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HomeMy WebLinkAbout032-2143-50-000 0g ��� / , \ D § t Q! / -3 / E ° @ Z E E_ q 9 § > - =EE k( 2 f \k % : / C & 2 q , / / / to to \ C \ \ /§/ %� \k / CL G ° (D \ \ \ \ . . . 2 0 @ co z 0 0 0 \ - � 2 § § § 0 � Co R ca to co) = c CD =4; c o v § ; f ® 2 £ . . , 2 \ \ z e . ; 7 ~ z z � 0 o 0 � \ =r k \ ƒ U) § 3 a CD / � $ § � z \ # § $ o z \ g z . k m k E z @ 7 z ® E �� 2 ± 0 z CL \ .. � e � ) . . � N \ k I tA 0 ) @\ k(D � �2 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division 0 " I INSPECTION REPORT Sanitary Permit No: 408207 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. Collova Builders, Inc. I Somerset Township 032- 2143 -50 -000 CST BM Elev: Insp. BM Ele : BM Description: /0 6t i a TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / � � D Benchmark Dosing Alt. BM 3 Aeration Bldg. Sewer l.0 . S Holding S Ht Inlet (.,.� TANK SETBACK INFORMATION tOutlet TANK TO P/L WEL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t l Dt Bottom 1 2U I '( 3� 3 5- 1 Dosin Header /Man. r Aeration Dist. P ding Bot. System 3 PUMP /SIPHON INFORMATION Final Grade Q ufacturer Demand St Cover GPM Z. 06` bS Model Number :�� TDH Lift Priction Loss Sy Head TDH Ft F emain Length Dia. Dist. to Well F_ SOIL ABSORPTION SYSTEM BED /TRENCH Width :F Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L e BLDG WELL LAKE /STREAM HING Ma act I' INFORMATION ,HA MB OR Type Of System: u UNIT Model Narpber: -�' , I ct " I . � DISTRIBUTION SYSTEM / 5 — C a A4 C,4am, G.eA— 1,,: Header/ix Hole Size x Hole Spacing Ve Air Intake A e(s) lni r Length Dia Length ` I`t 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 [ l No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / U Inspection #2: Location: 1681 87th St Somerset, WI 54025 (NW 1/4 NE 1/412 T30N li Blue Stem Prairie `�Lo-�t'�5 Parcel No: 12.30.19..1251 1.) Alt BM Description = •(' ( 7 ���� �'d{a 2.) Bldg sewer length= -amount of cover= "aJ - 3 ab ca ,o Plan re io a fired? Yes o Use other side for additional information. - Date Insepctor's Sig ature Cert. No. SBD -6710 (R.3/97) Sammy and Buildings Division COunty 201 W. Washington Ave., P.O. Box 7162 L r WI 53707 - 7162 Site Address F Visc nsln ,sue ,� r sr. Dep ment of Commerce ?/ v Z Sanitary p • Number Sanitary Permit A In accord with Comm 83.21. Wis. Adm. Code, personal information you provide ❑ Check if Revision - my be used for secondary purposes Privacy Law, s15. 1 m State Plan I.D. Number I. Application Information - Please Print All Information Parcel Number Z - 30. �°(. (ZS' Prope Owner's Name C, C 03z- 2.1 `(*S -SO- Ciao iry Location Property Owner's Mailing Address Ptope ,, i . S J Z T —%. P E City, tate Y Zip Code Phtp fd >�FF CE Lot Number B lock Number Subdivision Name CSM Number <�` U. Type of Building (check all that apply) c5 s 13City or 2 Family Dwelling - Number of Bedrooms S �Vr7lage ❑ Public/Commercial - Describe Use op ❑ State Owned � Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use ew 2 Replaceent System 3 ❑ m Replacement of 6 ❑Addition to m Tank Onl stem Permit Number Date Issued B. ❑ Check if Sanitary Permit Previously Issued IV. of Permit: (Check all that apply)(numbering scheme is for internal use) OiW 0,-f 00 44 on - Pressurized In- Ground 210 Mound 47 ❑ Sand Filter 5o ❑ Constructed Wetland 22 O peed In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' tment Area Information: / Design Flow (gpd) D� Area Dspersal