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I SCvn t � -e rr►�� �g210 � 111111 lllllllllillllllllllilll i 8 Tx? 6 4181248 Document Number Document Title 994258 St. Croix County BETH PABST REGISTER OF DEEDS Occupancy Affidavit ST. CROIX CO., WI RECEIVED FOR RECORD /� 04/01/2014 4:18 PM D >'- 11` Allf EXEMPT #: Name— (Owner)Typed or printed REC FEE: 30.00 being duly sworn,states,under oath,that: PAGES: 1 1. Helshe is the owner/part owner of the following parcel of land located in St. Croix County,Wisconsin,recorded in Volume Page Document Number970tr f 1 St.Croix County Register of Deeds Office: Recordinq Area Y, 5 Name and T Address M()W/ ' A parcel of land located in the/J` /,of the /,of Section / ,'" T 11 N—R _W,Town of IC;r,h I C'k Loum-i--� St.Croix Syq' 10/L E u 2-1 e-P (L.p� County,Wisconsin,being duly described as follows(include lot no.and gClf Yo Z3 subdivision/CSM or detailed legal description): 0ZZ- blz $O - C)Z5 a F G5 7 - 41 W (,0 Parcel Identification Number(PIN) As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a ,S bedroom home,or a design flow of 756 d. The design flow is calculated by assuming 150 gpd for 2 /0 occupants are permitted individuals per bedroom. There are currently occupants living in this residence; _ p Pe based on the design flow. Therefore the septic system serving this residence is code compliant. However,I understand that if there are intentions to exceed the number of permitted occupants,the system will need to be modfed t6 accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated s day of v^l • * t AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) 1/111110 ' )ss• authenticated this day of i� St.Croix County. ) day ri Pers Ily came before me this o •'•• •'• the -nwned =g�r Y2 TITLE: MEMBER STATE BAR OF W ISCONSItg �j (If not, - i �� S Z Q me known to be the person(s)who exe t::: Q Instrument nd�acknowledge the same. authorized by§71�.f)C,Wis.Slats.) / THIS INSTRUMENT WAS DRAFTED @t5/ •••••.....«• C !Z' Notary Public,piate drIMS-reonsin (Signatures may be authenticated or acknowledged. Both are not My Commission n ion is r %t�lf not state expiration date: necessary) Date: J ' HIS PAGE IS PART OF THIS LEGAL DOCUMENT-DO NOT REMOVE" Ttds infommeflon must be con#eted by subrrdtter document title.name 6 mtum addre ss and plN(Il required). Other information such as the granting clauses,Joao descrollon.eta may be placed on this lust page of ft document or may be placed on additional pages of the docurnent.hEQW Use of Oils cover page adds one page to your document and$ZQQ to the recording fee. IMsconsln Statutes.59.517. St.Croix County 994258 Page 1 of 1 0 CO) 01 3v0 tv r� (D n v W A� cn T. "0 z cn 3 T. - 0 z . o y (D 0) m p 0 y (D 0) m O W N � 7 � N to C)a N C_ 0) G) 4) N C G) A y O 7 M N O' 7 Q 7 N O. 7 0) 7 Q v 00 O O N G O R C 0) m A'I 3 3 o N CA . n y A I" cn Z cn Z D m cn z cn z D eo F Y+ v • m (o D (& D m (n D (o D a A C a CL C ° ° o o o � O < z z o o CD f7 r N O y O O O O C A Q 3 ^. C (r� M M lZ`111 d .. .. O' .' z z o ° :* ]? y < Z n v m c (a Vl N O m D 7 3 3 0) > n cn to to v v G O N O O O O --1 O O �_ o 3 3 3 3 d w cc 3 m rn N N �• I a a 7 0 r► O 0 p O 0 N. m Q 0 y. m j a C I O 7 0 S O j° S O d � ap m CD n y Qo c Q= c c c a no 3 a ao 3 N CD M 7 7 y M O(A 0) 0) 01 . 7 . 70C cr A O 7 7 N I = CD _ � y Z N Cfl a W m o m CD o, Z 'o P M m m 3 li m o C4 Z I II MCL o 9 Z avi Q I 0 =rn,AO 0�y�o: I m a �_ m o 'm c I u z Nam Z a O O. O 0 O. p �D 0) ((A ' f D 0) cn o m 'a o m n n8 X00 o cn� o cn0 U c y �k C m o ai 0) CD co C = 0 c y n y ov_ oa fi CO = I = fi 0. 7 0. C 0 OL h O O V fD a� m a� I j < j < 0 (D 7 (D O O q ( CD A w 00 II A O O 0 0 O O I r a O 0 L 0 O L N Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Fredrick Lenertz Govt. Lot NE 1/4 SE 1/4 S 5 T 28 N R 18 E(r® Property Owner's Mailing Address Lot # Block # Subd. ;Name or CSM# t uildin 1 e Lenertz 220 Lives ock Exchange B g City State Zip Code Phone Number City rl illage own Nearest Road St. Paul MN 1 55075 1 ( CTH N New Construction LlseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD ® Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable to ft. General comments This sites is suitable for a mound with the system design not to exceed 0.2 gals. /sq. ft. /day for and recommendations: effluent concentrations of less than or equal to 30 mg/L BODS due to platy structure This reported information is in addition to a report that was filed by Adam Shoemaker on 07/10/02. Borings 1, 2, & 3 are his original borings 4 ] Boring # 0 Boring Q pit Ground surface elev. 14 ft. Depth to limiting factor 99.79 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3 /3 sit lmpl mfr cs 2f .2 .3 2 9 -14 1 r4/4 sit lmpl mfr cs if .2 .3 3 14 -17 10yr4 /4 f2f5yr5 /8 sit lmpl mfr cs 1f .2 .3 4 17 -20 10yr4 /4 c2d5yr5 /8 sit lmpl mfr cs if .2 .3 5 20 -32 10yr4/6 c2d5yr5 /8 A Om mfi - - .3 .5 F5 Boring # Boring 13 98.11 El pit Ground surface elev. ft. Depth to limiting factor in. Soil : Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -7 10yr3 /3 sit lmpl mfr cs 2f .2 .3 2 7 -13 10 r4/4 sit lmpl mfr cs if .2 3 3 13 -16 10yr4/4 2f25fr5/8 sit lmpl mfr cs 1 f •2 .3 4 16 -24 10yr4 /4 c2d5yr5 /8 sit lmpl mfr cs if .2 .3 5 24 -34 1Oyr4/6 c2d5yr5 /8 s l Om m f i - - .3 .5 * Effluent #1 = BOD > 30 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 12/04/03 715- 246 -2454 err 2 3 Property Owner Parcel ID # Page of ❑ 6 Boring # Boring Pit Ground surface elev. 13 ft. Depth to limiting factor 100.63 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3 /3 - sil lmpl mfr cs 2f .2 .3 2 8 -13 10 r4/4 - sil IM PI mfr cs if .2 .3 3 13 -16 10yr4/4 2f25fr5/8 sil lmpl mfr cs if .2 • 4 16 -38 10yr4 /6 c2d5yr5 /8 sl Om mfi - - .3 .5 F-1 Boring # r Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * 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- 8330Test (R.07 /00) PAGE 3 OF 3 f%mr Ll NORTH LOT LINE 115' M1,11 0 so' 161' A B6 D 3T 231' E 226' B1 A ' s _ E 5% 34.14 m SCALE V= 40' SLOPE B E BM3 TOP OF CONDUIT 100' BM4 TOP OF CONDUIT 100.43' , 84 99.79' it 85 98.11 86140.63' BM 40 B2 4 OTHER SOIL TESTERS B3 100.48' 98 ' 1O2' E NOTE: THIS IS A SUPPLEMENTAL SOILS REPORT, PROVIDING ADDITIONAL. 