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032-2019-60-075
O O 0 N N I y ry bq i'! N e~o 4 ° tj x ° o N rn CL c u ° c N M(D N 0 =�`NO N'O D. p x O O.G A N co y w Zo ° ! I�C:O V C L N I� ma's O Y 3� O � co a� 0°� v, N t N w m N aS N O) p0_U z r O O C C 7 C p �O- Cr CL CO N LL 7 O x N y 0 c�6 0 `y O j N:= N c ?+ 'a CL LL LD E ° 3Q.5 o v, E QU�rn mm-' ° o CL > v (D E z N O R Oa .0 Lu z r M d G! (n D. m N N N O Z a m 2 O c fA F' r (n H N N E to O N LO = O O N O O O • '! U L 'V •U N ►Ia r O > O Q Q 0 w O z z Z z 0 E V LO 1 U > I v l6 Ln v CL N 00 d -O E w Q O !, F- �I v �+I�J zr > P H'333 CL U) • w Iaaaa �o CL �i O _ O aNi C0 _j U ° °o o LL N N p } LO 00 O O N M f0 co 4m z a O O O O _ 'v co O O N N N N N N �p O O •� •O E V a m 2P too r- `m r- r z v d Q n U) Q LO c U)y O Y! C O C� 9 U 7 7 d j `7 00 r N N (fl (O V E C . j2 °o °o0000o L C y O f6 'p N_ N to C U U C N O 00• co Y j C ' E Uoo o ) ri o Z U) r E E v € a �w c c c _1 A tia � 000) 0 Q o a°i °o Ci N •, 03 °� 03 u of eo 4 O ° I r� Q Y O O w0 p m o Y V N o— a C o (A m w I a o M" 00 I)o 00 cm 0 oy `(L 3Ey 8 N a`)WLL ¢ c Oi N (D Q O O O� [Qao -CL W p E .3 O ° O L" M N C C N oo C) 0 O O III L N 0_a N 4.) ° n � U a- Z 3 °LL X N O M O U N >> v LO y-° 9 Z O O N > O LL C 'O C O L N C LL C 7 O O�j m O n O-0 U O O ° ` E O O N m m N o N N Cc it E Q °m °N o m E ¢ L- 3a x of ° U U m o m O CL CL v W m N m N rn E E Z N = C = C o zi � XLLJ am am 3 N N y 0z � I0 ; � m V E O N .N. a1 Z O C O C N H (n c N d M V O) N O a) CL E £ 3 2 N N O ° N 'O N M V N •N 0 a m L M y L N C 0 > F- O S m Z Z O Ln N I � Z Z w o Y a v m - m m > Lo ` m CL atS N N N W O N ` N 00 o a a L m >' d m a) - CL z >° ' I � o a o o o N o 0 o a LL •N a a m m as a a a co a. 7 O N 04 (N N U) J U i? rn rn ( m rn rn c v m a0 00 04 Z — w N N m 0 0 "O C O O 3 a w m CO m N N U m N O .m �' ¢I z (n :3 m O r O O ° _N y H H to o w c N c _ _ o o o o o to CL a m a o n v 0 a> y c N E E a N N E 7 N T \ O O S N O 4.w 'I Y L L O Z t O •O O O (n Y 04 O Z N LL .n- O Z N F- V E E E v� m € a € a �t a ttom�• 0 a � .2 j � a. � a� CL _ `�1 A O a! , O N U O vii U RECEIVED 4 S Q �yyam�►► 5I 3 G1JU(i ATAL�EEA r'E 5036 REGISTER OF DEEDS ST. CROIX CO. MI RECEIVED FOR I?ECORD ST. CROIX COUNTY 08/05/2805 03 s 10PM SURVEYOR'S RECORD CERTIFIED SURVEY MAP CERTIFIED SURVEY MAW't BEING PART OF LOTS 1 & 4 OF C.S.M. VOL. 7, PG. 1868. LOCATED IN PART OF THE SOUTHEAST 1/4 OF THE NORTHWEST 1/4 AND IN PART OF THE NORTHEAST 1/4 OF THE SOUTHWEST 1/4 OF SECTION 5, TOWNSHIP 30 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. NORTH UNE OF THE NW 1/4 (R.A. N8731'03'E 2881.89') LN57'50'49'E 2881.83' 1802.32' { 87961' � f NW CNR N 1/4 CNR 35 -30 -19 , 35 -30 -19 L4I ill. FOUND 2' I.P. .J FOUND 3" ALUM.'- '--� -� MONUMENT 1�>Llti. N ?LP4,4 � N a4 W5 E 544.30') M (R.A• 8 - ! N71'30'27'E (R.A. 69.46') B EANS AS WOW / �F / EX. aIAC �a ON C.BM, VOE. 7. / / !/ P0. 1898 / / UES SOB' 4'31'E < / SETBACK / ' 0.93' OF SET PIN LOT 1 °E 359725 S.F. I ! � 8.26 Ac. S UNE OF THE NW 1/4 E I t Sq." S 8831'31' W 81.84' (R.A. 58838'51' W 81.61') 4, )' N aa'36'S1' E 27.775' 'V /ENd41�'1Fi ' ROGER I_YNN w c-% ._LE air '�lyp" st,iRV� • NOTE: BEARINGS ARE REFERENCED T O, HE N NORTH UNE OF THE NORTHWEST 1/4 LEGEND: ASSUMED TO BEAR N87 50'49 "E O SET 314" BY 18" IRON OWNER PIN WT. 1.50 LBS. /FT. ■ FOUND 2" IRON PIPE SURVEY CONDUCTED AT THE REQUEST OF THE • FOUND 1" IRON PIPE � OWNER: JIM HARTWICK COUNTY SECTION MONUMENT PO BOX 339 (FOUND AS NOTED) 454 HWY 35/64 SOMERSET. WI 54025 ' THIS INSTRUMENT DRAFTED BY BRIAN PERSON SHEET 1 OF 2 Vol 20 Page 5036 a Aw e t I J CERTIFIED SURVEY MAP BEING PART OF LOTS 1 & 4 OF C.S.M. VOL. 7, PG. 1868. LOCATED IN PART OF THE SOUTHEAST 1/4 OF THE NORTHWEST 1/4 AND IN PART OF THE NORTHEAST 1/4 OF THE SOUTHWEST 1/4 OF SECTION 5. TOWNSHIP 30 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. SURVEYORS CERTIFICATE: I, ROGER L. HUMPHREY. REGISTERED WISCONSIN LAND SURVEYOR S -2188, DO HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BEUEF THIS MAP IS A TRUE AND CORRECT REPRESENTATION OF PART OF THE SOUTHEAST 1/4 OF THE NORTHWEST 1/4 AND PART OF THE NORTHEAST 1/4 OF THE SOUTHWEST 1/4 OF SECTION 5, TOWNSHIP 30 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE NORTH 1/4 CORNER OF SAID SECTION 5, THENCE 587.50 - 49 "W ALONG THE NORTH LINE OF THE NORTHWEST 1/4 OF SAID SECTION 5 $79.51 FEET: THENCE S01.32'04 "E 2507.22 FEET TO THE POINT OF BEGINNING; THENCE H84 "E 544.18 FEET; THENCE N71.30'27 "E 69.74 FEET; THENCE N72'08'00 "E 281.57 FEET; THENCE S01'32'32 "E 263.00 FEET TO THE NORTH RIGHT -OF -WAY LINE OF STH "35 "; THENCE S53'42'06 "W ALONG THE NORTH RIGHT OF WAY LINE OF STH "35" 620.51 FEET; THENCE CONTINUING ALONG THE NORTH RIGHT -OF -WAY LINE N88'36'51 "E 27.95 FEET; THENCE CONTINUING ALONG THE NORTH RIGHT -OF -WAY LINE S53'42'06 "W 236.36 FEET; THENCE N43'31'18 "W 182.51 FEET; THENCE S88'51'31 "W 81.84 FEET; THENCE N01'32'04 "W 480.77 FEET TO THE POINT OF BEGINNING. SAID PARCEL CONTAINS 359725 SQUARE FEET OR 8.26 ACRES MORE OR LESS, AND IS SUBJECT TO ANY EASEMENTS OR RESTRICTIONS OF RECORD. THIS SURVEY CONDUCTED AT THE REQUEST OF THE OWNER: JIM HARTWICK, PO BOX 339, 454 HWY 35/64, SOMERSET, WI 54025 1 HEREBY CERTIFY THAT I HAVE FULLY COMPLIED WITH THE PROVISIONS OF SECTION 236.34 OF THE WISCONSIN REVISED STATUTES AND THE SUBDIVISION ORDINANCE OF ST. CROIX COUNTY AND TOWN OF SOMERSET IN SURVEYING AND MAPPING SAME. EACH PARCEL SHOWN ON THIS M !S SUBJECT TO STATE, COUNTY AND TOWNSHIP LAWS, RULES, AND REGULATIONS (I.E. WETLANDS, M IM M LOT SIZE, ACCESS TO PARCEL ETC.) BEFORE PURCHASING OR DEVELOP NY PARCEL CON CT THE ST. CROIX COUNTY ZONING OFFICE AND THE TOWN OF SOMERSET. ROGER HUMP L • f- ► J�/'�1l tC e1 �J * ROGER LY M Htrc.'• `REY DATE: S-:.•t8 H �� V (� c((bCA WOODVILLE , ulna' �' 'e s / 2o�S EN l sua M SHEET 2 OF " „Vol 20 Page 5036 Parcel #: 032 - 2019 -60 -075 11/17/2006 10:21 AM PAGE 1 OF 1 Alt. Parcel #: 5.30.19.541 D -20 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 08/05/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - KURYAKYN HOLDINGS INC KURYAKYN HOLDINGS INC C - MEIXNER, GREGORY F & JENNIFER L GREGORY F & JENNIFER L MEIXNER PO BOX 130 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 448 HWY 35 SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 8.260 Plat: 5036 -CSM 20 -5036 032 -05 SEC 5 T30N R19W PT SE NW & PT NE SW Block/Condo Bldg: LOT 01 BEING PT OF LOTS 1 & 4 CSM 711868 BEING CSM 20 -5036 LOT 1 (8.26 AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 05- 30N -19W Notes: Parcel History: CSM 20 -5036 APPEARS TO TAKE PT OF Date Doc # Vol /Page Type MEIXNER'S PROPERTY. THERE IS NO RECORD 08/05/2005 802555 20/5036 CSM OF THEM RELINQUISHING ANTYHING TO 07/28/2004 769994 2625/369 WD KURYAKYN HOLDINGS. WILL LEAVE BOTH 08/02/1999 607833 1446/51 LC NAMES ON UNTIL SOMETHING IS 1075/51 WD more... I more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/05/2006 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 8.260 86,300 1,432,400 1,518,700 NO Totals for 2006: General Property 8.260 86,300 1,432,400 1,518,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division , t 0. , INSPECTION REPORT Sanitary Permit No: 395186 GENERACINFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. (0 Permit Holder's Name: City Village X Township Parcel Tax No: Kuryakyn Holdings I Somerset Township 032 - 2019 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: C TANK INFORMATION r EIZIEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �cSrel 2— SO 35 Dosing w I � � Alt. BM ion Bldg. Sewer S Sr Holding — _ t Inlet a 83.8D� TANK SETBACK INFORMATION St/Ht Outlet (,p p p � 83.3 TANK TO P/L WELL BLDG. Vent to AijIntake ROA D Dt Inlet ' 83.0 % Septic I , Dt Bottom Dosing f Header /Man. 4, 60 � SD MID A 40 ' Aeration ___�__ Dist. Pipe HoUgg— Bot. System kl) S• 3 'Y - 30 / Final Grade PUMP /SIPHON INFORMATION Manufacturer D mand St Cover k PM [Q� Number to 144*_ 3 3.1 2-0 ' TDH Lift Friction Loss , System Head T Ft t D L2, ,1 S $6 as r Forcemain Length ^ Dia. N Dist. to well It ti " 3 ? f � SOIL ABSORPTION SYSTEM + 1.�` = cr BED/TRENCH Width Length No. Of T4 alCups R ts Inside Dia. Liquid Depth Q / DIMENSIONS r p f (o1 I SETBACK SYSTE TO i P/L � BLDG WELL HIN anufacturer: INFORMATION 3 ' 5 5 Type Of System: r , f ?�fFi / IT Model Num DISTRIBUTION SYSTEM Header /Manifold y Distribution / / �� x Hole Size rr x Hole Spacing Vent to Air Intake _ Pi e s /c� V t Q Length 3 -® Dia 3 � L ngth -1_4ia ( Spacing (� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil [1 xx Yes [W No ❑ Yes on No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: q / 3F Inspection #2: - S5'► Location: 454 Highway 35/64 Somerset, WI 54025 (SE 1/4 NW 1/4 5 T30N R19W) Lot N 1, Parcel No: 05.30.19.541D 1.) Alt BM Description =r�``~ ' y `J " ^� `f ✓Otiu I�I�e 2.) Bldg sewer length = I� - amount of cover ( Contour P n revision K equi > rek [nj Yes )< No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) �. _...__ cry • Safety and Buildings L'itiit;s A 20: W. Waswgtoa Ave,, P.o. Box 1162 r, ,,,..,,... L✓ J X -I N * I s� o ns ln 1 Madiecat, All 1 3707 _ 1Sl42 � Sisd A s �s ,u„ 3 CA pe rttstent of C MM r • jj pmt Number 38 tery Permit APPUCWOU 3 s1Slo In MOM wlalt assns 8.21. Wk. Adot. trade. persaasi ipforts460 YOU proaide � (� Cbeak if Revision D, Number Stw � t. Applbnttars Ys�a�nesettMa M lMMMi� 1h1ot Att Into��tiaa ( Z2 _,,,�,,.,..� PraPerty CN►lY1r's ease Ae ! r o v -. 0 JD Q Properr� a S• 30 • l r s L- ( OWW WAMN MOM tom, stns cone hose Humbor P 7 M . r --- 7 ,me CsM k�atnbe= 1 V. Type at swubs (elook au SW apply) ti. ��loQ,: ��� Ckmv �Publldcomms l Dasotib� Use O C 44-v e S O :e" A �S CC,fes�dl - 9 . o 7 NeatreaaI G stxse 0wnect �)C 9 l ' os 6 1A. Type o[ Fseoaitt f ban on ltaa A (u=batq fthmt for WOW M)- Con+► IW bw 8 it' appliatble) A, 3 ❑ 1lepiscstwat of 6 C ActditioA w ; Aar aq'vse 1 2(�Repi S ete DAIS Issued lt. taic it ;dray leoue� i Nttmbet ►Y+�pe o f Ra - (Oak ul that pplp w Wfts saw is tar Fir is I we? k i 44 G hw► - Ptuwtited Ieef3�rauiad f 47 M Surd Filter S0 G Coaatro - zod Wodaad j a ! G Holdinf Teak 4t 13 sap Pain s l Q Dray lane 11 G Areslttryted Itt•Gtonad { 45 A 46 0 AM TssaMUB dais 44 0 Aeeitcul 30 ©t7tlter eat Ares D Men So Appiioedon Pereoladon Rate syseur. FJevati♦m f Ftna! gads Proposed Rsas(3e1sJDgslSq.Pt.) (MItt.Rgob) Elevation GI WS Tatalc l tY Toast 2dnmber Zdenufuauer Sid steel 1� ber MUM; GaUom a! Tardis ; Ct rfte Coostatscmd nss rw Mae or - Q t1 ! 41 s" v a ..- •----� I V& !as of pQW+ s *,Maas tlu attas�w y MP Nmais,t But�aeee llifoae wabor e I (f t 6E Art j u Lt/�si• , s 0104 , p Code) f �e SPA ONY AyptQwd Q die � Fee (ttao! Gaottndwevr pea is Astlot sttatuta ! 'a 9tarttpaj o 13 ixwnae f3lva► Mal Admit • gZs f 3 Tofll Tz. C at altAwatte !or n4ap praval v �4� o f "^a. N cv� `ec ur � as s� aae s MW .a4 RD4308 (R. 05101 J f Safety and Buildings 4003 N KINNEY COULEE RD . t LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 N vi sconsin N `, `� (�� www•commerce.stsconsin.gov �_ � www.wisconsin.gov Department of Commerce O�X 51 GR � b Scott McCallum, Governor GO ooc Brenda J. Blanchard, Secretary Cy/ April 19, 2001 CUST ID No.691727 ATTN.• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/19/2003 Identification Numbers Transaction ID No. 634221 Site ID No. 628089 SITE• Please refer to both identification numbers, SITE ID: 628089, Kuryakyn Holdings, Inc. L above, in all correspondence with the agency, St. Croix County, Town of Somerset SETA, NWIA, S5, T30N, R19W FOR: Description: Commercial Mound System - 816 gallons per day Object Type: POWTS System Regulated Object No.: 787088 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Note: This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. •- ARTHUR L WEGERER Page 2 4/19/01 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review 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, DATE RECEIVED 04 /03/2001 • ' FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM jswim@commerce.state.wi.us WiWW'c*, x'633;. i I Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Vilconstn ��, www.commerce.state.wi.us /sb www.wisconsin.gov Department of Commerce 'p Scott McCallum, Governor Brenda J. Blanchard, Secretary April 19, 2001 CUST ID No.691727 ATTN.• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/19/2003 Identifica ' n rs Transaction ID N 634221 Site ID No. 628089 SITE: Please refer to both identification numbers, SITE ID: 628089, Kuryakyn Holdings, Inc. above, in all correspondence with the agency. St. Croix County, Town of Somerset SETA, NW1 /4, S5, T30N, R19W FOR: Description: Commercial Mound System - 816 gallons per day Object Type: POWTS System Regulated Object No.: 787088 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Note: This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. ARTHUR L WEGERER Page 2 4/19/01 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review 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, DATE RECEIVED 04/03/2001 OA" 0 • FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM jswim @commerce.state.wi.us WiSMART code: 7633 I TITLE SHEET Page , of g MOUND SYSTEM FOR o F CC Pkfi This plan has been prepared in accordance with the Mound Component Manual SBD- 10572 -P and the P - Pressure Distribution Manual SBD 10573 P LOCATED IN THE S C 1/4 OF THE NW 1/4 OF SECTION S ,T 3 D N,R 19 W, TOWN OF So Ms(rr <:!-ZO tX COUNTY, WISCONSIN. INDEX PAGE 1 of 8 TITLE SHEET PAGE 2 of 8 SYSTEM MANAGEMENT PLAN PAGE 3 of 8 PROJECT DATA PAGE 4 of 8 PLOT PLAN PAGE 5 of 8 PLAN VIEW CROSS SECTION PAGE 6 of 8 DISTRIBUTION PIPE LAYOUT PAGE 7 of 8 CHAMBER RECEIVED PAGE 8 of 8 PUMP PUMP APR _ 2 2001 PREPARED FOR SAFETY & BLOGS DIV, �v�Y R1�c�lN 1't0 �O1►v 6S -, l = STII.�_L.1`F��Z� MN SSDaZ __ PREPARED BY WECCEI�EF2 SC3 I L TEST 2 N AND. DES I GiV SEF?V I CE P.O. Box 74 421 N.Hain St. River Falls, WI 54022 Q��yg�,4yOS"6D M Phone 715 - 425 -0165 Fax 715- 425 -6864 a (� O.W. Ym � EllSr;)tiTN . �. Cpn it y �� • • �, ;, Ap P MM NQ ENT O OO gIlD • pEPART ET !►N 3 .3 � --�� p►V►S►Ot� OF E�yGE SEE G0RRSgP JOB NO . l-- Z Mound System Management Plan page Z of 8 Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. 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. Puma 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 the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. 