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HomeMy WebLinkAbout026-1013-30-200 Wi sconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division • INSPECTION REPORT sanitary Permit No: 453314 0 GENERAL INFORMATION (ATTACH TO PERMIT) State 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: Stock, William Richmond Township 026 - 1013 -30 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /ao . Ocy -(-� F , a" Pv C P: p-4 04.30.18.47F20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM 4 Aeration Bldg. Sewer Holding St/Ht Inlet 4 .ZZ T7 TANK SETBACK ? St/Ht Outlet TANK TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic - zzmQ g `fir �_ Dt Bottom > \ Dosing Header /Man. \ Aeration Dist. Pipe 1 6.1641 •7 16 626 2 714- Holding Bot. System S _ 9S 3 w� + ��ds K z 8• y -s 4,5 PUMP /SIPHON INFORMATION Final Grade y.7 ja 8Z If 9g. Manufacturer Demand St Cover GPM Model Nu e Prot• iru n �, s_7 c'j 7,85 N Y TDH ift iction Loss System Head TDH Ft lit 7 — F rcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM �' ►a BEDITRENCH Width Length 2- /3 No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. 7 id Depth DIMENSIONS -3 C4_ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR f3. o cc� & y ta6��✓ Type Of System: Z � UNIT (7 Model Number: w ..- , � .. s T� n V c. ti . � oY DISTRIBUTION SYSTEM SG ..-,- Header /Manifold Distributi -- x Hole Size x r_ Hole Spacing Vent to Air Intake _, �� Pipe(s) f Length o `� Dia L-( Length is pacing 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 3 0' (a" Bed/Trench Edges Topsoil 0 Yes M Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 'i / 2 - 15 / o' - _ Inspection #2: Location: 1739 112th Street New Richmond, WI 54017 (NE 1/4 SW 1/4 4 T30N R18W) NA Lot 5 �(w �a P 04 � 1.) Alt BM Description = ���- �, 5 : � '• � � E- toc 4 QS ti V �vr C { �f 0.T 4 �oj 2.) Bldg sewer length= 8 •17 ' A.�'°'�'�ea Ll> 55.10... S '3 �� 3 Ip l��lcw o• - amount of cover = I C " Plan revision Required? [ Yes No �� Use other side for additional informs L- �_ C>.( 1 _ _J k L SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. n N O E v n r� ° c c 0) G eo F 3 CD n I � O z O�� ;o A N �• acs m �� coq' CD o y 5 w O CL is n O m o T o m 3 4 N O c w 2: R tr d o a N 0 z D CL ca D CD CL a o J �at N o �C O Z N o Z c ° a f 3 0 0 • M W � � —1 —1 p II I, o c+ Z n CO) fn f/1 - D 3 o v v CO cr o CD Ln I • c m z O 7 i o o d m p CD a 5 = ° m CD CD — ; m c wd3v m �. CD v c-, � 0 3 o d m° a jl A 7 $ 3 w CD . c� � Z W a - 0� v m W m m z 0m c A O M Cl) 0 3 � co f/1 C O y CD A •P � a a 0' o a CD N I ' M I y I � fi N O i •A A O O A fa < a Efl O O L ti Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 N visconsi n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) ent of Co o mm m erce (603) 266 -3151 5 3 3 1 Departm Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal infor _ /` may be used for secondary purposes Privacy Law, s 1 .04(1)(tg� E C C I y , E r. Pr ject Address if different than mailing address) I. Application Information - Please Print All Information Y e u![� 7J P /7 39 //�P ' s r� Pro j er's Name - P cel # Lo Block n i c� l �fa . C"RU X L�O'Jrar', _ 30 P wner's Mailing Addr / �j 70NINGOFFICE V/4,5�`/" 7 Y 1 ! / " Section � 'J1'� City, to Zip Code Phone Number / C t �4/ dZ�LG ,�C cle one) T�N, R EorW I. Type of Building (check all that apply) or 2 Family Dwelling - Number of Bedrooms Subdivision N e CSM Number ❑ Public /Commercial - Describe Use ❑State Owned - Describe Use f� 7 ❑Ci ❑vill fownship of K III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System g Q ❑ TreatmendHoldin Tank Replacement Only ❑Other Modification to Existing System B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply �6 - Pr�� ^•»_�n ❑ Mound > 241n. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized -round ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter aching C amber ❑ Drip Line ❑ Gravel - less Pipe ❑ O (explain) V. Ills ersaVTreatment Area In ormation: Design Flow (gpd) Design Soil Application Rat f) Dispersal Area Required (sf) Dispersal Area Pro ose (sf) . System Elevtipp VI. Tank Info Capacity in Total Number Manufacturer Prefab Tite Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank / >< 0 rT - .5 - Aerobic Treatment Unit Dosing Chamber VIL Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu is Name (Print) 1 Plumber's Signature MP /MPRS Number Business Phone Number P I n �t� � � 1; a v?f� d7 - � � 7c 1 l Plum is Address (Street, City, tate, "p Code) 3 7 &'36 J knl� VIII. unty el On] ` pproved ❑ Disapproved Sanitary Permit Fee (i eludes Groundwater Date Issued Issui=AgeSi e p s} Surcharge Fee) 9, LD C1 Owner Given Reason for Denial . S 4. IX. Cond itions of Approval sael l d NER 1 Septic tank, effluent filter and dispersal cell must all serviced /maintained as per management p provided by p c lumber. o S�� a G 2. All setback requirements must be maintained�� S as per applicable code /ordinances. AO a/ 26 t Attach complete plans (to the County only) for the sy tern on paper not less than 812 x 11 inches in size- - a SBD -6398 (R. 01/03) ��� � JatuW i PLOT PLAN PROJECT Bill Stock ADDRESS 1748 112th st. NewRichmond Wi_ 54017 SE 1/4 NW 1 /4s 4 /T 30 N/R 18 w TOWN Richmond COUNTY ST. CROIX MFRS Byron Bird Jr. 220527 DATE 6 - 07 - 04 BEDROOM 4 CONVENTIONAL XXXX -Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 49 , BENCHMARK V.R.P. to O 2" PVC pipe A SSUME ELEVKT1 N 100' PvC -0 9 -fi ❑ BOREHOLE O WELL *H.R.p. Same as BM AT, Vent SYSTEM ELEVATION T -1 =94.3 T -2 =94.2 T -3 =94.1 7, _ rf D Of Bio Diffuser with Co�er 3��1 .1�1 ft A2 per :::�� grade 6" at System 390' PL 61 Plevation Lon 34" 172 PL 99' Garage � Driverway O ob pipe 4 bed house 2. 10' � C° 112th st t 5' 81' Old 4 2 B1 PL 10 75' 10 alt PLOT PLAN PROJECT Bill Stock ADDRESS 1748 112th at. NewRichmond Wi, 54017 SE 1/4 NW 1 /4s 4 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MFRS Byron Bird Jr. 220527;' DATE 6 -07 -04 BEDROOM 4 CONVENTIONAL XXXX 7,-, CONVENTIONAL LIFT HOLDING TANK r- MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 49 Lk BENCHMARK V.B.P. top of 2" PVC pipe ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H,R.p. Same as BM Vent SYSTEM ELEVATION >12 T -1 =94.3 T -2 =94.2 T -3 =94.1 T - y_ Of Bio Diffuser with Cove* 31 .11 fttA2 per ('° c Grade at System 390' PL Lon 34" a' 172 PL 99' Garage � Driverway O ob pipe 4 bed house 112th st 10' t B3 81' 75 75 4 B2 PL 75' 0 alt page of REPO VALUA SOIL , E ent of Commerce- �m 85. Nis. Adm. Code County / ?o sin Departm in accordance vin must 7i�' 7 wiscon Buildings parcell.D. © pate of Safety and than 8 112 x 11 inches in size. Division nt ction and / 3 on paper not less (BM), dire and distance to nearest road • view /G lete site plan I an d horizontal and�ocebce Attach come to: vertica north arrow, include, but nots�+eeor dimensio ation• 1 (o / please print a ll inform La 5.15.04 O1 N R percen t slope. oses (priva �oca�y# T urP. property '' P114 S d for se be us p 114 SM# rovide may Gov Lot Name or o (�- I information You P / , lock # Subd• persona L Lot # Q 0 G �� Gv� Property Owner Nearest Road J Village o ailing Address 0 City GPD Property Owner's ailing Phone Number S to Zip Code �J� C (((///��� - " .