every: 0 month(s) _ NA Other 1 - - - ❑ month(s) - NA At least once every: D year(s) Other. NP. MAINTENANCE INSTRUCTIONS ,Inspections of tanks and dispersal oeils shall be mace by an individual carrying one of the following licenses or certifications: Master 'Plumber, Master Plumber Restricted Sewer; POWTS Inspec tut, 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 pending of effluent on the ground surface. The dispersal cell(s) shag be ,visually inspected to check the effluent 'evels in the observation cipes and to check for any pending of effluent on the ground surface. The pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local Iregulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of !'he tank shall be removed by a Septage Servicing Operator and disoosed of in accordance with chapter NR 113, Wisoons:n 4dministrative Code. 1411 other services, including but not limited to the servicing of effluent fitters, 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 10 days of completion of any service event. pop -o START UP AND OPERATION Painting or other Chemicals that of the For new constriction. prior to use of the POWTS check treatment tank{s} for the Presence of dcted have the contents and/or damage the dispersal cell(s). If high concentr8tiorre are act may impede the treatment service operator Prior to use. tank(s) removed by a septage System start up shall not occur when soil conditions are frozen at the infiltrative surface. the excess wastewater will be the resbackup or tored stored th surface discharge of effluent. During power outages pump tanks may fill above normal highwater levels. When power is discharged to the dispersal cel(s) in one large dose, overloading the cell(s) and may Servicing result in operator Prior to restoring power to this To avoid this situation have the conteMS of the pump tank removed by a Septage Pump controls ' Pior to stori restore normal levels effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the within the pump tank. disturb or comptlct the area within Do not drive or park Vehicles over tanks and dispersal cads. Do not drive or park over, or otherwise 15 feet down slope of any mound or at-grade soil absorption area. the life of the POWf$: Reduction or elimination of the following from the wastewater stream may improve the performance and prolong bolts; condoms; cotton swabs; degreasers: dental floss; diapers; disinfectants; fat foundation drain (surnotics; baby wipes: ad vegetable peelings; gasoline; grease; herbicides; meat scraps: med~ons; oil; ping products; (sumpPump) water, fruit t and Pesticides: sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permarwtiy taken out of service the following steps shall be taken to insure that the system is props IY and safety 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. SarvidN Operator. • The contents of all tanks and pits shall be removed and Property disposed of by a Septage • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filed with sail, gravel or another inert solid material. CONTINGENCY PLAN code compliant If the POWTS fads and cannot be repaired the following measures have been, or must be taken, to provide a replacement system: sod absorption