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HomeMy WebLinkAbout020-1353-47-000 0 3 - o d _ °c 3 c 0 3 ol 7 0 g n CD 'O A� • • A :I ' .. t 0 O • N O W .. C O N *-C' • N 3 tD CD - t co -a = OD CO a 2 O • a to A N 0 • al O N N C reN N CO Q 7 co 7 O K) "Z 0 0 c C N W * v b � M O o d 4 W l� v> z D FD a > (D to D w d ; co co c I- m I I ` �' CO tO y o 0 o y c 3 ▪ re o 000 "'' C SS O I n o '0 N V o I o 3 m v v o I = CO CD , w gl O �tl 1. 0) - a a (V a 3 3 co � z ' co `� ° z = Z O v O D , m o �• y I tD _ S. N O fD 0 a Q g a7 7 z co m • KS '' —1 U) O z co n c) c 1 aa) ° I A z 7 o . = j co I m N co u z m tO I H z I CD a W F I a I s c O 0. I co to a I a A co) I I VO N O H I A I 0 '. a0 ?o ft E, 0 W ti c ., O a k Wiscons n Department of Commerce SOIL AND SITE EVALUATION 3 Division of Safety and Buildings Page i of Bureau of Integrated Services in accordance witi•rCommr3 .Q.9, Wis. Adm. Code ,. s ° '" County Attach complete site plan on paper not less than 8 1/2 x 11 inch is slfe. PlanAust r include, but not limited to: vertical and horizontal reference poir t,(BM), dire0ipft Ord Iii . ", -"--T (1.0 I k percent slope, scale or dimensions, north arrow, and location dnd distance fa' ``n esf road. __purse' I.D. # ,: p ) 1 Al,, 7 6Z6 — HO r &—C.) .- 0C)0 APPLICANT INFORMATION - Please print all iniformatibn. s ,, k „ a -- Reviewed by Date Personal information you provide may be used for secondary purposes (I s. ; ^, N ' " , ` , P roperty Owner _ l • `- - Property Loat On / /' Y14 \1® b 6 V�; L /et /A,\ / ' ,.! rT Go4 -1--of, o ck 1 /4 /4,S 6 T 29 ,N,R /9 E(or)W Property Owner's Mailing Address N- N- # Subd. Name or CSM# .VV `"G 40rzi,.• & Xi/r= 4/ 7 CO TOI`1W0O 6 g 1 1 , 4 E City State Zip Code Phone Number ❑ City , f Village al Town Neast Road, iii.....• ",?t, /%v. 1 : so, = ( o ' S' ) c - 6s' a NcTh c '► re C T H N ii I 0 New Construction Use: Residential / Number of bedrooms ._t Addition to existing building ❑ Replacement Public or commercial - Describe: `` Code derived daily flow 7 p gpd Recommended design loading rate a o bed, gpd /ft C - dF trench, gpd/ft Absorption area required e ,.S3 bed, ft .'J 6e .,, trench, ft Maximum design loading rate e o bed, gpd /ft 4) trench, gpd/ft Recommended infiltration surface elevation(s) � ,. Vs (2 ft (as referred to site plan benchmark) Additional design /site considerations /i! ., Parent material Cd ar ; 674. r,....:,,T Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system igi S ❑ u PI S ❑ U tV S El U al S El U '►.l s U ❑ S gri U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench A D -% iOAV4 L Q ih sbt 1 e_ w 1 co OA . 6 kiivig , i'-A lby — 75 S6 .l, l _ r_Liu — ©,s,G). Ground E2 scf '65 1my>24/4. — ,• S4 A)1 — 6.7 ;n. Depth to - - ' limiting ; fac VJ in. ' Remarks: Boring # - - . A 6-10 /®Y,e3/4 — L (6 T Sk3K Pic(' r LA 1(6 OA , 0.5 lig Z a. 2A 7 ibY44/- S S r r — 5 Swan '$ A7 /o'i 4/4 —, f6 S ,61 on I — 0.7 ; 01( Ground , elev. /02ft. Depth to limiting factor >107 in. Remarks: CST Name (Please Print) Sig e Telephone No. l441Z \I v JcINsoN ∎ :.