•- "� rate " ity Cr ( l Code derived design flow ft. F umber of bedrooms licable Reside ZpO� ntial I t`I Use: rnercia► Describe' Floo Plain elevation if app New Constructi public or co / (R Replacement / ©� / �✓` parent material y— � General comments ✓✓r �D� mentions: �' f_ and recomm endations' fl Rate Soil ApPlice !� � GPDlft De pth to Limit 09 factor , � Roots .Efy 2 - B ❑ Boring elev. tructure Consistence # Ground surface Texture S Boring Pit tion Gr. Sz. Sh. V_j Redox pescrip Qu. Z. Cont. Color • J - Horizon Depth Dominant Color Munsell F ✓` f n / Soil APP licatio m • factor GPDlftz Depth to limiting Roots *Eff#1 ft. Consistence Boundary B surface elev• Structure 112th st # Ground Texture Boring >a Pit Redox Description Gr. Sz. Sh. Dominant Color Ou Sz• Cont. Color f " Horizon D Munsell IL and TSS < 30 mg/ 5 < 30 m9 T Number * Effluent CS #2 = gOD ra >30 < 150 mgll- t hone f < 220 mgil- and TSS Signature -Telephone gO p S > 30 _ r Conducted * Effluent #1 ° / Evaluation ! �/ Date � SI CST Name (pI e Print) — o f Address LQ'�- 10 M - 0 alt SEPTIC TANK mAm i =iNz.,I., AND OWNERSHIP CERTIFICATION FORM OwnOwner/Buyer oC_ Mailing Address / 1 - 7 3 11- 5 �^ Property Address �� i r C �'t Zrl r , �Y o,/ 7' (Verification required from Planning Department for new construction) City /State Parcel Identification Number °Zg le/ .,3 —'' 2a a LEGAL DESCRIPTION Pro -_ - do %4, S � V4, Sec. T�N -3o Town of l�Y -� Subdivision Lot # S_ Certified Survey Map # b 21- 7 , Volume A6---, .Page # 4- Warranty Deed # 2 0 Volume Page # Spec house yes ❑ no Lot lines identifiable (dyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure 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 can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorphunber, j.nmeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year n date. SIGMA OF XPPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the pro pe escn ve, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNktM Of APPLICANT DATE « « « « «« bei revoked b the Zoni D * * * * ** Any information that is mis- represented may result in the sanitary g Y g p ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • J 2 13 4 P 0 9 9 -7 g2l,gE,:3E, 13 KATHLEEN H. WALSH • STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., YI RECEIVED FOR RECORD This Deed, made between Jody M. Robl, f /Wa Jody M. Simon 02/67/2003 08s00AM EXEMPT # REC FEE: 13.00 Grantor, and William B. Stock and Roxanne D. Stock, husband and TRANS FEE: 105.00 COPY FEE: wife, CERT COPY FEE: PAGES: 2 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area That part ofNEl /4 SW1 /4 rt of the SE1 /4 SW1 /4 Se . 4 T30N - R18W Name an ,#IA OGl_AND described a ollows Lot 4, 5 and 6 of Certi to urvev Map re corded in ATTORNEY AT LAW V 6 of Certified urvey Maps, page 4415, as D oc. No. 700587, St. roix County, Wisconsin. � P.O. BOX 359 HUDSON, WI 54016 An propert described on attached Exhibit "A" Part of 026- 1013 -30 -000 Parcel identification Number (PIN) This is not homestead property. (g) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of January 2003 • *' +Jody obi, Jody M. Simon AUTHENTICATION ACKNOWLEDGMENT Signature(s) Jody M. Robi, Vk/a Jody M. Simon STATE OF WISCONSIN ) ) ss. County ) authenticated this day of January 2003 Personally came before me this day of the above namec, s Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) I ' Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company, Fond du Lac. wl