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 BOD5, 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 [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. 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. Continaencv 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 3 � 6 _ Il f,Q Sr- C2.01X The system installer at — 1 LS - 3$ 6- IL—Z-1 SC 1: hVm ft 1 The tank manufacturer at ';E� 00 3 ZS - 8456 w IES�R The effluent filter manufacturer at tr The pump manufacturer at ( 4p G ULt_ , S i f PROJECT DATA Page 3 of a This mound system will serve office and warehouse buildings with a total of 38 employees and 2 floor drains. ANTICIPATED WASTEWATER employees: 38 X 13 gpd X 1.5 = --------- - - - - -- 741 gpd floor drains: 2 X 25 gpd X 1.5 = ------- - - - - -- 75 gpd Total = 816 gpd SEPTIC TANK design flow + (CXPEX3)+ (DXPE) 816 gpd + (11.61X1 -0.88X3) + (46.77X10.88) 816 + 378.95 + 508.86 = 1703.8 gal min. capacity required.` A 2000 gal precast tank by Wieser Concrete Products with a Model A100 -8X18 Zabel effluent filter will be installed. PUMP TANK A 1645 gal. Wieser Concrete Products tank will be installed. Page S g Approved Synthetic Covering ASTH C33 Distribution Pipe Medium Sand Topsoil - -_ - - H F _La Elev C1 so 3 E . u b �. % Slope Distribution Cell of Force Main Plowed 2" to 2 Aggregate From Pump Layer p o. S Ft. E Ft. CROSS SECTION OF A MOUND SYSTEM F o. Ft. G S Ft. A ° _ Ft. H 4 Ft. Linear Loading Rate = g 9 7 GPD /LN FT 6 q Ft. Design Loading Rate= 0.39GPD /SQ FT I. Ft. J S Ft. K `� Ft. L 101 Ft. W - Z Ft. . L � . Observation Pipe 6 K A o- -�-- -� 8 - - -- --- - - - - -- ------ - - - - -- - =-- - -- 6 _ _ _ dF orce Main �Dist ution 2 'n Pipe Cell of Z to s aggregate Observation Pipe (Mchbr securely) ' ' PLATT VIN OF A MOUND SYSTEM Distribution Pipe Layout Page 6 of S r 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' fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve, dumded cap or threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. PV C FuC PV C Latent Manifold Lateral X X x x W2 I xJ2 x x x x = Lateral Lenath — Lateral Length — p Distribution Line - • F -� - `- r�c�s soX — —o rrru���a S PVC pri7 -C y� i P �I S Ft Hole Diameter � Inch -- S 3 Ft. Lateral " 4 Inches) X ? inches Manifold 3 • Inches Force Main " 3 Indies # of holes /pipe Invert Elevation of- Laterals 9S•0 Ft. Z�xo.gI .q.sX 6 = S� .SB sue-, . : PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS' PAGE `]- OF 8 • lb • 4 • VEJ.JT CAP ti 'C.T- VENT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE 10' FROM DOOR, JUNCTION BOX COVER WITH WARNING LABEL WINDOW OR FRESH IYMILI. I AIR I&ITAKE 1 GRADE CONDUIT PROVIDE I IAILET AIRTIGHT SEAL I I . r I ICI APPROVED JOIIJT/ A Tank Construction shall comply I 11 APPROVED JOIWTS with COMM 83.15 and COMM 83.20 i 1 I A b I i I I I I O N C • I -- LL C1C 1. -JS FT __ J PUMP -� OFF D `I 00 COLICKETE BLOCK 3" AVPRoVED RISER EXIT PERMITTED OWLy IF TANK MANUFACTURER HAS SUCH APPROVAL gE Ib`lS -wIE2 SPEC IFICATIOKJS DOSE TAMKS MANUFACTURER: b.�"M - L°A�� IJU 1 e MBER OF DOSES: PER OAy TAIJK 51ZE: S GALLOWS DOSE VOLUME Z 3Z p_S ALARM MANUFAC ' S.-5. ej�C'T C SLIST& S IhI CL UDIrv� DACKFLOW: GALLONS Aoor6L NUMBER: IQ tL"y CAPACITIES: A= WCHE50R 'O GALLO IJ3 SWITCH TZIPC: - �� L°L�y g = Z INCHES OR 4 Irb G{ LLOUS PUMP MANUFACTURER: SOUL Ios C = -7 IIJCHES OR ' 210 ' S GALLONS MODEL NUMBER: 3bS S \ Vi D - L l INCHES OR U �' - 3 GALLONS SWITCH TJPE: �L�RC°_UR'Lj IJOTE: PUMP AMD ALARM R TO 5L I MINIMUM DISCHARGE RATE s&. Scb GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND.DISTRIBUTION PIPC.. FEET t MIWIAUM ' NETWORK SUPPLY PRESSURE ......... FEET <S -Ox-\ 3� -1- Z -S FEET OF FORCE MAIN X �' " F 100 tx FRtCTIOU FACTOR. FEET TOTAL DyWAMIC. HEAD = 2 _ FEET As per - manufacturer yS. gal /in. Liquid depth 3� • �y`r1P �Z- ��Z -�`'1 f ��V CE G l�fi�� 8oi- � uoOIAS — ,, Submersible } Effluent Pump LO 3885 APPLICATIONS e 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. construction. • Trailer courts upper and lower. 2" NPT discharge adaptable ■ Power Cable: Severe duty • Motels Power cord: 20 foot for slide rail systems. y rated, oil and water resistant. • standard length (optional • Schools ■ Mechanical Seal: SILICON Epoxy seal on motor end lengths available). • Hospitals CARBIDE US. SILICON provides secondary moisture Indust Single phase: Industry •'' /s and 1 /2 HP -16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket •Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • 3 /4 -1'/ HP -14/3 STO with m Shaft: Corrosion - resistant ■ O -ring: Assures positive Pump ., : bare leads. stainless steel. Threaded sealing against contaminants • :Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4" maximum. • 1 /2 - 1'/2 HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On GSA 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 Ul Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 ■ Designed for Continuous op series stainless steel metal o Impeller: Cast iron, semi- Operation: Pump ratings are en, non -clog with pump - parts, BUNA -N elastomers. out vanes for mechanical seal within the motor manufacturer's • Temperature: protection. Balanced for recommended working limits, 104 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90 stainless steel. ! ) 3 SERIES: 3885 ' • Capable of running dry 25 e° ' -t —'— SIZE:WS°LIDS 11YE1 ! i RPM: VARIOUS without damage to - ! - - ! �5GPM } components. 70 vu I I 5 FT , ! Motor 20 Single phase: = s � % HP, 115 V, 200 V, 230 V, 15- 5° I ! I 60 Hz, 1750 RPM; Y2 HP, z i F 115 V, 60 Hz, 3500 RPM, '0 4l) w E05H 1 I t I ! ; HP- 1 %HP,- 230V' a { ! } } 60 Hz, 3500 RPM s �'�� 30 • Built -in overload with " ` 25,,a wEO automatic reset. I •_Class B insulation.�a 5 "� 20 �J Three phase �•,'/2 HP ,, A 1 /2 HP 200/230/�� ' � �� ti . , o `466 V, 60 Hz, 3500_RPM. 0 10 ',20 30 40 50 60 70 80 ' 90 100 110 120 130GPM ' Class B insulation o io 20 30 m3m fi `• ,. CAPACITY ®1995 Goulds Pumps, Inca Effective May, 1995 11 B3885 r wlsc &Wn Department of Commerce SOIL EVALUATION REPORT Page I of -2L Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Q. j , '� I ic Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must - � T include but not limited to: vertical and horizontal reference point (BM), direction and Paroel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. by Date Please print a aifrn , t . Personal information you provide may be us a s ndary pu (Pri4a 4sw, s. 15.04 (1) (m)). „ 8 3 /D Property Owner . r' ".:.' Properly Location 1 , k 1 n - Govt Lot SE 1/4 NW 1/4 S� T So N R (�{ E (or) Property Owner's Mailing Address +� „ Lot # Block # Subd. Name or CSM# City State Zip QDW. pr ❑ City ❑ village Town Nearest Road I I wad- e a' 14 w 3 r' S m� ❑ New Construction Use: ❑ Residential / jb6rPbd+ r Code derived design flow rate GPD 0 Replacement ® Public or commercial - Describe: 35 c m plo v e c S Parent material Flood Plain elevation if applicable _ � / A ft. General comments S y sl - e M X13' Sd and recommendations: 4 F-1 Boring # E) Boring R pit Ground surface elev. F 3 • q0 ft. Depth to limiting factor 3�_ in. SoN A 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 'E02 3 Z 2 -1$ lu ryl3 5;I Zm rin -fr cis Iv 5 8 3 I g 10 r31LP -- Sd 2 rr,c,-b rv4 C 5 - y 4 3 -�8 to y l CZP - 1 .5 yr I C, W. rrrcr F-zl Boring # Boring ® pit. Ground surface elev. 91• (od ft Depth to limiting factor 32 in. mil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. I *Efr#1 *Eff#2 0 -1 0 1 6 Yr 312 S I mSb rn-fr c 5 1 f . '-I .6 Z 10'ZO 10 y r 141 3 SCI 2rn mfr- C5 I v-C • , 5 g 3 ZO -32 ,o yr316 Sd 2n-C bk nm(r c s — . ` 4 52 Lh 10 l-LI N C2P 5 r'-1 13 c Nor _ U * 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) gnature CST Number q Address Date Evaluation Conducted Telephone Number I Property Owner Parcel ID # pap > # ® ng Ground surface elev. Q�/ Qa ft. Depth to limiting facto in. Applicat Soil Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Effi" 'Efr#2 1 p -5 ID r'3�3 S m k m�►^ cs ► (� Z 5 - I D ( - 4Iy SCI 2 rn 3 30 -34o r31 t>= . 5 r y 1 S i cl 3 m5bk _ �-1 F—I Bori # ❑ Boring ❑Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/fl? in. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. 'Eff#1 '0102 Boring El Boring # Ground surface elev. 1t. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ' Effluent #1 = SOD > 30 _< 220 mg/L and TSS >30 1 150 mg/L • Effluent #2 = BOD _5 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. SBD4330 OL07ro0) PAGE 3 OF -3 NAME k y LOT# LEGAL DESCRIPTIONS C ' /•NW ' /.,S 5 T 30 N R /I _ E (or & SCALE: 1 "= 40 r —" I BM I ELEVATION /OL - d BM I DESCRIPTION AA,' i n ld "c I BM 2 ELEVATION 9ygs I f BM 2 DESCRIPTION ToP 04 3/ , j 'Qoogr D 0e— SYSTEM ELEVATION S ALTERNATE ELEVATION . Ot CONTOUR ELEVATION l y Sd �S � / q2, 0 00 2 IN, q� a Nt Z ti s Ar SIGNATURE '� DATE JUL- 2532201 17:15 FROM: TO:7153BS3121 P.001/001 JUL-JUN. s W KURYAKYN Tp; 4 38074 P.I. /I age- FAW I SoMmitgr PlW*jMq 11M! M0. a 3. 23 am P3 or CADIS CptI " 3 $ La ^ 3 1 C f IN't`IC TANK 00 AA' AND OWN =TMOM" POW Owmll sec r k Mdlq Mm MUM IV o�.n�► Adlwr ` a�rrw rrraNt� /.....� , Q tatftgm bQiwC1w swr d '�4ii rr 1�ONarrrw��t1�# '- Ag a sobs m yam AC Q� � , wlr� i�a�ili tNr�a�i�M��� �� ■�►O� MM �w�p�at — m►/ wftuwfs no to MM mum nail Vol. 1446,w STATE BAR OF WISCONSIN FORM 11 - 1982 I r LAND C C o t R tp A C K ATHLE EN N H (TO BE USED FOR ALL TRANSACTIONS WHERE OVER REGISTER OF DEEDS DOCUMENT NO. $25,000 IS FINANCED AND IN OTHER NON -CONSUMER ST. CROIX I is ACT TI ANSACTIONS) CO 1 RECEIVED FOR RECORD �i Contract, by and between Thomas E. Loviek OS-O2 -1999 !1:00 AN a /k /a Tom Lovick ( "Vendor', LAND CONTRACT whether one or more) and KuryAkyn Holding Inc., CERT r a Wisconsin corporation COPY �e �' ( "Purchaser', RANSFER FEE: 441.00 ser', whether one �r more). RECORDING FEES 14.00 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance PAGES: 3 of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the 'Property'), in — St. Croix County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS Part of SE 1/4 of NW 1/4 and Part of NE 1/4 D. Peter Seguin of SW 1/4 of Section 5 -30 -19 described as Mudge, Porter, et al. follows: 110 Second Street Certified Survey Map filed August 11, 1987 in Vol. "7 "_, page 1868, as d ocument num ber PO Box 469 4290 7, EXCEPT To 3 of said Certi� f e Hudson, WI 54016 Survey Mz.p and EXCEPT r to KuryAkyn Holdings, Inc. in Vol. "918 ", page 525 and 032 - 2019 - 60 - 000; 032 - 2020 - EXCEPT Part to Jeffrey E. Stelzer and PARCEL IDENTIFICATION NUMBER 30 -000 Lynn M. Stelzer in Vol. "1075 ", page 50. TOGETHER WITH and SUBJECT TO the private road easement as shown on said Certified Survey Map. , This is not homestead property. (is) (is not) Purchaser agrees to p urchase the Property and to pay to Vendor at a pl ac - reasonabi v *ies iana ted the sum oft 147, 000.00------ - - - - -- in the followingmanner:(a)$ 36,750_00_ --------- - - - - -- at the execution of this Contract, and (b) the balance of S 110 , 2 5 0 . O O - - - together with interest from date i hereof on the balance outstanding from time to time at the tact of _ 7.25 percent per annum until paid in full, as fotbrws: Monthly payments of principal and interest commencing September 1, 1999 4 in the amount of $1041.00 (One Thousand Forty -One Dollars). i l Provided, however, the entire outstanding balance shall be paid in full on or before the 1 st day of _ Augus t 89L& (the maturity date). 2 0 0 4 . FcAlowing any default in payment, interest shall accrue at the rate of 7 • 2 53 6 per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). [: 2dp "X#diA- XP4jt wm"*"X"MX* idf�iifd�lkdGliPE3k2�} fal(tiil ss�tar, �t��grl�eacae�p�tnswr 'a�c�l+�x�ai�ac sa�tx�caft��x�lcK�xac�caEi► ra�i+��aacug�e>actKxl�'�x��c��� �sn�lon�c x5c>IC �x sroa,r�a�K�a tyalsaa�faasrrra��c,8rlc x����.lstx �fas �I,�I�€�zrrxaa� x�lx�txx � �dcac»s �ical�bilatt'c�t �lix�i�cusasrz�tctl fatlttualagxuxt�t l�a�caK Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Wrifillb"3 Y*Aili67i6 Z-AboKpxmmmxa(atXpM:Fdt te*utl "XAI"It x x x x x x x x x x x x xx x x AS x xx QM) there maybe no prepayment of principal without permission of Vendor.