syste/n. _~Auitable replacement area has been evaluated and may be utilized for the location of a replacement requited T and w and compaction and the should not be replacement was infringed will upon result in by the now The replacement area should protected from dishirbance site and Proposed structure, lot lines and weer. Failure to protect must comply with the ruleat in setbacks from existing for a new ail and site evaluation to establish a suitable replacement area. Replacement systems effect at that time. ❑ A suitable replri tt area is not available due to setback and/or sod limitations. Barring advances in POWfS technologic a holding tank may be installed as a last resort to replace the failed POW, S. ❑ The site has not been evaluated to identify a suitable replacement area Upon failure of the POWTS a sal and site installed as wrist be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in piece following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in affect at that time. NOT <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. W ENTER A PUMP OR OTHER INTERIOR OF A TANK MBE TANK UNDER L RO ANY ICICOCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A SEPTIC, PERSON FROM T ADDITIONAL COMMENTS POWTS INSTALLER - POVYTS MAINTAINER T J Name _ _ f Name Phone i SEPTAGE SERVICING OPERATOR PU PER LOCAL REGULATO AUTHORITY Name Name L-LZ Phone < e- 7 Phone A [2 T J ` and 3a3.540), (2) b (3), wlsoonsuh Administrative Code. This doparrerx was drafted in comhpdance with chapter SPS 383.22(2xb)(1)(d)t:(tl •i'Ii lil p 1•~ P ~ ~ III I iall i ' UJiII IJ~l ~ / O I I p g O L ti` r CID Ci ST. CROIX COUNTY S13I'"1'I(, TANK IVIALNITNANCE 'tGREEML:NT AND OWNER.SIIIP CF.RTIFICATKIN FORM Owner/Buyer grading Address Property Address (Verification reywrect from Planning K Toning Uepart:ret t r new construction.) Ciry/Statc__ , _ - 1 arcel Identification Nurihel LEGAL DESCRIPTION Property Location C- IA , Sec:. V T(/ ~p W, Town of ~C':`n j Subdivision Lot # Cet-tified Survey Map t! _ Volume Page - VV'arranty Deed # /C/y y Volume Page T, Spot house yes m Lot line; identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIVICATION Iaupmper use and maintenance oPvour septic system could result in its pr.:maturc tadure to h::ndle wastes. Prober initintcn toot; consists of pmnpmF, out the septic lark every three years or so..net, :i uerde,i, by a liccused pumper. What you put uuo the system caw affret the function of the septic tank as it ircatanenl stage in the w::s'e disposal system Owner maintenance responsibilities are specified in § otnn. 8; 12(i) and in Chapter 12 - tit, Cmix Co arty Sanitary Ordinance,. ']'be property owner agrees to submit to St. Croi i County Planning & 7.onaig Ucparunrnt a certification f nu signed by the owner and by a inasrer, plumber, iourne ratan plmuher, iesui 'rd plu:ribcr of a licensed pumper vetifymg that (1) the on site wastewater disposal system is to proper opcrannt; contu!ion war m aft,: inspec.ion and pumping (if necessary), the septic tank is icss than 1 /3 full of sludge. Uwe, the undersigned have read @u: above ,ayriroutrr: b: and a?