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231-1047-70-098
, 2 ? 0 c ® g 2 \ ƒ ° S / 10 § n C , , Zr . f .- 2� 0 ƒ o R $ E # { CD k g A Q $ § # - . m w §-U( Cl) ® to ( (a CD § F c o © / ®�f t k / 0 k / $ $ \ � 4 / CL # k EI «- § §J g . a£ o o Q I E « CL \ 0 0 o k� @ / A § ■ ■ ■ « f § . k� O k ,� ■f�• M § } . / & § § 0 ( o m / ( "w- § \ i , e . \ / § . (D _ ■ ` k z 0 $ & ■ T q / -4 . 06 © q CA 7 z 7 �f ; E M > \� La CL ; = o � � . mA2EC 2z K X20 0 32; 2E ; E22CLE �m0 f U� § CD § $&0J - ka77 � 0 M. CD : . cr k C IS Q § ; o §7D % �� 0 % . * t \ @i �d k� «� � � k Wisconsin Departmeot of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division f INSPECTION REPORT sanitary Permit No: 430402 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information ou provide may be used for seconds purposes [Privacy Law, s.15.04 . 1 (m) Y P Y secondary I Y O 1 Permit Holder's Name: X City Village Township Parcel Tax No: Schreiber, Steve --r— I Cit of Glenwood 231 - 1047 -70 -098 CST BM Elev: Insp. BM Elev: BM on: Section/Town /Range /Map No: l C & j L { (Am / ) 27.30.15.754720A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Gvr q.`6U toy, 106 •a Dosing UV ^ ob Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ] Dt Bottom f nl,l IV / S• Dosing Header /Man. 3.15 / ►I, Aeration Dist. Pipe Holding Bot. System. PUMP /SIPHON INFORMATION Final Grade 'k s6 S -LL Manufacturer Demand St Cover GPM 1. I , Model Number A5 ,S c /a&, o / ,n. e TDH L Frictio S stem Hea I I , H Ft 1 Forcemain Length Dist. to well g 1) �n - SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. OfT+eRQIw" 1 �Q PIT DIMENSIONS No. Of Pits Inside Dia. Li id Depth DIMENSIONS / / 3 I 1 7 SETBACK SYSTEM TO I P/L BLDG IWECL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: >/ UNIT hA w In Mode er: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size I x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length a Dia 1 Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over I Dei2b, Over I xx Depth of xx Seeded /Sodded jxx Mulched Bed/Trench C Bed/Trench Edges I opsoi ? Yes No Yes COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 0_ /)q_J�1L Location: 107 Windmill Way Glenwood City, WI 54013 (SE 1/4 SE 1/4 27 T30N R1 5W) Glenwood Meadows Lot 20.6 Parcel No: 27.30.15.754720A 1.) Alt BM Description = �W*R/\ ^ 'SC I Y ,' 2.) Bldg sewer length = 3 8 " �j TA -amount of cover= " C OV Plan revision Required? Yes No f� Use other side for additional information. v U SBD 6710 (R.3/97) Date Cart. No. nsepctors Si nature Q Safety and Buildings Division County 201 W. Washington Ave., P,O. Box 7162 I ��Or��a/ i1� Madison, W1 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 Department of Commerce Sta Plan I N Sanitary Permit Application * q3o yoz � In accord with Comm 83.2 1. Wis. Adm. Code, personal information you provide Address (ifdifle !than mailing ess) may be used for secondary purposes privacy Law, s15.04(1 xm) Pto1 1. Application Information - Please Print All Information It) Q Q�luae C.% 6�,. Propeny Owner's Name a el N Lot p Stock-# t Property Owtter's Mailing Address y Location - -75q ?/B �� S r l %., %, Section AL City, State Zip Code Phone Number v le one 5337 )�! /��' T Ni R �✓ Eo� I1. Type of Building (check all that apply) m S tAti Subdivision Name CSM N uMMer -- t 1 or 2 Family Dwelling - Number of Be /f ej� oLi s ❑ Public/Commercial - Describe Use l = I W • O / K ! / _ ❑ State Owned- Describe 1, City se D t� - 111. Type of Permit: (Check only one box on line A. Complete line B If applicable) A. New System C1 Replacement System El T atment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Pemmit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. Type of POVVTS S stem: Check all that a 1 ❑ 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 Filter ❑ Recirculating S thetic Media Filter C1 Lzaching Chamber ❑ Dcip Line El Gravel -less Pipe C1 Other lain) V. Dis ersali7reatment Area Information: 7 Desig - 4 - Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevati Info Capacity in Total Number Maitufacturer Prefab Site Steal Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Scp( c ODD jj6fl �Li� Acrubic Trcarmcru Unit During Chambcr tJ ;LnWstatla V 11. Res nslbBl Statement- 1, the under n assume W fo the PO�YTS shown on the attach s Name (Print Plumber' gna s Ntunber � 7/ r 23 ✓ � `r/� Address Street City, State, Zip C Plumber's Ad ( 4 ?a r /� (/ C �r •fi r/ �J eI' < Vlll. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater D ate Issued !s g Agent Signature No Stamps) Approved ❑ Disapproved Surcharge Fee) I 11 Owner Given Reason for Denial 3� IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all tie S!rviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attaeb complete plans (to the County only) for the system on paper not leas than 21/2 s 11 inebes in size SBD -6398 (R. 01/03) s 3 a s Id 9 S m � 1 3 - _ Qj std' s �x � f J cr �, el Iz u s 9 I 0 i ' it ww � YkXY J N i c (t v s CIA CO PY �u► r M m/ a i Y i L Elk Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 MR TDD #: (608) 264 -8777 erc �sconsin www www.commerce.state.wi.us/sb ons .wisonsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary September 23, 2003 CUST ID No. 139462 ATTN: POWTS Inspector TODD L SINZ ZONING OFFICE T L SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 09/23/2005 Transaction ID No. 917568 SITE: Site ID No. 664864 Steve Schreiber Please refer to both identification numbers, Windmill Way above, in all correspondence with the agency. City of Glenwood City St Croix County SE1/4, SE1/4, S27, T30N, R15W Subdivision: Glenwood Meadows — lot 20.6 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 920325 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7 ) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may includ local ins pectors. s C0 , 4 sieve acnrewer - inouna" Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD - 10706 -P (01 /01) Location: Lot 20.6, Glenwood Meadows SE 1/4, SE 1/4, Sec. 27, T 30 N, R 15 W City: Glenwood City County: St. Croix Date: September 15, 2003 Owner: Steve Schreiber Address: 1201 141 st St. Burnsville, MN 55337 Plumber: To Sinz Signature: License # MP 139462 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management �r�asrrra,c rR�,i�i�; t DIVISIfiN Of SAf - ETY AfdD bulWINGS SERE CORr' L- O ^dD CE page 1 of 8 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg /L Anticipated septic tank effluent 30 mg /L < TSS < 150mg /L Fecal Coliform > 10,000 cfu/ 100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 4NO gallons /day hydraulic load Design Calculations In situ designed loading rate gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock in. Cross slope at system % Force main length ft. of 2 - in. Manifold /header length ft. of in. Drain -back gallons Lateral length Z•'a ft. of I` L in. Lateral elevation i "' t -� ft. @bottom of lateral Lateral hole size 1 At- in. @ 4L Q in. ft.) Spacing 3 holes /lateral 3 9 holes total Lateral volume 11.'S gallons Total lateral discharge rate 9 gallons /minute @ Z s� ft. head Network pressure compensation losses f Elevation difference a Friction loss ft. @ t° gallons /minute Total dynamic head 2 ° ' ° b ft. is l Pump /si*n gpm @ Z ft. of head i Manufacturer 0 Q_ °° Model # �� Z Dose volume -�4 4 gallons Lift/sipkon tank �� w���M' k 0oo -(9d'p 6 `--� gallons Septic tank gallons Effluent filter a tZ - ar:k Measurement pump on and off S, o in. Height alarm from tank bottom in. Reserve capacity gallons specs.calcs.res Page Z of 3 � 1 T f rl i cis 3 3 r J ' rr - 9 cr s 0 9 t L rn d � ? QJ al `90 � f { o r s 9 n U "�'1 \ \ N ^ y rt i n q d a J M i \ ' I , .1 0. O� rt � ~ L�� Qp � ' IL n o 0 z p `tom ° t e 2 .'} 3.4 r O T :.o• y K a-e %i a— o y w. a1 I I I I � I y /. V . wvh•.�1 "`/ 1�. \va.waC 6dL � -�.,rl �.e C7H.M (( �' � { } /'� O\ c� O ... 1 r. T cU. �C Qn.. aJ-�t Q C 1 \ 1 c .., \ ; .. � 5 n42. IL T i WE 4TH ERPROJF LACKIWG COVER .TLNCTIoN P.. 1vAn'�v�,uc .t ABED . &mac GVICK D16CXN14aCT ---\ ;I 'L-6. IL 4o PIP6 3' , ii /,77T;? nL) N01STuRbED Q„_ SOIL, 24u I.D, MAx t101F i V."; N 7 L.. P a I ,hHELT 0 K4 dr°^� R'r m'etit -14 �„ DN - Svc: Cle C i� \TQN :h Ow�ln�� i Ji.