* . Tv, 336- 40o Address ` Date CST Number Po 4( WuhSc�,v W) S OI J4NOiy f 2, 2000 z2.17 .5-7 # SOIL DESCRIPTION REPORT PROPERTY OWNER Page ` of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure G D /ft g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots P Bed .Trench A p -17 'oYl2 z/z P, GS 1►i-1 (5.4 o .5 / ; 7 7.SY,e 4/4 — S SC--a 1 1� Ground a7: / /'Y / yi l 4/4 AS 56 /17 I — elev. 103: ft. Depth to limiting factor 7 min. Remarks: Boring # A 0 -9 c CS 1 m 6,4 ;), g; 2.3 7.S>124 /4 s r- 1 (s — z3-2 l DY.P 414 Th5 SG /ii 1 — 0,7 ; O.F Ground elev. /671 ft. Depth to limiting factor > 3 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # A 6_7 IDYe %SC 1 ro, sioK rvrCr lj, 7 -71 /6Y/23/2 5L 1 slo i: — OA [) r� i Y 4/4 Cis -- 0768 Ground elev. / 02 ft. Depth to limiting factor > 7 in. Remarks: Boring # Ground elev. ft. • Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) . -x©1 ' • ----- fE►x14n,a -SPI ke. ,/., - reEE / E�tATid►J - /63.0X 1 JA 4d EtS.I -97 ,6 , . ,..«p•. g -Z . x o . 1 . .. \/6X7V . \,, . SCALE 1'; 3o' ElEV - /633 e i Millz-- /1 - h { g2' is I.A • 1 . .. ,• .. . X.1.Kt1 t 14e - 51'1 x.E t r. �C'�P , CE . \ 1 E ELE∎ ib 4 - /00.00 . ELL/. /02.3 ' 3i. - - . . /* Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division tt. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaJ�Ps§riit.44 No.: Personal informat you provice may be used for secondary purposes [Privacy Law, s 15.04 f 1)(m)). SttSS yy �� Stahlmann; tiot: I ❑ City ❑ � "ow riship State Plan ID No.: CST 8M Elev.:. Insp. BM Elev.: BM Description: Parcel N .' C / dZ� - � 3 53 -47 -000 too (do 31131 k4 ( - (r e m TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , (, _t , 606 Benchmark 10 . ( If b . 4 1 • • ` Alt. BM � S- 3 7o S-7 2, S"-- A- . on Bldg. Sewer ; _ ) Holding 6/ Ht Inlet ?, 6 K ` 7- f TANK SETBACK INFORMATION Ht Outlet Z, f 2- AO ,7 G TANK TO P/ L WELL BLDG. Ve n e ___ -- . Air Intake ntto ROAD Septic > 7 " , 5 - 6( id, NA - Bo fom Dosing A Header / Man. 7 5Y /el 3- n G Aeration NA Dist. Pipe k ". ,tc /01 - c" l ing Bot. System f0, ed la MO- 5-6 Ho a I. �� /. ePn PUMP / SIPHON INFORMATION Final Grade R ,-. '' � a 1/741;(5- 6 1--- • acturer --- Demand St cover Model Nu • •er M TD Lift Friction stem L. TDH F Forcemam Length Dia. Dist. To weTf SOIL AB • • PTION SYSTEM ( R) I t(.w, 41IGNICI■ ( 1 L -w,., 4 € r S BED / 1 Width , Length r No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN • NS 3s / z..S 1 DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE / STREAM LE • HING Manufa ur f SETBACK 1 % / r 4: INFORMATION Type Of F Mo el N / System: �) > yo , � / 3 11' /,AMP, DISTRIBUTION SYSTEM 'fru-- plo p(4r.- Header / Manifold Distribution Pi e s �3 .. / x Hole Size x Hole Spacing Vent To Air Intake y ( Length q / Dia. Y Length _b ' 'Dia. fi Spacing /1/4 '> 7 5 / SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) #1: r / /0/ Inspection #2: / / Location: 873 Alex Lane, Hudsori• WI §4016 (SE 1/4 NE 1 36 T29N R19W) - 3629192047C Ridge -Lot 47 3 ' 3'. o+' p,lc. a,,.. cl•. bcr �,J to tut e T� ,�0�"'I d Am 1 Alt BM Description = l,„„),„ 14 o/is�ry �- r� 2.) Bldg sewer length = p 1, Sit/ )Itcrt k.