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030-2080-80-000
I a° I Mi 0. 0 0 I e , c of I I Y ° 1 - I N N 3 :3 O - f0 Q C to r CLcar ra I es c a 3 = 0 E a 'ts w •v n I — I [\ U Co Z I N a I >U 0 E�Q,N o N z a« 1 z �� u�. c e? 4) a n U. c c c_"o I 3 a s § � 8 d c UU � � Hw N O N � Q y o �v Q w° I M I M I a 3 c rn m z E I o z :: 0 c x I = o m z m m `o I € d I LO Cl) a m co 1 a m a $ I I 0 z a) 1 ' m ' 4' (D c o E c E I a N E 0 N I j c 0. N Q' 0. m y h Y d I C C Y p v o Y c v Y p 2 z I z I I c y .. d I .. 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E V m / $ CL co CL B 2 2 5 2 §\ 2 r§ I d f I ® / E 2 � / E � ) 5 j k J . a S« 7 S $ E E § $ f CL 2 �,_ a @ o / c °° })\ co c c c 04 = a a . I E 12 .. k $ § % E 1 10 10= e I ©� ■ 3 a ) b o a ){ ° k k k k 0 E ' m % / a a a £ a a 2 ' 0 B 2 G 0) u i§ 2 t a$ ƒ I ƒ \ a 2 a. k / § 2 n m @ co Co @ , <@ c �£ �/ § k < z m 2 2 < D m ■ ƒ E § 2 E § 5 § c C c, �J / $ J e \ ! a r / \ 2 \ c k C O /� �� �k� 0 ) ° 2 °° 0 \ 2 k k I - g §\ �\ Q o )/} A o 2 E J � m )} } — , f .- IL » " » E e' c a§ k a§ ( In / 3£ 2 .3 U) Q A( , Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ! + INSPECTION REPORT Sanitary Permit No: 430662 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: Schachtner, William I St. Joseph Township 030 - 2080 -80 -000 CAM Elev: Insp. BM Ele ' BM ascription: ' j S ` Section /Town /Range /Map No. /00 ,6 n �10 � 6Yv~ 25.30.20.685 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , 0o Benchmark D `vv C/ �b O Dosing ti V ^ � Alt. BM 6 Sz Aeration Bldg. Sewer A) �S Holding ( � I L I 7. j jk` SUHt inlet vt� ` TJ / St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , 1 C Dt Bottom r 6Y Dosing H eader /M an. 0 , 7i j Z•O ?./ Aeration Dist. Pipe vv 9L b' D o G ID q Z Holding Bot. System C� IIS'� qj•c� / Final Grade PUMP /SIPHON INFORMATION U r��j ���� r�.„cl 2 ^q I 100 Manufacturer DeMand St over GPM 3,75" -j j . Model Number f V / v Ch rte+ `� , TDH Lift Friction Loss System Head TDH Ft s� d Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM 2-2 T PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth BEDlTRENCH Width / Length / No Of Trenches E q p DIMENSIONS 7` "-2 SETBACK SYSTEM TO P/L je JBLDG ( WELL LAKE /STREAM ACHI Manufa INFORMATION CHAMB R SI turer: [f1/ A Ty Of System: t 'i IT M " J � (Q DISTRIBUTION SYSTEM FIg ader /Manifold IDistribution x Hole Size x Hole Spacing lVent to Air Intake —1 Pipe(s) 1 u / N Length 1 Dia Length Dia Spacing t' _ SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of T Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil — ]Yes ,� No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: .3_/ 05 7 0 Inspection #2: Location: 1368 Pine View Trail Houlton, WI 54082 (SE 1/4 NE 114 TT,30N, R�20W) Woodland Hills Lot 8 Parcel No: 25.30.20.685 , _ _ / 1.) Alt BM Description = �dS ��'�1..� ��c� T�ii(/� (:G' Vf.�(, &a_ ^fb 5g4k a'�y 2.) Bldg sewer length - amount of cover Plan revision Required? Yes No v U a 3 Use other side for additional information. SBD -6710 (R.3197) Date Insepctor's ignature Cert. No. Safety and fB 1 County . RD l m 201 W. WashingA ve. ,SCOnsIn Madison, 53707 7 D Sani ry Permi umber (to be filled in by Co.) De artment of Commerce (� 546 2 Sanitary Permit Applica ' n Stay Plan I.D. Numbe in accord with Comm 83.21, Wis. Adm. Code, personal inf yogoo COUM y /� /VVrr may be used for secondary purposes Privacy Law, aIS. (1)(m) ZONINGOFFICE �O tAddress i differentthanmailingadd j I. Application Information - Please Print All Information 2 p \ / 13 �vi e- Y 1 e lam! I r�l Property Owner's Name �f Parcel # Lot Block # Property Owner's Mailing Add Property Location City State Zip Code Phone Number �5C %a �/4 Section lT�0 0,4 6clt C�IC� � /��l/l --�2 -3L� ircleo T N; of V� II. Type of Building (check all that apply) )el or 2 Family Dwelling -Number of Bedrooms f+ "C Z 63 Subdivision Name CSM Number ❑ Public! Commercial - Describe use i Licr `&.04 J /'t / t L ❑ State Owned - Describe use 4+ �Sr / 1 ❑City ❑❑Villagegl'ownship oP r u d III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ TreatmentJHolding Tank Replacement Only ❑ er M 'fica 'on to sting System Li jtlus Permit"bW Date ]sated 13 B • Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration Plumber Owner ,9�1- s/� ,m /� IV. of POWTS System: Check all that appl Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Consaucted Wetland Cl Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter him Chamber ❑ Drip ' e Gravel -less Pi er ( )!!n) V. Dispe rsal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) isPersal Area Proposed (st) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber rlastic Gallons Gallons of Units (,t// [ Concrete Constructed Glass New Existing s %d /0 fQ �r Tanks Tanks / 7 . Septic or Holding Tank AaabieTnratmentUnit Dosing Chamber VIV I Koo I / C1i�KS VII. Responsibility Statement - L the undersigned assume rVIlonsibility for installation of the POWTS shown on the attached plans. P 's Name nt) Plum s S' MP/MPRS Number Business Phone Number P umber's Address ( S t r e et, City, State, Zip r T /` - /Q. L t✓� Sc�(I L J t S�C�t VIII. oun /De artment Use Onl pproved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I Xsuing Ag Sign mps) ^� �v l ( a ❑Owner Given Reason for Denial Surcharge Fee) IX. Conditions of Approval/Reasons for Disapproval �i 3 YST ��lYivrit. 0 3 � ► �/l� / S�/� ? �f _ _GIJ / ► Septic tank, effluent f ilter and dispersal cell must all be serviced /maintained Q as per management plan provided by plumber. 2. teener s mus as per applicable code /ordinances. I /�/ A Aftseb complete plans (to the County emly) for the L satem oa aper not las that 8 x lack n size V 1'/ �Yi Gr t hs SBD -6398 8/�" I�1cerH Qa �'Y�,Nf PLOT r CRM GMCT10N PLANS ZAPPA ORW. eXCAVA7V4 IM - PROJOCT q 6& 1,,t,,l f &J rE WdUO1 difw,tY /Slog �rvEVt�w?� W ''rv..j j of 5 r 3oseo f R1 �rs- t•..v�. � lyE�G �4E � ��c15TINs. V 1 S fO�IT /Nt tF U5E OF Bf,►�1lll Ek�sTiN` 6diof?V77� AR" o . R �o�mSt1�A►s - / ����• = loo•oo� _ a I �� C, a : ;� �Qv�.d•' - w►11► -c-sfi Ex Isr.