�HC _T_ cgg p Pw•lP bcoCK �Sp SEPTIC �T f rr SPEGIFI�CATIOI�1$ U DO 5 E TAU. S MA►JUFAC7URCR; IJLIMBER OF DOSES: PEK ��_ TAWK SIZE ; � " V� 6ALL01J5 11 .DOSC VOLUME ALARh1 MAWUFACT•UKER; IWCLUDINC, OACKFLOW: � MOOCL WU; -%b 1 e I �'� •� Z6.0 CAPACITIES. A _ WcHEs OK IuCHEsOR 24' P / :P /1AWUFACTURCR: C a S . O ULnE OR .N MOpEL 1JUMDCR; IS Z - - _ D• g '`� 13 4,1 SWITCH T p VMQ.V &-A. ,,, INCHES CR 41A _ b E: - QOTE: PUMP AWO ALARM ARC TJ 6C t""IIIMUM DISCKAKU RATE 2$'g GPM INSTALLEO QW SEPARATC VERTICAL DIFFEKEWCE DETWCCIJ PUMP OFF AI,JO DISTRI15UTIOW PIPE.. * MI>JIMUM KIETWORK SUPPLY PRELLUKE . . . . . . . , FEET + FEET OF FORCE MAIN X ,'I' FT FEET I Yoo FtFRICTIOW FACTOR. _ ,'� t FEET ( -7 - 6 TOTAL O'dWAMIC. HEAD �~ FEET IWTERUAI DIME11610►JC • 0/ ,1 TA►JK� LE►JG7H ; LIQUID OE PT H ;` TOTAL DYNAMIC HEA6 /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 W w MODEL 152 153 50 Feet Meters Gal. I Liters G-1 TLItr, 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 i 70 265 0 1 15 4.6 53 1 201 61 231 a Li = 20 6.1 44 167 52 197 Q) 30 — z 8 25 7.6 34 129 42 '59 r 30 9. 23 87 33 ;25 < 20 35 1 10.7 -- 22 85 0 4 1 i 42 4 Lock Volve: 3 8. 0 F! (1'. 6-) 0 r, ,. 3 4m' 014508 I 0 20 40 60 80 100 GALLONS U?ERS 0 80 160 240 320 r- 4 FLOW PER MINUTE - I CONSULT FACTORY FOR SPECIAL APPLICATIONS e • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. T Sealed Qwik - Box available for'outdoor installations. See FM1420. Over 130 °F. (54 °C.) special quotation required. 152/153 Series !^ 1521153 MODELS Control Selection Mod el_ _ Volts-Ph Mode Amps Simplex Duplex N152 115 1 Non 8.5 1 2 or 3 _ _BN 1 115 1 Auto 8.5 Included 2 or 3 J -__ : _� E152 2 1 Non 4.3 1 2or3 SK2084 B 152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153' 1 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 ! 230 1 on 5.3 1 2 or 3 �BE 15 3 230 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level Float switch. Refer to FM0477. a CAUTION 2. See FM0712 for correct model of Electrical Alternator E•Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10.0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. c� RESERVE POWERED DESIGN 5 U For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 ,.'7 Louisville, KY 40256.0347 Manufacturers of. . SHIP TO: 3649 Cane Run Road 0 p FAX (50 Louisville, KY 40211.1961 QUd[ /Tr PUMPS S NCE `�/�� http: / /www.zoeller.com P4 ( 502)778.X(50 2) 774.3 774.3 918•PUMP 624 0 Copyright 2000 Zoeller Co. All rights reserved. • System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715- 235 -2644, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and /or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 1 1. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitorinz may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and. /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 L ,01RIGMAL 1822 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85 Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not F Plan st County include but not limited : vertical g in i St. Croix to and h6e�oi'nf BM , direction nd P ( ) Parcell.D. percent slope, scale or dimemsions, nocation and distance to n rest road. P Please prin a ►9 2003 ' � id B ate Personal information you provide may be purposes (Privacy Law, s.1 04 (1) (m)). � orii 3 I N! - ! Y J 3 Property Owner G `j RCE P opert Location LCN,N� � r y Schreiber, Steve Govt. Lot SE 1/4 SE 19 S 27 T 30 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1201 141 st St. 20.6 Glenwood Meadows City State Zip Code Phone Number 16 City j Village 121 Town Nearest Road Burnsville I MN 1 55337 952 - 432 -7368 Glenwood City Windmill Way New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement _ Public or commercial - Describe Parent material loess over limestone Flood plain elevation, if applicable NA General comments and recommendations: install 10'x 46' rock cell mound on 100.0 contour as upslope edge of rock w/ 1.0' sand fill; force sand basal area to 0.4 gpd /sq ft loading Boring # j Boring f Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 34 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -4 10YR 3/2 - sil 2 m gr ds gs 1f /m .5 .8 2 1 4 -9 10YR 3/2 sil 2 f -m sbk dsh gs 1 m .5 .8 3 9 -20 10YR 4/4 - sil 2 m sbk dsh gs 1m .5 .8 4 20 -34 10YR 4/4 - sicl 1 m sbk mfr cs 1 m .2 .3 5 34 -40 10YR 4/4 f 7.5YR 5/3 sicl 0 m mfr - - 0 0 common gy si coats on peds 11 -24 "; occasional gy si coats on peds 24 -34 "; occasional LS gr in horizon 5 Boring # Boring 16 Pit Ground Surface elev. 99.7 ft. Depth to limiting factor > 45 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -12 10YR 3/2 - sil 2 f sbk ds cs 1f /m .5 .8 2 12 -23 10YR 4/4 - sil 2 m sbk dsh gs 1m .5 .8 3 23 -32 10YR 4/4 - sicl 1 m sbk mfr cs if .2 3 4 32 -45 10YR 4/6 - sicl 0 m mfr - - 0 0 common gy si coats on peds 11 -23 "; occasional gy si coats on peds 23 -32" * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Tuent #2 = BOD < 30 mg /L and TSS _< 30 mgr CST Name (Please Print) Signature CST Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/7/2003 715 - 233 -0398 Property Owner Schreiber, Steve Parcel ID # Page 2 ` of 3 F3� Boring # -j Boring Gel Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 C � 1 0 -11 10YR 3/2 _ sil 2 f sbk ds cs 1f /m .5 .8 2 11 -24 10YR 4/4 _ sil 2 f sbk dsh gw 1 m .5 .8 3 24 -34 10YR 3/4,4/6 - Sid 0 m mfr cs - 0 0 common gy si coats on peds 11 -24 "; occasional gy si coats 24 -34 "; horizon 3 has occasional weak, fine, subangular blocky structure; generally massive w/ considerablel-S gr,cob.st (nominally > 50% LS) ❑ 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 P ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '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 ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 I I 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.07 /00) Certified Soil Testing it Property Owner Schreiber, Steve Parcel ID # Page 2 of 3 ` a Boring # ' Boring ✓j Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -11 10YR 3/2 - sil 2 f sbk ds cs 1f /m .5 .8 2 11 -24 10YR 4/4 _ sil 2 f sbk dsh gw 1 m .5 .8 3 24 -34 10YR 3/4,4/6 _ sic[ 0 m mfr cs - 0 0 common gy si coats on peds 11 -24 "; occasional gy si coats 24 -34 "; horizon 3 has occasional weak, fine, subangular blocky structure; generally massive w/ considerableLS gr;cob.st (nominally > 50% LS) F-1 Boring # 2j Boring . LJ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 I Borin ❑ Boring # —J 9 Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i f 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.07 /00) Certified Soil Testing � al �Qj Li x �( d Nv P -=� C -4 f? q 1 rn 0 d o� 9 rl N c I a � .4 A 9 ell cl 3v � g Ll CI j n ST. CROIX COUNTY WISCONSIN 1+✓e .,` ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER ' m e s s i n e s s No..r 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386A680 Fax (715) 386-4686 Fax ,. — www.co.saint- croix.wi.us To: L D Y� S L From: 6 - ✓ / Aj IY Fax: 2 Pages: Phone: ti ZY Dat Re: CC: ❑ If this box is checked please submit a check for a $5.00 fax fee made payable to "St. Croix County Zoning" along with a copy of this fax sheet to St. Croix County Zoning Department, 1101 Carmichael Road, Hudson, WI 54016. • Comments: r -- ii6, iii. 00 FRI 10:71 FAX 715 766 4686 ST CRX CO ZONING 0001 ST CROIX COUNTY SEPTIC TANK MAH ' TENANCE AGR.BEI, N AND OWNERSHIP CERTIFICATION FORM owner/Buyer f rP f Mailing Address Property Address (VcrificaUon required from Planning Department for new construction) City/State Parcel Identification Number I.,EGAL DESCRIP'Z'ION ��/� Property Location / <, /,, Sec. T N - R�W of SLl, bvisio � 1 lei � ' � _ - —. Lot # Certified Survey Map # 1 �� �' . Volume Page # 'Warranty Deed # -1 Page # , Volume Spec house ❑ yes Frio Lot lines identifiable ❑ yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its pretnnttu a failtrra to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper- What YOU put into the system car, affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. C Zoning Department a certifcation