�'s 1- Iras E 3 1 " , t° r t - amount of cover =' 9' Pl r evisio r 6 Yes PI No Use other side for additional infor , a'ion. IERIM „,r,_ (< s . . SBD -6710 (R.3/97) Dat: Inspector's Sig�,ature Cert No • • • 0 qp 8T 3 4- L►° Safety & Buildings Division Sanitary Permit Application 201 W. Washington Ave. Visa PO Box 7302 onsIn In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707 -7302 Department of Commerce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)J state owned.) Attach complete plans (to the county copy only) for the s <- ,y,,, 40 .a , e • less than 8-1/2 x 11 inches in size. County State P ; i` Number ❑ Ch M ,. , Sap ation State Plan L D. Number Y57 1) l)( � I LJ , s I. Application Information - Please Print all Information g � � I �') Location: Pro rtyOwner Name Rq tl Property Location _- �] alit) _5 / IM(akit) Ara 2 RAZE 1 t �t , . , --.1, Sr 1/4N 1 /4,S.34, Ta i Property Owner's Mail' a Addre" c: + I , u i COX d--... Lot Number Block k Number City, State 1 Gf'p Code p�Mttfa Subdivision Name or CSM Number / tJ 1 5 t n} al—Z it/ Z .� `T Z� l ( j • Gf�r)Oc1 "7 ye II Type of Building: (check one) �_� ❑ C ity 6 k 1 or 2 Family Dwelling -- No. of Bedroo : 3 ❑ Village ❑ Public/Commercial (describe use): RTown of ❑ State -owned /4/11 d /Mii III Type of Permit: (Check only one box on line A. Check box online B if applicable) Nearest Road A) 1. (7'(dew System L 2. ❑ Replacement 13. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) / 353_-J 7.. c ac System Tank Only I Existing System c;�1 -- 1 -- B) Permit Number ❑ A Sanitary Permit was previously issued 3 (o •ai . ( el . as g/7 Date issued IV. Type of POWT System: (Check all that apply) ''t Z 0 : 1 4--R-- 14-- -1(Ytt G 4... t . 'Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland • [[l� Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade i ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: 6Z ) x 6 4-re ,tck 1 V Dispersal/Treatment Area Information: vvt : /aD 99.a 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade "a � Required Proposed Rate (Galsiday /sq. ft.) (Miniinch) y 7o i , f'0 Elev ,3 7 ,3 7.7 7 / o 9 re) VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber - Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks I 1 ❑ ❑ ❑ ❑ Sep c / / /000 / Geie e ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement 1 the undersi: ed assume res. , nsibili for installation of thePOWTS shown on the attached .lens. ,Plumber's Name (print) Plumber's Si #phis 'P MP/MPRS No. Business Phone Number J/ ` _ J/ Akio ees fairy " p' - I. X01. -o /5 - &b - `0016 Plumber's Address (Street, City, State, Zip C. , i A 41.0 d5 ;,. e I l .2 0 VIII County/Depart ent U. Only ❑ Disapproved Sanita Permit Fee (includes Groundwater Date Issued sing Agent Si ture o stamps) l Approved ❑ Owner Given Initial Adverse Surging NO BO ' � Determination C- . IX. Conditions of Approval /Reasons fo rove: / re, S p k T , i f„ j _ t k, , e^'�t� - t 7' )/ lA 't" A eo` 6 et-&- VA P ''' ► A P E&vv Wt -P,vIcea '1 .....r • .............3w.. .........;...