Area Soil Application Percolation Rate System Elevation Final Grade �j Pro Rate(Gals./Days/Sq.PL) (Min./Inch) Eevation Manufacturer Prefab Site Steel Fiber Plastic VI. Tank Info Capacity in Total Number Concrete Constructed Glass Gallons Gallons of Tanks New Existing Tanks Tadca Septic or Holding Tank Dosing Chamber VII. Responsibility Statement - I, the undersigi responsibility for installation of the POWTS shown on the attached plans. Plumber's mrjMPRS Number Business Phone Number Plumber's Name (print) / G j Plumber's Address (Street, City. State, Z. e) • c 1 Y VIII. Coun /D Use Onl ent Si sire (No Stamps) Sanitary Permit Fee (i�ludes Groundwater Date Issued Issuing Ag 8m Approved ❑Disapproved Surchar Fee) ❑ Owner Given Initial Adverse r ` o Z Determination IX. Conditions of Approval/Reasons �easons for Disap approval � t' w . i s�� 94— rel ��; (�, �I 1�n�tt,tst�P,+t•� pu1j� T� 1— �QQ l.�x�C1 (OtL�.N►� . - ' Attach e p> oob> ear em on dat 8W X 1, !a size �, r �jPt3Lt"`t Ca�I c12n -AT4R iR 05 /01d PLOT LAN PROJECT P.C. Collova Bjdrs. Inc A R SS P.O. Box 489 Somerset Wi 54025 NW 1/4 NE 1/4S 12 /T 30 N/ 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6 / 24/02 4 BEDROOM CONVENTIONAL X00C IN -GR D SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambe 3 IL BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P Same as Benchmark SYSTEM ELEVATION 92.0/91.5 Alt. BM Top of steel Fence Post @ 96.5' Plans Designed Using Conventional Powts Manual Version 2.0 a� a 0 N 575' Property Line 97' Vents 96' 2 -3' X 94' Cells with >3' Spacing I 5' 3% 0 4 15 1 B edroom 20' 0 ouse B- 11A c� �S 5' M. 10 c Vent U 1,03 �'� 30 ' .M.g � 0' >6„ Standard Infiltrator` of Cover Leaching Chamber to Q , ents with 31.1 ft2 of Area 1 6' Long 12" 150' 34" Grade at System Elevation 370' Property Line PLOT , LAN PROJECT P.C. Collova Bldrs. Inc A R SS P.O. Box 489 Somerset Wi 54025 NW 1/4 NE 1/4S 12 /T 30 N/ 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 6/24/02 BEDROOM 4 CONVENTIONAL XXX IN -GR D SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL IH.R.P. Same as Benchmark SYSTEM ELEVATION 92.0/91.5 Alt. BM Top of steel Fence Post @ 96.5' Plans Designed Using Conventional Powts Manual Version 2.0 a� a 0 N 575' Property Line 97' Vents 96' 2 -3' X 94' Cells with >3' Spacing 5 ' 3% 0 4 15' S B edroom 20 0 H ouse B- ,fie, M. 1 o 5 0 o Vent 30 M.$ T 80' >6 " Standard Infiltrator B -1 of Cover Leaching Chamber Vents with 31.1 ft2 of Area 6' Long 12 150' 34" Grade at System Elevation 370' Property Line Wisconsin Department ofComrnerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include. but riot limited to: vertical and horizontal reference pant (BM), direction and Pal I.D. percent slope. scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information R viewed by Date Personal Information you provide may be used for secondary Purposes (Privacy Law. s. 15.04 (1) (m)). ` o 1 2 PmpertyOwner Property location 7 Lot 1/4 1/4 S T 3 b N R E W . � Govt. 1 Property Owners Mailing Address Lot # Block # Subd. Name or S �� City State, Zip Code Phone Number ❑ City ❑ Village own Nearest Road syO ) CrIaw Construction Us!! esidential / Number of bedrooms Code derived design flow rate C Q e GPD ❑ Replacement ❑ Public commerdal - Describe: Parent Q material JcPa Flood Plain elevation if applicable /V / ft. «r,d comments —Z&P. 7 41 93.7S/ 3,53 ls' G © Borft Boring Ground � Ground surface elev/ ft. Depth to irntiing factor