form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumba or a licensed pumper verifying that (1) the on -sito wasttwaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, the uadersigncd have read the above requirements and agree to maintain the private sewage disposal system with the standards on set forth, herein, as set by the Department of Commerce and the epArtmcat of Natural Resources, State of Wised 0.Ce� ti30 stating that your septic system has been maintained must be com pleted and returned to the St. Croix County Zoning days of Lhc three . vea3ss Lion date. DATE GNATURE OF APPLICANT OWNER CERTIFICATx N I (we) certify that all statements on this form are true to the best of ray (our) }mowledgc• I (we) am (arc) the owncr(s) of the pro escribed above, by virtue of it warranty decd recorded in Register of Deeds Office. DATE IGNATURE OF APPLICANT ••*•'• Any information that is mis representedrnay result in the sanitary permit being revoked by the Zoning Department s +sss• + Include with this application: a stamped certified survey map Re gister �erence is op made in the warmnty deed • 'J 2 3 5 6 P 3 5 `t 734 ?93 r; STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX Co., WI Document Number RECEIVED FOR RECORD This Deed, made between Secluded Land Company, LLC, a 08/11/2003 09:30AN Wisconsin limited liability company WARRANTY DEED EXERT # Grantor, REC FEE: 13.00 and Stephen C. Schreiber & Christine A. Schreiber, TRANS FEE: 139.50 Husband and Wife as Joint Tenants (MN Residents) COPY FEE: CC FEE: PAGES: 2 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Area See attached Addendum A for legal description and Name and Return Address protective tovenants. Secluded Land Company, LLC P.O. Box 10 Desoto, WI 54624 I 231- 1047- 70 -09B i Parcel Identification Number (PIN) This is not homestead property. TA is not This is non — marital property for James W. Smith. Grantor hereby transfers all interests in minerals, if any, it may have in the subject property. Municipal and zoning ordinances, any recorded easements, recorded Exceptions to warranties: building and use restrict_ ions and covenants, general taxes levied in the year of closing, and any liens or encumbrances created by the O P FORM NO. 465•A r: - 7.4 utif1'diimer VUL iG FAGE 4368 1,.-., c ............. Stuck No. 26273 KATHLEEN H. WAL,SH REGISTER OF DEEDS ST. CROI% Co., WI RECEI FOR RECORD 09 -05 -2002 12:15 P CERTIFIED SURVEY NAP CERTIFIED S IJRVEY MAP NO. 4 368 co py FEEL 1a' om VOLUME a 6 — 1 PAGE 43668 --� ;; � a LOTS 20.3 AND 20.4, C.S.M. 41613, VOL. 15, PAGE 4160, LOCATED IN THE SOUTHEAST 1/4 OF THE SOUTHEAST 1/4, SECTION 27, TOWNSHIP 30 NORTH, RANGE 15 WEST, CITY OF GLENWOOD CITY, ST. CROIX COUNTY, WISCONSIN SCALE: 1 N= �(JO• EAST 1/4 CCRNER DRAFTED BY : SEC.27, 730N. RISV 0014ALO 14. CLARK LEGE ST. MI CU. KLI 0' too' 200' 400'�w•j '" G x NOT r_ ty ;CORNER R OWNER: `' 3/4 "X44" REOAR FECLUDEI! LAND CO, LLC MD, 1673 13 1/2 AVE. 1.10 8 E, P.0.80X 99 O $al, 3/4 •x24• RE6AR CATION. Y/1 5401 k£ICHITJC 1.507 LEIS. I PER LINEAL ROOT, 1 VIELL HEAD ,o 0 N LOT 21.0 \ I V. 13 P. _3570 0,^ �• ° e? LOT 2 0.5 \ db rye' 147,207 SO. FT. N h (3.38±ACRES) g 145 12 9 o RES) LESS R \W M W � E3 N 74 2:3'90`E Ln --- '84. "E 44 8.94' o n q 0, o U l/11 _ 7 .p .p W W � 21 (n w LOT 18 z, J pa C.S.M. 3051 V, LOT 20.6 b . ,.••• °•• °� °•�. ,g 0. V. 1 1 P. 3051 T (5.391ACRES) � 232.975 SO. FT. `� 11,I ' Y} QQ�IAI.G NJ, 'z�` i � (5.35 ±ACRES) LESS R,W C LA FI IC ti °, �°� °�.....,. *.•'��«6 LOT 19 S 93.3o D2• E �-- +���� 387,30, o V. _11 P. 3052 N $00HEAST CORNER CEDAR CORPORATION UMPLATTCD LANDS TEC.27, 1 R15V 1104 'AIL5014 AVENUE ST. CROIX Co. moklu. MENOMONIE. 