� ..� ... _het /.K1.. -. ,.).. L.( .d.. . C.._ . 4V1./_1G.1..�;...1... ......._.__._....._._ f'e 1.1 a e.c I . " .. • � 1 1 .�► �r_�, � . 0 ` .- 1t - • A a0 i I • it*. _ Viii 4 mir I ! • (I 41 ! Q = aaP,,l,ol -iS 0= (oN (. < nr1121 3 I. >034,p Roo yh 1a I S r ) A -� IJ1361'.‘9.- vcv ��1i� c., ;ft, F' I/, ? tn 1 75 r35' i ,)- noNG , ` lz Lis > di? 3 k S 69 R 5 k I klR ?t ,------) (e to C. I-Pv- 100.0 r . : rt. ,.ik._ept 3A olopilleig 'Ct, 4 , 4 1 .0) �„ .v. 'I'I4N(At s e , R iN RRe Iry 103.08 Al/ Iilllili — ail _ u�� uQ� rl TaP,��i - , - f . e ,.sro. � s '` �.owr '' „ r( ()4 O 1 6 , I v III■ Da. .$ iiiI ogilllllli/ ' i ti bl Gen ) ai co • � - - Illii , u r04. 0 v ' , � � �Ilill� l.u'W,cti l l U .. ;� cv �. II Ihiiiiiii ii■ �+P � : } O 1110111M r w�, ,,,, , 4, •� G C } III 0 C N C7 I Y yCe O E C N X 10 V) ,�� •� b r _ E to , Inn�111 1 . -05 E -0 c ^ ) N C t , x co r to li �� � 4w o 'O V' 4- ` 1 rt y r y N D T II I I I� 1 _ � Iii A 4 ;`,' '' a ,. w ° ,x. co a a x ° . 1.. s a1 Z 0 - 3 IIII1II!II!U m � ! O ' 4 V 53 E u v tn CHID /'� 111181111I11 4 s= - ' P . 0 , 4 Q ; V.I. 4 1,.8.-,.,-- , `�i �j j 4 j ++ .r i C a 1 4, cyj •Cl. • • • ' ‘ 4 ...' ' CI) U) > .� f-7-7-- , • ,_.,.,_ ' • r ! _ 3..i'd e &1 tic .�.�..__.__ _ : I Al ' 1 ` -n A /49&L/ I ; U i���. .l • 14 - - - 1 i �/ •I►A.4 . *)A. iiIf r ' / ' ! ,... A i . P ,7 -/x_01 v AI J o= (34R4)\o)IS o =(3. r)r\Dik 3 (3.e flf 0 '» / 100u A - /0() � of d 45540;(- 4 4I ri (ten. . S' I 75 i 3N8.-1S 6914(,),( � 3y s iN1Rgt „ cI -9v -1 °0•0 15 � — — l ti 14k-ej € d 3A t llut NC�e 5p) e . iN IR.ee Fl-c.1 lo3.0a ./\ii. sa 111011111111111 ; b tol 1, —6n-rt. , IIIM1111111110,1 U i ���Y' J' • � , Ii111:111I 1 hui ' f bl Grz>y�e , � o 11111111111111111 ' u�P� rti 0 4 . o c ��II 11 I p — `� ' � k' Luc,.ci.If0•8° .. o Iull i k , E T c , al E I .- _ Lin ehnnil I '' , FA I `` N E V x --------- _;";)-11111 0-;i Iii ., N as A c r- C� - _ �11 Ilillui Lt (7--15 a. ° r . v v MINIM 0 I' P L 1 IiI Im I IIII111 1 41 :1111 .: b w ^ k C O N Q J 11111111111I11111� ; s tu a CI , al I III1111111111111 1 ' D � ' ' � ' � ° CD V wx ® �3 . o .3Oct3rn € x LL = U L � + N L C § m 1 o, 5 0.o, ? � , w d1 ,, �hv i -0 u v i . O = N N .O d1 � ° • • • • � ' , 9 0.. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 'Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ST i,, not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 2,6 - / /Q `- - ' c) -- 600 APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R'VIEWED B 1 1 IATJ< PROPERTY OWNER: PROPERTY LOCATION n� v ' d 41 �- '_& A A( (3u jI i �; / GOVT. LOT 1/4 1/4,S f; T 2 9 ,N,R / / E (or) W PROPERTY OWNER':S MAILING ADDRESS LPT # BLOCK # SUBD. NAME OR CSM # 47 C ; Tcvn) LA)c.)at, s a(J€ CITY, STATE ZIP CODE PHONE NUMBER ['CITY ['VILLAGE Eli NEAREST ROAD ( ) 1-luN4aA.l C.1 ' ] New Construction Use '] Residential / Number of bedrooms [ ] Addition to existing building L 1 Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL M�lO,UND IN- GROUND PRESSURE AT -GRADE SSY,SsTEM IN FILL HOLDING T K U= Unsuitable for system 43S ❑U ®S ❑U OS ❑U gl S ❑U ®S ❑ ❑S t U SOIL DESCRIPTION REPORT N,,.. c __, .