in. Pit Soil Application Rate Hall= Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E11#1 'Eff#2 4. , IF '1 7 1 Boring # Boring Pit Ground surface ele . ' `� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description TexUue Structure Consistence Boundary Roots GPD/fE in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = SOD > 30 < 220 WjWL and TSS 40 < 1 ' Effluent #2 = BOD 130 mg& and TSS < 30 mg1L me (Please Print) CST Number j Q,� �� Jl 2 2-61 r Address Date Evaluation Conducted Telephone Number Property Owner Parcel ID # Page of 3 Boring # ❑ Boring it Ground surface elev. O ft. Depth to limiting factor _/3?. in. M*Eff#1 Rate Haft= Dept h Dominant Redox Description Texture Structure Consistence Boundary Roots in. Munsell OU. Sz Cont. Color Gr. Sz. Sh. f#2 3 /z �� � " 'r , '� ,9 F Ong # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sol Appl ication 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 'EfM2 BonM # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. . Soil Appkafion Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - '01#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mgA- ' Effluent #2 = BO0, < 30 mglL and TSS < 30 nxYL 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. seD.uw QL6=► Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. Shaun d Address P.O. Box 489 Somerset Wi 54025 M #226900 Lot 5 Subdivision Blue Stem Date 6/29/02 NW 1/4 NE 1/4S 12 T 30 N /13 W Township Somerset Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 92.0/91.5 *HRPSame as Benchmark Alt. BM Top of steel Fence Post @ 96.5' a t~ a� a 0 N d' 575' Property Line 97' 96' B -2 45' 3% 0 4 15 Slope OW B edroom 20 0 H ouse B- AA 45' M. 0 10 0 B -1 80 150' 370' Property Line n tl * and Contingency Plan for a Gopft SY tin once Plan once emery 3 years. 1. Septic Tank is to be pumped in 2 Eftnt tier is to be chi once ayear. Plem rote: a WWfMer is being irk orde rto extend the mdronance ink of the i W- 3. Once every 3 yews, cis are tO be ires 8Md via the inspections oyes at the ends of the tells. 4.Owner agmes to Weases, gam, and wwor oDndftloner discharge MW the sYSIII 5. The owner agrees to save this plan. 6. Do not plant bvw nor park nor drive over system. 7. Watershed is W be diverted away from system- 8. Discharge into system is not oweed those negtin d as per Comm- 83 Control Plan 1. if system faft dine MM of re, use We nde area and WMW now system or Install system it a lower et ion. 2 Replace any other tolling components as needed. pkJmber. Shaun Bird 715- 246 -4516 r-- SI `l /ors - 80 Shaun Bird #226M J 1 l.1tUAA. t,V U0 1 1 SEPTIC TANK MAINTENANCE AGREEMENT AND . OWNERSHIP CERTIFICATION FOW Owner /Buyer �. I I cVA 81 � ►1 S =,v <-- Mailing Address Property Address (� [ Y (Verification rccuired from Planning Dcpartinent for new construction) City /State 1 Parcel Identification Number o 2— 21` 3 -- 9) - 12- 30.19. 12S1) LT?GAL DESCRIPTION ^ �� Sec. T � l -2 W, Tuwn of P roperty Locationto ,,, La i. R Subdivision 1 rGl � _ Lot it . i-ertilicd Survey 1l ii �— Volume Paec t Volume Spec house C yes Cl no Lot lirncs yc�: n�, S` I STEM MAINTENANCE:, Improper use and maiutcaanceof Your septic systcm could result in its prcataturc failure to handle wastes. Proner maintenance consists of pumping out the septic tank c• c--i three years or sooner, if needed by a liccased puwper. Wliat you put into the system can affect the functioa of the septic can's as a treatment stage in the waste