�►� •5�..t�� -+r . �ff{^�>� L,in7E � T A� -�o`^' /✓J't�+lf°�E � ��tcC Ax - i �n 7 4 ✓� .a Z �c� d /4ig� �p CJ�T �r �°� w 1{1/ICf. '�i►L7L^P N OQOf�•a7 - ! L,! IlE 2-� r 3 ' J �nh - /.i.uSOc�'�atJw Apt 11,3 4rda cg-smuf � " � sT. � ► Q,,_ .�_ ®^I �i0vr ,AtN FN4 i ` t 01:- edaOWAZe 0,6s ,6Q%1AT,0A, P, PF ucame: F /N �o�AgE Ne. Sc N yo P P� y ; SOII iE6 0Y: MAx! MyM 5�G" . Aaove . 64A&A sC.t t� - r- A IIM SH GlfAOE Side View 1 ¢941. 16e � Q So1.1 ?trtr End View oom I �rr 3 Sr DECj 0 . 00 Apeov .%otPActTV MoocL �Ij ,1 fekI �lvertt e op�. �NE .--PL8 67. . • PLOT & C SECTI PLAN ZAPPA ONA. EXCAVAWA INC MU)S1NG U NI T ... " PROACT cp0t p2lv6 1341 e7o-".,j r t: $T ,OSEPa .� CJVELL kPra� � ��x45Tewy C)j!Se0AJj jAtC j 0PC log 5 �x es•roN� 1e 6io ?PVo -I ARcc,r4 (3 o R oF41 . slO� dsB.Ev. = lf�•� � E.3(1 STIAJ& 44- I&EIIw)E Loiwucer�( � G/l,�tJfT`f �/ 'A'LtQ i \ L. /NE LcOw rC�► �ptE A ce � EX rS l iN4 `TR.�KS L F.oG•v £X a S�Ci/l] Aral J�n� /LAOS ®e �se� Ap 1 � o 4f9Az4 � ,/�I O rAo.v ' C A CH ENo SCALE ��E� �� �rMen �P OBScRJT io.� P, fF SIGNED: fr+rP o�.o c�85 v r��u o UCENSE: S/%5 DATE: F.N rsN �o�P,4gt Alc S,- N yo P PE z sou. TESTINq DV: Side View &EVATraA T --,j, N & ir. O if C.,, Ttsr End View T 16 15° _ t s o Id 34 . .� S ACOM efovActry /h oagL - i 1733 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1 of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I. D. 30- 2080 - 80-000 Plam M all j i fnnEIVED B Date q Personal information you provide may be used fa secondery WPoses (Privacy Law, s .15.04 () (m)). //rn l Propert Owner OCT 2 9 200 P Location G � William & Marie Schactner Govt. t SE 1/4 NE 19 S 25 T 30' NR 20 W Property n's Mailing Address ST, CROIX COUNT of # Block # I Subd. Name or CSM# 1368 Pin44evv Trail ZONING OFFICE na Plat Of Woodland Hills City State Zip Code Phase Number I City _j Village 01 Taira Nearest Road Hudson WI 54016 1 715 - 549 - 5332 StJoseph I Pineview Trail New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD +l' Replacement Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Evaluation completed to verify suitability of soils for replacement system. Se original eval. dated 5/5/89. Install two trenches at elev. 91.50' using 22 leaching chambe Boring # Boring ii Pit Ground Surface elev. 97.50 R. Doh to limiting factor >123" in. Soil Application Rate Horizon Depth Dominant Color Redox Descrption Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -9 10yr312 none fsl 2fsbk ds cs 2fm,1 c 0.5 0.9 2 9-27 10yr3/3 none fsl 1 msbk ds cw 2fm,1 c 0.4 0.6 3 27 -56 10yr5/4 none sit 2msbk dh aw 1fm 0.5 0.8 4 56 -123 1 Oyr5 /8 none s 0 sg dl - - 0.7 1.2 Tongues of sit observed from Hnt3 extending to 62' with f2d 7.5yr5/8 redox. concentrations observed in the lowest 2" of the horizon. Comm.85.30(3)2 appplied to discount redox. features as Indicator of seasonally saturated soil. Boring # J Boring ✓� Pit Ground Surface elev. 97.83 ft. Depth to limiting facto '118 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 0-8 10yr32 none fsl 2fsbk ds cs 2fm,1c 0.5 0.9 2 8 - 24 10yr3/3 none N 1 msbk ds cw 2fm,1 c 0.4 0.6 3 24 Oyr5 /4 none sil 2msbk dh aw 1fm 05 0.8 4 35-118 10yr5/8 none s 0 sg dl - - 0.7 1.2 `75 11 . ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS 30 < f W mg/L Z--LE #2 = BOD < 30 mg/l. and TSS < 30 mg/L CST Name (Please Print) Si ure: CST Number James K. Thompson 3602 Address A.C.E. Sail & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Larne, Osceola, Wl 10/142003 715 - 248 -7767 property Owner William & Marie Schactner Parcel IDS 030- 2080 -80 -000 Page 2 of 2 31 Boring # YJ Boring Pit Ground Surface elev. 97.98 ft. Depth to ttmiting factor >12W in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0-8 10yr312 none fSl 2fsbk ds CS 2fm,1 c 0.5 0.9 2 8 -24 10yr3/3 none %1 1 msbk ds Cw 2fm,1 c 0.4 0.6 3 24 -35 10yr5/4 none SO 2msbk dh aw 1fm 0.5 0.8 4 35 -120 10yr5/8 none S 0 sg dl - - 0.7 1.2 Evaluation completed with hand auger. Boring # I 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 GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots 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 = 130D 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. if= d P� E j � A ET¢da�loz O il w� 1 n �{ ° cam• i 3 h Clear a-4 tu� 0 63 pfopc sc d r c /4 c'.,, c,� EX !'s u MCI 5ysf -cm a, Z l R wee 'S cre It & 1'e4 Sys��► eLedaEivn• Cu s �yr,c� -ate 1//779 POWTS OWNER'S MANUAL & MANAGEMENT PLAN pop Z of L � MMOINIATION top* Taint Cl�dhl 1000 O NA PamNt : 3 D & l0 Z Slpde Tank Mwwfaaftrar t e�� EK s O NA ' Efr"m lMlar IN�tedaattNar Zabie O NA NwnOar of Sedroomte 3 O NA Eflkatme Par Modal A -1800 O NA Mm *w of POk fadkv Udto ;3t}1A Pump Tank CaP&* 'Too n NA Both — -I fbw l - ,, el 300 Pump Tank Mrwkeowor t ._. _ n NA Oedp lbw WO. MetNtta�H I x IA 450 loop n NA Sed Aop�Oaebn flee 7 � n NA Standard h lEOWK monddo sv@raoe• P1@aaaanerrt lknit F«ft ON f1M • am V= gm w4x I Par o o SWAVOM Prat war NA PO l n oel CIXV DSIVNM MOW I= MIOL O NA O Medre di Aaraden O Widetd Tool Saepandad $Oft (r= 9150 � O obbefi pd n O Odwr: Pretr@ated mom auft MondMll wara®e 0hpar M WIN O NA booiod DOWN" nomex IOraah!►1 O In•lfneund Ip TOM Siepandad fTSSi � T Sdit M O NA O AtArade O Mound Dial Whom lgaofnerb mtaaM 610' dWlOOM O 0000 O Odw Melewnum smis - t Parable sbe x ti a.. O NA 0 NA oom s m . •Vo" i"W for dani M waWj~ and sapeb tent dlb�nt. O NA MAwTENANCE ScilEOU« . :«Mee Ewmt SeMe. fragremaly Napm cod" of rick! 1 At loam any wary: 2 lMr+w■m s >yawq D Atop out comma of aNp! i When n 611 ad tdtedaa and aowtt @gttab ot04 Md fW d ant N do' O NA Mepaat dbPMW GIW At bmt any WMF 2 a.t�mrsf O NA Clan offtow faff At loom any @wry: 1 1 p'w► 13 momm bapeot pump, pwp oonoale & alarm At boat soft @wry: O O NA Pltah btarab and paaow@ loaf At beat Om @wry: 0 01 NA At boot =0 wary: O N NA o M NA MAwTBIIANCE wSTINIC'TIONS area of th@ 1o�owMp Eomnaae a � m oka Plumb d adoo and dbparsat o ft w l atoll be o : 9~ sm ppw@ar• Tank Meaar er; Maaar fkmmbar Ilaedoeed 981 POWM • Mupecdona moat Miottafa s viwNi inepeeden of tlt@ taMtbl to idatN" ow & III w OfoMmn hwdwam Moog m y araoks W ballet niaewrra to vowm of ew*kW dodp and Mn and m *ad W ow back Up Of paw d