100' A INFORMATION AS RELATED TO A REPORT THAT WAS FILED BY ADAM SHOEMAKER S ON 07/10/02. BORINGS 4, 5, +& 6 ARE NEW BORINGS, WHILE BM3 & BM4 ARE NEW BENCH MARKS T FRED LENERTZ P O NE1 /4, SE'I /4, SECTION a 61e E T28N-R18W R TOWN OF KINNICKINNIC Y L I LOT THOMAS NELSON E 227387 o 3 m o d O cn �� z cn� �= z ° c a n <'', c ° nr ° .> .�!• 0. N N N O ? 41. < p N 3 N N W p j . 3 A O c c ^ I° a o °' N a o N 3 Q 7 J Q 7 = - V cA n C) (D c a o o m c o (D c m i �� b $0 h 0 V 3 J 3 rn �_ 10 c p N N Z v v " R d cnz F 7 j z cnz co ZD cD a o m cn' D D D cn D r m ccw m �' a .� 7 7 W a o c a a o3 3 CO C `v � m O o O z z p o p p o p j Z y p N p A A d N [�'! Q N. CD M 3 T �Z T - 0 - 0 g A) z z 000 o v ° v y a m D Z 7 7 3 M 0 a- 0 CD � a v v v 3 3 3 3 e "—� m oN co °•: W p N N W CL d p M p p .. c Ca R 7 CD p T. m Z3 - p .0 y. m p �° c 7 o• CD m 7 7 m CY CL I n n CD Q0 c c 0 E w a ao 3 a ao 3 ro Z p m z m a --I N p O y p O 7 Ca 5 M 0) N v N d x ? A G 7 7 7 (D N z CL 0. m z 3 3 c CD CD p " In m OD OD N m a cn F I j m =r !zo D p 7 BOO D I w s a co m 7'Ln a 7 a vi Q 7 CL a i a5 rn o: a� y c m� Nam z yv(D z CL 0 3 a p o 3 a CD m CD o mn N o mn y I o c o c o v�o o i vim, n n � N 5 S =r CD a'< m a'a CD CD I (D 7 CD 7 A I o o I N N o o o o O N° f f o CD CD CL CL Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 453210 0 GENERAL INFORMATION (ATTACH TO PERMIT r y ate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Avalon Builders Inc Kinnickinnic Township 022 - 1012 -80 -025 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: VA Cs ( 05.28.18.77810 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark LTD Dosing � �S� CT13'0 Alt. BM Aeration U Bldg. Sewer Holding St/Ht Inlet , St/Ht Outlet s / TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , /� r Dt Bottom + Ss• mf Dosing / r Header /Man. 2- • S' D r > ) 3 2 � 01.30 Aeration Dist. Pipe z. SS' 21 SS f z. rS 2•S2. Jo�.2S Holding Bot. System 3,4 o , Fin I PUMP /SIPHON INFORMATION `G,rDade /2 -_ wal 6 .�- f w,�. Q Manufacturer Demand St Cover t 6 5 GPM `�• odel Number JA Q 3,7 S O ' TDH Lift Friction oss r System Head TDH Ft , \5'� 4• SZ .S0' Zfo `f o 3.8a otv•o Forcemain Length f Dia. Z r t Dist. to Wei ` J SOIL ABSORPTION SYSTEM Width Length No. Of TreNSpes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS q Q1� r . 5 1 A� 1� —7 SETBACK SYSTEM TO (7v P/L J I BLD DG G A � IWELL LAKE /STREAM LEACHING Ma f urer: INFORMATION CHAMBER OR Type Of System: —3oI (017" lr�'/ UNIT Model DISTRIBUTION SYSTEM b? 4- C.4 Header /Manifold tt Distribution f , x Hole Si a �, x Hole Spacing Vent to Air Intake y Pipes) O 3. D ? y Length Dia Length On.� Dia Spacing 3 6 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 e E Yes n No Yes No _ N�11(IE_ NT,S: (Inclu�i� ode dis re encies, persons present, etc.) In ction #1:�/ J / 6 pection #2:�f location: 544 euzinger d n (N 1/4 SE 1/4 5 T28N R18W) NA Lt DT, YsParcel No: 05.28.1 1 1.) Alt BM Description 2.) Bldg sewer length amount of cover C / Plan envision Required? ed s �No 20 - - -` - - -- _ - - - -- -- I — - - -1 w� : � -,� Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. ` Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7082 - C ec L x �s�� Madison, WI 53707 - 70$2 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261.6546 3 Z O Sanitary Permit Application Slate Plan I.D. Number In accord with Cam 83.2 1. Wis. Adm. C ode, personal information you provide may be used for secondary purposes Privacy I.aw, s l5.04(i )(m) Project Address (if different than trailing address) I. Application Ia[orruatioa - Please Print An Inf - SLH4 t� (ZE+ hL (n1G1 1 's Name Parcel M Lot 0 Block 0 -O Piupaey 's ling .f l v (!!, Property Location C State Zip Code Phone Number ' S-0—F 1141 y« r� S t Ak h 5�oa 5 T N O B it ) IL Type of Building (check all that apply) a4a S 19 1 or2 Family Dwelling -Number ofB n MNumbe-r -) O Pu blic/Commaeial - Dam Use rr � ✓vl C u x r • l A e d r� �� T' g o D State Owned - Deaenbe U LL W " " - I • ($ _ ;tinge ®I owasi of . III. Type of Permit: (Check only one box on thire A. Ceroplate line B if applicable) D 2Z ^ 1012_ _ �b - 0 2 S . •f - & - 10 A . R New Systan ❑ Replacement System O TratmeaMoktiag Tank Replacement Only O Other Modification to Existing System B. D Permit Renewal O Permit Revision D Change of D Permit Transfer to Now List Previous Parmt Number tad Date Issued Belbse Expo Pharba Owner W. TM of POWTS Check all that 0 Non -Pressurized M•Gmd Mound < 2d of suitable soli ❑ At -Grade ❑ Siagk Pass Sand Filter ❑ Constructed Wetland ❑ Prcastmizad In-Ground O Hokling Tank Peat Fiher Aerobic Treatment unit ❑ Recirculating Sand Fiber ❑ Recirculating Synthetic Meru Fika D Leach Chamber O Drip Late D Gravel -ka Pipe O other dmro V. tateat Area Information: Design Flow (gpd) Design Soil Application Rpe(gpdsf) Disperai Ara st) Dispersal Area Proposed ( Sytxem Elevation � �g u.o) 765 17 765 /M' -� VL Tank Info Capacity in Total Nurubtx Manufacturer Prefab Site Stud Fiber Plastic Gallons Gallons of Units Cancrew Constructed Glass New Tads Teaks spurtsliolftTank 1 S Ae"ioTrst eatuein oariss�tx.tnber I l ! k VII. Fes ponslbft Statement- b the wade sigmd, auame teapsagmuty for lwdaes �e.?0WTSS She" on the attacked plans. Q " 's Name (Prim) P Q "i/ a / t� Y N ! B �' - �/ Plumber's Address (Strap, I , S Zip ) �6 b /C t VIII. Coca rtar+ceuIt use Onl ' Permit Fee includes Groundwater Date ttuy ( issued i A Si (No Sum") (� Approved D Disapproved Sera � Fee) � . � O Owner Given Reason for Damian 35'� ZQD IX. Conditions o Approv SYSTEM OWNER; 3) 5 rte 1 Septic tank, effluent filter and S�(S ^ � «` .�i4n -{u , 5 V, ' dispersal cell must all be serviced / maintained . I „ as per management plan provided by plumb gg> - k nts must be maintainelT� 0,61 .