'f +t 54751 (715) 235 -4051 SHEET t OF 2 Vol, 16 Page 4368 �A 'O � 985•A �'��.19i V Stock No. 26273 CERTIFIED SURVEY MAP NO. 4368 VOLUME _ 16 , PAGE 4368 LOTS 20.3 AND 20.4, C.S.M. 4166, VOL. 15, PAGE 4168, LOCATED IN TIIE SOUTHEAST 1/4 OF THE SOUTHEAST 1/4. SECTION 27, TOWNSHIP 30 NORTH, RANGE 15 WEST, CITY OF GLENWOOD CITY, ST. CROIX COUNTY, WISCONSIN _ CERTIFICATE: I, DONALD M. CLARK, WISCONSIN REGISTERED LAND SURVEYOR, HEREBY CERTIFY: THAT I HAVE SURVEYED, DIVIDED AND MAPPED LOTS 20.1 AND 20.2, C.S.M. 3570, VOL. 13, PAGE 3570, LOCATED IN THE SOUTHEAST 1/4 OF THE SOUTHEAST 1/4 OF SECTION 27, TOWNSHIP 30 NORTH, RANGE 15 WEST, CITY OF GLEI•IWOOQ CITY, ST. CROIX COUNTY, WISCONSIN, MORE PARTICULARLY DESCRIBED AS! AT T R F 7 COM MENCING SHE SOUTHEAS CGRNE 0 SAID SEC 27' THENCE N,00'08'56 200.62 FEET TO THE PCINT OF BEGINNING; THENCE CONTINUING N,00'08'56 "E. 850.00 FEET: THENCE N.51'02'01 "W. 102.29 FEET; THENCE N.41'00'29 "W, 117.42 FEET; THENCE S.5214'54 "W. 133.39 FEET; THENCE S.35'42'1 1 "W. 350,97 FEET; THENCE 5.40'14'28 "W. 60.00 FEET ; THENCE S.12'13'36 - E. 559.39 FEET: THENCE S.83'30'02 "E. 387.38 FEET TO THE POINT OF BEGINNING. CONTAINING 381,777 SQUARE FEET (8.76 ACRES) MORE OR LESS. AND BEING SUBJECT TO EXISTING EASEMENTS, THAT I HAVE MADE SUCH SURVEY, LAND DIVISION AND MAP AT THE DIRECTION QF MIKE S_IVA, FOR SECLUDED LAND CO., PO BOX 99, BARRON, W, 54812, OWNER. THAT THIS MAP IS A CORRECT REPRESENTATION OF THE EXTERIOR BOUNDARIES OF THE LANE) SURVEYED AND THE SUBDIVISION THEREOF MADE. THAT 1 HAVE FULLY COMPLIED WITH THE PROVISIONS OF CHAPTER 236.34 OF THE WISCONSIN STATE STATUTES AND THE SUGDIVISION REGULATIONS OF THE CITY OF GLENWOOD CITY AND THE COUNTY OF ST. CROIX IN SURVEYING, DIVIDING AND MAPPING THE SAME. DATED THIS _Z DAY OF c i.� �, 2002. b �m C O /b DONALD M. CLARK, R.L.S. 1580 h g * / DONALD M CK S -1580 k MENOMONIE, ' � APPROVED: CITY OF GLENWOOD CITY VVcllace Lindholm. Mayor y1- r DATED THIS �` DAY OF 2002. CURVE DA F A T ABLE CURVE LOT RADIUS ARC CENTRAL CHORD CHORD HACK FARE 110. NO. LENGTH LENGTH ANGLE HEARING LENGTH TANGENT TANGENT 1 -2 60, 00' 133. 54' l 27' 31' 10' S. 14'00'49'W. 107,63' S. 49' 44' 46' E. S. 77.46' 24' W. 20. 5 60,00' 68.4W 65 1 B' 46' S. 17 23'E. 64, 75' S. 49' 44' 46'E. S. 15 34'00'W. 20.6 60. DO' 65- 14' 62 12'24' S. A6'40' 12"W. 61. 99' S. 15' 34' 00' W. S. 77'46'24' CEDAR CORPORATION 604 WILSON AVENUE ME'NOMOI'IIE, M 54751 (715) 235 -9081 SHEET 2 OF 2 Val -16 Page 4368 I . �4 y 3 � g ., ,z ♦ T ,2 r �r UP Rq v�oo Y oa T J „ TV, � of Glenwood _ 1 . AVE u SI DR � PARK to a i OR i $T In % _ TIFFANY A ? CHERRY do ST S ST VE ST < OAK ST I � s GLEN 3 ASSTV r DR CT F I n m U m i i 0 J 0 Fdm it U~ PwbAshw4 LK Q � wor FOR RESERVATIONS CALLA 00.2.RAMA I n y p - 0 n c d f = lu O co 3 Q 3 n m a • � - V _ Z O w l C v W lr• 0 (A o a m y o o° R N v S . ! \ 1 0 U � cn f a o 0 O 3 C D < 0 N CD K H m a D co �. y m o R w cn z D m a D U' a `C = W = 3 N C D O�� C � A O O � o o n r (n N w °w m 3 a • �y z 000 °Y "V C _ O N C O O y � m CL W W v 00 C- 0 o y �Wo 0 o =r � N y CD o 3 W fD O a 3 m z p n A Z O 1X 0 O I ' p' 0 / �. cnW� -o _ o m ; cn z V � O A cn W 3 m � CD `•1' W 2 m a CL 0 CL ca o- _ I S �CD p 2 / U m cr N CL G N N V 0 .A I f7 D O 1 � 1 O N w 6s o CD r 1 Kevin Grabau - From: Jansky, Leroy [Ijansky @commerce.state.wi.us] Sent: Friday, December 10, 2004 2:55 PM To: Kevin Grabau Subject: RE: Schreiber site Re: Steve Schreiber - residence SE, SE, 27, 30, 15W City of Glenwood City, St. Croix Co. Transaction Number: 917568 Site ID Number: 664864 I recall visiting this site and that nothing appeared out of order with the mound. Pressure was okay, and no leaks into the tank manhole risers (at least from our "water test ") were observed. I believe that the owner had to have the tank pumped out an extra time (or something like that) because there was a lot of backflow or leakage that caused the tank to fill up quickly. The reason for this could not be verified. The bottom line is that we cannot make the plumber dig up the entire system to see if there might be a leak in the piping somewhere especially since there was adequate distal head pressure. What we couldn't verify for sure is if the forcemain is broken somewhere. The pressure in the system was adequate, but we don't know what it was initially for comparison. If the pressure was real low there might be a break in the piping. In addition, we don't know if there is a 4" sleeve around the 