dVowet on Ow paNd aurfmoe• The 0 pareal aNd *41 be vbmslg MtaOMW m *40 tM MOM b b iA dto abaanradon plpmm and to ohadt � mml► paW oonddmn sod f@**" m die of @fusel an do gmw d enrfao@. TM p A I of @ohm* an t o !'mod auAaom OW Medioab a fal>in0 bwedlM nodlladw of tho bM 18POIory mdw tll• When dw pi 161 aoowadotbn of dodp and aoumt b any lank @gwle ofta4 d 09 W mare d do tank voMemta. N R 11 e ma ,ml tS d the 1" d" b@ rattt@u@d b SgAW Servkin0 OPwmlo" and dwpoad d IN aoeenlana wMA *NW Wboo mb AdMn WWw OWL AN ad+er @ervbes. bdudMO a perfarnted oardlied l--' ww � r wda, and anll am -- id o et A awla@ roport duS be paldad m VW bal raadOWV aadWky VAV& 10 dally d eon 'PI Mbm of off IW doe @v@ert. a1MW Ie1011 WANT UP AND OPERATION PIMP - .,L of � For new construction, prior to use of the POWYS d'dc treatrmant ankle) for d' pre6aree of j products or o0wr eheMdoils that may impede an wasnent prooess and/or damage the dispersal odlel. If high oonosnaadaa are doaasd have dM oo10ts me of the tankls) rernoved by a aaptaga me "in operator prior to use. Sp wn sort up shag not oodur when all conclMons ar frozen at the infiltrative surfaces. During power outages pump links rn'sy M above 10onnsl highwater levels. When power is *4 sldsssi wastewater wiN be disdarged to the dispersal ceNsl in am large doss, overbading the o6111sl and may rrsult in fire backup or surboo discharge of effkw10t. To avoid dais situation have tine oont is of Via pump tank is mvrd by a 8eptage ServM tg Operator prior to rmorbq power to the of mnt pump or contact a Plurnim or POWYS Maintainsr to modst In mauW operating dM pump controle to rotor• normal levels within the PUMP tank. Do not drive or park vdnicMs over tanks and dlepersd 06116. Do not drive or Park over, or 01IM - 1118 dsturb or compact, the are within 15 feet down slope of any rtnoil - ar st•grade mil absorption area. . Reduction or einination of the allowing from the wastewater etreem may improve the Polar s and Prolong the We of to POWYS: antibiotics baby wiper oigartte butts; 0o WNM' cotton swabs: dMeems,; I fb14; doom disinfectants; fat = tvao6r; fruit and wgetabla p~ g paw 'hioider meat scrape; m odiesdoos; 011; 'Prod c*,- 'p ry nap0m tampon:; and water sofww brine. ABANDONMENT When dw POWT8 fMb VWW le parnwm* taken out of service the following g saps dial fie taken to insure that the wow is properly and safely abandoned in compliance with draptsr Comm 83.33. Wieconain Adminlevolve Cods: • AN piping to tanks and pits d al bo discorrnemd and dw abandoned pipe oparinge sealed. • The coete nts of all sinks and pits shag be ranovW and Properly disposed of by a Seotage Servicing Operator. • Afar pumping, all larks and pia shag be moriaad and +moved or Chair covers ranovrd and the void space filled with soli, gravel ar amdw inert solid maaaid. OON1'MVOEIICY PLAN N the POWYS fails and eamnot be repairrd 1010 1011000 momwn haw bm4 or mwt be taken. to poride a code compim repiscennent systsm Tat A suitable replacement arts has bdin evaluaud and may be utN'n for 1110 1009d of a rrplaesrrtatt soil absorption *yam. The replawmtatt am should be protected from dbumbum and oortipactbn and should not be in hinosd upon by required setbacks from a fisting and proposed strnatare, lot 1 and veft fagura to propel the repiacerro ' sm wi11 result in the nesd for a new ad and sin evaluation to IN 1 a aaitable raplacsrrM era. Repleoern" systems must comply with the ndes in affect at that tin'. O A suitable repleoemant am is not available due to sedmk an dfor so11 & A - de Soft advances In POWYS technology a hokNng tank may be Nsall sea last resort to is t replace the fWW POWTS. A Jq not suitable re �ara� falurr elf tIn ,�� a so and sits be � :=� rop1 a. no rep) q!!!gt aiia a b�ls !- bolding ank may a last WTS. C3 Mound and at grad• soil absorption sysame may be reoontstru0ad in pim fogowing ren oval of ti' Mono at the bdiltrative surface. Nam, t u n d m Roof of such rpm= cost oomph) with the ndaa lm elhat at that tarn». < <WAI N >> SEPTIC. PUMP AND OTTER MATMNNT TANKS MAY CONTAN LETHAL GASSIIS ANDf OI I NSIA" NT OXYML OO NOT ENTER A SEPTIC. PUMP OR OT MM TREATMlNT TANK UNO01 ANY CNICIMASTANCIL DEATH MAY Rail LT. FAMOM Of A PEMM FI I THE MI'IFRIOIt OF A TANK MAY SE ONFPICULT OR MAPOSSMIL ADDITIONAL COMMEM POWYS WTAUSt POWYS MANTANM Nan' ) None P "Mm 715- 386 -2850 Phan* 715 -386 -2130 SEP'TAOE S111MI( 0 OPMAIM LOCAL REOULATORy AAI THOIrTY Nan- Tri County (Ben Morgan) N St. Croix County Zoning OfftE e Phew 715- 386 -2130. Ron' 1 715 -386 -4680 Thin docaeant Was drstad in oomphnp with 00% Come fp.? IXIM1111diltm and S3.SN11. 0 • fad. Wi600neN A0661"m do*- ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1�l lr a �, T a �' f'� a� C' S�4 4,,) r� Mailing Address 8 , L� it 1/ i j v (� /-�o �fi ( L z - Property Address r c.. s 5:-� o L c -- (Verification required from Planning Department for new construction) City/State L1-10- Luua LZ Parcel Identification Number n30 - 2 0 Z 4 8 O oo 0 LEGAL DESCRIPTION Property ,Location �C `/4, IU4'- '/4, Sec. ;� 5 , T 3 d N -R 2 d W, Town of _S4. Q �,s 47 4 Subdivision J 0Jd l a t., j ,� //s , Lot # _ Certified Survey Map # , Volume , Page # Warranty Deed # Vok , Volume i� � 7 Page # Spec house ❑ yes ® no Lot lines identifiable f9 yes ❑ 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper 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. I/we, 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 three year expiration date. — 1 / 12.l by NGRATAE OF APPLICANT 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 owner(s) of the property described above, by clue of a warranty deed recorded in Register of Deeds Office. //2 o SIGN OF APP CANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** 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 DOCUMENT, No. BTATII BAZ OF WISCONSIN TORY 1 3N9 tests 0"I'" asseays PM 111466000 ewA WARRAICrY DUO 46091 REGISTER'S OFFICE This Dead, made between „Robert - W : TaLlaad�Y ....... Sr CROIX M VA .......................•...................................................... ............................... sec' .............................. ..................... ..................... JUL 3 01990 snd.1�i11ia..Schaict .