•,ree to rnaie:au: the piivaw scwagr, eispusal system with the staudaids set forth, Immir., ir% set by the Dcpartrucnt oI (:o:otom c and (hc Drpamr. ant of Natnal Resources, State of Wisconsin. Certification stating that ),out septic system has been maintained must he conydctc.l and irturra:d to the St. Croix County Planume & Zoning Department within 30 bays of the three year expiration datr._ liwc certify, that all staterncnrc n is tbntt art: true to ihs best of ruy.'our kauwlcdgc. Ir'•,vc auYate the ow net(s) o!'dw property described above, by virtue of a airanty deed reeotdut in Register office. Ls Office. n Number of bedrooms SIGNAI [ Ofi APPLIC.A:'NT(S) DATE. "~,'ynY into matron that v; misrepresented may result in the sauCary pritnit being wvoked by the pianrvng & 7onm1; Depot uca' include with this application a iccorded wartanty deed ?Toni the Rogis:et ol'Dee& Office anal a copy of the ccrtihcd survey map if rcterenu : is made in the warranty teed. (RYV. 08/05) ( o f;~ ~Y~~S, to p C Z ^ 2. Y t ~ n , > x x i 9: n ~ ~ u> o < <LL I'CC7 t { t fi~~ I tv h t[ I I r.. I 6 i; I r' rr~A IJi Ildl,ll'I~,I~ f~l i. I, 11 i i. - t -Y-' I ~ ,I I B III _ , ~~I U n S I Yrr i,' 31r~ , O I I ~ Y r I xn Q fx3 ~ ~i cw ~i'i~ 1 yy -F I III i i i - -_J 01 I i x r V ~ i 1 '1 = ° - f tl'. j .E w - l i ut}t 1''i: i ~ a ~ ~ V ~ ~ its ip! i f11 d S ~ ' > s Q I Y °~=-:=t f O ifELf eE'f •i :~.f.; ..31[•7 ~ 3 ~i`!y - ; I ' I 0 3 I I ~°I 1 I ° .1 - I i'I L - - - - - - - - - - - - - r - - - - - - - - - - - - - - - x :I .h I I I I i I I I y; I~ a n li 4 ( l i 1 1 I mo t x ! 1 Al; If illl} il' tt ff t' 4 7fi r p 1 € It fil,I1~~!f l) i' ri!~l jti jj{! ~ti ' I J/ 3 j Iil it !alia!t oIii. li Ill it{.111 iRk - f 2 ;i E II II Il !l.{ !i ~ I 't 'I 5! I lil ' ~ i l39 : ll ~ ltd ll : 3 e ,a 1'I"~ III Ilh nll! I tyt ilk ~ ~ Ill IIII f [ i z"R r I E ~~Sae `i' tf f:i t i> 1 aj. JIL ~ ~ ~ea~iaae3 i i y~ it :j- i ! 3 d I` CCCCOO1111 ~ ]t E f'n ~A st ill: 1yitG , - i L vi it J - L .s s. Ec W .2 L* 2 9 a) C) C3 I ° w O ~ 2$` 1R W.L. z N 938;83 2 7 N89'14'13'E : 507.18' c w ZOM 1. x" 24189' TOTAL AREA: 10~°' I 131,780 SO. FT. 137,922 50. FT. ° g `1 o Q v 3.03 ACRES 3.17 ACRES tiP.914'1311' 2 8 " CRAINAGE% 36.55' LASEWN 1 134,944 50. FT. o I 3.10 ACRES ' O 58T}9'12'W I ~1971'O E` n 12,59 Z, •1~F' ~ 1 b 8 H h v~ ~~10~ O'1....L..(Ira 6if N 5~~`,LyR'^r ,I \s\ 4 I c ( • F 3014'121 27.71' 25 YR H.W.L. n I ~`'D 942.59 °3412'31'W 25 Y R H.W'.L.I 726. 49 J6 I 249^25_ $ -4 - « a 112f 1 211 56~p4"W ~ ~ ~ ~ ~ f I I 8i l H A D~ 0 VA 7119NOW SOIL AND SITE EVALUATION DI 177 e de;y aneiBuild,ngs Paya HweaL IW.graled Ser"ces in accordance with S. ILHR 83.09, Wis. Adm. Code Attach complete site plan on papwr wt less than u 1?2 x 11 inches in size. Plan roust aunty include, but not limited to vertical and horizontal tolerance point (BM), direction and St . Croix _ percent slope, scale or dimensions. north ano,v, and location and distance to nearest ro=d arcefJ.D. u APPLICANT INFORMATION - Please print all information. _ Rawp e? by Date ner:nnal informal ron yuu pweicu ntiy br w 'd 1,, se; is^w P~rprs ; (Pcva!y Lai,, s. 15 dd i11 {mil Properly Owner Pieter LoraLOn - Richard Stout Govt. Lot tin N h. 114.S 1 5 T 31 _N.R 1 E (or Y_ Property Ovmer's Mailing Address Lott Hlu,;k,. Su pd Na ~yr CSFd~ /2.3 ~X C~ 1353 Ataatukee 'f'rail 23 Shadol.,-_P1h c!; City Stale Zip Code Phono Number Olty Li village 0 Town Nearest Road Hudson N'1 54016 ( 7151')49-6'131 Soners~ 602 Str et 7; /S T Q New Construction Use: EXResdential ; Nomber o~ bc=,ms 4 Addition to exlsting building Replacement ❑Public.oicommorc:al Describe: Code derived daily flow 6 0 0 qpd Recommended design load:ng rate [-beet, gpdAC . 