--,1 (, 2oa) : C-g- 4-4 Boring # Horizon Depth Dominant Color • Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench t :4:i : {::: `. A /eyF 314 L 7 6 r! 'k( nor C. c., 1 c o 4 c ‘ ,::::...:: tit $- "s Ys 66V 4-14 — V-=5 Sc n-, I c.L.,j Q .S C.,. -s Ground eL II-VC fovi 4/4 els S6 f7 a. el i7-- n eley. ` t 7 . & ft. Depth to limiting facto 1 'i Remarks: Boring # - Vii: Z :Imo z6.-47 /6'1441 7-'-.5 s6 c.; Ground B. 4? /U7 ia`yP,4 4- r^/15 S 6 nit 6:7 61 •7 elev. 1LO Zft. Depth to limiting factor - ,>/A7 t&J Remarks: CST Nark$:— Please Pri Phone: Addles:: 9 �► f�:.:��:,) s z Si. f . ,; Date: CST Number: I (R.3-. -r - .c Z.2_/..7 S 7 PROPERTY OWNER SOIL DESCRIPTION REPORT Page " 2 of 2_ PARCEL 1.D. # -- - . Depth Dominant Color Qu. Color Mottles Structure G P D/ft Boring # Horizon . Texture Consistence Boundary Roots Bed Tench tomiliv . \ in. Mu n Sz. Cont. Gr. Sz. Sh. r '2 C_ -1 7 it\ ii / S& / p 5i Thcr e.s / 0 4 -> •:::::: 6, 17- 17 , 7 S YA 4/4- ,_ / 56 n-, 1 a -- 67 61 • -1-. Ground ig- Z' --ZO y(2, 4/4- ,___. 07.5 SC 0 / — n.7 elev. it___ ft. Depth . I' ,. g . 4r l ci,f 1C '•tb . {i7 C Remarks: Boring # A A 8-9 it`i31-2-. _ sL ,- r 4 . m .4 (SS 1 ill.41 iii 5 / 6 .:.............. 7. iii-iiii 8 , . ?-z3 7.s >R 4 id __ _ /1/5 e_:) ill I 6 s — 6,7 Sz 23- /6 A 4/4- .— MS . S6 0, I — 67 6Z 4 Ground elev,, /67.'i ft. Depth to ..,4.- /0 4, .8 ---- limiting i 3 • 21 c rl - L factor >133 Remarks: -.. Boring # — ?/1 5L / th st:31( / (S /ft? (3 ,4 6 .j •'( e 7-2/ ilvkv — (,-- ikv)t< Ground al_ 11-77 itxR.41.4. — i'll. S() All — 63 6.3' • I elev. /07 3 ft. ti Dept ng / h to 1 < C 44 4 limi a+-00•0 — xf72....,_ al- - ( eto3 . 3. Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) 'I,' ____ r ( _,_ ;.3 1_ r3tNC4Mitli2 .. ti - r .Pi k a. /NJ ` ELE - /4 ?.08 1 " 4 ELEJ- 9 7.6 / , 1 5 EtEV - /00. 1. • i i I 1 11 bi : i, , x ��SCAL ' = 30 ELEV - /639 e i " i l° , 1 gz' l� 1 1 I 1 11 I LI, HI I 1 I; e ELv/ -/n/.9 , i /S' ± - _____/ ELEv - iaN - /6U. , ELty. , /132.3 • 3,__ I , 4 (0111 i Page 1 of 1 Kevin Grabau From: Shawna Moe Sent: Tuesday, April 10, 2001 1:07 PM To: Kevin Grabau Subject: Harvey Kevin: Harvey Johnson called. He told me to tell you that the depth is 91. (Hope you know what he's talking about). Shawna Moe shawnam @,co. saint - croix. wi. us 04/10/2001 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page 1 of 3 Bureau of Integrated Services in accordance witb. . p- 171�'i3 Af.9, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches,X4t'size Pia mush^,, 'onty include, but not limited