• In the event of any prepayment, this contract shall not b,e treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amoltnt that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued is the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination accept: Ear :.ments, restrictions, reservations of record, road maintenance i agreement and water agreement. Purchaser agrees to pay the cost of future title evidence. if title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid, Purchaser shall be entitled to take possession of the Property on • Cross Ow One. PIP STATE PAR OF WISCONSIN ww-~ t 49N 2x-v CO.. irz' LAND CONTRACT - tgdtr du.: asd Csrpe--sre VOL 1W Purchaser promises to pay when due all taxes and assessments levied on the Property or upon Vendors interest in it and to deliver to Vendor rdamaged. demand recei�rts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils wn d such other hazards as Vendor may require, without co- insurance, through insurers approved by Vendor, in the sum of $ ful]_ f ns r; nab' 1 1 tae t Vendor shall not require coverage in an amount more than the balance oed under this Contract. Purchaser shall pay the insurance premium en due. The policies shall contain the standard clause in favor of the Vendors interest and, unless Vendor otherwise agrees in writing. the ginal of alt policies covering the Property shall be deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies d Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow waste to be committed on the Propety, to keep the Property in good tenantable ndition and repair, to keep the Property free from. linens superior to the lien of this Contract, and to corroly with all laws, ordinances and ulations affecting the Property. Vendor agrees that in case the purchase price with interest ano other moneys shall be fully paid and all conditions shall be fully performed at the times and in the manner above specified,Vendor will on demand, execute tad deliver to the Purchaser, a Warranty Deed, in fee simple, of the Property, free and clear of all liens and encumbrances, except any liens or encun:b nces creat d b the act or default of Purc an except: Easements, restrictions, reservations, road main €er�ance agreement � water agreement. Purchaser agrees that time is of the essence and (a) in the event of a default in the payment of any principal or interest which continues for a period of _ 3() days following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser which l continues for a period of 6_ days following written notice thereof by Vendor (delivered personally or mailed by certified mail); then the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendors option and without notice (which Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any limitations provided by law) in addition to those provided by law or in equity: (i) Vendor may, at his option, terminate this Contract and Purchasers rights, title and interest in the Property and recover the Property back through strict foreclosure with any equity of redemption to be conditioned upon Purchasers full payment of the entire outstanding balance, with interest thereon from the date of default at the rate in effect on such due and other amounts due hereunder (in which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property if Purchaser fails to redeem); or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment on the entire outstandin g balance with interest thereon at the rate in effect on the date of default and other amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at law for the entire unpaid purchase price or any portion thereof; or (tv) Vendor may declare this Contract at an end and r_move this Contract as a cloud on title in a quiet- ' title action if the equitable interest of Purchaser is insignificant; and (v) Vendor may have Purchaser ejected from possession of the Property and harm a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the foregoing remedies shalt only be binding upon Vendor if and when pursued in litigptien and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder (whether abated or riot) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and shall be included in any judgment , Upon the commencement or during he pendency of an action: of foreclosure of this Contract, Purchaser consents to the ap to g Pe 9' Y PPo a receiver of the Pro including homestead interest. to ollect the rents issues and profits of the Prop duri the pe ndenc y of such action perry, g a c P Pe Y 8 Pe cY and such rents, issues, and profits when so collected shall be held and applied as the court shall direct. Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchaser's rights under this Contract or by option, long -term lease or in any other way) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is first paid in full or the interest conveyed is a pledge or assignment of Purchaser's interest under this Contract solely as security for an indebtedness of Purchaser. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become imme - due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any mortgage granted by Purchaser) or under any note secured thereby, provided Purchaser makes timely payment of the amount then due under this Contract. Purchaser may make such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract. Vendor may waive any default without waiving other subsequent or prior default of Purchase. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, Legal representatives, successors and assigns of Vendor and Purchaser. (if not an owner of the property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the subject Property and agrees to join, in the execution of the deed to be made in fulfillment hereof.) Dated this day of July 19 9 9 Kur Akyn Holdings, c. l - Vo E . (SEAL) (SEAL) i • Thomas Lovick By: Patricia F rlong, Presi I (SEAL) (SEAL) i AUTHENTICATION ACKNOWLEDGMENT Sigrtacure(s) of Thomas Lovick and State of Wisconsin, Patricia Furlong j C Camry. � authenticated this day of , 19 Pe n came bef e rrte this a FC day of 1 4 _ 19-f&, the above named TTIU: MEMBER STATE BAR OF WISCONSIN (if not, authorized by $706.06, Wis. StatsJ to me known to be the person tho t�oecblfedt Ipregping instrument and acknowledge the sot y •.' ., THIS INSTRUMENT WAS DRAFTED SV * .c'�' 6� • ,'¢ D. Peter Seguin, Attorney at Law — Hudson, _ W1 54016 Notary Public, CtattntX Wes (Siputures may be authenuwated or acknowledged. Both are not My commission is permanent (lf not, state expiation date: ' necessa • NwFas of Per" op4 In any rapecity should be typed or pruued below their stwurcs. LMD CONTRACT - Lralrldaal sad Covr -rate - Stare Bar of Wismmla, T,mta No_ 11 -1"2 r 2446pcE 53 s STATE OF WISCONSIN, ST. CROIX COUNTY :,s: The fore goin� s rument was ackrowled ed before me this i" ` / by My Commission Expires: ;. January 9, 2000 Not lic, State of Wisconsin Roger Bevers d ROGER 0.8E1(ER$ =1y1TE OF MVf�3O�i n 4: _ S I / i STC — 104 AS BUILT SANITARY SYSTEM REPORT OWNER :&VA,rvAl A)AJg�9 ADDRESS 4 1 gf , 6 ' Al' y 3S - 5'0" - /?SE7 W. Sy vas SUBDIVISION / CSM# LOT # SECTION S T -7 N -R Town of �Jnrvc�t.r cr ST. CROIX COUNTY, WISCONSIN PLAN VIEW 6E,d,0AeK HOW EVE YTHING WITHIN 100 FEET OF SY$TEM l :q' O, of A/ o trd PQo d i"'J r AT A, oT e RN �� 1 YE.JTS AA Ek c < 9 l(� /uo. rx,' , �urE : /�I-135v1PPT�wVI IP6/1 ° I (,JEST l�R/RDE.o T v I 1 PRO PER n/ EPTFI ) 1 1 1 '7'�-AJk I y„ Sc rf V 0 I cy rlEw w i lira I ATE NOR4 ARROW No ScsE�E Provide setback and evation information on reverse of this form. Provide 2 dimensions o center of septic tank manhole cover. II i i b � BENCHMARK: l -Pool PF 4T A/. w. / -T �v ?NC? L : <E V. _ /Oy. oo' ALTERNATE BM: 11 'i.yis14 )L? ? of /l�Ew Bui�Qi�l� C'4 C V = I ©_�• SL' SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: hiFSEe Liquid Capacity: /2So UNlGQ /A.1 (. Setback from: Well / " Se G v Other Pump: Manufacturer — Model# Size Float seperation — Gallons /cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: S� Length /coo' Number of trenches a Distance & Direction to nearest prop. line: /Jo,prtl /o' Setback from: well: 9 r ?f" Other /J u J[d /.vr- ELEVATIONS Building Sewer /0a •SG ST Inlet, !Fe. ' ST outlet 1 2f. yo PC inlet PC bottom Pump Off Header /Manifold Bottom of system �G.00l Existing Grade /OS rC ' Final grade DATE OF INSTALLATION• / 1as ""'i IF PLUMBER ON JOB: LICENSE NUMBER: ly(PQS 3 3`�S INSPECTOR: 3/93:jt t Wiscogsin Department ofindustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX ' .Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village p Town of: State PI n o.: KURYAKYN HOLDINGS, INC. X CST BM Elev.: / Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �,' ,. Z_Z Benchmark Dosin Aeration Bldg. Sewer [Hol di St 1 14 Inlet l 70 TANK SETBACK INFORMATION St /Outlet TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet Air Intake Septic �.nµ? >�� NA Dt Bottom Dosing - -_ y NA Headers 71' Aeration Dist. Pipe , gG. ss Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade 1v,0 M acturer Demand Model Number GPM TDH Lift L riction stem TDH Ft Forcemai n Length Did. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length r No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION �Od DIME RSHMS SETBACK SYSTEM TO P / L BLDG I WELL LAKE/ STREAM Ma cturer: CHAMBER - Mod el Num e INFORMATION Type 0 . System:& ,} {�e r� �D /60 OR UNIT DISTRIBUTION SYSTEM HeaderfTO > / r Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length / Dia. 7` Length Dia. Spacing_ - — 1 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Sys Depth Over Depth Over xx Depth Of eeded /Sodded xx Mulched Bed / Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Somerset.5.30.19W, SE, NW, Lot 1, State Highway 35 Plan revision required? ❑ Yes Ergo Use other side for additional information., / SBD -6710 (R 05/91) Date Inspector's Signature Cert No. � l ADDITIONAL COMMENTS AND SKETCH , SANITARY PERMIT NUMBER: ' SANITARY PERMIT APPLICATION _ 01LHR I n accord with ILHR 83.05, Wis. Adm. Code COUN STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 4 /q o -7 3 / 8% x 11 inches in size. check if revision to previous application -See reverse side for instructions for completing this application. STATE P 1. N R 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION '/4 '/4, S T , N, R 9 E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER / , 11. TYPE O BUILDING Check one) CITY - NEAREST ROAD ( State Owned O VILLAGE - r 4 Public ❑ 1 or 2 Fam. Dwelling -# of bedrooms — PARCEL T AX N NUMB � III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo - 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 ® Office /Factory 13 ❑ Other: Specify IV. TY�P7EI OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ICJ 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 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 IS 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 b C) _ S — , Oc) Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exp INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks T anks strutted Se tic Tank or Holdina Tank Lift Pump Tank/Siphon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) f*P /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): IX. UNTY /DEPARTMENT USE ONLY ❑ Disapproved Sary Permit Fee (Includes Groundwater ate I ssued Issuing A ent Si at re (No mps Approved I ❑ Owner Given initial !) Surcharge Fee) Advers Determination vw X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -8398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber r 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 rer ewal 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 a 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 gailo 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' /z x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimens on location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; veils; water n °.ai;�s /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorp tion systems; •e��acernent system areas; and the location of the building served; F) horizontal and vertical elevation refe-ci-e points; C) complete specifications for pumps and controls; dose volurne; elevation :differences; fri - tion loss;; pump performance curve; pump model and purnp manufacturer; D) cross section of the soil abs- :rption 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 tFe creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The rnor; e co;l,r:cted through then - c surcharges ar�L used for monitoring C4WU ter, grct,r;i . water roniarnination investigations and establishment of lafridards. SBD -6398 (R.11/88) I SAFETY & BUILDINGS DIVISION i 2oi E. Washingtan Avenoe P.O. Box 7969 Madison, Wisconain 53707 State of Wisconsin Department of Industry, Labor and Human Relations June 2, 1995 LACROSSE PLBG SUPPLY CO KURYAKYN HOLDINGS JAMES POEHLING TOM RUDD 106 CAMERON AVE 4886 HWY 35 LACROSSE WI 54601 SOMERSET wI 54025 RE: OFFICE /MFG KURYAKYN HOLDINGS 488 B HWY 35 SOMERSET County of ST CR:OIX Plan Number 95 -04- 0127 -6 Area: 9,500 square feet Suprv. Professional, HVAC: JAMES POEHLING Your HVAC plans have been conditionally approved. The above - referenced plans have been stamped CONDITIONALLY APPROVED based upon review for conformance to the current edition of the Wisconsin Administrative Building and Heating, Ventilating and Air Conditioning Code, chapters ILHR 50 -64, 66 & 69. These plans have NOT been reviewed for conformance to the Plumbing Code (chs. ILHR 81 -86), the Electrical Code (ch. ILHR 16) and any ILHR code not specifically mentioned. Subject to local regulations, construction may proceed except for those conditions listed below. The necessary corrections must be made before construction begins. The owner, as defined in chapter 101.01 (2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. The owner shall notify the state building inspector and local officials before taking possession of the building. The building will be inspected during and after construction. ILHR 50.15 EVIDENCE OF APPROVAL. The architect, professional engineer, designer, builder or owner shall keep one set of plans bearing the appropriate stamp of approval at the building site. All future plan submittals required to complete this project must be submitted '= , 5c - ia ass wH, 6c : 6e -%, 7-© Nnr I SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue ` P.O. Bot 7969 Madison, Wiston9in 53707 State of Wisconsin Department of Industry, Labor and Human Relations LACROSSE PLBG SUPPLY CO June 2, 1995 Page 2 in quadruplicate, and be accompanied by the Plans Approval Application form (58 -118) and fees, When the building volume exceeds 50,000 cubic feet, all application forms shall include the name of the building or component designer AND BE SIGNED BY THE SUPERVISING PROFESSIONAL OF THE PROJECT. ILHR 50.18 New building to be located north of current buildings. ILHR 63.12 The thermal performance calculations indicate that the values permitted by 'fable 63.12(a) are being exceeded in this building. ILHR 64.17 Automatic controls for maintaining design temperature were not indicated on plans. Reinforcement is required in roof areas where unit heater; 1 -3, and furnace are to be hung. This building is classified as No. 6, metal frame construction. Sincerely, Randall R. Dahmen Mechanical Engineer (608) 266 -3162 RRD:vs:0148 cc: State Building Inspector, R -4 Dahl (715) 232 -6600 Thursday Building Inspector, SOMERSET SBOA -55M IR. 0945) E, C 'd 1-1HoE : 60 s5. 7-o wnr f r ♦ . ♦ i ' SAFETY & BUILDINGS DIVISION State of Wisconsin rQ . Departlrient of Industry, Labor and Human Relatio May 12, 1995 2226 Rose St La Crosse W 0 4 601Ay 5 x995 � srx v ZAPPA BROTHERS O"VE 710 6 ST N �.�.. HUDSON WI 54016 P £ RE: PLAN S95 -40174 FEE RECEIVED: 120.00 KURYAhYZQ HOLDINGS INC SE,NW,5,30,15W TOWN OF SOMERSET COUNTY OF ST CROIX NON- PRESSURIZED IN- GROUND SYSTEM The Department has reviewed the above- referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based= on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is continent Upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR -64, Wisconsi,. Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit. expires. The licensed plumber responsible for.this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriat<: inspector when inspections can be made. All permits required by the city, village, township or county shall'be obtained prior to installation. Note: Because of the excessive amount of site alteration proposed, please be advised that the proper erosion control and site stabilization methods must be followed to ensure safety, environmental requirements and proper zoning ordinance procedures. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely rard 1 Swit Plan Reviewer Section of Private Sewage (608) 785 -9348 cc: St. Croix SBDA -9997 (6.10194) a w rn m z � o b r Vv km � � b Z z Q 2 W fA W J�logrrt PRo pz fi y 4 o Aw l —� gS 45fnlc�liYli'(_ ' V ENrs CoeNEjf E4F ✓, s /00,00• � dl 1 ,{ kSd AlT T -lo,J Ak ge /oo' SrrE I�Er�ER T •3F ,(EVrc �,p � ErXok 01 rmO 54 895-40174 A A/ C' /'� G.4L c 'sf Ti Tit�vk - ' �' MhN E ADJNs - rA* 4AJJr �- <L7 . Nvcpr EACV. ,o OE SYST VATE S�WA �,Nr o ndition allY ' S VISION Q TN.r� iM o us � � � ``� ♦ SEE CORRE NO SYS TEir� '* IS 4"IovEQ S - 51u ?N �JESf Tp P�� /eery �,tiE � Ex ./ / JIrNM/,V du5 �iUR y � yy f c00 JO.1i 4a . 390' f icc,I cX wE�c NWy •5,�:, �- A C iX � r)a� o 8 y oil y usq. OF N SY• u g19E1.i1�GS n, y P ONy�Ei��E o SEE COB 3 r d LA) N g O a � • L e a � O Z Z kA s e can Cn Aa ` o 0 uP o u o 0 0 O Q p y G q .� fi 0 � � Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page ! of 2) La�nr and H`,�man Relations Division of Safety &Buildings � ECE,,�rd with ILHR 83.05, Wis. Adm. Code COUNTY V f/� 9.5 "401 s Attach complete site plan on paper�s t n x 11 inches in size. Plan must inc � lude, A not limited to vertical and horizontal referenc�poM), direction and /o of slope, scale or PARCEL I.D. dimensioned, north arrow, an issttaannce to nearest road. APPLICANT INFORMATION - PLEAS P - RT1gT 1 INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION ' ` I ' R k f �,5 /IQ GOVT. LOT ��_ 1/41`10 1/4,S S T 3o N,R 1 9 E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SU D. NAME OR CSM n CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE &OWN NEAREST ROAD Q� New Construction Use[ J Residential / Number of bedrooms ( ] Addition to existing building j J Replacement J* Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd /ft trench, gpd/ft Absorption area required bed, ft trench, ft Mal clmum design loading rate bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation - m s) Ne ft (as referred to site plan benchmark) Additional design/ site considerations Q'( 7 'Ti:s ?i -3cWc � fFT �, i , r.I g Cc�; �' ry 5; "r C', Parent material r X,,(h, d S Flood plain elevation, if applicable ft F = Suitable for system CO VENTIONAL MOUND IN• ROUND PRESSURE AT RADE SYSTEM FILL HOLDING K = Unsuitable fors stem (O S O U ;K S O U S O U S❑ U O S U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bcur)cbP1 I Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench `f A lnxY 3 Z L 1117 1 � Z O. 0. - 14 14.vR - 3 L Z M Altr Q Ground in Y, e r ' Z <'; G _ y►, K r� ; ��> { �' N >� elev. /41A6ft. 0 S Depth to limiting factor > j3 <�b Remarks: Boring # A -� 16 M 3 z L 2 n, C r /1,i w Z n� a. 4 `(3 S Ground Sd S 3 C + 5; L C" K MCI "t Ile a Yf2 S T �r Jh 1 r .q •5 / , ft. i Depth to limiting factor Remarks: CST Name. Please Print s � Phone: � Address: Signatur w Date: r CST Number: 4 PROPERTY OWNER it.y n! SOIL DESCRIPTION REPORT Page of I 1 PARCELLD.4 S9 5 -40174 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourday Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I i Bed Tiench 3 O -r 3 6 yl, 3 L Z n, C r- ,,I w Z rat 0A O.S L Z m q ,,k nJ, w 1 (3A , Ground gj - S`L JpY�S C ,k Ask A -Fj e w N r4A / -2yix 3 SZ - ►7 _Sy2 4 S (� ' r n, 6.A 6.S Depth to limiting factor > 19Z Remarks: Boring # .• . , $, )/ -4 - 7.SYO, 4 s n, qbi-' M w I-�'. o•Z 0 Ground S - l4 Y+Q. 4- 4 S r 4 lev 4 .e ft. Depth to limiting i2 D� Remarks: Boring # 1 Ground elev. S 1 ri S � / g3 � V144 0-�' o.� Depth to limiting factor 3 Remarks: Boring # I E3 Ground elev. ft. Depth to limitin 9 factor Remarks: SBD- 8330(R.05/92) I (A CD 358.40 � - O 109.55 108.09 0 �w `. C1p 00 UD -f 0, _ \ r z� 380' 0q O r CTI - ' 0 0 w �c A z r7� 7� 693.4 0) W , 0) 0 I P. r REOC11M>dkV . I °ik6W P►ae S'aUAJd, S95-40174 CLG _ 16& 66'. Z S _Q Acl' g- 5 �� RE4>Mrn��ib� �vs�rLm I � �LtVA` T lay - kLA 'A'= U 'TwEtn1 3.06 Aoj& 97b6 Ia�l cur 4 �b�TU C'eCYm TNT NIu. TaP. I 44C tx La 2 �� � �E� ►mss Loy- t»� Q ISCALl< 1�= s'n'�,,,.��' �.+ � , ��, _ - ' g�4 ec CS►� . IJa Lo e ,2 Cx �s J q1 � W CJ d u -2 INis PA LCL 15 uLSC PoRCA Im `TNAT' LAAJ.& -J (� CQ >uTR►�LT f:Er.��'.dED IhJ �t�� �I� T"�L•E SZS 4-74-61-7. Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page ! of 3 Laborand.Human Relations ;Division di Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but �S G +tQIt" i X not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION– PLEASE PRINT ALL INFORMATION REVIEWED BY DATE I PROPERTY OWNER: PROPERTY LOCATION �Q 5 A\JCGOVT. LOT 'SC_ 1/4 t4tj 1/4,S S T 36 N,R 19 E (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SU D. NAME OR CSM # I � l I SM c �2 - 7 O CITY, STATE ZIP CODE PHONE NUMBER ❑CITY (]VILLAGE ZrOWN NEAREST ROAD Q(1 New Construction Use [ J Residential / Number of bedrooms [ J Addition to existing building j J Replacement [ Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd /ft trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) fin► PA6 3 nC ft (as referred to site plan benchmark) Additional design/ site considerations Qc44 'TO TL-aciv c 'FeE - ' or S s W iL. ie Parent material ' &S 7 EM, eS tNS , , q tii C t,. Flood plain elevation, if applicable ft S = Suitable for system CO MOUND IN ROUND PRESSURE AT- SYSTEM FILL HOLDING K U= Unsuitable fors stem 6p S El U A S [I U S❑ U S C3 U [I S ,k U O S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITirench v. :iti.4•\i\i aY�23 Z -- L 2 M c 1 2 O. q 0.'5 Ground . 7 -4-0 �py►e 3 r S �- °' L'V Al t ," v) elev. ,p /a� ft. L1i S- 2 SM44 - S In - d 4 O S Depth to limiting factor Remarks: Boring # 6 �P, sL3 oi m-W— �F Ground ' SAS S 3 C Z S; y,, in •b r Depth to limiting factor Remarks: CST Name:— Please Print j j� evEy 6a � 56Q Phone: Address: 6 - &x ry 0&sc ) W l -9S� Signatur Date: / 4 CST Number: — " I PROPERTYOWNER J�Z;K'Y OKW4 SOIL DESCRIPTION REPORT Page 2- of PARCEL. J.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench �t 3 o -- 13 love" L_ L z rh Cr W 2 n� D,S _ L Z rh 4 6.4 ®, Ground $'- jZ 16 C 5; L elev Depth to limiting factor > 1.17 Remarks: Boring # •7SY� 4 0 itK m i w o2 0,3 Ground f S Y+2 S T r 1 4 t"� lev. �q •e ft. Depth to limiting factor Remarks: Boring # 4 � I X :..h1Y:. \'tiQ Ground � � -�� >O`/ �S 3 � •�; �° � ,� ��►� ��r� i-�I '-- � .� 0.3 elev- V 14 1 4 s - �'1 ! — 0 4 O Depth to limiting factor Remarks: Boring # � :':M1: 'ca�datia�s`'R's Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) c Pa 36 .3 ��►,)Ct1 M id � �l i�oN �i tP � ` . CMG• \IATiou z S g_5 t3 I �.'Eli>°''R' VWL �ysi Efi LLLJA ids - - 86 rQ 93.0o Asib- 97.06 t>o ' �a� ► p��e���►�G Now Muc.0 is c. c� . r, Q 2 kc:,it6,s Lar L► ,,E- p B ETw aCl., LTS 4 4- Q fig, ol g -4 csc CS�S , nfo Lo�,tGe Q CX 15; J Qt � w 4 kke -C IS bESUR►BE-b, IN -rwAr LAAA J �; d� tncumf -ksro 47461-7. a r r 4Z9O57 d M CERT IFIED SURVEY MAP Located in part of the Sb i of the NA and part of th NL4 of the SWt: all in Section S, T30N, I119W, Town of Somerset, Sr. Croix County, Wisconsin. LEGEND O 2 ,I 30" iron pipe weighing 3.65 lbs. per linear foot, set 0 1" ,I 210 iron pipe weighing 1.60 lbs. per linear foot, set A' N W N N N ., 1" iron pipe found C � � 5 19 County Section Nonun found I" Iron pipe T N lies SI5 °; :L Marsh Arcs LOT 2 LOT 3 °' ----- •• -- - -- " Unplatlyd lands owned _Ly otilor` 0,06 of set pipe. --.... e Found rehar lies Nolllt line of ll,c S[1 of the NW} of Seclion 5 — R 110 t110 E, 2.041 ° t , „ , to n S08 I.1 0 W 080,01 of set pipe. I.I�.G C rr 7 1" a •r 0 APPRO1��(� rl+ ♦. r . h , AU G U ; i.l ,' �r ; G' a 11f .J '•U'llrr7 G, i• 1! � ^+ _' iu Oil) j1�i 1111 \: (.(71L:.111'1 t•► 'j \ _ I !., C) ri .• fff r M •:, 110 1 I 1 � / ` � � r J ,� ; , h.. �, C. �` ,1 (7), 17 • vl 1 ,/ ) � '- u /L \ - 3 1` co 1 y \; \ go t d "` /;G17o a G1 r 316 o il c. , t 1 j v , 1 1„ l• � 1 - 1 LOT 1 .�: , •t 1 .'��, r;r _ w w ; ; •,•• 'e.,� ^ - '� �,'' Lon' n ')` 1" t ..,� 1 ,,� �-.� i Found 1" iron �•� ��((������ � L'�+'"; r LOT r pipe lies i t r1P��''L �' (� t' ::' ' r15� 1' 1 , i �4� ' NO6 0 06' 00 "11, f l ,�' �,\ 0.9'9 of set 1/`►,..�. `\ It.. 1 j• 1., EXISTIr511ED` / ��' 1 �, :; i O I"• '� � ` pipe. ry (:irC Otl:nlI on—�. bfi' (1 mi,L o 'b ci found I" iron pipe lies • — ^ -- '' , {� N4J ° JJ' 10i 0. 19 of tile back of � ZQ� 1 \,t off` c�t,L A�t it. 71leet 2) L sat pipe. 1010,4G' `111.111' cxlsrlaa IIrn15¢ —�1 .• p'I.J6' ! J94.49' �►— r r �: +' Z :+'� { 1 • N011 °Jli'S1 "[ Center Section of W1 Corner of 0 °Jb'!it " c T, � .a � E, ::,/ f Section 5 Section 5 �' �','• r r:1 �f ��'' ,tj�.tl ^Soulh I inr. of the NW1 of " I" Iron pier Found r 1 �,••y1 1 1� •r r r n' 11' 11 I f.01111ty Monument f�li!'• t. \1 , i �� ,retina ,,, N00 IG rl C 269(1,46 . 01t,ick SCA t•e IN r•l::CT 0o% 2 4 nr. 1 o flu 2 U— —1 o Sonrrset 1 WI 5 110LUMG 7 PA0L 1868 r Ihi; in;lrulncnt ua: dr,lfll:d by frtli �Illrskarck J !1(.. 00- SHEET I OF 2 S E TS ' � r STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Kk�V_LiArV_Yh1 tls S MAII.dNG ADDRESS 'u•w��. �c� PROPERTY ADDRESS (location of septic system) Please obtain f om the Planning Dept. CITY /STATE PROPERTY LOCATION S 1/4, KU-) 1/4, Section T N -R _L�__ W TOWN OF S_ 1�'!� Sri f 0 31.'.201 — o , ST. CROIX COUNTY, WI SUBDIVISION 1 60j< <u,(3 om S t o LOT NUMBER CERTIFIED SURVEY ,VOLUME, PAGE, LOT NUMBE aC �� Improper use an d maintenance o 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 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 60% 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 system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater 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. 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 DNR. Certification stating that your septic has been maintained must be compl d and returned to the St. Croix County Zoning Officer within 30 days of the three ye Expiration d e. SIGNED: DATE: S— / 7 — ? St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 • S T C - 100. This application form is to be completed in full and signed by the owner(s) 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 I VOO1 AC- I L Location of property 'Sr- 1/4 1 /4 , Se tion t , T 30 ,N -R Township SWJK sell Mailing address q 8 6 CS Address of site °� �� At r W i, Subdivision name — _LTV! 1 k Lot no. "T Other homes on property? x Yes No 04E . Previous owner of property JSA I.o ✓lc.�� Total size of property AC2cg _ Total size of parcel Date parcel was created AoG Are all corners and lot lines identifiable? , Yes No Is this property being developed for (spec house)? Yes _K_ No Volume and Page Number 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 recorde n the office of the County Register of Deeds as Document No. 0 - `j7,- , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run 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. S' ture of pp 'cant Co- Applicant Date of Signature Date of Signature y . C" ` � 910 VDL7F° E� EASEMENT THIS INDENTURE, made this 14th day of April, 1995, between THOMAS LOVICK, his successors and assigns, hereinafter referred to as "Grantor" and PATRICIA FURLONG of Kurakyn Holdings, Inc., her successors and assigns, hereinafter referred to as "Grantee." WHEREAS, the Grantor, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration paid by Grantee, does hereby grant unto Grantee, an easement for ingress and egress over and across the following described property to wit: As easement for ingress and egress for the property located at 488B Highway 35 in Somerset, Wisconsin, with the legal description of Lot 4, Lovick Subdivision SE 1/4, NW 1/4, Sec. 5, T30 N -R 19W, Town of Somerset 032 - 2019 -50 Parcel No: 5- 30- 19 -541B. Part of the SE 1/4 of the NW 1/4 of Section 5, T 30 N, R 19 W, Town of Somerset, St. Croix County, Wisconsin; being parts of lots 1 and 4 of Certified Survey Map recorded in Volume 7, Page 1868 at the St. Croix County Register of Deed's Office; further described as follows: Commencing at the W 1/4 of said Section 5; thence N 88 °36'51" E, along the south line of the NW 1/4, 1818.46 feet; thence N 01 °32'32" W along the west line of said lot 4, 358.40 feet; thence N 72 °09'28" E along the north line of said lot 4, 68.76 feet; thence S 01 °32 "32" E, 109.55 feet to the point of beginning; thence S 88°27 "28" W, 66.00 feet to the west line of said lot 4; thence N 01 °32'32" W, 100,00 feet; thence N 88 °27'28" E, 66.00 feet; thence S 01 0 3232" E, 100.00 feet to the point of beginning of this description. The above described parcel contains .15 acres and is subject to all easements of record. / The Grantee shall use the easement strip for driveway and utility purposes only and it is expressly understood that the Grantor reserves the right to also use and allow others to use the easement in any manner not inconsistent with the rights granted herein. The grant of easement herein contained is for driveway and utilities purposes only and is in no respect a dedication for public roadway purposes. Said easement shall not be dedicated for public roadway purposes without the written consent of Grantor and in the event that said easement is taken for public use, it is understood that the entire award for such taking shall belong to Grantor. The Grantee agrees to accept the property in its present condition; and to construct, operate and maintain said driveway at no cost or liability to the Grantor. - S T C"' Y 18 1995 1~t 4:00 tf3 o t, IN WITNESS WHEREOF, Grantor has caused this instrument to be executed in his name on the day and year first above written. "Z e:2-�l O Thomas Lovick STATE OF WISCONSIN ) COUNTY OF Personally came before me, this �( day of , 1995, Thomas Lovick to me k�d�x ass th�� owner of said property and acknowledged that he executed the foregoing instrument. F s ?- Xj- Notary Public, State of Wisab � e t OOC:UMENT NO WARRANTY DEED I TMIS SPACE RESERVED FOR REGC7^i.Nt: OAT^ I i 1 i!STATE BAR. Or WISCONSIN FORbi 2- -1�83t • Tor, lr.. Lovick - and ..Mary „E. ?d, and wifE ................................................................ ............................... ! MAY 1995 .. ............................... r................. I......................... . ......... ................,.............. ........ i� 9:45 A.. conveys and warrants to ,huryakyn tioldirzgs L It�c II �,_ .. .......................... ............. ............. , ............. j r t . .....................•...•..... ..... ............_ .. ......__._... ....._. - .,..........._... I --- ....I .... .............................................. ............................... .. . ... .. .... ....•....•. ... ... ........r •.•.....•,..... ,., .... ......... ...... ...,.'.. .r RCTUILN 'TO`+wwww�..- .wow.....-- r -� —_• 1 44, 1-.a 7 i Co M rn o r .............................. 1 the following described real estate in ,fit...- �.raix .... ........................bounty, •. --- �•- ..-- •- , ..- , --.M_ _.. ? _._. __ :state of Winconsin: Tax Parcel No: _.• ......... .................• See Exhibit A attached tier -ere) _ fs 19 's FEE This .14. -iioV ............. homestead property. (is) (is not) Exception to warranties. D oted this .. .........t l'..LJ..+.. ............... day of April_ . . _ 1o. -95..- i ..... ...(SEA t.) l rl . Tom E. Lavic ... ........ ....................... (SEAL) I Y G Vk lr�l!1C -!G �....... (SEAL) 8. .. •• ................_.... ............................... .,. ... ............. ACKNOWLEDGMENT ACKNOWLEDGMENT STATE OF WISCONSIN STATE Or WISCONSIN ss. - ^ ss. .............. ........................county. h / Peraonally came before me this ................day' of - - - -• Count y. �/ Per nasty came before mo this ...a a1day of 19........ the above nanaeLl ApLral ................................. 199.i_�.. the above nanacd ................... ...................... .• -- -- ... - -- . -- • ........ - Tom. F Aud...Kar ...E....L0.V .c,.k............... ..........._......• ............. .... ......... ... husbaud. s.ud. w- Lfe .................. .................... ........... to me known to be the person ............ who executod the ...........................: ..................... ............................... foregoing ir.xtrumuutt and acknowledge the same. .................... a................... to me known to be Ote person4.... :':' 1h the roregotng instrunierLt and *ckn Notary Public ......... .... ..... ..... ... .... ....... County, Wis. ......... ............................... w .. AI t• Commission is permanent, ((f not, state expiration bt _ dote: ................ ... ............................ ..... 19.........1 Notary Public ...................... is. T-115 tNSSnunsl_rsT WAS DRAFTED 6Y y Commission is permanent. � v ., t�fion , +.rn.f7rnS.> w%A .?17c �%f �4° .. date: ... . ......... . . . .... . .. �� 4 tv- t l b l t y S f; zt . _ •. ;nwq to /a.y e. :L. ..h,...!.t L. ttY•.�.1 .. i• 1'•.I .. tiv -.r o.G UUL�i.•e. - Ut 1LI ; '!t 1--': � t I I if U14 -JEH iH L* i I r" h�i F' 1✓9 Exhibit A Part of the Southeast Quarter of the Northwest Quarter of Section 5, Township 30, Range 19, Town of Somerset, St. Croix County, Wisconsin; being parts of Lots 1 and 4 of Certified Survey Map recorded in Volume "7 ", page 1868 at the St. Croix County Register of Deed's office; further described as follows: Commencing at the West quarter of said Section 5; thence North 88 ° 36'51" East, along the South line of the Northwest Quarter, 1818.46 feet; thence North 01'32'32" West, along the West line of said Lot 4, 358.40 feet; thence North 72 °09'28" East, along the North line of said Lot 4, 68.76 feet to the point of beginning; thence North 01 °32'32" West, 108.09 feet; thence North 84 °41'19" Fast, 478.16 feet to a point on a 233.00 foot radius curve concave Northwesterly, whose central angle measures 27 °44'45 ", whose chord bears South 16 °40'55.5" West and measures 111.73 feet; thence Southwesterly along the arc of said curve and the Westerly right of way of a 66.00 foot private road easement, 112.83 feet to the point of tangency; thence South 30 '33'18" West, along said right of way, 106.72 feet to the point of curvature of a 358.00 foot radius curve concave Southeasterly, whose central angle measures 37 °23'48 ", whose chord bears South 11 °51'24" West and measures 229.54 feet; thence Southerly along the are of said curve and said right of way, 233.67 feet to the point of tangency; thence South 06 °50'30" East, along said right of way, 17.71 feet; thence North 62 0 06'44" West, 383.40 feet; thence North 01 °32'32" West, 109.55 feet to the point of beginning. Together with the private road easement shown on said Certified Survey Map. :9109 VOL 112 87 EASEMENT THIS INDENTURE, made this 14th day of April, 1995, between PATRICIA FURLONG of KURYAKYN HOLDINGS, INC., her successors and assigns, hereinafter referred to as "Grantor" and GREGORY RIEDESEL, his successors and assigns, hereinafter referred to as "Grantee." WHEREAS, the Grantor, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration paid by Grantee, does hereby grant unto Grantee, an easement for ingress and egress over and across the following described property to wit: As easement for ingress and egress for the property located at 488B Highway 35 in Somerset, Wisconsin, with the legal description of Lot 4, Lovick Subdivision SE 1/4, NW 1/4, Sec. 5, T30 N -R 19W, Town of Somerset 032 - 2019 -50 Parcel No: 5- 30- 19 -541B. Part of the SE 1/4 of the NW 1/4 of Section 5, T 30 N, R 19 W, Town of Somerset, St. Croix County, Wisconsin; being parts of lot 4 of Certified Survey Map recorded in Volume 7, Page 1868 at the St. Croix County Register of Deed's Office; further described as follows: Commencing at the W 1/4 of said Section 5; thence N 88 °36'51" E, along the south line of the NW 1/4, 1818.46 feet; thence N O1 0 32'32" W along the west he of said lot 4, 358.40 feet; thence N 72 ° 09'28" E along the north line of said lot 4, 68.76 feet; thence S 01 °32 "32" E, 109.55 feet to the point of beginning; thence S 62 °06 "44" E, 383.40 feet; thence N 06 0 50'30" W, 17.71 feet to the point of curvature of a 358.00 foot radius curve concave southeasterly, whose central angle measures 37°23'48 ", whose chord bears S 11 °51'24" W and measures 229.54 feet; thence northerly along the arc of said curve 6.58 feet; thence N 62 °06'44" W, 380.89 feet; thence S O1 °32'32" E, 22.96 feet to the point of beginning of this description. The above described parcel contains .18 acres and is subject to all easements of record. The Grantee shall use the easement strip for driveway and utility purposes only and it is expressly understood that the Grantor reserves the right to also use and allow others to use the easement in any manner not inconsistent with the rights granted herein. The grant of easement herein contained is for driveway and utilities purposes only and is in no respect a dedication for public roadway purposes. Said easement shall not be dedicated for public roadway purposes without the written consent of Grantor and in the event that said easement is taken for public use, it is understood that the entire award for such taking shall belong to Grantor. The Grantee agrees to accept the property in its present condition; and to construct, operate and maintain said driveway at no cost or liability to the Grantor. r— -RR : `S OFFICE i ST. CROD(C9 , Redd for Pzc=d MAY 18 1995 4:00 P A. i IN WITNESS WHEREOF, Grantor has caused this instrument to be executed in her name on the day and year first above written. 6 atricia Furlo STATE OF NWSe&fRM ) COUNTY OF p Personally came before me, this c 2 k� day of April, 1995, Patricia Furlong to me known as the owners of said property and acknowledged that she executed the oregoing instrument. Notary lic, tate of Wisconsin mmM yA •- i 5 29110 VOL it EASEMENT THIS INDENTURE, made this 14th day of April, 1995, between THOMAS LOVICK, his successors and assigns, hereinafter referred to as "Grantor" and GREGORY RIEDESEL, his successors and assigns, hereinafter referred to as "Grantee." WHEREAS, the Grantor, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration paid by Grantee, does hereby grant unto Grantee, an easement for ingress and egress over and across the following described property to wit: As easement for ingress and egress for the property located at 488B Highway 35 in Somerset, Wisconsin, with the legal description of Lot 4, Lovick Subdivision SE 1/4, NW 1/4, Sec. 5, T30 N -R 19W, Town of Somerset 032 - 2019 -50 Parcel No: 5- 30- 19 -541B. Part of the SE 1/4 of the NW 1/4 of Section 5, T 30 N, R 19 W, Town of Somerset, St. Croix County, Wisconsin; being parts of lots 1 and 4 of Certified Survey Map recorded in Volume 7, Page 1868 at the St. Croix County Register of Deed's Office; further described as follows: Commencing at the W 1/4 of said Section 5; thence N 88 °36'51" E, along the south line of the NW 1/4, 1818.46 feet; thence N 01'32'32" W along the west line of said lot 4, 358.40 feet; thence N 72 °09'28" E along the north line of said lot 4, 68.76 feet; thence S 01 °32 "32" E, 109.55 feet to the point of beginning; thence S 88 °27 "28" W, 66.00 feet to the west line of said lot 4; thence N 01 *32'32" W, 100.00 feet; thence N 88 °2728" E, 66.00 feet; thence S 01 °3232" E, 100.00 feet to the point of beginning of this description. The above described parcel contains .15 acres and is subject to all easements of record. The Grantee shall use the easement strip for driveway and utility purposes only and it is expressly understood that the Grantor reserves the right to also use and allow others to use the easement in any manner not inconsistent with the rights granted herein. The grant of easement herein contained is for driveway and utilities purposes only and is in no respect a dedication for public roadway purposes. Said easement shall not be dedicated for public roadway purposes without the written consent of Grantor and in the event that said easement is taken for public use, it is understood that the entire award for such taking shall belong to Grantor. The Grantee agrees to accept the property in its present condition; and to construct, operate and maintain said driveway at no cost or liability to the Grantor. 8T CROIX U, v J rued ln! 2 . --:; J MAY 18 1995 CAt 4:00 P. i UU A 1_1 ._ J • ' r V0L A IN WITNESS WHEREOF, Grantor has caused this instrument to be executed in his name on the day and year first above written. Thomas Lovick STATE OF WISCONSIN ) COUNTY OF t c� Personally came before me, this 1 / day of ZP1, 1995, Thomas Lovick to me kgpjfi a�.the -- -; ; owner of said property and acknowledged that he executed the foregoing instrument. Notary Public, State of Wiscons J ` Sj e' w EASEMENT THIS INDENTURE, made this 6th day of March, 1995, between THOMAS LOVICK AND GREGORY RIEDESEL, their successors and assigns, hereinafter referred to as "Grantors" and PATRICIA FURLONG of KURYAKYN HOLDINGS, INC., her successors and assigns, hereinafter referred to as "Grantee." WHEREAS, the Grantors, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration paid by Grantee, does hereby grant unto Grantee, an easement for ingress and egress over and across the following described property to wit: Key y�� As easement for ingress and egress for the property located at 488B Highw y 35 in Somerset, Wisconsin, with the legal description of Lot 4, Lovick Subdivision SE 1/4, NW 1/4, Sec. 5, T30 N -R 19W, Town of Somerset 032 - 2019 -50 Parcel No: 5- 30- 19 -541B. The above described parcel contains 7,000 sq. ft. (.16 ac.) and is subject to all easements of record. The Grantee shall use the easement strip for driveway and utility purposes only and it is expressly understood that the Grantors reserve the right to also use and allow others to use the easement in any manner not inconsistent with the rights granted herein. The grant of easement herein contained is for driveway and utilities purposes only and is in no respect a dedication for public roadway purposes. Said easement shall not be dedicated for public roadway Purposes without the written consent of Grantors and in the event that said easement is taken for public use, it is understood that the entire award for such taking shall belong to Grantors. The Grantee agrees to accept the property in its present condition; and to construct, operate and maintain said driveway at no cost or liability to the Grantors. IN WITNESS WHEREOF, Grantors have caused this instrument to be executed in their name on the day and year first above written. Thomas Lovick Gregory Riedesel STATE OF WISCONSIN ) E%HIS1T COUNTY OF Personally came before me, this day of March, 1995, Thomas Lovick and Gregory Riedesel to me known as the owners of said roe and d acknowl P riy edged that they executed the foregoing instrument. - i G CERTIFIED SURVEY MAP Located in part of the SE 4 of the NW 4 and part of the NE 4 of the SW4 all in Section 5, T30N, R19W, Town of Somerset, St. Croix County, Wisconsin. LEGEND O 2" x 30" iron pipe weighing 3.65 Lbs. per linear foot, set 0 1" x 24" iron pipe weighing 1.68 Lbs. per linear foot, set v m N N n W • 1" iron pipe found 3 �, M County Section Monument Found 1" iron pipe a lies S15 0 31 1 05 11 W, ° a �[ Marsh Area Unplatted lands owned by others 0.84' of set pipe. d `� Found rebar lies North line of — the SE of the NW4 of Section 5 z (1) N04 °21'40 "E, 2.04' S88 15 880.01' o CD of set pipe. 390.0 490.01' rn a cn .� rt m = ° o+ m y rt rt � co c N O m rt - O O S ....'"