�^�^ 2. All setback requirements q as per applicable code /ordinances. l Amasses �t� t� (b tre Catamty aaty/ f net less tbaa atn: IaeYa b rlsce �y SBD -6398 (R 08/02) NVIscoissin Ztll W. Washington Ave., P.O. Box 7162 Madison, WI 53707- ?162 Sift Addreas . De ailment of Commerce Sanitary Permit Number Sanitary Permit Application In accord with Comm 83.21. Win. Adm. Code6 personal information you Provide ❑ Check if Revision nay be used fot secondw =yaxes Fsivw Law s15. i m L Application In wpindon - Pltmse Pd at All Information State Plan I.D. Number Property owner's Name Parcel Number Property Owner's Mailing Address Property Location ''A elf • S T N R B Ciry, Stare Zip code Phone Number Lot Number Block Number Subdivision Name CSM Number IL Type of Building (check all that apply) ❑city ❑ 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe Use ❑Towrtsbi ❑ State Owned Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 ❑ New 2 ❑ Replacement '*y Win •3 ❑ Replacement of 6 ❑ 'Addition to For Cou�y use.. stem Tank out stem B. ❑ Cbeck if Sanitary Permit Previously Issued Permit Number Datc Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 ❑ Non - Pressurized In -Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Sittgle Pass 51 ❑ Drip Litz 45 ❑ At-Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculaft 30 ❑ Otber V. D 1l'heattnent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(GalsJDays/Sq.FQ (Min./Inch) Elevation VL Tank Info Capacity in Total Number Mau fitctmer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Ustioi Tanks Tanks Septic or Holding Teak _ i Dosing Chamber VII. RespwsWW Statement 1, the =Auxlp4 asmmie respowligr for o // APTS shown on the attached plant� Pbmrber'a Name (Friar) s Signature Plumber's Address (Street, City. Zip 01 >d e �s V1 hUse ❑ Approved O DhWroved Sa dixty Permit Fee (includes Groundwater Data istared bming Agent Sigttatuee (No Stamps) • Surebarge Pee) ❑ Owner Given Initial Adverse . DearmhatIon EL Canditions of A.pp WraUReasons for Ditappr ng i Alt elt complete plain (to the Con* tot,) tar the o9m an paper amt feu than 8U2 = u heirs in slze SBD -6398 (R. 05101) g ¢ ' PLOT PLPN Scale l" =5() Page -' of o� I 4 LL � C . - T • I`1 N ` _ x;,11 10 . II � • 0• p' au K -- N It l m Sv 66 �TS`t� pp tJuT e. C+^� nPreT O� k _ yz► v_Gw� S �D2 `N1 � r I III _ N I �I 1 1 i ll � I li J- � J I I q? I z' (° 3 G9 COcu1OvZ EL. }� 12•L U Z,16 (DZ kz NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1 yOU ! 6 O Ogallon capacity manufactured by � CO►vCt Ck�.l 1 000 A Op- � fZ - 1U07-"\a Fi� PV`- 1P`Pf�kM za lUUI3 Gm e. 4. Bench marks = Sk � 5. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings 4003 N KINNEY COULEE RD . LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 mmerce.statemi.us /sb Visc www °° www.wisconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary December 16, 2003 CUST ID No.267341 ATTN.• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/16/2005 ___ Identifi Numb ers Transaction [D No. 951144 SITE: Site ID No. 669402 Avalon Homes Please refer to both identification numbers, Kreuziger Road above, in all correspondence with the agency, Town of Kinnickinnic St Croix County NEl /4, SE1 /4, S5, T28N, R18W Lot: 1, FOR: Description: Five Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 935776 Maintenance required; 750 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Cone and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in APPR chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. pE ENT{ The following conditions shall be met during construction or installation and prior to occupancy or use: aF General Approval Requirements: SEE CORRE • 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). • Per manual cited above, 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. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. ARTHUR L WEGERER Page 2 12/16/03 • 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. Stat • 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 include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise makin g necessary for code compliance. As per state stats 101.12(2), nothing in this review rY P P shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 TITLE SH EET R �'CE e of MOUND SYSTEM L FOR A S BEDROOM RESA%7ya I /� . This plan has been prepared in accordance Faith t e Manual SBD- 10691 -P and the Pressure Distribution Manual BD-1 n SBD 1 (N.01 101) 07006 6 -P ..(N.01101) LOCATED IN THE iJE 1/4 OF THE SE 1/4 OF SECTION S , T Ze N , R �E TOWij OF h,.►dv I1 S1`•`-m1,C COUNTY, WISCONSIN. Jnj - INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MAI AGEMENT PLAiv PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHA21BER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR R l O tV H z �-rvT r LlrzF , y"�N SS�ZS ` °Wally PREPARED BY OVED WEGEIKER Sp I L TEST I iVCC )�M�ERCE AND. DES I G;V SIE:RV I CE 3POINY P.O. Box 74 421 N.11ain St. River Falls, WI 54022 Phone 715 Fax 715 - 425 -6864 v gP Te a . ,p ELL�':i'pciT•i Y LZ -� JOB NO. 03 -1 6 3 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Pa Z - of SL%Pti Ic 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. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the 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 sludge and scum 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 a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and th moun shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetrati ne Traffic (other than for vegetative maintenance) on the mound is not recommended since. soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 6005, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual and local or state rules pertaining to system maintenance and maintenance reporting. SAb _ IDb q1- P No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. Continpencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1 j -3ip 6 - 68 S1^ -0-M lx The-system installer at S_QG�SC.) G l vft v The tank manufacturer at g�� -. ZS -g�S LUt�L The effluent filter manufacturer at gpu— ZZ( S?tlZ 3LsZ The pump manufacturer at Z� PLOT PLAN Scale Page ' of 0 9 T 13w1 _ I I N, I i 566 �`� oo tool e pr,��PreT o� I lS P'�*N) /Y �k >� L. �' U I : /o N j y I 1 � � � I �. a, I A Q I Iii T ��1 CO rv�OvCZ �1. 