to: vertical and horizontal reference point SN4) direction iftei : - CYO tY percent slope, scale or dimensions, north arrow, and location ardistance to nearest Road Parcel I.D. # ffffff Rb n. . APPLICANT INFORMATION - Please print all information , : ; :r ii }ii d by Date 'r,w Personal information you provide may be used for secondary purposes (Privacy Law, ( !j� 1 ,Q-: ,�. / r yk 7. Ili Property Owner `_ Govt. r eF E"ocatib,ri' � Q\d-KA t ,, ✓ ` , ,.L4ti" 1/4 S E 1 /4,S 34 T Z et ,N,R lei E (ore Property Owner's Mailing Address 'J t I p y g �) ock# Subd. Name or CSM# \?,5 3 Av` \Q-Vsk --. ee - t. 4--1 (.,o+- }},, u lxxod �k.c e� City State Zip Code Phone Number ❑ City ❑ �� Village Ch Town Nearest Road At xka - 1 W■ 15 1(lk5 15yq - 031 N- t kc0fmr> 1 C' -'y Qo\ N 0 New Construction Use: residential / Number of bedrooms 3- 1 Addition to existing building ❑ Replacement (- El Public or commercial - Describe: Code derived daily flow Ob gpd Recommended design loading rate • Z bed, gpd /ft • 3 trench, gpd /ft Absorption area required 30Q0 bed, ft ZCO( trench, ft 2 Maximum design loading rate g g • Z bed, gpd /ft • 3 trench, gpd /ft Recommended infiltration surface elevation(s) qg'• U° ft (as referred to site plan benchmark) Additional design /site considerations eon-lour C-i-ev- ? 7.00 Parent material aC CX13 ( 1 wilk,S(\ Flood plain elevation, if applicable 4//4 ft S = Suitable for system 13 Conventional Mound_ In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S U S ❑ U ❑ S (0•'6 ❑ S El-cr ❑ S RD ❑ S - zi SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 0-12. ibyr3I 5L. I maul< mc'r C5 t 5 2. 12 I ® r L4AP si I 1 mottk rr,fr- c 5 -- - 2 • 3 Ground 3 I tbyr OM C201.5yc L 4IIc St 3vcr me t CS — rvP 'I"P elev. 9710 ft. Depth to ' limiting factor s3j_in. ' Remarks: f Boring # OH) iOyr .3J — s L _\ 1 abk, MCI C._ (P • LI : - 5 2- 11 `&) 1 Cry r 9 )0 61 ) tr,a1(�It °m -C GS 2. . 3 3 A 16, 31`1 (2p-� 1� Si ?w me. (5 Np, ',Ns P Ground elev. 45: 7i1 ft. Depth to , limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. Address / Date CST Number C./0 e' act( 5 K - e /1 �mR.rs=e t,✓ / s 25 L/ /5 -9 7 ,et.s'330 q PROPERTY OWNER SU� SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D.# Boring # H orizon Depth Dominant Color Mottles Structure ry G D /ft 9 Texture Consistence Boundary Roots f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 6 -7 I () yr 3/2 SL_ ImQbk mfr c.-S 1f' 4 : -5 Z 27 IbyryI(p — St ►mabl< mgr cs — 2 3 Ground 3 2 - 7-33 1pyr 51ti - 1 -Syr `IL Sf ,3vcm N rYle-c 1 cS elev p p 9'4•sr Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... ........................... ........................... ........................ Ground elev. ft. Depth to limiting factor in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) 1 3 44.3 Sec& (Re / _ /00 .. Aa : I i..tS U (3,.►•, 1 a 1 ev• loo . v AQt t : n Lo •• o4.K am Z e(ev• iCS0 sxsfe.� ete�r • S�$•00 3C -Our GI V. 9 700 • er. � , n►Z • G1� a n►o, Ladle. 