�uod_Ix..C..cACAx. .. ............ M ............... ............................... ....... ............................... Grant+a, Witnes seth, That the said Grantor, for a valuable consideration...... conveys to Grantee the following described real estate in ...... Sta.. .Craix.......... 'aN County, State of Wisconsin: Lot S, Woodland Hills Subdivision to the Town of St. Joseph, according to the recorded plat thereof, Tax Pared Nos ... ....._ ......................... and situate in St. Croix County, Wisconsin. 'Inn * �.F f This deed is in fulfillment of a Land Contract between the above parties dated ember , ore D ecember 12_ 1988 in the 3t. Croix ountq egia er of Dee a ice in Volume !A232. Page 239 as Document No. 443744. i This - is _ not ........... homestead property. I (i9 not) Together with all and singular the Sereditaments and appurtenances thereunto belonging; I� And .......... Robert W. Tellander ••----.......-• ........................••---•-•----•-•-- ._....•- •••- ................. ..... .._._.................._....... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements and protective covenants or restrictions of record, if any and will warrant and defend the same. Datedthis ........... 61h............•- -_.... day of ...................... July .......................... ........... 19. t • -- • ------ ••• - • .. ..................•- --- ...... -- -••-.................(SEAL) ..... Kai.. C ._.�J:..__.�..._....._._..__... •-- - -•- --- -- -..(SEAL) ' -------• ........................... ....... •- •....._.__..._._...... RQSgRx..�i, .......................... ...(SEAL) --....(SEAL) • .............•-----°_............• ................_.....----- -... ' .............................................. ................. AUTHRMTICATION f `I lICSNOWL1iDtiMBINT � ` Signature (a) ------------------------------------------------------------ STATE OF WISCONSIN as. ................................................................................ St. Croix .................. ... •-•-• °•-•- °"--.County. authenticated this -------- day of___________________________ 19 ..... _ Personally came before me this .A rn._day of ------------ July ..... .......... 19.99_ -. the abqv named ,. ----------•---------------------------•-------------- •----- ..._...---- ._....._.. Robert W. Tellander _ ..... • J� • Jr �i" ............................................... ............................... '-----..._.._...._.... _..- ..___........_._.......... . .� TITLE: MEMBER STATE BAR OF WISCONSIN , ........................................... (If not . ..................................................... 4c --•- -• -• -• , authorized by 1706.06. Wis. State.) ` "; to me known to be the person ....... _._; -olio e�cbten e foregoing instrument and acknowledge TFI18 INSTRUMENT WAS DRAFTED BY O ' - sy, He cod dl Carl b Samuel R. Carl = _ '''�':: ,•:••��� :.._. X ............. ..................... •_..... , ' T / rt c 1 . _ . P.O. Box 229 Hudson WI 54016 Di t .......... .....t................................... N o t ary Pu is .... .... St.._Croix . -- County Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (tf not, ate expiration K are not necessary.) dater g za. ) - *Nana of parsons rianins in any eap"ity shou:d be typed or printed . below their aignatures. i1 WARRA:•TT DYED STATE BAR OF WISCONSIN Wisconsin Leval Blank Co. Ine. - FORM Ns. 1 -1902 - _ Milwaukee. Wis. io 0 90 ( (0 M { 5 2.75 ACRES 3.31 ACF fp P A % ASS �° -W co I , fob 0 .9 0 , h 3 \ `It 7 OT Q \ 71.95 6 65.04 , N ® a 2.30 ACRES 2 \� N89 °5424 W 137. \ - co A . ~ 89°542 t 13703 \ : 0 7484 ir 5 s a cv iv `' i. \ 3 g � , �Q- � 2.52 ACRES \ 81 I °36 04 3 co 9 134c tips° 35 46. 2 ° m S S 4° Cf 3.04 ACRES 6 S .tia 3F 4 t a 0 / ? ?8 • A. 0� ry h �Q. \6 3.08 ACRES �°c3 i��S N 81 °43'34 „ W 38 0.o4 02 � o• 0 2S OS � � M N 25 °1712 �� E 15.00 ~ 2T o 1 V6 10 4° o� 42Iw. by M� 3.34 ACRES hh {Y 23 A to SOY'' 1 �� - - 1 • t Form- STC -104 AS BUILT SANITARY SYSTEM REPORT OWNER I L C , �y �i r /1/L =fa TOWNSHIP SEC. 2S T d N -R Zd W ADDRESS ST. CROIX COUNTY, WISCONSIN 03 - 260 - 1, Zr 30. 00 •= lv �� SUBDIVISION Cr�[�c_�i7L Enri� ////, LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of II,HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM HOLIs .xS ri IX 2 s,1r)t e INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 1X2 4VAy,0 5`%-* A - Elevation of vertical reference point: lot Proposed slope at site: A SEPTIC TANK: Manufacturer: Liquid Capacity: /IVY-) Number of rings used: _ Tank manhole cover elevation: 2 Tank Inlet Elevation: Tank Outlet Elevation: _� 5 �---� Number of feet from nearest Road: Front,VV Side,ORear, O �- +. feet From nearest property line Front 10 Side,( Rear, 0 -- zr feet Number of feet from: well / , building: 6,; (Include this.information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE J PUMP CHAMBER Manufacturer: U' EL ZK S� Liquid Capacity: C Pump Model: N 7 Pump /Siphon Manufacturer: 2o,- -- , �; Pump Size Elevation of inlet: �r E Bottom of tank elevation: Pump off switch elevation: 19zae Gallons per cycle: Alarm Manufacturer: L haiaLA,X/'_,,,Z Alarm Switch Type: Number of feet from nearest property line: Front, 0Side, 0 Rear, p Ft. �2t�L� Number of feet from well: /6L Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: k Trench: Width: f Length: > Number of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, 0 Side, @ Rear, 0 It . 