STATE BAR OF WISCONSIN 800- 655 -2021 WARRANTY DEED FORM No. 2- 1999 Property Owner j p s�? Boring L ` r L He Borir Horizon D 'Efflu The Department of need ma SBDA8330 (R.07/00) Page Z of 2 START UP AND OPERATION ° For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tanks) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or: must be taken, to provide a code compliant replacement system: 9 1 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T aluat g fj/'� a o rn an be ' e ai a flg1) 418 rrej�,, 9:b P_ N/6 Co N STK� O ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name f� Name L Phone Phone J SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY E me Name �T_ G 0 one 6 Phone "7 / S— 3 ( _ (p (� This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83-5400 & (3). Wisconsin Administrative Code. U 213'iP 100 EXHIBIT " A " The Northeast Quarter of the Southwest Quarter of Section 4, Township 30 North, Range 18 West, Town o c . roix ounty, Wisconsin, — kc — ept l trw following, described parcels: (1) That property described in a Warranty Deed recorded in Volume 504 Page 612; (2) That property described in a Warranty Deed recorded in Volume 507 Page 181; (3) That property described in a Warranty Deed recorded in Volume 1160 Page 255 (4) That property described in a Warranty Deed recorded in Volume 582 Page 289; (5) That property described in a Warranty Deed recorded in Volume 515 Page 497;- (6) The South 264 feet of the West 330 feet of said Northeast Quarter of the Southwest Quarter, (7) L nL�bt7 Certified Survey Map recorded m Volume I Page 257. (8) f Certi fied Survey Map recorded in Volume 16 of Certified Maps, page 4415, as Document No. 700587. i Ty R q ' v 116 PAGE 4415 �.. .: BODGE �� KA'1'FILEEN H. WALSH ' S'2'34 REGISTER OF DEEDS C LEAR LAKE, ST. CROIX CO.. WI RECEIVED FOR RECORD Ur��';`�`;0 12/83/2002 08:06AN CERTIFIED SURVEY MAP RECFEE: 13.00 Located in part of the Northeast Quarter of the Southwest Quarter and part of the PAGES: 2 3.00 Southeast Quarter of the Southwest Quarter all in Section 4, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin. S89'57'53'E 5297.35' 1330.59' g 3966.76' £AST -OFST OUAR7�R L /N£ i iWS OUAR7£R CCRNER 9 _._, _-. S£CnAN 4 -30-19 EAST OVAR7FR CQ4ME74 )-OUND ALUM /NUM SEC7700N 4 -30-19 Comely mcmA ENT) g r (ESTABLI -WED FROM A£S) 3,31 � m LOT 3 I CER77_f7£D SURVEY MAP UN_PLAT7ED _LANDS UNpL ��O 1 ry In o 1 - - -PAGE 3428 _ VPLUME 597 PAGE 181 � � YOB U� �� LAND S89 57 - E 666.96' - 25.31' 641.65' — �� DRIVEWAY EASEMENT FOR LOT 5 l- o o z P47H 1 �! '25.53 390.06' LO � X' 1 A Arc S89'57'53 "E 415.59' o X C — l�ojo� N � I�I l� l <o to LOT 5 N N LC7T 4 .� .. I I' i`i O I ' t0 -0 w = to o � � I � 1•rl t0 � � m N89'47'00 "W 416.23' tl() 1 ( 26.13 390.10' w $ l I" o o — co _ P No I o�c a� r v v :„J �! W V; Ivl ff 3 1 o sE-oL0T 5 �, I Q I D it0 GVP/tWAY cp f�► m �1� a t O S to 416.85' 40 m 0 w' T26.72 390.12' 249.41' i y � CERTIFIED SURVEY MAP Located in part of the Northeast Quarter of the Southwest Quarter and part of the Southeast Quarter of the Southwest Quarter all in Section 4, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin, SURVEYOR'S CERTIFICATE: I, Ty R. Dodge, a Registered Wisconsin Land Surveyor, do hereby certify that by the direction of Jody M. Robl, I have surveyed, divided and mapped a parcel of land located in part of the Northeast Quarter of the Southwest Quarter and part of the Southeast Quarter of the Southwest Quarter all in Section 4, Township 30 North, Range 18 West, OT'own of Richmond. St. Croix County, Wisconsin, described