1:33 7 ear • a \O es f1 • 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). Table 1: System Design Specifications Sanitary Permit Number T 91 Number of Bedrooms Design Flow - Peak (gpd) c_ D Estimated Flow - Average (gpd) 3 W Septic Tank Capacity (gal) Soil Absorption Component Size (ft') W - ; '• Type of Wastewater "b mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absor tion Component Design Flow - Peak (gpd) 1m5 3�' ' cep Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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. Th 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 • Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank 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 Tess than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 1. • Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 83/13/2881 16:21 _ 7153868473 COPY CAT PAGE 81 - _ • ST CROIX COUNTY . sonic TANK MAINTENANCE AGREEMENT AND OWNERSHIP CBR11F1CATION FORM Ownettlityer Be .0 . Meiling Addeo. - 3F-75 ""e^e ' r 4 „lye, . A ), ( /) 5 - 5 7X 4. 2 ..i Property Meow 0 . Ar -■., • e...- /-- wenrweriee topired from Phoning Department foe fess constiva(ion) ite• / City/State 4} - r Parcel Identification Number 1 _ UrreetiringicZEIMIN . ,K ofrt .zycei pd 6: , r Property Location 1 /4, VI, Sec. , T N-R W, Town of Subdivieion - ..r co•-xt cc> — /I / 4' "-- Lot # f:2 Cortland Berm Me? I , Volume , Page 0 • Spec house 0 yeeftno Loi litres identIfishIoXyee 0 no iininhtMejtainAlEg . *Nm tee a ndalliairinablier raw NIP* system «mid molt In km pressture thilsre to hasee wean. Flom emesseraseo eseursio otposopber got do oink tank only gine roan or poser, if seeded by a Moored poops. Who yes pot into the emus aaa aim ihe 6110110 st ase mpg, lea as ei beetroot temps la dee Is ilispesitt wysion. immisr b l Palm, Immo Woe Se rim* to lit Cro Demirel* a cuttrZ eigarl by the WIWI poi try o it - bow epee** raditlea awl* (2) ,.,,everetea end pimp* ( faseeleary),Ibe eeptie talkie ler tier 14 !tat*. ' -*10 4 Ihra, Ora ariarelped boo reed do . - ' . t eed epee to reeirdeis the Ovate sewage elierreal vetakiftlaisteerimis WM& liarait• le era tri dr Durward 'WS* Deportment ef Natural Iteracces, Siete arillermilarCestillailua *erg lie yeat rya - bear arabletbralmei be curpierd red retunred la do St Croix County Zen* Otlise widths 30 - .0, 014 m r , ow 161 4 14 4 APPLICANT DAIS *. . . . intrila4aaajaCKIIM I Oft) ratify Ilhat ell rastereato esArZik;liet are toe to the hest eine Ora) knowledge. I (we) MI (111110) dr arra(*) at 4 — *ern% ttY *See gisie.MetenSy deed reseeded he Register af Deeds 010r. X 4r A/c!, ./.4r/ fira / - 4 '` . . : ' " W/O 1 _NONA rr OF APPLICANT 4: :, i. DATIII "" Any latermatiou that tie atimpresilikaamenit is dr uratery port loins Milked by Ike &rift Repairs*. "me :Am. :00•A 4 w* 'N de aie appUrauler e sampperimermmy deed Ara der Resler at Diode trMee a caleY et 01i esetlesd nom map It Memos is eras is the warraray deed VOL ' fl 1FAGE .23 6. STATE BAR OF WISCONSIN FORM 2 - 1999 '� Q7431C) Document Number WALSH WARRANTY DEED REGISTER H. DEEDS ST. CROIX CO., WI This Deed, made between David 0. Ousdigian and Deborah G. RECEIVED FOR RECORD Ousdigian, husband and wife 03 -19 -2001 3:30 PM WARRANTY DEED EXEMPT # Grantor, and Robert D. Stahlmann and Dawn R. Stahlmann, husband Y CERT - CO FEE: and wife COPY FEE: TRANSFER FEE: 225.