1 WTAV ' d� 1z12�U Z1Y6 - 02 NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation ipes with approved caps. ( Z required) Septic tank to be 1 UOO �6p Ogallon capacity manufactured b wj2>y�J� `UOZf1q. q�`RS2 PU�P`ft�klU 3� 10W G y,�� Z�� 4. Bench marks - S �OV� 5. Divert surface water around system to prevent ponding at the uphill side. Page's 01 Annroved svnt..hetic cove-inc ASTH C33 Distribution Pipe Medium Sand Topsoil —� r F IG Elev. BOO. S 3 c b �.1 S CQ Slope Distribution Cell of Force Main Flowed Z" to 2- Aggregate From Pump Layer _ CROSS SECTION OF A HOUND SYSTEM F y- `� Ft. C 0 , S Ft. A Ft. H 1.l� Ft. '' ' Linea_ Loading Rate- �.9 G?D /ILL�T FT B Ft. Design Loading Rate ='p, k 4G_D /SQ FT J 8 F ry i n L I O Ft. -04- L 'Observation Pipe y E � K A -- - - e - -- --- - - - - -- ------ - - - - -- - - - - -- Wo-" — - - - - - - -- - - - - - -- ------------------ - - --�- o Force Main Distribution , „ Pipe Cell of to z 2 aggregate Observation. Pipe (anehbr secarely) PLATT VIEW OF A MOUND SYSTEM Distribution Pipe Layout Page S of Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45' f rtma to a point within six inches of the final glade. Terminate the ends of the laterals with a valve :threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. J `1 P 1 C17 L. C\ S S'�L�1111�j PV C F\ Lateral Manifold L�,_ X X X x X!Z x2 X X x X ' Lateral Lenath — yP Lateral Length — p Distribution Line C_ - -o M It F-J S PVC wQCE nelt' i o— _ _ � a P yu 5 Ft. Hole Diameter )) 8 Inch S 3 Ft. Lateral n Inches) X 3 Inches Manifold Z Inches Force Main " Inches I of holes /pipe )Y Invert Elevation of -Laterals 10\.b 0 Ft. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF VEUT CAP 'i "C.Z VEIJT PIPE - - WE ATH ER PROOF JUU APPROVED LOCKING MANHOLE 10' FROM DOOR. JuiJCTlOIIOL J BOX COVER WITH WARNING LABEL WI NDOW OR FRCSH 12•MIU• I AIR INTAKE GRAD I 9 CO►JDUIT � -- __________ I S I Al. 11� UULET • PROVIDE T AIRTIGHT 5E/1L f I I v APPROVED JOINT/ A I I I APPROVED JOINTS I ( I i I A I LARM I ! I I ow c I -- CLEV. 2 3 FT PUMP J OFF 0 COLICRETE 5LOCK Y • RISER EXIT PERMITTED olJLy IF TANK MAlJUFACTURER HAS SUCH APPROVAL 3 "APFRWE: SPECIFICATIOMS DOSE TAWKS MAM UFACTURER: lJUMBEA OF DOSES S 3 PER DAy TANK 51ZE U) GALLOWS DOSE VOLUME I Ai -ARJw1 __M/14UFACTURER: STP_(1 SLi ST S` lAICLUOIWG 6ACK /60W: 1 b�'` GALLONS MODEL 1.1UMBER: 1p 1 tti,y - CAPACITIES: A= 1 p CALLOUS SWITCH T�PC: r��1ZC V� t f 5=- _INCHES OR S S , G{ LLOL15 PUMP MANUFACTURER: C= b INCHES OR 16-2- CALLOUS MODEL NUMBER: W COS D- 12 INC O R 2-2- 3 GALLONs SWITCH TYPE: 1 u 07E: PUMP AJJ ALARM MARL TO ()�- o MINIMUM DISCHARGE RATE 3�`�� INSTALLED 0!J SEPARATE CIRCUITS S:b� VERTICAL DIFFEREIJCE CETWECN PUMP OFF AUO.DISTRIbUT101J PIPE.. i FEET + MIMIALIM NETWORK SUPPLY PRESSURE , � • � , � , 6, Sp FEET �S•c�X 1, 3� +A FEET OF FORCE MAID X Z`SI F c f �FRlcTlou FALT Q 13 FEET TOTAL MAMIC. HEAD FEET -�- - - - -- - As per:manufacturer gal /in. Liquid depth 36 t) " I' uUUIQS ' Submersible - Effluent Pump EXWwit PumV \J 38.85.... � n APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the be provided in starter unit. bronze impeller available as without damage. following uses: • Shaft: threaded, 400 series an option. ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Farms • Bearings: ball bearings type for maximum efficiency • Motels f . construction. p • Trailer courts upper and lower. 2" NPT discharge adaptable' • Power cord: 20 foot s ■ Power Cable: Severe duty or slide rail systems. rated, oil and water resistant. • Schools standard length (optional n Mechanical Seal: SILICON E o seal on motor end • Hospitals lengths available). p xy p CARBIDE VS. SILICON provides seconds moisture • Industry Single phase: p secondary •Effluents stems •' /a and Y2 HP -16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket y Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three gUNA -N elastomers. wicking. SPECIFICATIONS prong plug. g. • 3 /4 -1'/z HP -14/3 STO with ■ Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. W maximum. •' /z -1' /z HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian Standards Association TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat !!L Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide - stationary seat, 300 0 Impeller: Cast iron, semi- ■ Designed for Continuous series stainless steel metal open, non -clog with pump- Operation: Pump ratings are • parts, BUNA -N elastomers. out vanes for mechanical seal within the motor manufacturer's Temperature: recommended working limits, 104 °F (40 °C) continuous Protection. Balanced for g 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90- -- ---- stainless steel SERIES: 3885 • Capable of running dry 25- S IZE: 80. ___ _ + j �r, souos WE15H ; RPM: VARIOUS without damage to j i =- --► 5GPM - —t— —�- components. 70 WE,aH , 5Fr Motor Q 20- so -_- i Single phase: _ -WEO • Y HP, 115 V, 200 V, 230 V, 60 Hz, 1750 RPM;' /2 HP, Z 1-5 50 I 115 V, 60 Hz, 3500 RPM; 'c 40. tvEOSN HP -1 Y HP, 230 V, p 10 - ' alllEO E i i 60 Hz, 3500 RPM.- 3 ° � I • Built -in overload with �-� - i - -- - - 20i WED3L i automatic reset. ' . j Class Bins' ulation. Tf i I - - Thredphase. "' 10 Y HP 7 =1' /z HP.200 %230/ . o o X 460 �/, 6U H Z, "3500 RPM " 20 . , 30 50 - 60 70 80 90 100 110 120 130GPM CIBSS B insulation. o 1 CAPA ITY 20 30 m� /h 4 01 C ©1995 Goulds Pumps, Inc. X q Effective May, 1995 X71 � � � ❑ ^ac, Wisconsin Department of Com erce ,�rniy ; oUU SO' L EVALUATION REPORT Page of Div;,;Ipn of Safety and Buildings i s ST. (fN;6TnN "th C m 85, Wis. Adm. Code Attach complete site plan on per nom FI es in size. Plan must County include, but not limited to: vert an orizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. . Please print all information Re 'ewed by 'Date Personal information you provide may be used for seconds u 1 m secondar p ur p oses ( Priv a cy �v Law, s. 15.04 c> c» /I'1 1 Z I qt, Property Owner w ` Property Location Rv � LAN )+ 6evt hot ?J� 1/4SL,1/4 S S T N R �j E Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 1 I - ►vt v o t-. \ City State Zip Code Phone Number City Village (4 Town Nearest Road � T `PCYzC Y4 NJ I SSbZ5 1 (6S1 )�-)� -ao80 � )tjYv1e. lG�`�Z ® New Construction Use: ® Residential / Number of bedrooms S Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ G \_ -PrCl R Flood Plain elevation if applicable ft General comments � r s and recommendations: U 'F PrrAj F1 L i c- u L,Z SU C% q Boring # Is Boring nn , / E] pit Ground surface elev. " t 't ft. Depth to limiting factor 9 in. Soil Application Rate { Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o -�F� Jo�tz31► — Si 7,W)s't r rn`P- cs Z ►0 -1a \O - Sj w Z Sb h1`�I^ •�( . b I t F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. ' Soil 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 I 'Eff#2 u o� `Rfi� n'CWI�US T C�.t UL� t3 �Zln./Gg 1_7 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD,, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) � Si lure CST Number Arthur L. 'Wegerer r� v 3 -I ( Z� -'-.) - 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, NI 54022 \Z - 715 -425 -0165 PLOT PLAN Paae 2 of � Scale l' =50' Z OTV — )6? - D ? �- � '°' 7. - __LS? -_, lob • 0 ` ou- _� _ ,�- K - - __`+ h e •PST 13w1 i 8.