2" forcemain leaving the tank that might not be sealed adequately against groundwater infiltration. I felt that it could be possible to have a leak real close to the tank so when the pump cycles it flows into the tank through the 4" sleeve (if there is one). However, we did not observe this when the pump was activated, so there is likely no breakage near the tank. The owner should monitor the situation and if there is a repeat performance we should be contacted to observe it so we can document what is occurring, and maybe pinpoint the cause. Please consider this e -mail as a report for records. Leroy G. Jansky Wastewater Specialist - - - -- Original Message---- - From: Kevin Grabau To: Leroy Jansky (E -mail) Sent: 12/9/2004 3:46 PM Subject: Schreiber site Leroy, 1 .� You and I visited a,site that had a mound, in June if this year. It was in Glenwood, top of a huge hill, installed in October 2003. The guy was having problems with his mound. He also had a bunch of gophers burrowing in it. Something about some backflow from his system. We connected your clear pvc tube to check for pressurization, and it seemed fine. Do you have a report on this? I cannot seem to find any of my notes on the problem and what we found, beyond what I wrote above. Plumber was Todd Sinz. I think the guy showed up after we were there a while, and you borrowed a 5 gallon bucket around the riser rings to check for groundwater infiltration. Do you have any info on this? Owner: Steve Schreiber. Kevin Grabau St. Croix County Zoning Department 1101 Carmichael Rd Hudson, WI 54016 715.386.4680 keving @co.saint - croix.wi.us Zoning Department Web Page < http: / /www.co. saint - croix.wi.us /Departments /Zoning /default.htm <http: / /www.co. saint - croix.wi.us/ Departments /Zoning /default.htm> > 2 ST. CROIX COUNTY f WISCONSIN ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER ' i I I M ■ M ■ Noted 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386A686 www.co.saint- croix.Wi.us To: S Z Fro m:�� F= A - - 2 �Y Pag Phone: 2 Da te: �/ /7l o ` f Re: CC: ❑ If this box is checked please submit a check for a $5.00 fax fee made payable to "St Croix County Zoning" along with a copy of this fax sheet to St Croix County Zoning Department, 1101 Carmichael Road, Hudson, WI 54016. • Comments: 0 c g ' • o / c f 4 � § 0 2 _0 ° t o 0 2 § - CL 7I E C) \ ) i \ § E E ( CL § k E o k \4\ © g )z I ¢ k' 3 i / 0 § 0 $ se %i CD k § 0) CD j \ �I § E e m § Z' z 0 0 0 \ e § § D < © Q / \ \ ■ ■ ■ « % % { [ ¥ 7 v v \ i E g_d cc ' B § ® ƒ CL } § E 2 9 a c = I k O 2 0 \ / 0/CD 7 CD \} 2 j z {2 � \ wm 0 B & �� ■� k % E ( �Q$ 0 f j CD ■ T m / j a E, � z � � i » 7 a q 7 c $ M 7 » W 0m> E}E C ; 573 § Gam/ R � }\� CD CLC # \ » sk U) = (§ k . gCD § crk \ �, \ . g§ < k . < -o �§ - PAID Wisconsin Depariment of Commerce SOIL EVALUATION REPORT Page _/ of 3 Division of Safety and Buildings In accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. y jd 70-0 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. Reviewed by Date Personal infonnauon you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). Property Owner Property Location c� Govt. Lot 5� 1/4 SC 1/4 S �) 7T N R J J E ( W Property Owner's Mailing Address Lot # Blxk # Sutxi. Name or CSM# g City State Zip ode Phone Number ? ity ❑ silage Town Nearest Road rMReplacement w Constriction Use: LC} Residential / Number of bedrooms _ Code derived design III w rate �'C GPD ❑ Public or commercial - Describe: Flood Plain elev ation if applicable � Parent material .�D+r'Sf /D General comments � / ✓ 7 �^� l / rn h `l L and recommendations: G.