!..w� CD fy 0 APPROV m LOT L 3 !1-1 m rt lO O S A I0 T (P LP kv I N � 8 I K Sl r GP S S O �0 � Y N - -h 1 d � tGMP z r1 is s ., (d4�tl � o E N AND ZOi�lf r�C% CUs..... �i i;4 I d o --� o N83 ° 1g�07�1 i ` ° i Cl- N 5h 001\�� W 37 4.24' r � � a� � i f m S �OSw� 2 80.00' 1 l � v S �\ I S 4 , S \O 316 02 o $S�� � �� (ltt i I N LOT 1 N N CE) I rt D 7 I 8 e (b CID N LOT`�;��� "I 4 4 Found 1" iron � pipe lies ti N04 0 06 1 00 11 W, 0 ,�`� �1d '• < ` �" I � i� o"'' �� �` 0.99' of set a 7 f� w EXISTING SHED 1 4 / a , �� ` h� e pipe. ;E " s i ° (See Detail on �� 66' I� �O �� 1 Found 1 pipe iron i e lies = �y l .0` ce ° a I o_ the back of / ®¢ i x e� L a� o poi N43 0 33 lII W, 8.19 of 3 sheet 2) set pipe. '� ae 1 0 1818.46' 81.81 EXISTING rOO .8 },361 1 394.49' N88 °36'51 " Y' y`� oN88 °36'51 "E Center Section of W4 ' Corner of E 9` j B� 19 ��ti �6` ���� / Section 5 o 0 C �Q 1 Section 5 O . n S 9 South line of the NW of 1 Iron Pipe Found County Monument `'�3� Section 5, N88 0 36 1 51 11 E 2698.46 Small Tracts ------- - - - - -- OWNER SCALE IN FEET Thomas E. Lovick Box 240C 0 100 200 400 Somerset, WI 54025 VOLUME 7 PAGE 1868 This instrument was drafted by Fran Bleskacek Job No. 86 -47 SHEET 1 OF 2 SHEETS s v' • y g� i� j4 G / _ 'w g ii3Afk! v ' �S quvlo o o g v _ AS uMe1� v r �37��vag , . ®N � LET-SL3 AaAj peas woij asadde siaunno 6ululoipe Aq sluawyosaoua ou 1e41 pue 'sauil AJjWW AlloW ail (10U op) (op) sluawanoidwl pue Out -ppq Ile leyl 'sapepunoq 0 41 JO Oleos 01 uo muasarda.i pauolsuawlp A1138ji0o a si dew 6ulAuedw000e a411 pue SpJ030J leeoy"o 0% !3 of 6ulpa000e A1jadoid paddew pue peglJosap anoge 0 41 peAaAins I - a-EL 4 UO m4l Aping Agalay op 'joAaAjnS pue-) wsuooslM paialsl6a.i ' , oNno:i S3>I`d1S NOW 0 1a8A OUI = HONI l - dVIN 30 3l<l0S t _.� W to Aluno0 I N3A1»a S3>Itl.LS NOW O ( ulsuoosjm 10 a 08033a SAM OS unnoa x1083 1S I spa . yy 0 "c'6' a cam u o 'S N 01 133S -40 S3?J :)V L39'0 N31N331V 0Nn03 ; 3cHd NOaI 1 0 ,66'L Lb 1 S 3 M 1 S b 3 OV(103 dl „I 3NIl N01133S N318vno 1S3M -1SV3 ' q •aasoe LZS•O suTNIUO3 TS0JWd 02uTOU12eq 3o iuTod eqj of OUTT PTs BuoTs 4989 90u941 : auTT UO T4009 .r*4jl Ab %son %ate •lq,4 + '06T MaSZ O'loVIAt 90 uoq,L 699•z'1ZauTT PT" VUOTV Mu5£tb�( .BuTuu sq jo JuTod aq1 ovTs IuT•q u'19uPut as£x •H',b•6 ,to auTT 0*.j0.. JOISOA WOO , o,4 66' LL'1 OuTT uo T u R - MOSS sa!l.zmb Nqp ftiTt �t�rtw x saousgs:6 u011082 JO ,zOW63 eq-4 l4e odTd uoJT uv 4v guTa tldMoo 9A0TT0a 9W paq TJ*S6P JQq%^T 2uTaq •uTWOOOTA 'A xTo.zo•zS . 1 299jeWS jo WWI 9 J f morl ' uoTzoes jo CMS 6111 3 �N au2 uT P92 WOOT PUNT a T90.z d uopduase� 5ZO15 uTBUODST 1 106 8MOS 310 TAO Igor aumN Parcel #: 032 - 2020-30 -000 12/14/2009 10:34 AM P A G E 1 O F 1 I Alt. Parcel #: 05.30.19.542E 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 5 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - KURYAKYN HOLDINGS INC, RETIRED RETIRED KURYAKYN HOLDINGS INC Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 0.527 Plat: N/A -NOT AVAILABLE SEC 5 T30N R19W PT NE SW.527 ACRES COM Block /Condo Bldg: CEN SEC 5 W 477.99 FT TO NWLY R/W HWY 35 & 64 & POB S 54 DEG W 242.68' N 42 DEG W Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 190.92' TH E 327.37' CSM 20 -5036 TAKES 05- 30N -19W ALL Notes: Parcel History: Date Doc # Vol /Page Type 07/28/2004 769994 2625/369 WD 08/02/1999 607833 1446/51 LC 658/08 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/11/2006 Description Class Acres Land Improve Total State Reason Totals for 2009: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2008: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r *IL, of Des" CERTIFIED SURVEY MAP °' � r Located in part of the SE 4 of the NW 4 and part of the NE ; of the SA all in Section 5, T30N, R19W, Town of Somerset, St. Croix County, Wisconsin. LEGEND O 2 x 30 iron pipe weighing 3.65 Lbs. per linear foot, set 0 1" x 24 iron pipe weighing 1.68 Lbs. per linear foot, set v m • 1 iron pipe found C a County Section Monument Found 1 iron pipe " ° lies S15 °31 "W, 'C. Marsh Area unplatted lands owned by others 0.84 of set pipe. ----------- - - - - -- - v Found rebar lies North line of the SE of the NW of Section 5 z N04 ° 21'40 "E, 2.04' S88 880.01' o of set pipe. 3 9 0 490.01' a � m rt � z r O w r. No O OD ' C � ( P M rt 1e N O S Y W O h CD tt 7. N N Cn Ol O Lo N A P PR 0 �?'E LOT 2 �''�' L 3 r� rt o ow z O v" CP ST, c.!:'. �•� S O O 1, COMP:<cH:ild','J;[ r...,'..'; ,'I..,,;rHii,i !y No I D AND ZOiJLVC: _U.:...( Il:.a cn _ w f I n IV gy p` N83 019'07 "W 374. 24 1 \N° ; a E Q. o CD M CD 56 8 °0`a I I 3 16 �2 S511 \ 5\ \ o I o d am ' �1.: F \( ' y' 2 81 ' 52 I s I n O N LOT 1 34.96 w t I .•:� i N r o g3 X28 \ \E ®I � w s i �', a y b9. cb r • w . 3 , Q . , vw .� . • �/� LOT' Q'�� nr o Q� !I U Found 1" iron 11 lzk� q �^� / `t '� W pipe lies 1.:. " r.is'ti� "� �' �� N0400610011W 0.99 of set Y aw: j • EXISTING SHED I a r �� �O' �� �� e pipe. Cn 0 w Found 1 iron pipe lies-� (See Detail on �� 66 ��v�� �,a o a�` o 0 11 i the back of ®¢ .� ti es �L a� ti o° ^ N43 30' 18 lJ, 8.19 of � I s heet 2) � h 'iy e e set pipe. ��` ae 1818.46' 81.81 EXISTING HOUSE ` . 87.361 ! 394.49' 0 w4 Corner of N88 °36 "E f9. �Q\ � oN88 °36 Center Section of 1� t v — Section 5 T & ' S` .�� Section 5 `q�, South line of the NW4 of 1" Iron Pipe Found County Monument Section 5, N88 2698.46 F Small Tracts OWNER - ------ - - - - -- Thomas E. Lovick SCALE IN FEET _ Box 240C 0 1 0 200 400 Somerset, WI 54025 VOLUME 7 PAGE 1868° This instrument was drafted by Fran Bleskacek Job No 86 -47 SHEET 1 OF 2 SHEETS { r 8 0 0 W ID f/1 cc C N 0 7 cx o W A yam � o�g ^ y ip _:@ Qj W C y rl f I C�ATI� Nartm OM�R &, 5.30.19 • PRI VATE SE'WA�GE SYSTEM /64 county: Labor and Huvn.Relations INSPECTION REPORT Safgty and grildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Permit Holder's Name: []City ❑ Village [Town of: State Plan ID No.: PAT FURLONG I SOMERSET CST BM Elev.: , Insp. BM Elev.: BM Description: n , Parcel Tax No.: 032-2019-50- TANK INFORMATION ELEVATION DATA A9200218 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing r Aeratio Bldg. Sewer Holding St/ Inlet Sl' 9/ 56 TA SETBACK INFORMATION St/ I Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake v Q Septic NA Dt Botto 7/ /96 NA Header /Man. � �y. Dosing ��5 . " / 30 9 : ' / Aeratior Dist. Pipe HOldi Bot. System y PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand ma y' ° Model Number GPM TDH I Lift Friction System TDH Ft m ead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Liquid Dep DIMENSIONS DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA Manu acturer: INFORMATION Type O e/ , BER Mo a Num e . System: we'ZA,,,_d OR UNIT /ciao .y.i� DISTRIBUTION SYSTEM �` 9 Header / Manifold Distribution Pipe(s) x Hole Size x Hoe Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only - � ? Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) 97- Plan revision required? ❑ Yes No Use other side for additional information. w 0 SBD -6710 (R 05/91) Date !��Inpector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH Yy m SANITARY PERMIT NUMBER: • E a 1 7 13ILF4R In - SANITARY PERMIT APPLICATION accord with ILHR 83.05, Wis. Adm. Code STATE SANITAR PERMIT # – Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / c f 8% x 11 inches in size. Ch k i f revision to prey ous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROP TYOW PROPERTY LOCATION - - VAl } p q I' � b�'+ 5A '/4 /1! /a, S 5 T 3Q , N, R 1 'fter) W PROPERTY OWNER'S MAILING ADDRESSj LOT # u BLOCK # N r CITY STATE ZIP CODE PHONE NUMBER SUBDIVISIO NAME OR CSM NUMBER c,-tQS ar, 5$1611. /jJ !t? A- J / / A. 1111. TYPE OF BUILDING: (Check one) ❑ State Owned VIL LAGE - 5 Qyytyr S-t�7 NEARS ROAD �+► 11 Public ❑ 1 or 2 Fam. Dwelling –# of bedrooms — A E TAX NUMBER III. BUILDING USE: (If building type is public, check all that apply) Q 1 El Apt/Condo 1 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 0? Office /Factory 13 ❑ Other: Specify } �>s'As �- IV. TYPE OF PERMIT: (Ch only one in line A. Check line B if applicable) A) 1. ❑ New 2. X 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 Issue V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ 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 -ln -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 /06) 8 3� 3 p JV y • ! G �- c� Feet 19 S' ? Feet VII. TANK CAPACITY Site INFORMATION in aallons Total # of Manufacturer's Name Con- Steel Prefab. Fiber- Exper. New isti Gallons Tanks Co ncrete structed glass Plastic App Septic Tank or Holdin Tanks Tanks Tank �° Ot.r� -• '�- Lift Pump Tank/Siphon Chamber x l VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name P0, ): Plumber's Signatu : ( o Stamps) IV /MPRSW No.: Business Phone Number: Lu h w e ,rg Plumber's Address (Street, City, State, Zjp code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issu' Agent Signat o Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination rA I X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber l y INSTRUCTIONS 1., , A ikEkpitaicy..permit is valid for two (2) years. 2. ` -Out s�rn taffy 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 lumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be 9 P or P re q subrtteo to the county priorto installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) mustrbe pumped by licensed pumper ovh necessary, usually earbsry,2 to 3 years. - ;, a.. 6. If you ha%�e questions concerning your ons)te sewage system, contact your local code administrator or the State of µVisFg is nsin, Safety &Buildings Dygn, 608 - 266 -384,5 ,�. � r TQ pry corf th'ti 96nita-ry*rmit 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 ingtalled. IL Type of building being served. Check onty'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. f. `T 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. Eomplete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. 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% 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 performa�Ace curve; pump model and pump manufacturer; D) cross., section of the soil. absorption system if, required try the t-ounty; E) siil test data on aV11.5 form; and F) atsiking informatioh- '- 6 R $URCHAAGE ` 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. Tfie rationies eollected through these Oyrcharges are used for monitoring groundwater, grou.�d- , na _ water contamition investigations and establishment of tandards: ' -A SBD -6398 (R.11/88) I Wisconsin'DepartmentofIndustry, PRIVATE SEWAGE SYSTEMS Private Sewage Section Labt and Human Relations 201 E. Washington Ave., Rm. 141 Safe%y and Buildings Division PLAN APPROVAL APPLICATION P.O. Box 7969, Madison, WI 53707 (608) 266 -3815 INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received. The reverse side of this forrrl describes most of the required plan information. Further requirements may be contained in the Wisconsin Plumbing Code, which can be purchased from the Department of Administration, Document Sales and Distribution, 202 South Thornton Ave., P.O. Box 7840, Madison, WI 53707, Telephone (608) 266 -3358. Plan Review Appointment Date n nVi 'cation er. 1. PROJECT INFORMATION (Type or print clearly) I; a Na a of Submitting P (plans returned to same) Project N e e rs Street Address, P.O. Box # or Ruraj Route Project Ad ress or Legal Description C it or Villa State Zip Code City ❑ County 2/L nt J Village ❑ of C Telephone No. (include area code) 3 — $ /3S Town _ 5 47"11W51-1 Std ro 1 y Designer Name Own r Telephone No. (inclvde Vea code) Telephone No. (include area codef Street Address, P.O. Box # or Rural Route Street Address, P.O. Box # or Rural Route (9c;";'0 C O r- . City or Village State Zip Code City or Village State Zip Code S o/ 2. APPLICATION FOR: ❑ Experimental Mound System ❑ Holding Tank ❑ New Construction ❑ Large System ❑ Conventional Gravity System ❑ Groundwater Monitoring * Replacement ❑ At -Grade ❑ System in Fill ❑ Petition For Variance ❑ Revision ❑ Pressu S yst e m ❑ System i Flood Plain (attac S BD -6698) ❑ Other Alternatives 3. FEE COMPUTATIONS (include existing tanks) FEE SUBMITTED FOR OFFICE USE MAKE ALL CHECKS PAYABLE TO SAFETY & BUILDINGS DIVISION. 00 N a. 750- 1,500 gallon septic tank $ 50.00 b. 1,501- 2,500 gallon septic tank $ 60.00 C. 2,501- 5,000 gallon septic tank $ 80.00 d. 5,001- 9,000 gallon septic tank $100.00 e. 9,001- 15,000 gallon septic tank $150.00 f. Over 15,000 gallon septic tank $ 250.00 g. 500- 1,000 gallon dose chamber $ 30.00 h. 1,001- 2,000 gallon dose chamber $ 50.00 i. 2,001- 4,000 gallon dose chamber $ 70.00 j. 4,001- 8,000 gallon dose chamber $ 90.00 k. 8,001- 12,000 gallon dose chamber $110.00 I. Over 12,000 gallon dose chamber $150.00 M. 500- 5,000 gallon holding tank $ 30.00 n. 5,001 - 10,000 gallon holding tank $ 55.00 o. Over 10,000 gallon holding tank $100.00 p. Revisions $ 20.00 q. Groundwater Monitoring - Per Site $ 32.00 (other than a proposed subdivision) r. Petition For Variance: Setback $ 25.00 Site Evaluation $ 50.00 i Subtotal: S. Priority Plan Review: Enter same amount as Subtotal Total Fee: o o+ o NOTE: Appointments for plan review should be made prior to submittal. You may contact one of the offices listed below. Ha ward Office LaCrosse Office Madison Office Shawano Office Waukesha Office P. O. Box 754 2226 rose Street P.O. Box 7969 P.O. Box 434 401 Pilot Court, Suite C 209 West First Street LaCrosse, WI 54603 201 E. Washington Ave. 1053A E. Green Bay Street Waukesha, WI 53188 Hayward, WI 54843 Phone (608) 785 -9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548 -8605 Phone (715) 634 -4870 Fax (608) 785 -9330 Phone (608) 267 -5119 Phone (715) 524 -3626 Fax (414) 548 -8614 Fax (71 S) 634 -5150 Fax (608) 267 -0592 Fax (715) 524 -3633 SBD 6748 (R. 07/91) NOTE:Fees are pursuant to Wis. Adm. Code, Chapter Ind. 69, and OVER . are subject to change annually. d P1 b. # - 60 1/78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS_ ��� D iy LEGAL DESCRIPTION �� .Sew S' T'3 /v — K - 1 tj OWNER a �u r `onG _ MAILING ADDRESS o?o? ZIP ARCHITECT, ENGINEER, (2 !u r n P W e � ADDRESS / q �, 9 Ik-5 A- PLUMBER OR DESIGNER n TELEPHONE NUMBER 21 5 - — (> ) '16 5 13S 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building k New building Addition ( ) Apartments and condominiums . . . . Number of bedrooms ( ) Assembly hall . . . . . . . . . . . Seating capacity ( ) Bar . . . . . . . . . . . . . . . . Seating capacity # of meals served ( ) Bowling alley . . . . . . . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number o:f.unsewered sites Total number of sites ( ) Camps . . . . . . . . . . . . . . . ( ) Day use only Number of persons ( ) Day and night Number of persons ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Church . . . . . . . . . . . . . . . ( ) No kitchen Number of persons ( ) With kitchen Number of persons ( ) Dance hall . . . . . . . . . . . . . Number of persons ( ) Dining hall . . . . . . . . . . . . Number of meals served daily ( ) Dog kennels . . . . . . . . . . . . Number of enclosures ( ) Drive -in restaurant . . . . . . . . Inside seating capacity Car - service -- Number of car spaces ( ) Dump station . . . . . . . . . . . . Number of dump stations Employees ( total of all shifts) Number of employees ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit ( ) Medical and dental office bldgs. Number of doctors, nurses, medical staff Number of office personnel Number of patients ( ) Mobile home parks . . . . . . . . . Number of sites ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . . Number of persons ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . . Seating capacity ( ) Dishwasher and /or disposal? ( ) 24 -Hour service ( } Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . . . . . . . . . . . . . . Number of classrooms __FT Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . . . . . . . . Number of cars served daily ( ) Swimming pool bathhouse . . . . . . Nil-' of persons ( ) OTHER (Specify) . . . . . . qr2 Adulo. COMPLETE OTHER SIDE 2. Indicate whether the following facilities are present. Floor drain yes no < Number of drains _! Food waste grinder yes no _N Dishwasher yes no yC Automatic clothes washer yes no Number of clothes washers d 3. Septic tank capacity Holding tank capacity Septic or holding tank manufacturer 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches depth number of trenches SEEPAGE BEDS: total square feet width length of bed depth SEEPAGE PITS: total square feet outside diameter depth below inlet total depth from top to bottom of pit N Signature of p son completing form: FOR DEPARTMENTAL USE ONLY A Address Z2k 9 zip 5 D/z Telephone Number 7/_S r /_.3 Date i S�NW..`�5 T- N I`� PA-1 Fu R1c,rjG H Lk-A-cz W-1 5 c I b WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a -- `J1�.�.e,jc.�y - �' .l��oy -A-�-, The site characteristics are: 3 y Depth to groundwater or bedrock in. Landslope _ % Percolation rate min. /in. Distance from dose chamber to distribution system qG_ ft. Elevation difference between sump and distribution systern 3_ ft. Step 1. WASTEWATER LOAD S"�„ X o� ����►' � gal.' Step 2. SIZE 'T'HE ABSORPTION AREA A) Atva required /uo �` /.a / �, _ 9 ft. B) Brad or trench length (B) _ ft. C) Bed or tr ?nch width (A) _ _3 ft. D) Trench spacing (C) Wastewater load .24 ��al /ft /day B ft. trei� Step 3. MOUND HEIGHT A) Fill depth (D) s _� ft. B) Fill depth (E) = D + slope (A)+P) i _�iL ft. C) Bed or trench depth (F) _ / ,`d 3 it. D) Cap and topsoil depth (G) _ ft. E) ZCandtopsoil depth (H) = , r ft. .'iun: ✓ ..7�.� -� _ PA rU � - X02.0 �=de r• fir. - Step 4. MOUND LENGTH A) End slope (K) _ C D + E + F + H x 3 , ft. 2� B) Total mound length (L) = B + ?_(K) a Y8.43 ft. Step 5. MOUND WIDTH Al) Upslope correction factor z • 3 7 A2) Upslope width (J) n (D + F + C)(3)(factor) _ ft. (; j - 53 3 �- A , _3 x ,s7s = - 7 93 B1) Downslope correction factor f B2) Downslope width (I) _ (E + F + )(3)(factor) _ /D,55 4-431 x 3,x . l,/ 9 10,,y9 Cl) Total nxund width (W) for bed = J + A + I = _ '90,9 7, y34 3 # i 0.55 :fib• C2) Total mound width (W) for trenches J + + (no. trenches -1)(c) + A + I ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil = gal. /ft /4ay B) Basal area required = wastewater flow natural soil infiltrative-capacity - sq. ft. i zr�:` , 2 Y = /35,/3 Cl) Basal area available for bed for sloping sites = B x (A + I) _ sq. ft. C2) Bas are avail le for trench for sloping sites = �, B W -- A + A 3 39q sq. ft. x — ( - 2 , Y3 •+ C3) Basal area available for trench or bed for level sites B x W = sq. ft. S i j d 7,4 Liconse Wu : D ata: . .1..1.C:• �P�� r p r. Step 7. DISTRIBUTION SYSTEM - 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size in. 2) Hole spacing in. 3) Distribution pipe length 4) Distribution pipe diameter = /� _ in. 5) Spacing between distribution pipes in. 6) Distance from sidewall to distribution pipe �f in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = _� 2) Flow per pipe GPM 7C) SIZE MANIFOLD 1) Manifold is central/ end 2) Manifold length a AIIA. ft. 3) Number of distribution lines s 4) Manifold diameter = in. 7D) SIZE FORCE MAIN r 1) Minimum dosing rate = GPM 2) Force main diameter 3 in. 3) Friction loss ,8 /`z ,S3 ft. 7E) TOTALL, DYNAMIC HEAD 1) Vertical lift = ft. 2) Friction loss = J,53 ft. 3) System head 2.5 ft. ft. 4) Total dynamic head = /� ft. a i n 6 4 c. P ' o i , 7F) PUMP SELECTION 1) Pump selected will discharge 73- GPM at ft. total dynamic head. 2) Pump model and manufacturer G � C [���1� ► s w� Fri 3 it 4 7G) OOSE VOLUME " 02 1) 10 times void volume of distribution lines gal. /cycle 2) Daily wastewater ZomuV-- _ ,�S _ gal. /cycle for -$e 3) Minimum dose volume gal. /cycle 7H) DOSE CHAMBER 1) Minimum capacity required a_ gal. N Q rvr%'?c1 SiGn: Lict;nse u:� _ Date: i P°57qxa Lij P9 6w la N� r 4 MA &+( m , fine •-� 5` tor) /1 n un aistuv -ba�3 4 CcU `� uVE ' y IL P C C I A-,e. Ln -t 3 Ci by I g `AGE S ;�' S7 "L cot, pp 41W ' SIM ... DE u 5 :ia F ?i11Rt�,V REI;AT,tN5 QiViS�C'fl, Or ti:fi' Tv Ait'( liti+ ?_J!A,;S ` � fi boa SEE i.t3ri" Sr�EvisCi!d".a± �� �� . 35 . N+ f wvr y 6 � ri s Page Of /0 Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand -� tt- a•� fa I Topso _,� - -L .. S % Slope C}NSITi= Bed Of 2'- 2 % Force Main Plowed SE -WAGS SYSJEM Layer ggregate ► E /. Ft. � APP . 1 .sr5 c on Of A Mound System Using 5 � nCpA i<<�r r. }, F Ft. For The Absorption Area i G Ft. ;, + tr , •� RELATIONS (3 fJSi�t`3 � i, r ; � �,;�i RE S '•' t. t ( {..:� 1111 n. � E A 3 Ft. H IS Ft. Signed: B 8 _� Ft. License Number: K " 6,. /Ft. Date: L J Z s� .3 Ft Alternate Position T p/ ,r,�s Ft. of Force Main W ���,�� Ft L F A i Observation Pipe i� - Force Main W I , , Distribution Bed Of i z -2 2 Pipe Aggregate 1 Observation Pipe Permanent Morkers Pion View Of Mound Using A Bed For The Absorption Area - tA ai,b P490 Perforated Pipe Detail n End View Perforated End Cap PVC Pipe Hotee Located On 8ottom, c Are Equally Spaced - / F / ��� OIS f;04 fool) - Last H.I. S t2l /�y Next To End Cop S EWAGE SYSTE ribution Pipe Layout P Ft. cj R EPA AP F w ., 4 1, D S R � >4. t ft NIA ' I��tS�4r1Y r C l Pi3�1 ?f ,�iiL rrr� X -- -�'- -= Inches RECD .. Inches Signed: F `° Hole Diameter --�� Inch t Lateral / Incri( ) License Number: ��lo —� Manifold " — N Inches � Date: .S �� - g� Force Main Incil�; N of holes /pi pe_ Invert Elevation of Laterals 99,yj Ft. 4 rt t t� T C3 V� 1 vv N Z ro 1 `1 C A � ' En N En r+ y ro rt. H m i U) n n m `- --- - - - - -- fn 0 fD M o � :j 0 d K W Jr ON ? E SEW x AGE SYSTEM f�2 r+ #' OF ' 1 'J1�7i(;rf1 �,- c�1t' :6,�, � . °; t „�,� nu RELA TUS M yv SEE Coigi n a a PAGE OF C= PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS R ot Lk Y-1 arm VCWT CAP ����{ , L�-r Sy01 (, 't 'C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING 25' FROM DOOR, JUUCTION BOX MANHOLE COVER WINDOW OR FRESH 12 "MIU. AIR INTAKE GRADE I `1" MIK1. CONDUIT PROVIDE I - - - AIRTIGHT SEAL APPROVE D JOINT A I I I APPROVED JOIKIT: W/C.I. PIPF. ( II EXTENDIAIC. W/C.Y, PIPE 3' I II EXTENDtWG 3' 0►JT0 601.10 SGt;. ALARM 8 I I OWTO SOLID SOIL ON ONSlTE E �E SYSTEP.�9 I OFF CONCRETE BLOCK 47EPAF T ( tf�n RtSa>, EXIT' P ;Rh1i i 'J� U#STANK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIOUS SEPTIC AND �' V{J�IILJ. 4t►L 44S_ E TAf.IKS MANUFACTURER: IJUMBER OF DOSES: PER pAy TANK SIZE: GALLOMS 005E VOLUME pr G �j ALARM MANUFACTURER: -J t �` INCLUD!!;C :,;C;.FLOW: / ik GALLONS MODEL NUMBER: ,Z 1/ 17' A.) CAPACITIES: A= 2 0 _ INCHES OR GALLOWS SWITCH TYPE' n B = INCHES OR _ �� • GALLONS PUMP MANUFACTURE I S r C= IKICHES OR �� GALLO MODEL NUMBCR: _ .3 -4✓�� //L � /}P 0 - --2-- INCHES OR $ 'GALLONS SWITCH TYPE: �. NOTE: PUMP AMD ALARM ARE TO BE PUMP DISCHARGE RATC C J"Gp INSTALLED OM CIRCUITS VERTICAL DIFFERENCE Bjq PUMP OFF AND DISTRIBUTION PIPE.. g FEET f MIUIMUM NETWORK SUPPLY PRESSURE /� + _U 2.5 FEET 0 FEET OF FORCE MAIN X / FT/• • .� — � IOO rr.FRICTION FACTOR_, FEET TOTAL DYNAMIC H = E-=- -- FEET ' IUTERNAL 0IMEWSION; OF TANK: ►.IG / m C LIQUID DEPTH S I G IU E 0:� ✓,may ��}t � .. �5.� � q r LICE.WSE NUMBER: -117- 1 r. now _. s , w �'�' t m GgULDS SUBMI RS. SEWAGE* 'AND EFFLUENT PUMPS • • � Bt M' LvJ Y EP0311 � . I.ISr Dlsc. pptmFp0311 142 M311 1/1 NP 115 V Efflumt Pulp 1/2" solidb 256.80 172.10 EE t1 +• Subme a ble MODEL EP0311 `Effluent SIZE 3 /e° SOLIDS , t. r METERS FEET ti 25 Y si �'tt7 t 2. •� -y C 1 t •� r !t J r i " S n{ S° S O a , � f t* 1 ,v r �t 0. O + • 12 . 16 2�.. 2S 02 36 .o. GPM Y 0 2.5 S.0 7. 5 m'/f1 ., •�. CAPACITY d '. • , r^ t. t'. Performance Curve 3885 1 MODEL 3885 SIZE 1 /4" Solids f /r d e 70 q tr , E, Kf w[orA do ,o -E h5 _ w[oll _ , — }} , '• ; 'q'�t o a co too tto 12o , ovw to ... 20 3o Wm Y �• /1 Jr / cuxaTt t}• LIST DISC. X . i ir + y eeY S OoUN'E03111. 142 hF0311L 1/3 NP 115 V Lar H 3/4' solids 191.55 329.35 3/4" solids 491.55 329.3S CX7l A.E0311M 142 ' WE0311M 1/3 NF 115 V tbd N Q7UP4.?.OS1111 112 1ie 0511H 1/2 1T 115 V liiph N 3/4" solids 104.25 471.8S r p�l7R1E07121i {.'E071v'I 3/4 NP 230 V Nigh Pd. 142 3/4" solids 843.65 56S.2S �� 4M }tor •.' C yE ° xt•� +SF�,F13CdLWING PAGE I P131FCftMA1>CE AND SFE)cIFICATIONS. afw ,'s �, <• DEPT 30 PAGE 07u 10/88 ST. CROIX COUNTY �``� WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE xaz r = 911 FOURTH STREET • HUDSON, WI 54016 .lam (715) 386 -4680 May 28, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite investigation of the Pat Furlong property, located in the SE 1/4 of the NW 1/4 of Sec. 5, T30N -R19W, Town of Somerset, St. Croix County has been conducted. This onsite revealed suitable soils at a depth of 24" below which seasonally saturated soil conditions were observed. This site will require 12" of sand fill beneath a mound for replacement. Should you have any questions, please feel free to contact this office. 9 ames erely, K Zoning Administrator cj DEP/t�.RTMEI OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS JNDUSTRY, DIVISION �LAB 0J' AND PERCOL TESTS (115 MADISON W 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) 1.Ut`nT(c�N: EC71�N: - __ -_. -- - .- .___.. -_ I UWN51111' /MDQNK«`tOOd.`ll Y -- L01 N(1.: RLIC. NU.: , 1-1 VISIpN NAME: - SL ' /4 M 5 /T 30 N/R 1 °r► W Somerset n/a n/a n/a COUNTY: S BUYER'S NAME: MAILING ADDRESS: St. Croix Pat Furlong 220 Cedar Dr., Hudosn, Wi. 54016 i US DATES OBSERVATIONS MADE NO. BEORMS.: COMMEE DESCRIPTION: PROFILE UE G ONS: A 10 TESTS: Ff Residence n/a office EINew ?Replace 3 -17 -92 3- 24 -92 RATING: S= Site suitable for system U= Site unsuitable for system CONVEN O'NAL MOUND: Ifd- dh6UND-PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) �osoulc�s❑u as ®u asc�u osc mound If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the un der s.1-163. indicat n/a Floodplain, indicate Fl elevation: n/a decimal' PROFILE DESCRIPTIONS page 26_ SaC2 BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER RUXX IN, ELEVATION OBSERVED ES CHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) .75, 10yr3/2, l.; 1-.25,10yr5/4, sil.; 2.17,- 6- 1 4.17 95.92 none 2.00 1.0yr4/4, mot. s.l. .67, 10yr3 /3, l.; 1.33, 10yr5 /3, sil.; .75, 10yr- B_ 2 3.84 95.92 3.00 2.00 5/3 mot. sil.' m B_ 3 3.08 94.32 none 2,00 .58, 10yr3 /2, 1.; 1.42, 10yr5 /3, sil.; 1.08,- 1 B- i B- B- deciaml' PERCOLATION TESTS TDEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL- INCHES RATE MINUTES AFTER SWE INTERVAL -MIN. P Rtt�D t [ ER I D - _PE U_ PER INCH 2.00 none 30 1 z 1 1 30 2.00 none 30 7/8 5/8 5/8 48 none 30 1 3 /4 3/4 40 P_ 1 PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of syi able soil areas. Indicate scale or aistanc€s. escribe what are the hori- z zontal and vertical elevation reference points and show their location on the ploww atT` Sh th e surface elevation at all borings the direction and rcent of land slope. �r` C� SYSTEM ELEVATION 96.59 --- _ <_ > 2- 3 Q• f t A� k X00 t:V MAr W 2 ' \ V . 41 ' H_ v . t :_ 1, 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. AME ()rint): TESTS WERE COMPLETED ON: ry L. Steel 3 /24/92 __ cSS: CERTIFICATION NUMBER: FqENE NUMBER(oplional): ? 00th. Ave., New Richnond ,_ 11i _54017 22 9 - -_ 10 CST SIGN ) E: iginal and one col)Y In Local Amholily, Property Owner and Soil Tesler. �t ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, W/1 54016 715 386 -4680 May 28, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite investigation of the Pat Furlong property, located in the SE 1/4 of the NW 1/4 of Sec. 5, T30N - R19W, Town of Somerset, St. Croix County has been conducted. This onsite revealed suitable soils at a depth of 24" below which seasonally saturated soil conditions were observed. This site will require 12" of sand fill beneath a mound for replacement. Should you have any questions, please feel free to contact this office. i erely, yc • ames K. Thompson Zoning Administrator c' 7 IVNI9180 IVNIJIIlp cc Z � 1 W i-z 2 a 11 W 00 p cc Q o W O zo a M a co _O w F G W V OtE °~ r a s w O a O ~ Z Z• Z W~ WO < < x w W ♦ a C<.1 H j p oN < c H p J uU? a p Hit ? 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CL = F- J v CO W Q - p y z Ci O m z CC O Z ►- W r) U F I- W 0 Q � ° � N W tt a i Lit U O ¢ ul w w O > V a< w am ir ¢ W Z p a X Z d, F O _ O -� ~ i X z o •— Z U r =C z a N z U H ¢ - _ O HO V MW x ce a_I- w> �W > Cl) CC LU rn U w '.0 ' 1 w O W V x a d+ OD a p - W U x a d, co < U I- W cr .- L) CC s r� x o cr¢ co � ^` N a H a =¢ 0+ z LL LL I' Z w .i d+ z W W 0 X m in CC O� rn I- t i 2 I ' I- o c M 0. z u ¢ o F - 10 it I LL V C _ HIf? - a 0 a ro 0 UI- a> a 67 a MIt)UI- a U W 0 a m tJ oWG am U?(A t.AJ LnVi — En a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT 0 St. Croix County z ty a OWNER /BUYER - PA + F � H �-t /- a� G M ROUTE /BOX NUMBER QQ0 Fire Number .CITY /STATE tA t-1-4s y-\ W.r ZIP 5 f 6/6 PROPERTY LOCATION: 5,e k, 'h, Section — , T R1 Y_W, Town of dm -2 rSe� , St . Croix County, Subdivision hYIA Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you pdt into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% 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 veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), 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. '- 0 I /WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - ►o ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoni ffkge wi hin 30 days of the three year expiration date. SIGNE DATE - O St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715- 796 -2239 or 715- 425 -8363 Sign, date and return to above address. S T C - 100 This application form is to be completed in full and signed by the owner(s) 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 P -� - - -- � h�� V-- ------------------------------ Location of property 1/4 Nr- 1/4, Section -5 , T 30 N - W Township SD rn.,a�r� sue! Mailing address vZo� �crer t-- Address of site Subdivision name - Lot no. A Other homes on property? yes X No Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? _ Yes No Is this property being developed for (spec house)? Yes / ` No Volume ' a llnd Page Number -S� 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 & 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. r 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 1�t e of the County Register of Deeds as Document No. , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No pli nt Co- applicant Date of Signature Date of Signature y 4". "Mom" shmm low Aftvw# 0savem Mw S"26 abe" W6"* 0"a" Sabo "1 "d 4wv 839.64 9"tj qk Mo aw 9"" Old" so = dw so baii i as 488 pop"& so I eb %#Now" 'fit �ks ra wad sm 14W lavlawdiv at i 4W to WON Of *ALM *000 JIS dft o4ft aft . 16 0 tjejM O f tb* edmotpW *Vail The I*LtW'� Nook. Ui*, 4MONOO.-OW11 be &"tied to istepw 004r* --sold amount wor a the lost Cofit roe 1 SNMK of �vqp&4*4% Vriswipol On under the t Amos). bdmn a" be "M IS SIN I bommmok- dwA awse at do n% Famimift mor M% ddkWMUM "W"L 10 Vnft bilem" to PW MMOAF I Ito 4MN"U" vAss &a go be ago" Job M womw fe" w sken not be fteatW as in —A *Up" tam im swb e� acmiar b"Na bj�w Aw bd$b% WWSW ha" bm I On; 1 papunaft " be coadawd la 00a humod pnodwis belft dwrmftw =du" -&-a ]Pw *am b nmk" with the thk #a Awn by tM dW o� is dw ovid� Is --r-W-77 is Pei& 7A w October so As ywouly uid w... » ». .. &Y of . . _...lD�zstb�ez ...............w. I IIP ... .� » • .. .. : .. ..._ SEAL) .. ... ............................... t AOXXOWLN �►umm" STATE O!' ` ts) �. ....... w .... .:...............__.- :..,.:.... �� � �!! .. ...». .. ............................. ..ST ; CROIZ ............ »...C�. : � • ....� ozr..w ... . .............. i9..... October _ ...... »... , .. . » ............................. ..Isms. -I. » r _ .zapre�eatatixadE.l�tM« .................... ...».w.»...w�www.......w....! t , 4N�M,' ts. ifsib.) to r k oik b M i OWN— GV GNU=, gftkrg MM GHERTY, S.C. i,k.�... .�.. .... • III •• Mj.. S jql 6.... M a � e �14r 429057 pUG a1oo� t CERTIFIED SURVEY MAP Located in part of the SE 4 of the NW a and part of the NE ; of the SW4 all in Section 5, T30N, R19W, Town of Somerset, St. Croix County, Wisconsin. LEGEND O 2" x 30" iron pipe weighing 3.65 Lbs. per linear foot, set 0 1" x 24" iron pipe weighing 1.68 Lbs, per linear foot, set v o0 N fD N W • 1 iron pipe found County Section Monument Found 1 iron pipe 11 lies S15 °31'05 "W, o w .t. Marsh Area Unplatted lands owned by others 0.84' of set pipe. Found rebar lies North line of the SEI of the NW4 of Section 5 z N04 0 21'40 "E, 2.04' SB8 °15'04 "W 880.01' co of set pipe. 3 0 490.01' m _ a rt m = ° o, m N � rt � Z O t 0 p C 00 CD N CD E C rn rn APPROV 1 L0T 2 "�° L O 3 CD rte rt r �yy�� r iJi z AU (i' •� {' � ms' 1�9� � m j� �o °$ S, Z I >v ��, ST. ( ?:' >' �•� S ' ma y Z III w rt f N o ° o AND ZC)Nl + 4 C/ c.P \\ N 83 °19' 07 "W 374.24' 1g � titi nn I N IV °j °",� 80. OV P , N Ln I tZ m C5 34. r z i v �. S6 p is I 316.p2 o . 6• rn 9 Q7 1 1• n o N LOT 1 `1 / 3� 96`1 9 Za ILI w I rt F` 6 � 4 '32 0 p 4.- C:) t c Y q e5 31' cb LOT �^�' o e �iCo Found 1 iron �' / U t R q ,'� ©`' pipe lies G !, 61 . N04 /o�� 0 ,i�h� / a 0.99' of set EXISTING SHED O ! 4 �� i `` 5 2 pip 4 i �''� II lies— o (See Detail on �� 66 Au��� 1� �o``�` e1 ti a� co Found 1 iron pipe ® 1 v o N43 8.19' of sheeta2k of + i.�� e �� e 3 �L�Q a � ae � ti ° ° �1�` ° — set pipe. a¢e 1818.461 81,81' EXISTING HousE`. 87,36' 1 394.49' Wj Corner of N88 °36'51 "Es �`x� s 0 36 1 51 "E Center Section of l vL ',`O� •`�� Section 5 Section 5 9 `O South line of the NW,I of 1 Iron Pipe Found County Monument f ' 9 �. ° �o �' Section 5, N88 ° 36 1 51 "E 2698.46 Small Tracts OWNER ________ Thomas E. Lovick SCALE IN FEET Box 240C 0 1 0 200 400 Somerset, WI 54025 VOLUME 7 PAGE 1868 v� This instrument was drafted by Fran Bleskacek Job No. 86 -47 SHEET 1 OF 2 SHEETS ARM 9£OS a9ad OZ TOA M Z 30 L 133HS NOS83d NVIUS .l6 03l -iV8G 1N3Wn6ISN1 SIHl ;ZO49 IM '13S83WOS 49/9£ AMH 494 (0310N SV ONnO�) 6C2 X09 Od 1N3WnNON NOLL03S .UN600 :83NM0 3dld NOW .L ONnOd • 3H N 1 30 1S3n03a 3Hl 3dld NOW .Z ONnOJ ■ 1V 0310nON00 A3ANnS �'3AI�10 '1.A /•SBl 09'L '1M Nid NOW „9 L AE3 «b /C 13S O 3 „64,OS.L9N NY Ol 03WnSSV �� � */L 1S3MH12iON 3H1 JO 3Nn H1210N 3Hl Ol 03ON383 -4MI 3NV SONINV38 MLOX • nw CIM KIWI bavom J�ti _ jf1H h 4 ,B6'GZ 3 .sq.BC.BB N - •�. / / M 1 " M .tC.tS.BB S i/t MN 3Ht e0 3Nn S 3'S 9Z469C ; isig �- Ve• t �s � s= Nid 13S 1 I 3.t£.fl-0OS San ` / 100 A i WO / \ I •d'1 .1 ONnO! 1 / 0901 /d ['x DO'18x3 / NM0/6 SV 1N Wd .99 avoa 31vn1aa .99 t i t / tiG'E9 3.LZAGtLN v / I ,Sf N z C,ov"Q 3 h CZ �. `9 a a L N •al 1 _ wig .a� gam ts3 i x1 CAS° 3 ' ME \ Wmv aNno (- d•1 .z ONnOj �.f�M GL —OC -4C I 81 aN.7 MN aNO */L N I /L.t4•642 l,ze•zo6l / L � CB'LBBZ 3.6i (,86'IBBZ 3.CO,LS.LBN w•a) 1/I MN 3HL -40 3Nn HLaON 'NISNOOSLM 'AINnOO XIOaO '1S '13S2l3WOS jO NMO1 '1S3M 6L 3ONVN 'HI80N O£ dIHSNM01 '9 NOLL03S 30 b/l 1S3MH1nOS 3H1 .40 b/L 1SV3H.LNON 3H1 .30 IIAVd NI ONV b/1 1S3MH1LlON 3H1 j0 b/1 1SV3H1nOS 3H1 d0 IbVd NI 031VOOl '999L *Od 'L 'lOA 'W'S'0 30 b 2 8 L S1Ol d0 IbVd ON139 z33ji*�W KH1 aflS GaIJIIUR� dvH ASAM tI3IdI.L89a 00003ki 8- HOA9AUM HdOr =Ee s"Z /se /se A1N moid •is C80034 sod CMAI3338 Qa K IA 'I08a .LS sa330 rro t .csl9 Q - HsaxR - R3 9£OS SElycl 3 OZ "TOA SSSvPJB DEPARTMENT OF REPORT ON SOL BORINGS AND SAFETY &BUILDINGS INDUSTRY, CC DIVISION BOX LABOR HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON WI 53707 (1-163.090) & Chapter 145.045) LOCATION: '' SEC TOWNSHIP /M�TY: OT NO.: BLK. NO.: SUBDIVISION NAME: SE 1 /4 NtT/4 5 /T 30 N/R 19 or) W Somerset n/a n/a n/a COUNTY: 'S BUYER'S NAME: MAILING ADDRESS: St. Croix Pat Furlong 220 Cedar Dr., Hudosn, Wi. 54016 USE DATES OBSERVATIONS MADE NO. BEDRMS : OMMERCIAL DESCRIPTIO PROFILE DESC IONS: PERCOLATION TESTS: Fl Residence n/a office ❑New Replace 3 - 17 - 92 IP 3 -24 -92 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: S STEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) EIS HC E4S ❑u ❑S ®u ❑S Do ❑S DV n° und If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5) (b), indicate: n/a Floodplain, ind ic a te Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS age 26 SaC2 BORING TOTAL DEPTH TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER SIN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) .75, 10yr3 /2, l.; 1.25,10yr5/4, sil.; 2.17,- 6- 1 4.17 95.92 none 2.00 10yr4/4, not. s.l. .67, 10yr3 /3, 1.; 1.33, 10yr5 /3, sil.; .75, 10yr- B- 2 3.84 95.92 3.00 2.00 5/3 mot. sil.; B- 3 3.08 94.32 none 2.00 •58, 10yr3 /2, l.; 1.42, 10yr5 /3, sil.; 1.08, - B- B- B- deciaml' PERCOLATION TESTS TEST DEPTH I WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD2 PERIOD PER INCH p- 1 2.00 none 30 1 %2 1 1 30 p. 2 2.00 none 30 7/8 5/8 5/8 48 P_ .00 none 30 1 3/4 3/4 40 � I PEPE PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of s A table soil areas. Indicate scale o ncl�D� cribe what the hori- zontal and vertical elevation reference points and show their location on the plot the surface elevation at all borings a he direction and rcent of land slope. SYSTEM ELEVATION 96.59 _.� _S z Il ; r 3 i r i F : _ .�,�.� o : t : n - o e X( r 1, the undersigned, hereby certify that the s te reported on this for j�er made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data reco the loca "n of test t r rrect to the best of my knowledge and belief. NAME (print): 7- r, TESTS WERE COMPLETED ON: Gary L. Steel o� "' 3/24/92 5 ADDRESS: CERTIFICATION NUMBER: � 154246- 6200 HONE NUMBER (optional): 1554 200th. Ave., New Ric., m Wi, 5`4017 22 CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SSD - 6395 To be a complete and accurate sail test, your reOort nwst include: 1. Complete legal description; 2. The use section must clearly indicate whethe r this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement systern; 5. Complete the Suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; S, Make sure your benchmark and vertical elevation reference point are clearly sho'vvn, and are per manent; 9_ Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropniate; 10, If the informafiOra (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible conies and distribute as required, ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (osier 10 ") BR - Bedrock cob -- Cobble (3 - 10 ") SS - Sandstone gr - Gravel (under 3 ") LS - Limestone �s -Sand HGW - High Grcxrmduvatt=r cs Coarse Sand Perc - -- Percolation Rate med 5 - Medium Sand t,N -- Well fs Fine Sand BM9 - Building Is - Loamy Sark? > - -. Greater Than I Sa,�dy l_c >arr� - Less Than Loarn Bit 13rovtr7 �sil -- Silt Loam BI Biack si - Silt. G - Gray cl - Clay L oarn Y - Yellow scl Sandy Clay Loam) R - Rod sict Silty Clay Loam mot - Mottles sc Sandy Clay with I ssc - Silty C lay fff few, fine, lama c Gla cc - corninon, coarse pt __ Pea- Into Many, mfadiuna III - Muck d d;stinct p p omment IIV,;L - High water level, " Six c1ener t soil lexturt�s serrface Watel for liquid haste disposal dM - Bench Mark VRP -- Vertical Reference Po?nt TO THE OWNER: This soil asst report is the first step in securing a sanitary oe, rnit. The county or th(i D epart ywnt May r rr iltc-tion of this snail test in the firlrl prior to perf issuance, A'complete set ,,f plzm €; for The SCIwage syslom and a permit tahf.lica�t ot'a must Ise submitted to trw a,.>,)rOtariate local awhot;ry in order t(; oh,tam a pet"nitl:. The Sanitary rtep must bt3 obtained an d po stixl to th", start of arty c(instructior"' DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, `` DIVISION BOX HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON WI 53707 (H63.090) & Chapter 945.045) LOCATION: SECTION: T LOT NO.:BLK. NO.=SUBDIVISION NAME: S 1� W1/ 5 /T30 N/Ri9� Somerset n/a n/a COUNTY: ftVkW'S BUYER'S NAME: MAILING ADDRESS: St. Croix Pat Furlong 1 220 Cedar Dr., Hudson, Wi. 54016 USE DATES OBSERVATIONS MADE NO.BEDRMS.: 1COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: I EIResidence n/a office El New Replace ' 3 -17 -92 13-24-92 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ❑ S lyv EA S ❑U ❑ S OO 1EISHU1 ❑ S iRU mound with variance If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n/ Floodplain, indi Floo elevation: n/a decimal PROFILE DESCRIPTIONS page 26 Sac2 BORING TOTAL DEPTH TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER IDEpTH= ELEVATION OBSERVED EST. H IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 10yr4 14 B -1 4.17 95.92 none 1.17 .75j10yr3/2,1., .42,10yr5 /4,si1.13.00mot.s.l. B-2 3.84 95.92 3.00 1.07 67,10yr3/3,1., .42,10yr5/3, sil, .75,10yr5.3, mot. - sil. 2.00, 4 4 B 3 3.08 94.32 none 1.08 .58, 10yr3/2, 1., .50,10yr5/3, sil. 2.00, 10yr4/ mot. sil. B- B- B- decimal' PERCOLATION TESTS TEST DEPTH I WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ❑ggM I AFTERSWELLING INTERVAL -MIN. PERIOD PERI0132 PERIOD 3 PERINCH P_ 1 2.00 none 30 1 P_ 2 2.00 none 30 7/8 5/8 5/8 48 P_ 3 2.00 none 30 1 3/4 3/4 40 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. SYSTEM ELEVATION 98.41 • ap�ro4al (per dig �n bite b S ro x ou ty Zo it T _.. _. 1 _�.. p }� J i ( (_. t q 1 -1416 6 � I E 0 I LJ y k } wo 1 I ._..... .«.. _ ..,, _ ._..._ -m I, the undersigned, hereby certify that the soil tests reported on this form were ma 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: Gary L. St ADDRESS: CERTIFICATIO NUMBER: PHONE NUMBER (optional): 2298 7 CST DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — f INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 61395 To be a complete and accurate sail test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use planned; 4, Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS: 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagrarn accurately locating your test locations. Drawing to scale is preferred. A separate sheer may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10 If the infor mation (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Slone (over 10 "') BR Bedrock cob Cobble (3 - 10 ") SS Sandstone gr - Gravel (under 3 ") LS Limestone * s - Sand HGW - High Graundwatea cs Coarse Sand Perc -- Percolation Rage need s - Medium Sand W - well fs - Fine Sand Bldg Building Is - Loarny Sand ) - Grt ater Than 'sl - Sandy Loam < Less Than '`I - Loam Bn - Brown sit - Silt Loam BI - Black si Sit Gy - Gray cl - Clay Loarn Y Yellow sci - Saardy Clay Loarn R - Red sicl - Silty Clay Loarn mot -- Mottles sc Sandy Clay w' -with sic Silty Clay fff - few, fine, faint c Clay cc; - common, coarse pt Peat mm _ Many, rnedium m -- Muck d - distinct p - prominent . HWL - High water level, Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP- Vertical Reference Punt TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Departmc;nt may request verification of this soil test it) the field prior to permit issuance, A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local author4y in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction, IN I \9� N I Zl 001 . m I M LO I w I I M LL 1 C4 � � I w (U U f I Q I M to \ LO w l n. _ w ,6b'269 � I 'S'i• tc) M �•� LL LO co Q I'n �— tn 1 092 ILO co OD I t LO � I I .p 60'901 59'601 OD s ob'ss£ I 06Z b9'199 `I ;ky I Q V to to I y N lNr 1 Q LEGEND CURVE DATA 1� COUNTY SECTION MONUMENT CURVE RADIUS CENTRAL • 2" IRON PIPE FOUND NO. LENGTH ANGL IQ Q 233.00' 27 ° 44' 4 • I" IRON PIPE FOUND 0 I" X 24" IRON PIPE SET 358.00' 37 _ - -- - -- - - - --- CENTERLINE EXISTING DRIVE © 292.00' 37 ° 23'A 0 ® 299.00' 32 ° 26' 6 N84° 41 19 E 4 7 8,16 .16 66 °o9? 0) sj�' / % O �- • % �- m 09 Lc) lb o – of 0 Q� 0 / s X62 ° to p 06 �V W o_ U a O M / z &3 S06° 0'30 ° ,E 17.71' N06 0 50'30 "W 4 24.28' O 66 T� S0 ° 50 30 "E O F 23.92' 00 N 36 ° 17'54 "W / 6/- i I . 24' S 36° 17'54 "E 28.59 _ 1\ c, h� N88 ° 36'51 "E �� ��j 1818.46. 8 1 . 81 , 1 15 . ' J88 °36 '51 "E N88 °3651 "E — T - - -- ---- ____. -. 27 .s - 87.36 "' �- SOUTH LINE OF THE NWI /4 OF SECTION 5 N88 0 36 51 E :ORNER OF 1N 5 s .. 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