� N tYl I _ N ll y 15 °Jn r , i x I � o I IBS' I �q ��__�oT cfl�an_c� o�� ��si�.�r�3 '�•E .Pn?�'R. 1 S'Dpf�;s�jP�_.LF__�1�.rD 715 - 425 - 0165 220254 03 _ ► 6 3 CST Signature Date Telephone I CST No. Job NO. Wisconsin Department of Commerce SOIL EVALUATION REPORT -- Division of Safety and Buildings Page of in accordance with Comm 85, Wis. Adm. Code o Attat;h complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction'and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Reviewed b Please print all information Y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location -Gevt:-6ot )JE 1 /4SL 1/4 S S T Z4� N R j �j E (or)r Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number y [] City ❑ Village ® Town Nearest Road Y4 NJ f SS b ZS 1 (6's 1 C) �3 g 0 vt- )U N 1 `�` l >U lv 1 C ® New Construction Use: [ Residential / Number of bedrooms S Code derived design flow rate — 1 5 _ GPD ❑ Replacement ❑ Public or commercial - Describe: j Parent material Flood Plain elevation if applicable fV 1'N' ft General comments and recommendations: U4 F1 l- c-U LZ SV , Cl \ q . O E Boring # ❑ Boring ❑ pit Ground surface elev. "l 't ft. Depth to limiting factor '7 ( in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E f #1 'Eff #2 JoL�1z311 — Si 1 �w,sb'r C \vim .S • s ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft I in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 I - Eff#2 2.1 S or `rte n�wt�)us r % t3 NZ)noGg 1,Z ef 3• Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) �p S�ature CST Number Arthur L. Wegerer 0 44 r 9 w d�. v 3 -L 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number [ +21 N. %iain St. diver calls, WI 54022 \- Z_ \3_O3 715 -425 -0165 PLOT PLAN Pace 2 of Z Scale 1' =S0' . 9 �T 13ri1 I q erv} i i $.l N ,rY � � N y 15 !b O 9 i sz f 16 (�)2 lZ 715 - 425 -0165 220254 CST Signature Date Telephone ITo. CST No. Job NO. Dec 12 03 02z37p Davic Steel 715- 246-5085 p.l 394 Wisconsin Department of Commerce SOIL EVALUATION RE ?ORT page 7 _of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steen Soil Service Attach complete site pan on not less the n 8% x 11 inches in size. Plan mu,�t County include, but rut limited to: vertical and hotorr 9 reference point (BM), direction and ___ - -- St. Croix Percent slope, scale or dirnemsionS, north arrc v. and location and dstarrce to nearPSt rand. Parcel I.D +` - -_ - -- I — — Please print all i. fiormaiion. — . _ P ending — - - - -- - - Persona irdormeticn you provide may be used far eaortdary p.rrposes (Priraty Law, s. 15.04 (7; ;m) }. Reviewed By Date i Property Owner Property Location Avalon Ho _— - - - -- - - - -- Gort. lot n NE 19 SE 114 S 5 T 28 NR 18 11►1 Property Owner's Mailing Address -- _ —_ -- Lot # - - - - - -- —`— Block # Subd. Name or CSM# 855 West Broadw _ 1 _na _ Vol. 17 Pg. 4616 � - - ^_ -- Ch State Zip Co; :e Phone Number City — Village V Town Nearest Road - -- — -- — Forest Lake ] MN i 5502: i 651 --464 - 9080 Kinnickinnic Cty Rd N ✓ New Construction Use. ✓ Resider Val / Number of bedrooms 4 Code derived design flow rate 604 GPD ; - - - -- -- Replacement Public c rcommercial - DescrLha:na - - -- Parent material Grou an d end m orain :s, pitted glaical drift stood plain elevation, If applicable na General comments -- — ano recommendations: Mound design, Sys em elevation 100.808 based on contour line elevation 98.90ft. Minimum of 18• ASTM C33 sand. ❑ Boring # :...: Boring _✓_ Pit Ground St rface elev. 99. 34 — ft. Depth to limiting factor _ 18 in. Soil APP li tixt Rate 1 Horizam I Depth r Dominant Color Re 'ox Descr"w r Texture Structure C- ormster:ce I Boundary Roots G PDJW 1 in. Munsell ou. Sz. Cort. Color I Gr Sz. Sh. 'Eff# 'Eff#2 1 _- 0-9 10y none sit j 2msbk mfr Cs 1vf . 5 8 i 2 9-18 10yr4 /4 none s ic] _ j j 2 m s bk ; mfr Cs na 4 i 6 3 18-29 ;W 11217.5yr5/6 sic[ 1 2msbk mfr Cs na - .4 b 4 2948 5yr4/4 -_ _ - C2 d 7.5 yr5/6 ° scl 1 2msbk 1 mfr na na 4 i F E Boring # Boring ✓'; Pit Ground Su face elev. _ 9 9,30 ft- Depth to limiting factor 2 3 - -in. Sod Application Rate Horizon Depth Dominant Color Rec MDscription Texture r Structure Consistence I Boundary Roots _ Gpotftz ir►. Munsell Qu. ;z. Cont. Color Gr. Sz. Sh 1 I •Eff#1 •Eff#2 1 ` 0 - 1 3 10yr3 /1 none sit + 2 i mfr ! cs i 1vf 5 8 2 10vr4/4 -none slot 2msbk mfr cs 1 n -- �- - - a I 4 1 ---- =- i —�- --- � 6 3 - 2 3 3 23-30 10yr414 f1 17.5yr5/6 _ siG 2msbk - cs_ I na I .4 _.6 ` 4 30-48 I 5yr4/4 C2 ! 7.5 ' yr5/6 scl 2msbk mfr ! na ! na 4 6 Effluent #1 = BOO > 30 < 220 mgr, and TSS -30 15o mg/L ' Effluent ty2 = BO? < 30 mg1L and TSS ,30 mg/L CST Name (Please Print) is 7ntu ` ` _ CST Number David J.' Steel __ 24895 Address Steel Soil Service ; Date Evaluation Conducted Teleplwne Number 1564 CR GG, New Richmond, W154C i 7 12/12!2003 715- 246-5085 RECEIVED 8 2003 1394 Wisconsin Department of mmergEC 1 S IL EVALUATION REPORT Page 1 of 3 Division of Safety and Buil gs ST. CRoiAC,&idbrbnce th Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site pI ZO ING OFFI 2 E in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Pending Please print all information. Re4 iewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Avalon Homes Govt. Lot na NE 1/4 SE 1/4 S 5 T 28 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 855 West Broadway 1 na Vol. 17 Pg. 4616 City State Zip Code Phone Number City J Village W1 Town Nearest Road Forest Lake I MN 1 55025 651 - 4649080 Kinnickinnic I Cty Rd N 01 New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement J Public or commercial - Describe Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na General comments and recommendations: Mound design, system elevation 100.80ft based on contour line elevation 98.90ft. Minimum of 18" ASTM C33 sand. Boring # J Boring 1m Pit Ground Surface elev. 99.30 ft. Depth to limiting factor 1 8 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 -9 10yr3/1 none sit 2msb�C mfr cs 1vf .5 .8 2 9 -18 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 18 -29 10yr4/4 f2d 7.5yr5/6 sicl 2msbk mfr cs na .4 .6 4 29-48 5yr4/4 c2d 7.5yr5/6 scl 2msbk mfr na na .4 .6 F2] Boring # I Boring e Pit Ground Surface elev. 99.30 ft. Depth to limiting factor 23 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0 -13 10yr3/1 