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Addre Lot 47, Plat of Cottonwood Ridge, Town of Hudson, St. Croix County, .riVrQ Wisconsin. 400 S .g.4 So.N44. %S .f-3a00'70 020 - 1353 -47 -000 Parcel Identification Number (PIN) This is not homestead property. 1) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. p g Y Dated this /GO b day of March , 2001 * • avid O.Ousdi • n * * Deborah G. Ousdigian AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. County ) authenticated this day of 1 , Personally came before me this I day of March , 2001 the above named David 0. Ousdigian and Deborah G. Ousdigian, husband and * wife TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *`) y, tlikk rT Attorney Kristina Ogland Notary Public, St. to of Wisconsin Hudson,WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) 3'1(Ug .) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Company, Fond du Lac, WI STATE BAR OF WISCONSIN Public 800-655-2021 WARRANTY DEED FORM No. 2 - 1999 Notary State of Wisconsin Barbara J. Burke Sent by: EDINA REALTY HUDSON WISCONSIN 715 388 1502; 03/14/01 8:55; jetFax #108;Page 2/2 I - le-I -‘..-j k F-- 1 r • — - I i ' / . 1 2.Q55 ACRES MI 1 . eV- • 31 . 1 . 7 119,534 SO.FT. in 1 ' t. its Co) . i 1 i , 1 • C .. . 'I .1 1 2.104 ACRES -. i cz, 33 1 33 i 4 ca TEMPORARY CUL-DE-SAC 1- -4 91,673 SOY!. ' en I N ..1 -..'-• i t ' 'I Z. — — — — — NOTE " t i s i AD • t , t ' CuL-DE--SAC TO BE REMOVED 1 .44 1 i lid i ' ' 1 i 1 UPON ROAD EXTENSION I " I 3 S ,..1: im i i • ---- ----,....... , 1 ......-' I I 1 I 1' - I t.31 I 1 11, t.. I 1 3R, __. _ _1 t -- — 410 i • 'i,-) ig i : . - .. > • \ i __,-. V ) -,- "'" ..- ., - • ....... ........ 4 1 - • .„, t • -,- - 1-) 3 i .- --- _.-F ____-- sertTea*Ty 356.74' . • ,...,_ ...---- ...,---- . .- - • . - A , ---- --- -- - - -- -'' -- /I kJ A _- - ..---- @ - ...- - .., - - - ...--/ 1 1 1 14 - ------.- ,,, , --w ___ _ --r 3 3 3 - 3 .. - - — • • '' • • • * • - *1 ...,"---. -- __,,---- 31 3 11 1 H.W.L. w . • 1 1 I 989,0 . - , I t . • 11 . • - t 11 4 .1 1 . 1 ......,?.., ..., r 1 1 i i ;44,0 i i 4.506 ACRES 1 ,, i i 1 1 196,272 SO. FT. i i i jai 4.226 ACRES tics r-•:t 1 140 184.084 SO. FT, cu t I.,p ti .1 ai 1 i 4 t 'co i .41 i I it...3 t 142. 1 it W.L. 977.0 . t I t 1:4 ,I • t to .t 1 i 1 i -in . 1- '1:-. I 1113 3 I :3 1 31 i 3 . GRES I t t I H $ SO. FT. t 1 u .1 .1 1 t 1 1 t 11 .1 1 I i i 1 „ 1 1 3 3 1 1 13 ,1 i 3 31 .1 1 1 11 1 I 1 1 i 13 ! 1 11 .1 1 _a95,00' I _ _ t __ ___ __ _ 319.. ___ _.. _ --- - .., N88•46 1311.24' / ,. .,,,- 0/4 coiR / SECTION • SOUTH LiNE or THE 5E1/4 OF THE NE1/4 -----/ — III