6 Number of feet from well: - Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liq depth: Bottom of seepage pit elevation: Area Bui Has either a drop b or distribution box 0 been used any of the above soil absorbtion sytems? (Check one). ti HOLDING TANK Manufacturer: `.. . /Capacity: Number of rings used: e"Vion of bottom of tank: Elevation of inlet: Number of feet from n crest property liner ` ont, O Side, Q Rear, OFt. umber of feet from well: !" Number of feet from building: Number of feet from nearest road: A arm Manufacturer: Inspector: Dated: - - 01 Plumber on job: License Number: CO5- 3/84:mj DEPAPTMENT'OF IND INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: SL 4 NE 4 j S25, T30N -R20W (It assigned) CONVENTIONAL El ALTERATIVE h Town of St. Joseph ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound 3; 0 E ADDRESS OF PERMIT HOLDER: INSPECTION DA William Schachtner Route 1, Box 78A, Somerset, WI 54025 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP /MPRSW No.: County: Sanitary Permit Number: Donavin Schmitt 3205 St. Croix 119467 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER �p Q G PROVIDED: PROVIDED: 1 C�.rLO � 0() 0 00.03 p I , �p 5 [] YES ❑ NO ❑ YES 2 NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH C ALARM: FEET FROM S V LINE) C ` / / AIR INLET: ❑ YES XNO I EJ YES NO NEAREST �� V J Vtf V (i► DOSING CHAMBER: MANUFACTURER: I BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP /SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER / Q PROVIDED: PROVIDED: J ❑YES O ✓�� M zo���� WYES El NO OYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN a V FEET FROM LIN A N T: PUMP ON AND OFF YES ❑ NO NEAREST —� J _S7 I ' f -I SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil Can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED /TRENCH WIDTH: ^ LENGT NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID DIMENSIONS /v` S TRENCHES: M RIAL: PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. ISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIP, 9 ABOVE C ER: ELEV, INLET: ELEV. END: �� C PIPE FEET FROM LINE AIR INLET: ( ( / C � NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED /TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR, PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV: DIA.: ELEV: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO 1 ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: iAREST MBER OF PROPERTY WELL: BUILDING: COMMENTS: ET FROM LINE: [:]YES ❑ NO ❑ YES E] NO � 3 , �3 lj_� T3 u J Sketch System on �� -- Ffeta "Tf1 to county file for audit. Reverse Side. SI TITLE: SBD -6710 (R. 06/88) Zoning Administrator 17 5 "p- ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITARY PERMIT # — Attach complete plans (to the county copy only) for the system, on paper not less than I`9' Zl & 7 8% x 11 inches in size. ❑ Check if revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION – PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION X M4, S S' T_ , N, R Z ® E (or PROPERTY OWNEFUgMAILINd ADDRESS LOT # BLOCK # STATE ZIP CODE P HONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) ❑ State Owned VIL LAGE : NEAREST ROAD ❑ Public 50 1 or 2 Fam. Dwelling -# of bedrooms N u B () a � a �o- 111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo Y 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Off ice /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 (9 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION Y50 6 e 70 Feet Feet VII.. TANK CAPACITY Site in allons Total ## of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App I Tankslianks structed Septic Tank or Holdin Tank 0 Lift Pump Tank/Siphon Chamber I x+ - XI 7 F Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum Signature: (No Stamps) MP PRSW No - Bu T — Ir - s Phone Number: r s y -d 'P lum b er's Address (Street, City, State, Zip Code): -Pe IX. COUNTYIDEPAR7111ENT USE ONLY Lj Disapproved Sa itary Permit Fee (Includes Groundwater Date issued Is ing Agent Signature (No mps) pproved El Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/86) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608- 266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served - Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'f x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. - -. • SBD -6398 (R.11/88) T o , X ' 10 0 , cc APPLICATION I FOR SANITARY PERMIT S'�- �Z 0. 68S STC -100 This application form is to be completed in full and signed by the owners) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property .f�±� (_A..m �� �, d 14a+ t Location of property 1/41/4, Section :L S , T 30 N -R 0 W Township TOSZ4Q4 Mailing address dIf-l-dwIZ- - Address of site � �ihC V" leW l - - -- - — Subdivision name �06ne/ Lot number Previous owner of property Total size of parcel ac;—es Date parcel was created FG4r� z 1 - 3Y-4, l 97b Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes _� N0 Volume and Page Number 2_ 3�_ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required, PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. V1 ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. ). - JA >I , -� �- -10 -- Signature of Owner Signature of Co- Owner (If Applicable) gym. 3 . '/ 9 / Date o4rSignefture Date of I i4hature fir +s sa y - 7 "t . • 1 � l� 4 icy . :. _ "M",•In m i i ~ .. ..ww...�rw ..� Afiftw..... �.. .w_..w.w..y.d for POW, 8:30 . � ,� •a.1YArlship a ry dw pro as p. ,N,I,IMe, t laa�r.ry, tat Via t1 .....w ....... .................... (�aa . #. Lot Of woodland Hills Subdivision located ' in the .Nor Township M 30 n �t �#�t 4G of Section 25, Tow Jose ► s RirljW 20 West, rownshlp of St. j, ;;' W _ Ix County, W ia T� PaMal Na -• x`� V 9CM.... is . ... �`.... awl pr'aDerty. :�; � •I�ot► me y t... , the Property and tu e at IYo r> t. K W. 9s ................ is the to vendor at .... P_.l ce Vendor i aE Mhttee a° the balanse of =.f��n.' manner• (a) _... 1.a�2 11..QQ ..?:$.Cts from time to time at the r 1-s-�12.Q„QQ .. .. .......... together with ..- -- -•,. » 4iA I• �. As 411owa. ate Of......Z. usterest from dote - P.37 .......................... per Cant per s R C010"neing January 9, lgg9 and on t thereafter, equal monthl he ninth day of each and every month the " Y installments of $, 0 _ ., bo�o�rr, t1w -sat m+tatrndihp b a l ance tx sh a l l be paid in full on ads a" .., ><s. ni n t h .. -- (the maturit or before the. . ....... ....... . Qe�ak t,lt is payment, interest shall ' abaU facl without limitatio accrue at the rate of .. -.. ►, n, delinquent interest and, u pon ace accelerati r a ttaleaa >;a " ' died by Vendor w Y Vendor � ��' �� asaeeateents fire and required � Pay moathl to Mat I""" to apply Daytnents to t roquired incur �unounts aulticient to premiums when due. To Pay M ��i' am" - b a" �raaOe �Moo obligations when d e. such amounts received b extent recel►od by V 0AWwka "Quired by law. Pae+ced into an es rvw�i and or trus Y the Vendor for p Z tee account, but shall not j parittsaoe 611611 be applied Ant to interest am~ bear � #"*& d witbout unpaid balance at the rate a ' Preathtm or tae uPOn Principal at : +n PecrBed and then to prl }p j the e*aat of an k pdK �lORtirkQ%+)t Y +me 1l/idFX7(:tY._?