disposal systcm. The property owucr agrccs to submit to St. Croix Zoning Dcpartnicat a cc:titicadon forth, signed by the owner and by a master plumber, journeyman plumber, rtstrictcd plumber or a liccascci pumncr verifying drat (1) the ou -site wastcwatcrdisposal system is in proper opc:..ting condition and/or (2) after inspection and pumping (if accessary), the septic tank is Icss than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewagc disposal system with the standards sct forth, herein, as set by the Department of Commerce and the Dcpartmcnt of Natural Resources, Slate of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning 011ice within 30 days of the three year expiration date. 1 SIGNATURE OF APPLICANT DATE OWNrR CI✓RTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowlcdge. I (we) ant (arc) the owncr(s) of the property described above, by virtue of a warranty deed recorded in Rcgistcr of Dceds Office. SIGNATURE OF APPLICANT DATE 4 ssst Any information that is n represented may result in the sanitary permit being revoked by the Zoning Department.'• s «.. " Include with this application: a stamped warranty decd from the Register of Deeds office a copy of the certified survey snap if reference is made in the warranty decd FROM P C COLLOQl; DLDRS. MC PHWE 140: : 715 247 2747 Jun. 06 2002 06:14AM P4 .L U.tsrU.L last U ?;va reL 1.;7 r'44 310 MWULEK Ul' I) hWb _ wjUUY fj 1144n xr�rrsnaOFWjscroMrrrawt1.tM i�r9w�Qypx �wlwdwanil TRACT ' k, T K DF DE MHeUSEVSCPe�LluvS s W111 1praf B T. 01 Ch. 4K , S:saanrn Lol�," cateem nd.�AQ Foe 84M rr `. , tat+ -foot' el�o m WNTR ,� ad bptweoa ;in; to viwa flap •Jahl Hp i$M t , ;AIg InIiTFAGT - � Vatttbr"• w6athmi pamvoo ar morn? min ��C dipvg psi •" r� lsw.co !� �, Wlutll%x OR Lx rec!t�, Vardar aei iG and s�reee to eaeruy to Area Y ttpwr IM prompt and full perfowmansm orthia clam of try F'arcitaw, 4 tm and a4ture Addfetm dulbilow14 i➢fdio411w, in With the ronLA, p►enul, fllttlrea andatg4r Dick Stout ipptptsn4nT Stt`raata � tNi1m4 the "F4uparr7 °), in $t, Gvir: 7 353 Awatl:kee Counfl, vuh orw4eolitr Tr, ilI 54016 032 - 2044 -? -� iti.�we ra�iar.aoe� " Lob !, n. S 4, E, d.. 7, $ dEr! e, Alma of $iyC Stamd p o ; few of 8do arses, $t, Cfebt cocnty. Wimeuia in. i i �' � � h0rratead pr'olpertt, f PwmhoaaF to prdahaX Sftc troprrrty and to pdy to Vef a& Y - Wee Vudtpolw A d+ol sum et: i!r?sW➢e in ry falloff raonnar; � ' i rt lha anean.oe � raa hc�incc'ot7 d,,,,,�sA6 - -- y�.� M°�li frdane� h0in date• )M. <at` Sale b{1�{SPd WnY1114brnQ f!'Oat LixJe W C7RlC �L dfi r�la Gi — h� '!i ikasrrd Pit annum ! uarll ltaYtt ie All; m rett:ewe Them 1luU he va 0!estx btnrlyd ee fha pr�e:�r EtaMwa br � nrneAa !ek►•ri a tl.e rxeutlan ur mtc i Nava& stop khrorxtAsIll �t h- a- m;+ r awPriai9rar maw 611lyrr$O7Qet. {eL+NtaObdwWtdfrosddLLA.d CoMrsatrpaa paysur a ta4tlea aafaatd.han 6o mptrt and ez the pria.4e[bdf.ea)!at 0t> a wtlh wtarm meow bn tka i O ged P" Ipel UiiRaart 441 ap r4i My )Fatssr raR rek�rl ihaY reEilbld tlB /W;awl� ie Ee by pYnUW IN Vmdor f0/tllttel -i a °i ` pl1t RIQ,EdO eL Cbam naiaaea nnnweh pIm 1S,i11.11(lnrerr! et an 537Da"for 5f d:r: A atelelOrE�ga�•la is rrMlRise. mcoesnber6, t09AtMeeaHNlbeedYlntlfMliypayumiddtVeodorb, Parrthl4Mf eta aardteut tlatabieYtaa M'idepnl irrdaaem. (� G.ebutd MdLw= rr0i 1dpd.1 utrnwr, tae tntilt oahtardiwa r „wee shell t 0 paid in t'd it xn 0r bof x41 tlfe� day W tOliawinr Yny dtL1t is m idzptea tt4al1 ar C ll4e rWa of !.S annum) on the Calla stnour,+ In doQltlf 1► pA a f Y�' tfrdp atwtl iaaluda, wi� l�itari d sllnquent;wae.e 4 t W?