8 -wench, gpdft' Absorption area required 858 _ bed, II`_ ivend. f;' Maximum design loading rate .i bed. gtyWe 8 trench, glxl4r Recommended infiltration surface elevation(s) See p 2 o 1. p'. a n tt (as referred to site plan benchmark) Additional design!site considerations Parent material C oC 2 _ Flood plain elevation, it applicable _ it S Suitable for system Conventional 1fMound In-Ground Pressure AT-Grade System in Fill Holding Tark Unsuitable for system S n ll DC-~ S LU F S ❑ U i F U U S F~ U U S I~ i; SOIL DESCRIPTION REPORT Bering It Horizon Depth Domineit Co„r Mottles Texture Structure Cnri isten e Boundary Floors GPDr in. Murse l Ou. Sz. Cont Color Gr. Sz. S'1. Ded Trcech 0-' 1Oyr2/1 - 1(111 ' 1f 2 10-_0 10yr3/4 r.s osy ml CS Ground 3 30-e 4 l0yr-4/6 ms osg Inl CS .7 .8 ae - - 95.2Of Depth to - - - - I miting ioctor 9 4-in. Remarks: Baring It 1 0 -8 10 l-2!1 little tr .8- 2 2 30 1 0yr 3%4 - CS 1 i%v}l r, rn1 CS .7 .8 3 W-94 10yr4%6 S osy rni CF; .7 .8 Ground elev. 96.6Qt Ct t _ r1 Depth to im.ting lacrcr g , in. Remarks: CST Name (Please Print) Signal - I elophone No. / / - Address Data CSTNumber PROPERTY OWNER tic*. a r d r SOIL DESCRIPTION REPORT PARCEL I.D.ft Boring # Horizon Depth Dominant C, or Mottles Structure GPD4t2 g Tamura COMIStonce Boundary Roots ai. FAunse'.1 (]u. 5~ Ccat. Color G' Sz. Sh. Bed Trere;h 3 1 0-1 10yr2;'1 iS l;t:u.•.i mvfr CS 1= 7 .8 18- 10 10yr4/ ms osy ml cs .7 .8 Ground elev- - - , - - y6.20it n Depth to limiting factor 1 fl in. Remarks: Boring M 1 0-1 10yr2/1 - .RL`r r: c. 4 2 16-.8 10yr4/6 - ms os ml cs 8 Ground e'ev. Depth to - limiting foctur 8 in, Remarks: Horizon Depth Dom nant Color Jdotlles Texture Structure Consistence Bounda Roots GPDrft2 in Idunsell Go Sz. Cont. Color Gr. Sz Sh. ry Bed Trench Boring# 1 0-2~ 10 '1 1s 1 L; rr.vfr (IS if .7 .8 5 2 24-% 10yr3/4 is I,r,r+, mv`r 1f 7 .8 i '36-E4 10yr4/6 ms osg ml cs .II Ground 61 a ev. 1 - 9 1 . 40_ft. Dept. to - Onuting - _ _ 'actor S ` ''n. Remarks: Boring k Ground elev. - - - - -ft Depth to limiting factor , n Re-marks: SBD-8330 {H. 07 1961 PROPERrvowNER - icnarc SOIL DESCRIPTION REPORT PARCEL I.O.# Boring ?t Hozon Depth Domi-lant :cc,r 1,10-.10s Str=jm 2 lexvue consistence B:n:noaw I Rcos .~111) it m. Pd~nscll O., Sz.Coot Gorr (i Sz. Sh i 9ed Inner. 1 1 Oct 1 Ri^ r CS 1 f fi- 1 G}'_ 4 - m ; CS 1 - ml cs - - Z Ground - , - ~,-)eptr to I,rnltinc ~ 4~ Remarks: Boring 4 4 Ms .,round - I - . : lun:;ns Remarks: H:xvon Depth Dominant Color I I totattles Texture SIfucture Consistence Boundary Roots GPD'fr in. Id;mseli 4u. Sz Cont. Color Gr. Sz Sn. Ber. 'ren::h FJOflrtg i~ ' J-~ Ov'2_ mv(r cs 1: u L9-.6 'Cyr?!9 C. It1rfi.r; mc=r Cs 1t` - 8 'c 4 10yr4 *E.. nts o=q rr._ - CS GrounC A q 0 f: Doptn to i iimiling f1'IDI it 4 in Remarks: Boring tr iY Ground tt _ DepU' to limiting iacto• Remarks: SBD-A330 IP, 07196! r•,,tim.rk ie~ i00 ~n Ire 16 A, ?Ire Y 1 t ♦ ff r i