� �� , �' (e //,9" < Cl�� 8 l�lD e�) ?7q I T [] Boring Boring # r / Ground surface elev. L �' � ft. Depth to limiting factor 3 r in. Lf�F' Soit (cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. k-J J 1 4 10 \l ' C d �t Boring [3 Boring _ r1 g n 7 9 S limiti factor �. — in. . ' G lev . ! ft. Depth to I g Soil lication Rate G surface e Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD Etf#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. r S— I `� 3 _� L 2 c 'Ft t.J J 3 o � 101►/ .f- � S i � sb�. , . or a Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 130 mg1L CST ame (Please Print // Signature c� {� CST Number I ( Address Date Evaluation Conducted Telephone Number 40- 1% Property Owner Parcel ID # Page °� of Boring Boring # Ground surface elev. 1- ft. Depth to limiting factor z in. t Q w G P DA Rate Pi So' Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary R 3 f#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. psi S 0 I ? 0 11 S. r Boring # Boring 2 g, q/ h, Depth to limiting factor in. Still ication Rate l.� pit Ground surface elev. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots fE GPD/fF in. Munsell Qu. Sz. Cont. Color fit S W tv s o 3 y 5 �.F I Vie ( s � in. El Boring # Boring Ground surface elev. _ ft. Depth to limiting factor M*E ❑ Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/l_ ' Effluent #2 = BOD, < 30 mg/L and TSS S 30 mglL 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 -8730 (RAM) 99 N �..M, loo. C)o. Top E# Ii" pu` p, y' ` �` Ie9o� • s d kex f to P1'toc f f 'b0-iv -e �a HLU �� P Wisconsin Department of Commerce SOIL EVALUATION REPORT Page -/-- of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code minty Attach complete site plan on paper not less than 8112 x 11 Inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. �, r. j�T _ �11 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Date Please print all Information. Reviewed by Personal Information you provide may be used for secondary purposes (Privacy Law, S. 15.04 (1) (m)). Property Owner �f p q a Property Location /-�/t /ry /hS ©✓ Q Govt. Lot S 1/4 SE 1/4 S � 7T O N R 15 Property Owner's Mailing Address lot # Block # Subd. Name or CSMaY - ox a City State Zip Code Phone Number ity El Village ❑ Town Nearest Road New Construction Use: I�Residential / Number of bedrooms Code derived design flow rate yS'o GPD ❑ Replacement ❑ Public or commercial - Describe: R Parent material Ysf Flood Plain elevation If applicable /j General comments and recommen ations: 97 yy El Boring . lev ace efsur d Groun # ° f'L1. eo tt Depth to limiting factor In. Sou ication Rate a Boring it Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Gr. Sz. Sh. *Ef�1 In. Munsell Qu. Sz. Cont. Color a r� o s bb V , F o , �? s - l tsl � Ca Boring # 0 Boring n_ C in ication Rate Son l� �t Ground surface elev. l 7 9 � ft. Depth to limiting factor � . Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots .E GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -g 0 �` ?l7 Y1 1.`t ( J . • Jo JL C �- 2 C `Fr t cJ b OY/c d- (c S Io1C u Effluent #1 = BOD > 30 1220 mg/L and TSS >30 _< 150 mg/L ` Effluent #2 = BOD _< 30 rng/L and TSS < 30 mg/L CST ame (Please Print 1 Signature CST Nuimbv -P-t r% I ( Q-cQ h-- Af Tele a Number Date Evaluation Conducted P Address. -7 7a WI-D-07 720 Ave, riK AL U)r y property Owner Parcel ID # Page °� Of C] Boring Boring th to limiting factor Soii ication Rate Boring # Ground surface elev. • K. Depth -3� _, Pit GPWfE Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 • EfN In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. c bdC f � t5 0 V V r ❑ Boring Boring # $ it. Depth to limiting factor _ in• Pit Ground surface eiev. , q S ication Rate Texture structure Consistence Boundary Roots GPWff Horizon Depth Dominant Color Redox Description Gr. Sz. Sh. •Eff ll in. Munsell Qu. Sz. Cont. Color W > S , d J 1 v � ol y? O W1. d 42 ...� c sbk 3 t -------------- 5 v F-I ❑ Boring in. Boring # Ground surface elev. h• Depth to limiting factor Sop icsdW Rate ❑ Pit Horizon Depth Dominant Color Redox Description Texture SWcture Consistence Boundary Gr. Sz. Sh. •Eff#1 OEM in. Munsell Qu. Sz. Cont. Color Effluent #1 = SOD > 30 220 mgll. and TSS >30:5 150 mglL • Effluent #2 SOD 5 30 mg& and TSS _< 30 nVL 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. 1. SeD4)30 (RAW) w a d 6. 4a q a a q a,� - �►, r . .s �_ 9 d N To of I " Pvc- P. ,e \ � Vev fay k*.�k �g� G � 1 ® of � r � k /690 Top ant e A)e)e f to 93 � 1 ) k - q'4.9 �•, t'1'�Va -f'C �o- iv G 4c, Hwy In