(X) ?i x.2CX.X 7 pnepaypt ADC,. XXsX�C,11J( at tbo aepaid of priftI sad in a con (d shall hot be treated a in pr elp►1) is !ap than the tit (cad in such case accruing efault with respect to rte: ry so 01*0" made at first sPft &d Abm s amount that said lad fi rotor(' trr n month to month hall be 'do:loq�, . provided that monthl ehtedneav world have been had the mnnth}7 Pa i asuraaoe or eaadtmsnadoa, the condemned y Payments shall be cor:tir•j in the .vent of cr �+ab+�+ar states that Aremises being thereafter excluded herefrom, edit of a is puMhaser u sahsbed with the title as shown h �teation �ppt c l the title evidence +j=hmitted to pu Pon "W !lRr a to WY the cost of �, by Viu�der until the t u future title evideACe. If title evidence i in the form of 'Cr. haaer shall ba eatf#J p Prr is Paid.. ` y } oa. elit r Possession of the property On W "10111, jPAt�1�M� ��A1� affil ` s- drr"a eaetaiietri # emu Vendor. . drrhAvoat da•iasisrance+ theoptfl► ► �' gal • K. ' as *� at x•...,....15 «.._�........ .. ».� bet Vendor sshall tit regni ew '1'i►a.P�� M •adir tW p W V1.W 'Vendo pretaiusas who fa7trt ah �s ittfJoll �- sad. unless VEador athsrwisp pr omptl y ip trli of ' Rich endor. ["urchaser shad promptly gin j 11atn:or. aim p a�+d alt Nt Wd Vaudor otbe�ui rtung insursnEe Pz� 1 d "wided the rest"► or rlpaiit , > (d the lro"ty ra, t1Mt �.�M•It1it Raatt aor aUoR Rasta W to committed on the Property, to keep tM P� to • �.� the Prepa ru frog from lions superior to the Len of this Coatr*84 "A } t1 g M rs ptaiioaa aRaet" the and S Property. p> 4► sad all candationa '_ +� 040M *0 ill M tide lw� R�It iststwst and other moneys shall be and. e and denser la tip at: tiYi aitaas asd is tM atasasr ste apwAed, ''eador will on demon iMM�4�4 i• tM abkR i00 Preysrq+, free sad clear of all Item Ilk µ MiNS�R MMa Matlad M at et tM o d dt da of Purchaser, and 021 'epe: . ..... . '. _ ...- _._.. «. nt of anY iagwo tisM is of tide easaaaa +aid (a) to the event of a default in the payme , :f fl... -d+0 fawastug the specified due date or tb) in the event of a da3awg b . • -�" - . _ a�tar,dMPbiett continues for •period of o .. days foil dw of Pwcbsaor w oRirf� tit su nstisa tReim t`y cerurw mail}, then the entire outstanding t "lance u t hi s eartttaad '_ ifi soi pitysirie is full. at Vatdor's option and without notice ivrhiCh Purehasetrtwirehy - Y ip tlli�iise`tltai hrnie the foibRbg rig�and roQ1i� 'uD�ect to any limitations provided by is7t} fir at in equity: !i) Ves�M PropeMttyh h is through str ct with any ��y f Y t is i t Pro y +� r �� ;nll payment of the entire outstanding balance, with interest thereon isism �� sa sub x as IkP"ated damses for to to fulfill thin Contract and ss rental Sot the td isi4aan . or (ii) Vendor l /ater.=t at the rant in a ne dr�� ow V shill: he auctioned at judicial ;alc and Purchaser f` , " MNatdK. is M&W mss s at event tae Property' defialt ar Vdtdor ix law tar the entire inpa!d purchase price r any portion w ttosraaft h1 mtiy dgc3are hie Contract at an end and main ' ( .• t",, �'..nirsctasscloud on title in a Tuiettt�tt is action if titre eslstt" 6; t of Purebwr is isaignitieant: and (`) 16 cndor may ewe Purchaser elected from pos.esstott' Ac tM and hate s reviver ap pointed to collect any rents, i.l'� or pro, ,luring the pendenc kai y of Any actegA�; Ot 1"W 111. (ii Or (h above. ad' any oral or wraten stweniei,ta or actions of Vendor, ati election of a>Rp' O do r sates alalt�t upon Vender' if mid wher. pursued in laiitation and ail coats and ) to .� fees of Vet►dor incurred to erdorcr Hny r.nieu}" hcr.urder lwhpther abated or nail to tht �tant ost ibited by la v ied e7tpowes of title evidence shall De added to Principal and paid by Purchaser, as ins ' suetMd. stall t» ka&ded la MW jg Wmelsit ' 1 13Y fie etnMasn t thi of any actiaa of foreclosure of this Contract, PnrehaMe eaoMMAa }.� a lr j t Prop irtrt4 in d sue^ lediag honustaad interest. to col n a rents. le sh and Praa1►. s , to the �M pub aetieQt, as cents, twoes. and profits wh Mi collecte shall M t►atx a"80W 80 a MW alydl e quita ble pWrdasar sltisl oat . ail air Of MY ooatey any legal er l wo or inercat other wa% ) ,vVthout the p� ec parNgue o ri f t snider tteis Coetraet of t►y option, ton! -term the outstanding under i Masses o vandoo a s" sititn' tstanding balance pay able under this Contract it first ity in full or the iaterwlt t � ,a. agWX M"tof Ptn'chatier's interest an der this Contract spiel} aR security f the*stir*ou$M*VAU E fhe *ran of asw snob nob trartafer, xaie or ton", without Vendor's written connerit, a■Itisr tWs Contract shall becwms humediatei and payable in full, at Vender's option wttttettt spike• ` obeli stake payments wren daft under an%, martuage outstaadinit against the Property -on the data at (�eapt far rtgW granted by P "ipiy 3 t r o yirebnser) or under am rote secured thereby, prodded PurchaMe a` � rapt of tbeawtgtl »ts then due under this Co ntract. Purcfla:er may make and this such paleneats diractir q t!< p }# Vgw&W faM do so and all pati*ietits eo ensile by Purchaser shall !M conzidered Payments made` tie tltkt Contract» Vealdar of the Property the spouse of Ve t RMvs any default without waiving an} other subs.yuent or prior default lr Purchaser• tatives, te t~ of this to of t ehali be binding WPM and inure to the benetthe fitirs, Iagal A »preset+ ��1 and Purchaser. (if not an owner' ndor Ora valuable _ bo »loses bomestaad rights In the subject Property and agrees to join in the ataeutiat of *a M target.) a�, ` zzinth day of December le 88 Dot it ibis ............... .. (SEAL) (SEAL) Fiober•• W- .