none sil 2msbk mfr cs lvf .5 .8 2 13-23 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 23 -30 10yr4/4 fl d 7.5yr5/6 sicl 2msbk mfr cs na .4 .6 4 30 - 48 5yr4/4 c2d 7.5yr5/6 scl 2msbk mfr na na .4 .6 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) 2 -7 ign ure: / CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG , New Richmond WI 54017 12/12/2003 715- 246 -5085 - Property Owner Avalon Homes Parcel ID # Pending Page 2 of 3 3] Boring # _j Boring tJ/ Pit Ground Surface elev. 97.40 ft. Depth to limiting factor 22 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 1 0 -12 10yr3/1 none sil 2msbk mfr cs 1 of .5 .8 2 12 -22 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 22-48 5yr4/4 c2d 7.5yr5/6 scl om mfi na na .0 .0 Boring # Boring _ F Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring 9 F I 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 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD -S 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST - POWTSM 4V // ° New Richmond,WI 54017 Lic. #248956 NE1 /4 ,SE1 /4 ,S5,T28N,R18w Bus.(715) 246 -6200 Town of Kinnickinnic, St. Croix Co. Fax (715) 246 -9372 Lot, l Legend I " =40' ♦ = Benchmark Ele. 100.00ft Top of 3/4" PVC Pipe • = Alt Benchmark Ele. 100.00ft Top of 3/4" PVC Pipe ❑ = Borings Boring Elevations B 1 = 99.30ft B2 = 99.30ft B3 = 97.40ft B4 = 00.00ft � I s �P T �V Sio�e S� 6 f l' x Alea a2 ' S V 4" %0 ' C - ...I..G vl .aGV 1141`1 :7. h.7JUMW V 9� TO BEAR S88'04'02 "W • r N i E o O�ilD MV UDDAUMG WEST UNE OF THE NW CORNER OF THE A NE 1 /4 OF THE SE1 /4 NE1 /4 OF THE SE1 /4 , 800 °15'11 W 4122 75 OF SEO MON s a (V: 313.2 ; gt ac ca z ee ! Q O i v 1 C 7 En 3•y i / r2 s to a :,,� � 1 �sor1 a 33•E 2sa.9z � _ _ ! ^, _ _ _ _ -.. � a a Road --- a z OON ,` y = m t u Is zz m y �a�,$��� ri ri in m { t "1 z I � I I� (S� Z I � 3 ► 1 Zm � m o m soo�39.44�i/ ! .ati $ t i Q vvvvr I 381.10' ii ° ?� v 4 tot { I 1 1 t •1h� ., gw 0 N C N OGD GI t i tt�� m m �I p tai I t 74 wtoccooODg: m i o y �! AI t ° i� 90 2 C v � cn z z --I '71 v s00'39.44'Wr.. .._ t i >. Q to N 1 § 0 - m t 0° 378.90' L.. �� i i X i N o w aw � � Q � ol m1*i ma I Zq U) z I , ; 4 0, y .� m '0 � So $ Z j 396.$8' u w q I .•� N 1 I ° N00 43 cc W I . _ i 1 WEST UNE OF THE EAST 200" i 3 m m r7 g OF THE NE1 /4 OF THE SE1 /4 N 2 z CJI � � I P -° _mod �G9_ �• j m � Z t Z j 1 V? n �I m M rn -•1 z , I 8 B 8' A PQ1333 9 0 o C Maq =m0 L4 r r 1� m rn = n o --i 0 °1 0 - ST. CROIX COUNTY �,,,,.►. , WISCONSIN ZONING OFFICE M M W M ■ — rrrrrr+r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road AN Hudson, WI 54016 -7710 ,- (715) 386 -4680 FAX (715) 386 -4686 Page—/— of 2- COUNTY ON -SITE VERIFICATION FORM Inspector: I ti AKA, Date: 1 Z l 140 0 S Parcel ID Number P roperty Owner PropertyLoca on Lj_- N &K_ Govt. Lot N& . 1 9 S& V S T 2 1 N R b #far Property Owner's Maii'mg Address of i # „ 81ock # SLbd. Name or CShAit 2zo L ; ve t -- or es Ms µ1*1 ity State Zip Code Phone Nureer ❑ City ❑ village Wown Nearest Road Pmt Vw :K_j c NN c NN1 L i CTH J\/ ❑ New Construction Use: ❑ Residential J N umber of bedrooms ....... ....................... Cade derived design flow rate .... ...... ..... .... ........ ....... ....... .......... ...... ....... __ .......... ....... ... GPD ❑Replacement ❑ Public or commercial - Describe :..............................................................................................................._................._._._.... ....._. .._--- _......_...._...--- -...._ - Parent material ___W Rood plain elevation if applicable _ __.._.______.__ nv_,_(– _�_� — ff. General comments and recommendations: ❑ Being if Being pit Ground surface elev. Depth to limiting factor_.___ in. Sail Application Rate Horizon Depth Dominant Color RedoxDeseription Texture Structure Consistence Boundary Rods GPDVtr= in. Munsell Qu. Sz. Cont. Color Gr. Sz. 5h. 'Efffil 'Eff#2 Conditions: Soil Survey description: Notes: s4 ,,_ e `r FEE: O_C� " ock A+ Ift NQjs �'5 a'.� �� P S vio'ci v" ` j P46., --� W'e - 5�:'� Page 2 of r ST. CROIX COUNTY ON -SITE PLOT PLAN Scale: Owner Name: L4fj &e I -?-- , Q ` Parcel ID Num So AJ ST. Ceo /X C6-LL&TF �3 • RECEIVED Wisconsin Oe Com name FEB 0 9 :2004SOI EVALUATION REPORT p age 1 of 3 Division of Safety and Building in accordance with m 85,1Nis. Adm. Code ST. CROIX COUNTY County St. Croix Attach complete site plan on x0396 8F1Y25t 11 ' in size. Plan must include, but not limited to: ve (BM), direction and PM I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all /nformatlon. ewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). PZ �. Property Owner Property Location 0 Fredrick Lenertz Govt. Lot NE 1/4 SE 114 S 5 T 28 N R 18 E (or) W Property Owner's Mailing Address l.ot # Block # Subd. Name or CSM# 220 Livestock Exchange Building le Lenertz City State Zip Code "Phone Number 0CIty 13Village • own Nearest Road St. Paul NP4 1 55075 1 ( CTH N 0 New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement .Public or commercial - Describe: Parent material Flood Plain elevation 9 applicable NA- General comments This sites is suitable for a mound with the system design not to a /s . fl. /day for and recommendations: effluent concentrations of less than or equal to 30 mg/L BOD5 due p aty structur This reported information is in addition to a report that was filed by Adam Shoe I0102. Borings 1, 2, & 3 are his original borings 4❑ Boring # ng 1.: l � Bon pit Ground surface elev. 14 ft. Depth to limiting ng factor in. Soit Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tF in. Munsell Qu. Sz. Cont Color Gr_ Sz. Sh. *Eff#1 'Eff#2 1 0 -9 10yr3 /3 - sil lmpl.. mfr cs 2f .2 .3 2 9 -14 l 4/4 - sil Im l mfr cs If .2 .3 3 14 -17 10yr4 /4 t2f5yr5 /8 sil line! mfr cs if .2 . 4 17 -20 10yr4 /4 c2d5yr5 /8 sil Impl mfr cs if .2 .3 5 20 -32 10yr4 /6 c2d5yr5 /8 sl Om mfi - - .3 .5 5 Boring # ® Boring 13 98.11 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -7 10yr3/3 sil lmpl mfr cs 2f .2 .3 2 7 -13 1 4/4 sil lmpl mfr cs if .2 .3 3 13 -16 10yr4/4 2t25fr5/8 sil lmpl mfr cs if .2 .3 4 16 -24 10yr4 /4 c2d5yr5 /8 sil IM21 mfr cs if 2 .3 5 24 -34 10yr4 /6 c2d5yr5 /8 sl Om mfi - - 3 .5 * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg& CST Name (Please Print) Signature - CST Number �.. � r.,� y Thomas C Nelson 227387 ' ^ t ..,. Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 12/04/03 715 -246 -2454 Properly Owner Parcel ID # Page 2 of 3 E Bodn # Boring g E] Pit Ground surface elev. 13 ft. Depth to limiting factor 100.63 in. Soil Application -Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3 /3 - sil Impl mfr cs 2f .2 .3 1 4/4 2 8 -13 sil lm 1 mfr cs 1f .2 .3 - 3 13 -16 10yr4/4 2f25fr5/8 sil lmpl mfr cs 1f .2 • 3 4 16 -38 10yr4/6 c2d5yr5 /8 sl Om mfu - - .3 .5 F] Baring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # [a Boring F Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOR > 30 < 220 mg/L and TSS >30:5 150 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- 8330Teg (807/00) Mnscmmslw Department of Commerce SOIL EVALUATION REPORT P age 1 of 3 Di*AmAtSalety and Buildings In accordance with Comm 85, Weis. Adm. Code Attach complete site plan on paper not less than 8 W x 11 siz j:V �_ �� r St " Cr r Include. but not limited to. vertical and horizontal reference point M): add I.D. percent slope, scale or dimensions, north arrow, and location and nce to nearest road. _.._ .. Please print all information. 0 5 2003 R ey Date Penn riromm;wUm you tilde fe*y be umd for seoomidwy pumpom few, s 16.04 Property owner... r^ec� �k net Z Govt. Ld, 1/4 L 1/4 S T N R I YE ( or) 10 Proper owners Mailing Address Lot # # Subd: Na CSM# 22.0" L, i v e S +oc 1Z � �cho� �Xti 1C�; :.. _ .- __ J✓/` � � . City State Zip Code Phone NUmber ❑ City ❑ V71age ® Town Nearest Road ® New Construction Use: Residential / Number of bedrooms - Code derived design flow rate 4 106/4'6o GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material T , I Flood Plain'elevation If applicable AV . 16 General correr,erns 5 y5�t m e /C v. �°� 3 0 and recommendations: c / ( e I err• � r�- S—d �,..0`� I �• C� Boring Boring # ❑ Ground surface elev. Cjq Z p ft. Death to limiting factor $ in Pit .L 1- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft In. Munsell Ou. Sz. Cont. Color Gr. Si. Sh. •Eff#1 •Eff#2 vyyPr CS -1 V P . 5 3 ► - Zlo r`t�ln C 2 - 7.5 /co j ' ZmSbk D Z Boring # Boring c/ rz Depth to limiti factor J3 p Ground surface elev. in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft in. Muttsefl Qu. Si. Cone Color Gr. Sz. Sh. •Eff#1 •Eff#2 i 0 -11 f0 r J5 5 ? M -cf- cS /'X .5 .g -11 (0 4rLtI S C5 `4 3 -Z5 / C2P .5 r `�/w "inns �r q . Lo • Effluent #1 = SOD, > 30 < 220 mg& and TSS >30 150 mg/L ' Effluent #2 = BOD < 30 mglL and TSS < 30 mg/L CST Name (Please Print) nature CST Number a W\ Sr✓1w 2S` 30 s Date Evaluation Conducted Telephone Number Poly Owner L en e,.. �-L .Parcel ID # 2 of �- Page _ Boring Fs� Pit Ground surface elev. ft. Depth to limiting factor M. Soft lion Rate Hpftm Depth Dominant Color Redox Description Texture SMxcture Consistence Boundary Roots GPD/tt In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 +Emff#2 0-9 b ,313 Sii ( \; 5 •8 cI -Pi- c S t 75 "r ylco e)c..! k y, -,-fir , �{ I a E Wng,V ❑ Sxing ❑ 0,t Ground surface elev. R Depth to limiting factor in. Horimn Depth Dominant Color Redox: Soil Application Rate Description Texture _ Sfnrchrre Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sr- Sh. •Ett#1 •Eff#2 Boring # ❑ Bonng ❑ Pit: Groan i surface elev. it. Depth to limiting factor in. Soil Application Rate Hodson Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 - ' Effluent #1 = BOD > 30 < 220 mg& and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mgti and TSS < 30 mgIL 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. sao433062aruool 1 . PAGE OFa r _ NAME l ell L LOT# f LEG DESCRIPTION NE Y SE Y ,S T Z ,N,g, / l E(or SCALE: 1" U BM 1 ELEVATION /DO_ d BM 1 DESCRIPTIO o-� / ,�Vc Q, _ BM 2 ELEVATION O BM 2 DESCRIPTION - 16,P SYSTEM ELEVATION SYSTEM TYPE o v r CONTOUR ELEVATION c y S - 0 • s J � � l tA i o � 03 es cf, 00 a V SIGNATURE ---= DATE — a I tMsconsin Department of Commerce SOIL EVALUATION REPORT Page ) of 3 Divisirn of;%ety and Buildings In accordance with Comm 85, Wis. Adm. Code Attach Mete site plan on paper not less than 8 W x 11 inch siz . V F } my S1 Lro Include, but not limited to: vertical and horizontal reference point M); Parcel LD�� ^ percent slope, scale or dimensions, north arrow, and location and !stance to nearest road. Please print all information JU N a 5 2 0 0 , R 'ewed by Date Personal Info T65on you pie rney be used for secondary Purposes (P Law. s. 15.04 (1) (m)). Property Owner. -. Fred r c k enev � Z, Govt L 1/4 L 1/4 S T N R I A (or) # odc # Su t�d Name " w CSM# 220 L f v e - 5fcck G l«ho , (�Xli 1 d ' -- - (Q (o . Property Owner's Mailing Address Lot City State Zip Code Phone Mmber ❑ City ❑ village ® Town Nearest Road Pry MN I c ) A e\ ® New Construction Use: Residential /Number of bedrooms - - Code derived design flow rate nel leo 6o GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 711 Flood Plain elevation If applicable ti A ft. General comments 5 �5� m �� ✓ rp p . . and recommendations: d l"o�i��r e l eV Boring Boring # - ❑ Pit Ground surface elev. d ft. Depth to fimiting factor In. Soil Application Rate Horizon Depth . Dominant Color Redox Description Texture Strudure Consistence Boundary Roots GPD/I1 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 "Eff#2 o -t In 31 — S.1 2 mIPr C5 Ivy .5 ,8 ( LI N — S i c l Zrn hk ry)Vr C_ 5 3 i -2.1a C g` IP C 2 - 7• 5 41(0 / ' Zvr) sbk F Bod�g # ❑ Boring q - 1 J3 p Ground surface elev. q� y� fL Depth to limiting factor O in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munseil Qu. Sz. Cont: "Color Gr. Sz. Sh. 'Eff#1 'Eff#2 DAI 11 A l �`E S -I m r c5 — L - (P 3 -Z5 C2 .P .5 (�1I <P !S Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature CST Number ,qj W\1 �1w ,� S` 30 A ddress Date Evaluation Conducted Telephone Number - >� ��s z yom8 1O. r < sy oz �' Len 4L lb Property Owner L en er�-L Parcel ID # Page ' Z- of F-sl Boring # ❑ Boring II ® pit Ground surface elev. ft. Depth to limiting factor lA in. Soil Application Rate Horizon Depth Dorrunant Color Redox Description Texture Structure Consistence Boundary Roots GPDtftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 F 'Eff#2 I o-9 2 c ( J 5 g Z - th l (d rn r c5 - 1 -4 -� 3 - i CZP -7.5 . r `11co Sc1 2 k VY -(0 F-1 Boring # ❑ Boxing ❑ p;t Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture _ Structure Consistence Boundary Roots GPDtftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 A F-1 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 GPDtft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- ' 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. SB - 8330 (807/00) PAGE �S OF NAM Z e eCiZ TOT# l LEGAL DESCRIPTION NI= -SE;/4,S S T ZB ,N,R, ll E(orY SCALE: V= y� BM 1 ELEVATION /00- C) BM 1 DESCRIPTION o p-f 4 4 e— BM 2 ELEVATION O BM 2 DESCRIPTIO SYSTEM ELEVATION 160 • 3 0 SYSTEM TYPE yi 1 o v r cj .� CONTOUR ELEVATION y� 6 e s a X V 20 S GNATURE ---- DATE — 0 MAY -12 - WETS 03:23 PM WANG EXCnVnTZNG 17154255 44 P.01 ST CRQIX COMTY SEP TAM MAINTENANCE AGR]aEMMT AND OWNERSW CBRTMCA TION FORM E__ Property Address r (Verification required from Planobg bepattment for new cons( rucdou) - Ci !State t i3 - ParceX identification Munber - - t - -S vz.z - property Lo0at3on E ' !., J F V/,, Sec. . _. T O �- N -�O w, ToWU of A ?I Certified Survey 14" 'VOW= � / Page # Warranty decd page # _ .,_L�... -. .--.a Spec house K yes ❑ no Lot tines identifiable yes 11 no �, TEJ ;NANCE Iry use a11d maintenauccof your septic systems could result in its premature failure to handlo wastes. Proper tnaintenanre wrist t of nuiuping out the septic tank every flee years or sooner. 1f needed by a Hoonsed Ruver. What you put into the system rim %ff, t the function of the ampsr. W* as a treatment stage in the waste dis'pasal systom. The property owner agrees to submit 0 St. Croix ,Zoctg Department a czr"cation fordo, signed by the owner and by a masterptumber, journeyman plumbtr, restricted pltunber or a Uctnsed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after ices don and pumping (if peGessary), th0 aseptic M* is loss t 1/3 f4U of'sludge- Uwe, the =dersigned have read the above vxMizC =ts and agree to maint i the private savage disposal system with the staudaods &ct fo herein, as set by the Isepa� rent of Commerce =d the Department of Natural Resources, Stato of Wisconsin. Cfif c araden I t ' at your scp m has been maintained must be completed amd returned to the St, Croix County Zoning Office within 30 r al �'kbc three yraax ex tion+date. � r {'T SICiNA'L'fntB QF At'YLICANI' ;f f� Yl�� n DATB O'ER CERTIp'rCA' I (we) certify that all statements ore this form are true to the best of my (our) knowledge. I (we) am (are) the owAor(O O th r erty descnUd7j5pye, by vi of a warranty deed roeorded in Register of heeds Offloo, �r TA'iTlt}3 OF iCANT A6 rvv / 17A'I'1; * + * ■* Any information that is imis- represented may result in the sanitary portazt beilag revoked by tho Z,otAng Department. „ Itickude ^with this application: a stamped warranty deed from tree Register of Deeds ofuce it copy of the cadirlod survey map if reference is made to the warranty deed IOOII00� .aU1 saWOH UOTU ff 9F.FMIC9 IM MR 1HZ MZ/U /20 The wRy home. FACSIMILE TRANSMITTAL SHEET To To ' i r I- 1-Y-1 C hvi'-s CON7ANY; D ATE: / ,I V FAX -NUMBER: TOTAL NO. OF PAGES INCLUDING COVER. 142 _x»/ PLP-A$E COMMENT El PLEASE REPLY PLEASE RECYCLE 855 W BROADWAY, FORli$T LAKE, MN 55025 6 FAX 651-982.1326 800 /1002 'Oul 80010h 11 0TUAV 9MMIN IVA LCM Gl�� f,009/91/20 yl h 1'if I S. •4 rte* C',I l i m o n f a J I' I, ,�b I E, a � I s w II' I 'A tr. ' h III' j I R i I e� I I I I� I I. II i� s I � I o ; II I ! I r E I� I I �I IN 17 El E E3 EE i I ,' ! , I I �I JOB 00 3 102. �IL —,'i�l lJ COLIAN l UIz. ^T f Roo /g00 ' Oul sau[og UOTR V 9NUHT99 NA S M Qllli MZ /N /90 --- --- - - --- --------------- - ... ...1.. ------- ------------------------- ------------------------------- --------- at L pw 1 H. 3 4 IN L- t vy ---------- ---- — ------------- -- -------- --- m (Q141 ---------- • - ;;. , a I j ---------- RE C L L ----------- -- -------------------- ---------- — ----------------------- o Romooz 'Oul SOMOH U01PAV 9MMIN 1 H:6 Gh MZ/91/H I n I I � ♦ � I � II� �I I "o. 21" R'3" — '� r i — e f,l ic W � � °° '. �• r rll' � � I�' �+�5 �Nn / ILII li i I! 1� 4'-a' 4'-0" X S 63 . � �. I� I 800 /g00 'Oul SOMOH UOIVAV 9NIMT99 XVJ 10 :01 Gh t009 /91/90 05/12/2004 iqD MOO FAX 6519821326 Avalon Homes Inc, 2004/008 F7 713� ----------------- CY ---------------- . ; 'EV: �'HtlM�� W�' kl��*�iii �FG J il p N 6 ---- j ----------- A ,.I .� �d �` , �� � �, I I � k Q I OP � � 1 ��II � ¢ A '-r �' Ij 6 '�J I � � 'C . 01 a nn & t2 Di luzy'lM aum k l � n O.,YL —�— „D,,6i � 05/12/2004 ffED 10:01 FAX 6519821326 Avalon Homes Inc, 006/008 J li n rya I L �\ � H I , I g � r I e.� H n�i• j 717 tA a f I 1 li , I, �i� � ===- T 5 ii i 1 �' II II' 7Y.. — 1 ' ,u \ I \ � `4!' LL_�L ___ _mow- w.o4•Y.YL• ' 59011 ID 39117NM I 05/12/2004 ffED 0:02 FAX 6519821326 Avalon Homes Inc, 007/008 a a i pro � »Bj4r,6 ,z/t�'F I �r! � � � �uC �� IO • u' rn ----- ------- L 1-7 F ex U 2y90P ?_01 11 7S 1 36121 STATE BAR OF WISCONSIN FORM 1 — 1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between Frederick G. Lenertz ., as a single person 01/12/2004 10: 15AN Grantor, and Avalon Builders. Inc. , Grantee. WARRANTY DEED Grantor, for a valuable consideration conveys to Grantee the following EXEMPT # described real estate in St. Croix County State of Wisconsin (the "Property"): TRANS 11. 00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address Avalon Builders, Inc. Lot 1 Cty Rd N Kinn�kYnta.T�y,�l filrl• S UITE 200 19W SILVER LAKE ROAD ` t1 1 1V BRIGHT N. Mf j bbtts 022 1 DI I - l D - 000 Parcel Identification Number (PIN) This is N W homestead property. (is) (is not) Lot 1 ertified Surrey Map filed in Vol. 1 7, p eg# 6 a 461 D oQU enf Igo. 740870 located in part of the NE ' /4 of the 1 . of Sec 5, Twn 28 N. R 18 W, Town of Kinnickinnic, St. Croix County, sconsin. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except 1 %" Dated this day of (S AE L) (SEAL) eric hAke (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, } ss. 4 A authenticated this 71N L 'y S P U g�-I C St. Croix County STATE O F W � S CO N Personally came a re me this �_ day of n the above named r' k n as a Ningle on TITLE: MEMBER STATE BAR OF WISCONSIN - (If not, authorized by §706.06, Wis. Stats) Notary Public, State Of Wisconsin THIS INSTRUMENT WAS DRAFTED BY My commission is ermanent. (If not, state expiration date: Caldwell Banker Burnet 11� 1301 Coulee Road Hudson, WI 54016 3 -54504 (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing In any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 — 1998 Milwaukee, Wis. 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