as follows: Commencing at the West Quarter corner of said Section 4; th. rice, on an assumed bearing along the`east -west Quarter line of said Section 4, South 89 degrees 57 minutes 53 seconds East a distance of 1330.59 feet to the west line of the Northeast Quarter of the Southwest Quarter of said Section 4; thence, along last said west line, South 00 degrees 58 minutes 44 seconds East a distance of 660.10 feet to the south line of a Certified Survey Map recorded in Volume I2 Page 3428; thence, along last said south line and the easterly extension thereof, South 89 degrees 57 minutes 53 seconds East a distance of 666.96 feet to the northerly extension of the westerly line of Lot I of a Certified Survey Map recorded in Volume 1 Page 257; thence, along said extension and along last said westerly linp, South 00 degrees 52 minutes 31 seconds East a distance of 693.52 feet to the norfh6ly right of way of 173 Avenue (A Town Road) thence, along last said right of way, North 84 degrees 46 minutes 29 seconds West a distance of 224.08 feet to the south _ - line of the id N�Oheast Quarter of the Southwest Quarter; thence, along last said south — line, North degrees 47 minutes 00 seconds West a distance of 112.86 feet to the F < pstdrly line of that property described in Volume 812 Page 269 as recorded in the I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach 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 Parcel I.D. / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. view / / �, C Da Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). , GIN V�'t 3 Q Property Owner d y Property Location G Ro 0 k) i - Govt. Lot 1/4 �1/4 S T Q N R/ E (oe /\ Property Owner's ailing Address Lot # lock # Subd. Name or SM# Y Gv� '7 Qo s�. Cit S to Zip Code Phone Number ❑ City ❑ Village 24 Nearest Road �( New Construction Use: PK Residential / Number of bedrooms Code derived design flow rate �� GPD 7 � 7 ❑ Replacement ❑ // Public or co m -- Describe: Parent material /Gt G� <C GllGc�tr4"�i� _ Flood Plain elevation if applicable ft. General comments and recommendations: ✓ j '— = gl( O 1 2002 Y ✓� = p 0� ST. CROix coui ri r 7nNING OFFICE F/I Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor 7 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 !,a S ❑ Boring X"6 4 Boring # n °y Pit Ground surface elev. f t. Depth to limiting factor in. 10 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 — ;Z 0 legt 961 .� 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 (Plgge Print) Signature CST Number Address I Evaluation Conducted Telephone Number SBD -8330 (R07 /00) . 6 Property Owner / �� / / Parcel ID # Page of ❑ Boring j Boring # Pit Ground surface elev. ft. Depth to limiting facto 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 a aZ r i 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 GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # E] Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit 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 * 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) L Soil Test Plot Plan Project Name Bill Stock Byron ird Jr. Address 1748 112th st N e w Richmond Wi. 54017 CSTW #220527 Lot 5 Subdivision CSM Date 10/10/2002 County CROIX N E 1 /4 1/4S T 30 N /R W Townshi Ric X Baring Q Well PL Property Line # Alt. BM Asume Elv. 99' top of l' pvc pipe /� /�? a La gm/ ,BM or VRP Assume Elevation 100 1t Top of 2" PVC pipe System Ely. T-1 =94.8T-2=94.7 H.R.P. T-3=94.6 �-- I 390' PL 172 PL Cr 98 112th st B3 '15 v� 75 -IS B 8 PL 10 75' 12 ' BM alt 5 L 1 � sl��