- ..Tell3nder �uilliam �s . �chci: � ,(�t ,f�cyr ,ttCsJ (SEAT:) (SF'A1.} ! V -4 c �. t +3az"iB�.SC2",3CT.trler y " AiS1TIfts3�iTICAT1OII1 ACKNOWL1tDOhtENT STATE oF SCO. S!N 1 19 ss. rli` �h du;; of authentic this::..._ da; of u ?etiember 19_� the above named xj • ie ` e 'chachtner c cber> 1 : i TITLE. lk1£98ER STATE: BAR OF t31 � "'t +1 � i• A li not _ .. ss;thorized by .f ;1)C-04. ttis. „t:,t =.) to the &n- n to 1, t r.on Who exceuted ehe , . . +r 11: in:�tr:.f icfE .;�r:y1Az1�C tiie xF, ' lNSIRIJMLW WA-, ra*.FTE'? tiny �>< Qt irrLey `at T� tti - ' . t . - 1oi ;: S$t�nait3tesaTtpS 4sss aut,teutacateEl "«sr avkr��r•t+ dt;c«t;. l�+th -a t, .t 'S,.z.,ti.?s. .a's'100`� .. ,.; . " :' rr�lll� �. • "whit �[ t' •J��'.7� vhf,.��a as ... _.a`.� ..- I I t tl Oz SaNVI 4311V <�R , ;► �ca� .f cu ca /• co rx: ` kloors y tt+'oos ti x ,09 ctt 1 '- .s6 a. t, C ! ~ it Z , y , srfN st,asa.ot , IPi' I .erwl►:. ." WE Ago kal,60.0 N 7 O J ' `r \'lid • y am x �t i d 90"0 bol tz of s � • :w y � , o • ,� t r / e ' 4 i �cri.ca, ce im *A tom 10 7Nr1 a4a) • }� let 4. ac m OD \ /4e ✓ �ti4 '�74 3 « / f all N• « l ti e►AN o � � � « `I► ssj ° ?. n ,� App /b +� �s w M M 7„1S v►A N� It: < . ,..4 aC Q► 3 • + — a Ito M j ,e / ' its ..: , .,, ' - - - � .n,• .emu ,n�,r+�c.� _ �� r � s: •:,:, ... L_•::. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER /BUYER Ll J h a M.. T, x Mo C. S o 4 .,_ 4 hie. ROUTE /BOX NUMBER 13 4 Y , -kaI V rw 'rrd; � FIRE NO. � 3G CITY /STATE I �' z � „J.c. ZIP P1032 PROPERTY LOCATION: 1/4 Section T '30 N, R 2 o W, Town of Tos�e 4 , St. Croix County, Subdivision 42000 /a t d A' r , Lot No. 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 SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after Inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE 221=,� -� sol St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386 -4680 Sign, Date, and Return to above address I OF RE PORT ON SOIL BORINGS - ND SAFETY &BUILDINGS INDUSTRY, _. DIVISION LABOR AND PERCOLATION TESTS (11 ) MADISON WI 53707 HUMAN RELATIONS (I LHR 83.09(1)& Chapter 145) 7 LOCATION: SECTION: OWNSHI UNICIPALITY: LOT N .:BLK. NO.: SUBDIVISION NAME: siz /� 1 / z 2 N /RzoE (or ST . 6 - WaoDt_4x,D *t Ls COUNTY: UYER'S NAME: MAILING ADDRESS: TZ.4l1 - AO�C 7 8 A ST.GvusUc WIL.UPty -1 Sct{aC t{rQG:?' so sE Lu1 syozs USE DAT S OBSERVATIONS MADE rGr NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFI L DESCRIPTIONS: 1 PERCOLATION TESTS: XResidence 3 1 - t � IRNew ❑Replace 9 S _ Q RATING: S= Site suita f sys tem U= S ite unsuita f sy stem ! C1 CONY - ENTI ]U . M ❑� IN - GR ms P ❑u RE: SY�� I ❑ � L �G ®U TAN K: �COM END E SYSTEM�1CpHona� � f J If Percolation Tests are e N NOT required DESIGN RATE: If any portion of the testeld area is s in in the under s. ILHR 83.09(5)(b), i Floodplain, indicate Floo plain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH TH ICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 6 1V • (y . >v aX4 E _._ .. S F� s EE PlItSC' _ 3 _d_F S - - -- B Z S 3 ;� -- i - -149- ._ 3 60 B - '1 O r ,, -- - -' 70 — �� - -- - - -- -- - -- — - - - - -- — - -- — - S S y B- fl Z9 B- $ b Lf ,, S S ff EZ 17->1\G OF S te SS to 66 til 3 $ '� r Z F, -- -- - - -- - - - - -- -- B- - PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEV L -IN HES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 I PERIOD PER INCH P- P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings an he dimensions of suitable soil areas. Indic to scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their qetion on the plot plan. Show the surface elev tion at all borings and the direction and percent of land slope. S Pi�E Z �IN� C ��T7✓1C— �N� 1 (� SYSTEM ELEVATION Zn S?�yE _. �•`� , . s Bb , 6l , A E ti 0>N S r s 9 Bt 1 1 4%11 T►M e�ttt s , , t"llzo►J Psi w1,.,8 SC40.L t=ron' , SFc. ZS I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME rint (P ) TESTS WERE COMPLETED ON: s- 1 �9 ADDRESS: p,(� 0 x 7 CERTIFICATION NUMBER: IP HONE NUMBER (optional): I V(GTL isYO 516 Its_tas -Ol6 CST SIGN T V DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 10(83) — OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SBD • 6395 To be a WMPI(ite and ,CGW ai:e ts. your i eport -; :: I, Complete legal description; 2. The use < nwq dew N hdicam whedins is is a "3 5 fleece or conninercial project; 3. MAX it` UM number of bedmorns or am use r mned 4, Is this --a nov oi ief)lacr ?Ment system: 5, Complete the soilability rating boxes. A SITE IS SUITABLE r-0P A I-RA MING TANK ONLY IF ALL OTHER SYEMMS ARE RULED OUT BASED ON S(, CONDII'IONS; 6, PLEASE we the abb, shiov n hue hr wnting proble ch=cQAkry and complming the plot plan; 7, MAKE A LEC.-IBLE dui�Irarn accurately lowing yviu; ,,.ca iori-- Dravving to -ale is preferred. A separa F te rnay il d; 8, Make sz,ae your ha xinywh and vw0al Mention shown, ind are pernianent; 9, Complete all appropr0e Nixes as to doe, Bern .n, ad&wsse, flood p!am, data, Percolation test exernp ban, if appropriate; 7(h if toe inlonuatAvi (:_.di as flood wvi, elnW xy nr,t p,!ac ;NLA, in the appropfiato box; I E Sgn die lorm and [d= your c rmt yid dew ani Yom Ca` odkohon number: 12. Nlil<e ;e�,Obte copies :aid as ALL SOIL 'TESTS MUST BE FILED "NITH 'THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLFYION ABBREVIATIONS FOR CER71FIED SOILTESTERS Soil Separzw, and Textures Othea synitio)s a - sume ova lw'), DR 8edIO& cob Cobh& (3 - 1 V)! SS sywnuae gv Gravel (imv,fi., '3`) LS *5 Sand H G'v` High Gmondt- vaten ('s 5,and Pay Parn-lown Raa rued . ._ Nledium sand is Fire SuO lz Lowny Sawi 7?w� SwAy Lwa & Lo�jm _ , A wl Sh x Lo no W Marv, ri Clay Loam 0 w-, sand,, gC:av S C Sandy C.ay v i y, h sic SMY Coy Of fine, faint 00a;Se P t pws wro Maw inedhirn M ievo;, SAX gwv�w Sol vauve-, , ,�,Wace vv'atpr for hqdd was r1romal Point TO THE OWNER: This soil test report is the first step in securfrig a sm)iiary pern"it. Tne county or the Department may request verification of this ski tat in the field prior to oern issuance. A complete sel, of plans for the private sewage system and a permit aplAWWOn mum be Mmated to We apWapriate kad authority in order