�'rK5s7arolilwt nr owriatrit prfa�llMi ialNflad�. y, :hW tn,ir- raarttamor, w+iwn OxWtdee! tp/ VOpdGr.:Yjrmee m F� roenlhN to VemEar su.vurh nt�ixiaat w ywy ra.ennml,fV h�.!e:. pp ataa a rat p) ttwta, spmd4, esloleemt re.rnd r00uirod idrurmr” om mimu m whet due. 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LA11 CONrUCT.lms dw!md 44141 Volt rtrolwade tlrrpra4 vtru Hs.:t • OR m•.. u , .••arawnxcc.,..r�nr.,d,w.,y,wi mwsammifii FROM P C COLLOUR BURS, INC PHONE NCI. : 715 247 2747 Jun. 06 2002 06:14AM P5 10/85/01 THU 01;55 F.kX 115 356 4847 REGISTER OF DEEDS X043 PurClwtldrttRtllritstw w. +�� OW 02 un is RU 4* dellvm in V asy dMtrd s/,at{,tP' s oDd rtwa7etatnri lrvlaA CM tha yrrapart). ar upon Yandari *W", W abo,ow rl »114r p c�mprw4n1111 nQ W. Mr �+ah va rmatrt- Ism" go "IatVti prrPan" avult etpfu hruryya ° Y inr,tM.2 a�ktatt e J ar 6b^asr waw 6y 1Tre, tsar sY YaSdM in thr aa.e1 pl @ - N/A atrr nay rtrsu)iG te' knnakNt. tnmuxh innew aarrevad lh°i !br batenaa Ott unMr�i :?a `Watitiae.' rc isr a i"- Lis Vw:dav' MYII act tegtr'.t wV&W in ku r^oras mwrp aptalin ilia /4artdtCa itm+aam Ia .bYar of aka Vm>dvr a in DW ilia Irt41lbhae bsara:um11 vIt" dro. 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WIG y"I: arc 6 1nt as — at pwahma W64 With 1 A WSNL iuY reas11 he fang pea?gittttyatthe tithes *W in vim mwuwehove ILPO and turar la& vii 40 ar ren palm mad an ttortslaiiew li w e. p � w tyaad, in 1$e sla�)1G. oPaha Paepa,W M..,�b., �� �rl1W l ma d, s pa k arms de0vp 1. a�hy ti,e am w Jnikult r+1 pwsitxr=r tkw exeept 1M+:at_ali� a il. eF..ps YaYCbx t 4h id a► . - WT sb^r is Of me sAk 'lo .�Q ,�- - •••�,•, +__ ".._.. iar.rea +rklah Q0at1°up Mr a imiad of W dxY► t6J�ala � &«tart e/w 4id d :^ ( pal shat orear fit -e sor&* alstr @bu6tdien orp; z; a rl i Uis 1pa riYlOd dQp dale ar (b} la 1M pwilo sm aVarat of s @a11►uR {o NtOaV411111191' V411111191' oatlwaad ids A Ocatl rsu r � aa -• . or N° t ^� . +� r dsYa fallowing riYlttam r tide# ahtif ba� VO surue I^lactld)ue' tkrtartsily or wagq I* 6artlGcd wail), aves them sam amtlr11 0 W16I+Ntp I d jlp VMl4ar al^tt al�to ig IbRO n�:< mid os Ivu�va t NV WI (whtuf Pu h watf°°1 ! {! 6POvlda law law Or Y �isyt (} v.naof iliac. ants e°aM^. a rminate ibisa / et p ) in Migsit, tills wad t.iter�t in rk tiia Propert y ar Me P=aftaRY list& s)twyh nrlu ix"Imurq Wlih UY+W>rity qt n+dernptYso N bs OOttdittgstad ttpna rveehtsrrs i4tl pyalAa *rdtrt #halo I tba dirt rordrrsi�s W tln t b rar 1!Met am row gals mad Odor Ot°�ading bd&mk. WI11s rutl"k 41111120. font pttid tIy tPatr sat, alto I! by 1#007,; [td ap Itw2fidptd a°e es , gilt tt#rweder :la WhWt owls °N Amlials blx Rrtyawy if nvrciraaa 444 W radotm)l 1 p ,4 Ynmdoe m g 19)trs to ruinh x!0111 Cpntn�r and u rantxt &v dw lmmu ta4 a f1�t l (} Caytroet rP M wli s ra autaauadtn ay asts tbr.sirs{!Ir bsrfor.urge er Nic Lru1lsaaat re wr°paI deft ill glad 011ie# y b16lanct, W Ito jora It tbtrtam at itne ryas in arlyn an Ma data pr #Matt h "' ^tl riwlmt harvandlar. In tvhi h ever,! the PrersaatY siWi ►, avtpsatd ll.ludtQlW lak. Alt! Igs v ltablp Mr my dray or (iii) VtnAar nay tut p. epw ra coigne unpaid purclumv br100 ar anx Utslrla� or YYMy V11111101 avq, 4wlart this Coarnag bt mn nW arts hltMJeva fY.ts Coryvs°[sa! a r•101cd an pqpp ieal raSf0. i° t Qttset -ta� a!'tho I!'eRa iyyilrbir tucptgt ufPur+attatw,lneidi�wtkc mad (wf Mradar wIq Itaw Peeet+vaer tjss.�ad fsiYon Yti@bt fA }, IY) Df (1vy�Abp Hetiwjdataad w4 eabq. JltthlYt 01 praPU Aurlk� fh0 psada°p� p( �l:ahY tt0! Orv:r{ften rem � #Otto# #PAW Cara�bltrj *claadlt# tbsii tat+ Aa Ntq to= r/0alar iPn.W wh:k reahtl Ha ob ##dull 40aU ol�d s # tcteses 24 1 not atw0a°bk aetOmryl tae of VsaA�tnaur bll d to c ^farts Coy "May h11rstmae l ab" Cooped, td °t�°hYlI�Ec+ rtd ry a&niad fe aey n Of told srultau ahbll W nedad tc pnnotpW and trout sty parC r jy�r � as inc pru Alts of W iiw y�poistownii u o(ldlla ply At* pOrtde,,.'Y 'g`.ry wtlnn wrt6racirravre ofthYS Cltntaaet. i -sre; h $11, 41 i Win tNpmt�er1d the pea duri {rrmsDat. to melMee M eanp !#seta. an.{ WhAd at 1 0 044K tboq jet G t yµt h kFi Qa. YaIt 7k0 rt,rv. lAiaes y,@ pMCtllt Wh011 00 wllat:rt° al t I[ be hold am of tarr ftt fl[�id Cotifeorl r yvtY t Y ts,�at u, wirtabds lasaraaq 4r tbY ProncRY i ( vy rtaxl8naaant it ahy wa"n"t of YMdit unitpe Olgter Ow 1 , Yet �vn nnytrrm Issas a In SKY Other ..w.l wY1M4u1 11r r(ar wflutn v atsualdln}'; balance MytBL tladuchip Celltpoo 11 Arts d III Atli o the tntarrrt Atupn%ilr - 1Ma��e,r f.p lowlenl ar Purchamrny lot' tag y,0y data Gus t laai 60m at atevQ lhrnt irslobtrdslea^ vt b# lluaurFrvawomawthisftnlrtat ahmhmtar. banArtwcwaYti rtxit)toasVcadar+rwrinan taelweirs Ali awmw im ®adiWtlr dos Ord payable Ia /tall, sd Voldm;t apnea vr "U •nti;a. vsndoe than mubc 1611 payeraals *04 s uv under any nvrtt:sba aaestpadini aplast the !1,1000 . 60 the dou of twit GgtbraF (et of pt hr #try Menzel 1praale0 by Purehaat spy teskoa Nnt y p xyahahl aYaha 61110" 61110" lawn.ius undar chit Cu t to ract fajo;A bertha saaabol as.e}. ° yy 11 e � tgytCr k0 r°fts C r� 4.p iado, iP pr lylle to O to &W ill %ymcrLs *40. Q6" by Ptuiesser shalt ba W =a[QeTr0 "VMS rAOde to vole dor Ator wai11t ally dw %UTA wkfiews wlaivlaaa wY other rabaegcsutt or Prlor derautl of Puraftasar_ Alt issee; Olt0ttg CAP"M el stall be 6hsdwl apah Qaa r0 I ^u ro t taersaills or Wt hel0a, seal ro suapmsoars a-W I to nrYaad 4cW to nr aid jlsrclaLSer. it l.ot Ca awrae of it m fwpen Mr a}7tgi tq o } r+*azanatt�mk' o b e a . 1e ,q ?t to MCA9C ynoR eyread alyhip {tt the aulojew n f tin In Nha ve st opr for d vWaaEle ot»i t be ';xilt rn i art 601aaG} Pr �R Y as �t+artutlen atihs Damd I11iR et Ge/ebtr�_ _apt - p.1 _ . Vol , .•�...iattda�.. ... (dCAL) /// ` 139AW I!ft 8. Ste __Vender 1. C C°I g4 Pkvddatt �„Ptvtttaser _ (IS°i.b) - 9 aabpT.Blaaf — ._.....— .,.,. ..... �YOtutpr • �.. . ASITPj�fY'rICA'tiON� -- .._. '— .-- ..,Horchafer 5i(;1lsistv(ri �� ACIt AyW&CiQF4W f WfATU OF WISCO ) __ )a 0003 Sumc Itch Y P COUNTY } ,.�..,.dyl'Of petaondlya°tAt•'�aYvrsla°dLe ��ryaf �., Ut3 --. - - -, %• -- �...__ .. UtalbiWC wtat#a _ 12gleteald Jatal F. SttrQl, hwlald mad aa,g . -... )� �It n 1 t17Ye maw ►. � Trte: Ad1- 31:IhRRITATIITOM0i ..�.• „. ... �_, lif tsa: OIc WI5',4'�' ro nc lsrrml. tm nOnts) wi,., s+rwrvt0d iL. tarc°0mp alrhirlra 40xQdyiVy, kaSpm d pa thec7tat: 1NliiMi P6A.t$N'J WAh _ naoay piths& Cavnty, w Irtnnaht t l Q atY a a rrtail► 41 tiwMnl�t�w .eknosbdsed. @ap.ntA i Pam ( au3aaepiratkaaQ6t°i avo w) ) ' aPplrimheiiE GaayUpaltrtsoJ )db0rypadarprinted ft elrtsblKi. WIn'ctAi'rrtY4r taimat Coy rna• err.sar frwatra+b MVnl 1% it. I%Q iNaa/drlWdwser..s.4... rr'Y. rM u,s aav Iao-3P:r .. ... ... ... 0 I I Lul N . .. .... .. . ..................... ..... ................ ................ LOI ............ ..... ................ ................. 4 ................... ..................... ...... . ................... .................... .............. ............ .......................... -W mom ....................... ......................................... .......................... N89 TE 300.1 6 ................................. . . . . . . . . ................... ....... ............... .................. ................ ........................ ........... .. . ....... ...................... ............ .............. ..................... ........... ...................... ......... .......... . . �-'-'LOT 3 z ............................. ....... ................ ....................... ui ... ................... ....................... .............. .................. 1 ACRES .............................. F_ ............... . 3.00 .......... Go ............ ............... ..................... ....... .... .......... LL .... ... ..... 130,721 SQ. FT. 0 0 . . . . . . . ...................... ................. ......................... OA, .............. ........................ ............ .9.e pn .......... z ........... ... .... ..... RAL 918.0 w . ................................... . .................................... U. CJ C .............................. 0 ................ ................ w z ................. ................ ............... . ........................... c i!Eid . . .......................... CC .30 ................... ...................... .................................. ................. ......................... CC . ............ .......... .............................. ................................. .. .................... .. ............. .......................... . ........................... ............... . ...................................................... *.,.,. .......................... ......................................... . I .... I ........... ...................... ...................... 3 00 ................... ... g g ...... �N ............... ........................ ........ ... .................... . .................. ....................... *.*.,.,.,.,.,.,.,.*.,.,.,.,.,.,.,.,.*.'.* ........... - L . ....................... ...................... ........................... ..... ....... _ .......... ...... ......... ....... ........... . .................... ..................................................... ............... ............ ..... ..... ...... ................... 0 .............................. 0 .......... * ........ ................... I ......... 0 % .............................. ........... W DRAINAGE . .......... I .................................. .. ........... . EASEM ................ ........................ ................ . * ......... .................... . ...................... .............. ................ - NTER. - Li ........ ..... WE ............... ........... 78 ........ ........ . . ................................ .... ........................................... . .................................... .......................................... . ........... ....................................... ................................... . ... ............................... .................. 4 .......... 9. 1 T I ........... 44WIL 923.8 m .......................................... .............. .................. ................... 6 9 ................... ................. ............. ..... ...... . . .. . . 1 1 .30;686 ; SD I .................. .............. .......................... ................. ............. .. . . . . . ... I............... ....... . ................................ ...... . o 26 26- .......... .......... '.. CENTER .. .. ................................ . ......... a+/- ................................................... .. .................. Cu ....................... ......... ....................... ........ ............................ *.,.,.,.,.* .... - .................................................................... ...... cl .... 66-00' BENCHMARK + 80' RADIUS TEMPORARY CUL-DE-SAC TOP OF 1 IRON PIPE EASEMENT TO BE AUTOMATICALLY ELEV. - 933-02 EXTINGUISHED UPON ROAD LISGS DATUM 1929 - 'Wis •onsin Department of Commercq SOIL AND SITE EVALUATION 1 Di�:ion of Safety and Buildings in accordance with C Page of Bureau of y�tegrated Services onva -a109, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in zt� 4�lah must County include, but not limited to: vertical and horizontal reference point (B �)rection�l percent slope, scale or dimensions, north arrow, and location and distance to neen'rr$t`rotl Parcel I. D. # APPLICANT INFORMATION - Please print all infoiKmaltion. j'�) Revfew y Date Personal information u provide may be used for seconds purposes Priv Law, s. 15.04' 1 fro P Y N P rP �cY Z Property Owner - Prdporty wopition ! Govt. Lot AV") f 1/4,,/) - 7 1/4,S Z T ,N,R 4 E (or)(I Property Owner's Mailing Address Lot # B1oc Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village © Town Nearest Road N'4' at> W S `6 (CIS) I Dor A i & v_k 6M New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: p Code derived daily flow 6 U O gpd Recommended design loading rate t 7 bed, gpd/ft r d trench, gpd/ft Absorption area required bed, ft2 ? 5 trench, ft2 Maximum design loading rate bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) �i r �� ft (as referred to site plan benchmark) Additional design /site considerations 012 -CY' 7 � f�Wtf 9y 576 Parent material Vu S �\ Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system fca S❑ U 5a S❑ U WS ❑ U %S 1:1 U I EIS U EIS 4 U L P SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench €� i l �F s -\Z (0 1 4k 3 LS 1 r-\s Ground 3 AjLo to 1 1L_ Depth to limiting �J 5 factor Gzc l l0 in. Remarks: Boring # I O -to 10 — Sl. X56 Yvc�Q r y 5 13 3 Z 10- IC} YCL 4 s Fes- L5 — A -►1S/ I0 6 va �- Ground q alev. ; �ft. Depth to limiting factor in. Remarks: CST Name (Please Print) Signatur Telephone No. k eQ- Address Date CST Number 3 0 r SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench - ' 6l 1 10. — s k �F� rF y S Ground 3 -I '-(I 6 — MSS ✓�� FY elev , Depth to limiting factor f I Z in. Remarks: Boring # :. M - iy 3 r-�5 'I it C S 1 S 1 - tZ L) I-A CA ( 4 0 kA, Ground elev. Depth to limiting factor —in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Boring 1 0-1 10,in y L Z 10 -t►6 Ground @llev.. It V0 ft. Depth to limiting , factor _J�b in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PAGE - S_OF_ NAME S fck4 LOT #S LEGAL DESCRIPTION*w 1 /4 K 'El/4,S IZ T 4a ,N,R (kE (or) SCALE: F'= $ Tack ( (AO 1 BM 1 ELEVATION O X BM 1 DESCRIPTION {„p, ( fa . , oL+ lgt*k _ BM 2 ELEVATION '7 C t• ? j g 1 12 BM 2 DESCRIPTION a+ , - o.D j t f\ SYSTEM ELEVATION q 4, 576 ALTERNATE ELEVATIO .(5 La.,tp q -l. So CONTOUR ELEVATION iC/ L-F l,}•w•�, am l �2 • G d a •�� Q e i, pv 83 p F• � �Z g' 1 SIGNATURE / ` % G�C DATE l