to obtain permit. The sabary permit nium be NAMM zind posted prioi to the start of any construction, ` DEPARTMENT OF RE PORT ON SOIL BORINGS AN D SAFETY & BUILDINGS INDUSTRY, ___ DIVISION LABOR AND PERCOLATION TESTS (115 P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (ILHR 83,09(1) & Chapter 145) LOCATION: SECTION: WNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: SC 1/ NEI/4 Z S /T N /1120E c ► sT . So S �1i 8 - Lv+'oo ti-R�vn (- }t�l s COUNTY: WNER' UYER'S NAME: MAILIN ADDRESS:p ST•e�p1X Spry SeT W S�!dZ5 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFI DESCRIP IONS: PER OLATION T STS: �Eiesidence 1� IVew El Replace y _ Z-� RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) I ®S ❑U ®S ❑u ®S ❑U �S ❑� ❑S �� �-cN LcN - S - `x So If Percolation Tests are NOT required DESIGN RATE: If an portion of the tested area is in the under s. ILHR 83.09(5) (b), indicate: � - A- Floodplain, indicate Floodplain elevation: A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) __---- - - - - -- �3 4 1 4 Q.y tr Z, tr 1 4 S? 1oZ -9 tt Zr B- 1S S(, I0q-V l 03. S B- r► Rio too .4 - 7 b 9 S I>Nc S o� S _ .- B 19 85 Zo3.q _Zo Fs % tn4. tr > B Z) 81 loa u g r, R R 8 > - - - -- 6- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD2 PE R OD PER INCH P- 1 2- 5)// . Z S// P _ g - l 0 Z /46 P _ 3 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 8avIrk SYSTEM ELEVATION C �'► �,k�M v t4 z a coutk out. h I PI S _ 99• Li- W04U S TA o �� crr -� 3 M I — SL I bu. O � Oki l 4 � ' ?. to � N j _ _ . . � � a° - o. � � ��� � �waa�► , �l"�k "Few W /L7ti1�1 r� PlP X -IT L. ST 5... '1 7M «. 541' � f 5 c�L� t Spy I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: ';;Px �• $09C __) L/ CERTIFICATION NUMBER: PHONE NUMBER (optional): SStozz S_? 10 - 715 _L/ZS - - 0145 CST SIGNATU E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. \: Z OF -5 DILHR -SBD -6395 (R. 10/83) — OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complNe and accUl . Ilc S00 `es" your i epotl m'u'3t 1, complpv- iegal (jescription; 2� The use secm,')n Ima cWwQ hwwa!:'-� �'-"'hether "'his �'5 a cornmercial project; 3. INIAXOAUM number of bedroorns o �'ornrnercia= use 4. Is this a new or mplaennent systow; g �)oxe's. A SHE 1S SUQ,'\JL I"Ofi A H01- IN TANK ONLY IF ALL OTHER SYSTENJ`iS ARE RULED OUTBASEE." ON C,0NDFIAONS, 6, PLEASE to the abore0mms Wwwr hoe Wr 11049 guye and, the Plot plait; 7, 1 A LEGMLE dATaM d=Wady kWONg YMP W hcmmns. Dra�,vmq to sca)e is prefeued. A y , para�e , z ,h(,et rn, lao-ised il desiredi; 8. Make stit e yoor henomwk wW vertim! vieumn ra%wyn w&t sho and are 9. convote all apposwe boxes db to dates, plaio daca Pei .Chia r test exemp- Von, it approprAte; 14 H o 44 b a A, p%, alowmioni ows not apYy, vine ALA. m the apuroptiate box; 11, Sgn We youf add�a"'s <-'A imp nquicahon nwvbm; 12. MAe wgiWc cases and d0ibme as requireW ALL SOIL "IFSTS UST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF CON';P! FTION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separaws and Tmhtre5 01mr Symbols st ( 109 UR Bedinc., co cobb;e 3 , 10"; SS smwmwe' G-avel (unrler 3'") LS LAWYane sn�"' H G �,�v` H6,'3h C'inqundvv'at,'r coam" knd Pvn Pwullon Raze meds 1�Ir,(JMM S '0" Fbe Suid OPM E N A d V Loamy Soni "d Swidy Low'! Los lhm *1 Lown yow!� % y 100" dd STV Gky Loan "lo, spycay ` iinc, f'aint J CAAAW P pomna '411. PQ 0 Wd & QV& S� qt!nt'�al s 1lQ6 W05 PEA In* Nllad< i VHP - Vemcw Re Poinz TO THE OWNER: This soil test report is the fintstep in securing a anday ponth, Me county of the Department may recluest verification of this sail test in the field Prior to norrnh ismance. A cornplete set (it plans for the private sewage systern and a penwt apolmion must be subr to Ne aMnalwAte NxM amhorky in onler to obtain a permit. The sanitar pornirt amm be AnAmd and posed phor ro tka gan of ony commetion. I I ' a X r {- - I I - I I� I I I I I I I f 1 i : , I I � I I I I 'No oxc -- ` _ l j d ' I � a - - - r 4 �o I I I I ' I i � r T I I i 1 � �u:9' - gip 1 , El EA +- i -- r �- J3,� I Ch VIA I I ( l I I I I t I � I 4 J J I I r ( I I I � I I I I I rt , 1 - t i I t t , i � 1 � t I I i i i 1 I 1 I I � I sib I SOIL DESCRIPTION FORM (Attach Soil Profile loca M ap On e_Suparate Sheet CLIENT W1 `-�� �I SCE �C T GM LINEAR LOADING RATE: PURPOSE: EUA LUKV W-3 Fo12 So) L N'B%fZ - ?7 ()M 'SL/ STEM SLOPE: V klt I L S OESC [ ON BY R t� UR L. � LJe6M� ASP ECT: V PMIE' DATL: - PPT?-t L- Z� 1 CURRENT LAND USE: L EtD COUNTY /STATE ST C _2yNy• ► VEGETATIVE COVER LOT DESCRIPTION U3 $ LA-WT:-P1 N& )41 LA-'3 DRAINAGE CLASS L`1 LOCATION: Tl1w Q OF %T. SC1 S EAR GALLONS PER SO. FT. PER DAY: O • 9 O TY SySre PARENT MATERIAL(s) /DEPTH SOIL SERIES: G `C� - ` 1 - E 1 z P fTYtI , AP Q CLASS I EIf�II4�1' HORIZON DEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PH BOUNDARY REMARKS in. moist Gr. Sz, Shp. COATINGS BbQa G � C) � -Sa TZ 3 m v � -r c S l b l i Tt, V/6 C Z � S 1 b 56k 11q • S `I � 5 � 8 Ivor "3017J A IG Z o -Z� »�V- I)I - is o S9 10�I. 31V v�S� 1 vs " v�� �S 3� _L9 It Ll I - S 3 tL) -1 R v A S � - 7 - s Y 2 5 Ab �T B6v-) J6 3 o � S 4 )y -2-1 1o`ICZ 3 1� - 1 s • C's • 3g -k4 4 �Z-L/ /6 y / Z � S 1 b P� �.S 'y ft hvUT )?,t,xz-i -moo ,.s I-TR 3�� - 1 s o s �, I s ro �IZ��. CM4 NG S o -io lo�� 3J3 - 1 � s9 rn l c s )b - / V S c� CS � 5 1g Nor Bo1z --t �6 6 o - t0 lb`1 3 �3 - S O S »I Ctw )b - era o m arz^uez Y/6 l S 1 Sb rn I �,s We S/F 10u47 o --? t o `•�t � 313 - �. 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EMI OH HORIZON DEP111 MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS P1 BOUNDARY REMARKS in, moist Gr. Sz. Shp. COATINGS tt 3! ( — g ) C-- s lo`.►RL16 �3 _ S 1.S V/61 w ag % c > 3ot�1) s i t z>� s b� 2 Y /6 — - _ - ).SIR VA. - w, s sg o- iZ -z y 1 0 � cz 313 — 1 s c� s m) c L v S 16 Z s c� S43 3b -fi ���►� s16 OTHER SITE FEATURES /NOTES: S76 o E - f S G S LIMITING FACTORS /DEPTH: Signature Date CST # HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE m STRUCTURE CONSISTENCE COATINGS PORES PORES ROOTS P11 BOUNDARY REMARKS in. oist Gr. Sz. Sh . i OTHER SITE FEATURES/NOTES: Signature Date CST # LIMITING FACTORS /DEPTH: