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HomeMy WebLinkAbout032-2122-40-000 � % 0 f 2 . � � \ � \ � 2 ® I � 0 � 2 � UJ . � : , o 2 _ E D n § % a m . § § 2 2 \ . k k 7 ! $ W ) = E 2 S, .� • 'S Cl) CY � * i })k ) in . z c / a 0 § E ) ) C ■ = � \ \ � co L0 — Eo 0 -� t a a a 7 � 5 2 o■ @ J _j � % E % / ƒ . z \ (D E k � ; y ƒ A C m A % � ; • � c 'C 2 2 E cl m 8 2 § C-4 � \ 2 § 2 § § 2 ~ & § ] c ) ) E -5 e K , ■ § r E % \ § co K o z f } £ / � ® � k © « k § CL 2 E� I� %C k k IL ) 0 & k ST. CROIX COUNTY WISCONSIN 1 ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER _ wixnas 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax (715) 381 -4686 March 20, 2001 REMAX Team 1 Realty Attn: Jo Hinz 103 Main Street Somerset, WI 54025 RE: Septic Inspection for Michael Germain located at 2116 76 Street, Rocky Knoll Estates (Lot 8), Somerset Township, St. Croix County, Wisconsin Dear Jo: A septic inspection of the above referenced property was conducted on 10/19/00. This property is located in the SW 1/4 SE 1/4 of Section 13, T31 R1 9W, Rocky Knoll Estates (Lot 8), Somerset Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, Kevin Grabau Zoning Technician cc: file nsin Department o f Commerce PRIVATE SEWAGE SYSTEM and Buildings Di Coun�it. Croix INSPECTION REPORT RAL INFORMATION (ATTACH TO PERMIT) Sanit��RRrr�yitNo -: - al informatio yo p rovice may be used for secondary purposes [Privacy Law p.15.0 (1)(m)]. V GG / OO aer's Name: ❑ City ❑ illa e T wn of: State Plan ID No.: -haelori�ers�t township CST BM Elev - - - I Insp. BM Elev.: r B Parcel,T ci2 2-40 -000 a0.0 O 5.4 -�- . U3l -L 1 TANK INFORMATION � DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic U' DiQA5 0130 Benchmark `� . 3 lt•31 Dosing t ' Aeration Bldg. ewer g� JD. /$ o 1(0 Holding St/Ht Inlet TANK SETBACK INFORMATION s! St /Ht Outlet i'l -3i TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet --� Air Intake Septic ) $0 Zg{j r ,, S NA Dt Bottom Dosing NA Header / Man. �'� s 1 1 .6 2- R. / Aeration NA Dist. Pipe S /0 q7. - Holding Bot. System I •8 !g I PUMP SIPHON INFORMATION Final Grade �bz.�� 4 Manu ac emand St cover -:10' 1 Model Number GPM TDH Lift F ' on a em TDH Ft Force Length Dia. Dist. To ABSORPTION SYSTEM a BED / Width Len th , Jva�Q Trenches PIT No. its Inside Dia. Liquid De - IM S 1z EN I N SETBACK l ola�5 DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING anufac INFORMATION Type O �, S,� r �Qr CHAMBE T AMBE Model Num System: COO To' J ' DISTRIBUTION SYSTEM Header/Manifold L e Distribution Pipe(s) Hole f x Size x Hole Spacing Vent To Air Intake Length i� Dia. -T M Length �Z Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound O At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (I nnc o d cr anti er s pr tc. ns ec ion nspec ion Location: , (SW 114 �I I 13 T �N Rl - ffl � Woc�y Knoll Estates -Lot S 1.) Alt BM Description.= _ 2.) Bldg sewer length = — }3 I i3 - amount of cover = 3 0 �. 3 - ©I - 2S�S,F rece� CST�.r�- Plan revision required? ❑ Yes No ! Use other side for additional information. 03 Zo q) 1 Z SBD -6710 (R.3/97) Date Inspector's Sign ture Cert. No. ADDITIONAL COMMENTS AND SKETCH s SANITARY PERMIT NUMBER: E i 1 _. — 1101 .�.., M g + 41- t -1 e € s I i _ _ 1 Q- I s s s § s ^ f , ]] e ., � m, F ae. +=g o Pm S } € s ..,.� .m.... q..,_.,, ?. , , z.e hm q t � § ,. a.......,.�. s s ...,,,. «,..e M - ........$e .. f b i € [ a, .'ve wam� . m. .w -.w..o � +� .v,..m- .�. m s a 44 e i nin .. E 3 E s S 7 § S € _.. ....s. ., s _.. �. _... _.. �.... _ .. . _ _ .., ... ..w, - s..- . ....., - ......... .�. ..,. - m.. El a A —r w�..A i t A s € I 1101 Cam*hael Road liudson. Wl 54016 St Croix Co unty Phone: (715) 386.4680 Foc (715) 3864686 Zoning Depa rtment Fc 3x r To: l tn� ELI From: l� Fam 2 ' 3 C, - 2 1 ? Date: > Phone: Pages: Re: CC: ❑ Urgent x For Review ❑ Please Comment ❑ Please RePIY 0 Please Recycle Wisconsin Department of Commerce SOIL AND SITE EVALUATION gy e_ STS Division of Safety and Buildings Page - of Bureau of lntegrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than S 1/2 x 11 inches in si ;e , Plah must' " include, but not limited to: vertical and horizontal reference point (BM),,dlrectio and n ,_ ;._ percent slope, scale or dimensions, north arrow, and location and d' oe to n` .rpWliow ' Patcef.I.D. # APPLICANT INFORMATION - Please print all infor Revi&kd by Date Personal information you provide may be used for secondary purposes (Privack Eav�, s. 15.04 (13 Irnl f Property Owner \ Ppr Govt. Lot �lj f 474s 1 /4,S T ,N,R /� 0 (or)(0 Property Owner's Mailing Address Lbt , I ploc Sub . Name or CSM# Ali, o /i s t. City State Zip Code Phone Number Neares u��6n Sy0l (��S j �� J y7� ❑City ❑Vill Town t Road 0 h e ® New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: u Code derived daily flow 6 60 gpd / Recommended design loading rate O bed, gpd/ft ° v trench, gpd/ft Absorption area required 5 7.0 2 bed, n trench, ft Maximum design loading rate • bed, gpd/ft -? trench, gpd/ft fAdditional ecommended infiltration surface elevation • • Y S n (referred to site plan benchmark) v r design/site considerations arent material �� �y ��C 2 pi �C f ��J h Flood plain elevation, if applicable Tr n S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ®S ❑ U ®S ❑ U ® s ❑ U ®S ❑ U ❑ S ®U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. J Munseell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench ll %Z 11' id S 2 X36 7. SyX �-dl qj Ground 3 L 07 elev n ' Z 5 Depth to qb •9S : e r g _`l y limiting (V.1 12 - � in. Remarks: Boring # 2 Z 7 -3 7 ` NA- si L 2m.4h t4 of )m S G" t r , Ground elev. ' 3191 I o Depth to limiting �fa�tRr in. Remarks: CST Name (Please Print) Signature Telephone No. Address / Date CST Number j7,0 — /�Z�e ve So�efse> bv� f0 -4— jf _Z31301 �� C SOIL DESCRIPTION REPORT PROPERTY OWNER *Page of PARCEL I.D.# Lod y ' Boring # Horizon Depth Dominant Color Mottles Structure Texture Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench nja4�' cw 2M 2 - /02 /oyR 6 �A yns 0- ry r o Ground le Depth to limiting y Y,' 8•`f Y � f 7o r in. • SZ . S 2 Remarks: Boring # IVA SZ / 4& y -S y 2 io-32 ,SY� 6 h- S'AZ 3 z9 io �1s i� /V ©J/ Ground 4e < ©o, 7-r'- Depth to limiting j#ctor 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 # oy/? z /VA SL / rh a6k X6 c 2 o . S ,4 S/ Z rhim S1 �c 1 / /'r r >� i b 3 16 y9 la % A/ 4 rns 05 G l�� , 7 .1 Ground el ev- Depth to limiting factor Min. Remarks: Boring # 6 _9 /a yR : �z A4 S L lAu, 2 7-1 7,a yR v /VA S,"Z 2 ASA Jar qJ 7'm 119q /o Y� I�1 as �L — lG b 7 k Ground ev fG 100. Depth to limiting fa �9 in. Remarks: SBD -8330 (R. 07/96) � ■iiiiiiiii■iii ®�■■�■■■ ■■� ■�■■� ■iiii■iiiiiiiiii■iii m om iii■i■■i■■■■i■■■■i i■iii■■■i■■■iii■i■'iiM■iii ■■ii OEM iiiiiiiii■ii'' mumo■■i i■■■iiiiiiiiEMENE M■ii■i MENNEii■■i■Rn� FA `MENEiiii ■iiiiiiiiiii■Li ;.1i■iiiii ■■■i■i■■i■■ir''iii'' �� % /■■ii!�il'�Jt� ■■MNON Em ommo mEM i■ /ii%iiiii ■iii■■iMEmomiii■m mME■■■ii ■�1ii���iiiliiiiir� %iiiiiiiiiii ■■ on■ i■ A�� '��i�i�il!1'il��/iii�■t'!t■■■■ ■OORiwilmuffin Sm iililW�■i mom iiimanum. ww womm ■i■ ■ 11�■ MUREiii 11100 ■ii ■ iii■ ■■ ■'■iii �`'.�'_! ■iill�iiii ■■ ii■ iiii �■il�iiita1!■■iitii■■ ■ ■■■■i ■oviommommsNiH.51i■i■■ ■v■■ i■■ ■ii■■■INEE& iiiiilltiii■iiiii■ ii■■ ii■ENNIMMi ■■iimilluiii■ii■■ii ■■■■iii■■Mi ■1' ■i■i�i■i■ii ■■ ■■ ii ■ii ■ ■■ ■� _ii ■iiiiii��i •ii ■i ■■ ■■i iir�© r��i ����i!ll�i■iit,`�Il�iiii■ ■ie ®�■ ■■ i■ ■■ii ■iii'�f�itii�iiiiii ■ ■ ■ ■■ ■ir ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■■�■�■ ■■■ ■■■■� ■�■■NEM ■■■■■■■ ■ ■■■■■■■■imi■■■i■■ ■■■ ■■■ ■ ■ii ■ ■■i■iiiiiii■1■iiiiii■■iiii■ - rw isconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of • Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must_ County include, but not limited to: vertical and horizontal reference point (BM), dlrectiort and percent slope, scale or dimensions, north arrow, and location and dis tance to nearest road> Parcel' 1. D. # � / ®.3790 - 006 APPLICANT INFORMATION - Please print all inforipafion. Re ieied by Date Personal information you provide may be used for secondary purposes (Privac� Law s. 15.04 (1y (m)). Property Owner Prapetl^y:Ldcet6h Govt. Lot w ' 1/4 S� 1/4,S /3 T�� ,N,R O (or� Property Owner's Mailing Address Lot Block# - Sub . Name or CSM# . � ' . DCK� City State Zip Code Phone Number ed u J6.1 � Syol � (7�S ❑City El Village Town Nearest Road � � �y9 sy�r o � �� -��-- 2 10" 6, -I e ® New Construction Use: 3 Residential / Number of bedrooms � Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow I � 60 gpd Recommended design loading rate ®� bed, gpd /ft ° `� u trench, gpd /ftz Absorption area required 0 a bed, ft trench, ft Maximum design loading rate 0-7 bed, gpd$ a `? trench, gpd /ft Recommended infiltration surface elevation(s) q . F ft (as referred to site plan benchmark) Additional design /site considerations Parent material �� �� XVt' 2 �i �� d G�GI h Flood plain elevation, if applicable /F ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U ®S ❑ U ® S ❑ U ®S ❑ U S E U ❑ S RU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 r in. Munsell Q�u. S Cont. Color Gr. Sz. Sh. Bed ,Trench /I'ft S� /rl��/L C L 2 m e 7 �a S 2 Y-3 76V i * ,6y 2xs d W of /m Ground O 5 — 3 1 7 0 ? / Y / � �ns� -c. L s ; . elev o ft. Depth to Rb 9S limiting in. Remarks: Boring # t'--7 1 � 1 1 4a j 6K z y M 2 7 -37 7 / t+� ` / �' /T J /�L G /4.44 �(f h a j AIA `ns df Ground elev. Depth to limiting ,fastRr in. Remarks: C YY S dd T � r Name (Please Print) Signature Telephone No. Address . ,& f I�Z a v e � f Date CST Number .So t° feT 60 /D - /9- y � z 3 /.My �7 �q PROPERTY OWNER C SOIL DESCRIPTION REPORT Page °{ of PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o s ���, 3�z N4 �� ���� C w - 2A1 2 oz lolle NA- �s 0-1/ „ o Ground Depth to limiting y y Y q$ f — , A4.2 in. Remarks: Boring # i1iA St ca 2 o y .S Z to -3Z sY� S'� Z Ground Depth to limiting factor. 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 # 6 - 1 / OY/? % 14 Cew S 2 0" 7,Jr� r� /r S� Z S4 Ground elev. 9�zsft. Depth to limiting factor �� Remarks: Boring # Q-9 z 4 L C(,, qj Ground q 0 ft. Depth to limiting factor ) in. Remarks: SBD -8330 (R. 07/96) G OWNEl�Zyy, Page 3 of 3 Name /fi �� C Brian Parnell Address cq& . fayiee Tk. CST 23J 314 u Aso W Date l � Benchmark 1 �� ��•� �OP L� t S)Wce pl?e G of�or��r� ot 1 �t �ot2 A Benchmark 2 Te on j'o - -Ah 6 a i-,;., e ❑ Soil Boring Suitable Area ,,/1" = 40' Scale { i t o c G IT 0 I I 3� _ � 3• L �- � M o� � L Safety and Buildings Division SANITARY PERMIT ON 201 W. Washington Avenue Vi sloonsib P O Box 7162 Departrpent of Commerce In accord with Comm m. ode .., i Madison, WI 53707 -7162 • . Attach complete plans (to the county copy only) fort em, 01 les , county than 8 1/2 x 11 inches in size. " • See reverse side for instructions for completing this a atio ti�{I� Sate Sanitary Permit Number Personal information ou rovide ma be used for seconds ur oses Ju 11 5'( fi ������ Y P Y rY p P Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)J. (7�1�+ ^' tate Plan Review Transaction Number I. APPLI ATI N INFORMATION - PLEASE PRINT A MATT'` Property Owner Name — tion d { / v4, S T , N, R E (or Property Owner's Waiting Adcfress Lot Number Block Number City, State Zip Code Phone Number Subdiv n Name or CSy Nu ber ( ) 11. TYPE OF 6 I I (check one) ❑ State Owned It Nearest Road p Village Public 1 or 2 Family Dwelling - No. of bedrooms - � Town of 111. BUILDING USE (If building type is public, check all that apply) &V— Parcel Tax Number(s) 1 ❑ Apartment/ Condo (�� V32 2122 4o Qt 13.31.19. `fo3 2 ❑ Assembly Hall 6 ❑ Medical Facility / Nursing Home 10 ❑ Outdoor Recrea Tonal 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. TYPE Of PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System___ __________ Tank Only__ __ Existing System ___ -____ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Presslurized Distribution Experimental Other 11 ® Seepage Bed 21 ❑ Mound 30 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure / 42 ❑ Pit Privy 13 ❑ Seepage Pit 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. /' ch) Elevation Feet 69,9, Feet VII. TANK in Capacit llos Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or ❑ ❑ ❑ ❑ ❑ Li iphon Chamber CI El 11 11 El El VIII. RESPONSIBILITY STATEMENT t, the undersigned, assume responsibility for i stallation of the onsite sewage system shown on the attached plans. Plumber' ame (Pr ) Plumb rs S tur • r0 mp MP /MPRSW No.: Business Phone Number: PI tier's ddress (St eet, City, tate, Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Iss gent Signature (No Stamps) RA/`p roved surcharge fee) p ❑Owner Given Initial ��� eo � � �9 Q� Adverse Determination r X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: 1 4, .SBD -6398 (RA 2199) DISTRIBUTION: Original to County, one copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. , 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal For in (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 pLemped 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 cocle administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 - 3151. To be complete and accurate this sanitary permit application must include: 1. Pfoperty owner's name amd mailing address. P-rovide 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. 111. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the tota' gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Cc mplete 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 1/2 x 11 inches must be sul: to the county. The plans must include the following: -A) plot plan, drawn to scale.or with complete dimensio s, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water see :ice; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; a the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and contro s; dose volume; elevation differences; friction loss; pump performance curve; pump model ant pump manufacturer; D) cross section of the soil absorption system if.required by the county, soil test data on a 11'J form; and F) all sizing information. -------------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number.of regulated practices which can effect groundwater - The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. 01/13/00 THIS 16:13 FAX 715 386 4686 ST CRX CO ZONING (loll Wisconsiri Department of Commerce Division of Safety and Buildings SOIL AND SITE EVALUATION Pa of - Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.. Plan must County _ i include, but not !invited to: vertical and horizontal reference point (6Pv1), direction and ` � percent slope, scale or dimensions, north arrow, and location and distance to nearest road,'' Parcel 1.D. if — — APPLICANT INFORMATION - Please print all information. Reviewed by — Date Personal informa ?ion you provide may be used for secondary purposes (Privacy Law, s 15.04 (1) (m)): i Property Owner Property >Location -- � 6 Govt. Lot j,GI 1 5 t le,S 1 T� , N, R /f (or Prop? Owner's Mailing Address � - — — Lot � BIocK# TSub .Name or CSM# City State` Zip Code Phone Nurnb Q City Q Village Town Nearest Road 6,; 123 New Construction Use; Residential / Number of bedrooms - -__-! Addition to existing building ❑ Replacement Q Public or commercial - Describe: Code derived daily flow _ _ �_ gpd _ Recommended design loading rate , - !— bed, gpd/ft trench. gpd /ft Absorption area required 07 bed, ft`_ � trench, ft Maximum design loading rate —bed, gpd /ft 2 p trench, gpd/f[ z -- Recommended inftttration surface elevation(s) - -__L !_ `__ -_ft (as referred to site plan benchmark) Additional design/site considerations Parent material G - _-- %t' _.�u f f�cr 16� —_. - - � - - Flood plain elevation, if applicable , _ S - Suitable for system Conventional Maur In- Ground Pressure AT Grade System in Fill Holding Tank U - Unsuitable for system (� S I U S❑ U I S❑ U ®S [� U Q S U Q S U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mortles Structure GPD,�f� 9 Texture Consistence boundary Roots in. Munsell Q /�u. Sz. Cont. Color Gr. Sz.1Sh. / M Eed , Trench 2 x'31 / S /'� -E / Ground }' � Y� -�- - -` h'1,jd- - - -` r �' - _ s 7 : elev. — -- - — /�o.yS Depth to - -- — _ _ -- limiting �4in, Remarks: Boring # 4K - 2M �r 2 7 -17 T yX �� — '! S/`4 3 /04 Ground elev Depth to '_ ------ - - - - -- - - - -- -- -- - limiting t7 J_�in. R emarks: ..�. .� CST Name (Please Print) Signature 4 Telephone No. Address. / Date CST Number 01/13/00 THU 1616::14 FAX 715 386 4686 ST CRX CO ZONING @G12 PRQPERTO' OWNER / ° r � y �� G ' SOIL DESCRIPTION REPORT Page . � of 3 _ � PARCEL I.D." Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Boats in, Mu�nnseli Qu / Sz. Cont. Color Gr. Sz, Sh. Bed , Trench Ground Depth to ._..__._— limiting / f ot Mtin. Remarks: _ Boring # 2 - %d -32 - �YG 6 P1 7 Ground Depth to - limiting s� clot Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD! in. Munseil C;tu, Sz. Cont. Color Gr. Sz. Sh. Bed Trent. Boring # 1) "c1' _ _ A �Yhag/C T ro e ® s has Ground eiev. Depth to — limiting factor Remarks: Spring # Ground elev. Depth to limiting factor Remarks: aBD -8330 (R. 07196) 01/13, THU 16:15 FAX 715 386 4686 ST CRX CO ZONING 16013 O%VINER Page 3 of 3 Name ; � 6 6 Brian Pamell Address T CST 231314 Date ft�/� Benchmark I 7bp Lot SYf� Jce ?1fe On 1 Ah L a ,wi,-, e ❑ Benchmark 2 Soil Boring Suitable Area 1 40' Scale — 7 191; -21 r A U 4— Lo + , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNER IJIP CERTIFICATION FORM OwnerBuyer ' Tv Mailing Address P.D. Lb!?, SCE my re g_ Property Address (Verification required f om Planning Department for new construction) City /State Parcel Identification Number 03-2 ' 103790'00 D LEGAL DESCRIPTION Property Location SW ' /4, aC_ 'A, Sec. 1 - 2� T - 31 N -R 6 _W, Town of UMgrseT i Subdivision R .=l_k s � )!� -,_p LL , Lot # _ Certified, Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house 14 yes ❑ no Lot lines identifiable K yes ❑ no SYSTEM .MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed.by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Vwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. u 10 SI NA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) ant (are) the owner(s) of the property described above, by virtue of a xk arranty deed recorded in Register of Deeds Office. L _ 3 /30/00 SIGl ATURE F APPLICANT DATE * ** *** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. "* Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed J3J ' 7 r ` + State PAr of Wisconsin Form 2 - 1982 WARRANTY DEED DOCUMENT NO ;A 14 7 1 P A' 273 ` REGIST'ER'S OFFI(,(; . CROD C O., wI l R&M for Record Lyle P. Klink and Marie A. Klink, _- ! � hus�a and w ide, _ NOV 2 1995 -- j - - -- - at 11:15 A. M conveys and w arrants to a nd — Mich elle M. Germain husban a nd _wife, Res �rd0+sa� ' THIS SPACE RESERVED FOR RECORDING AiA NAME ANC RETURN ADDRES /s o the following described real estate in _- S t _ CQi X i� County, State of Wisconsin: S � (Parcel Identification Number) SW1 /4 of SE1 /4 of Section 13- 31 -19, St. Croix County, Wisconsin. SUBJECT TO a 66 foot easement for ingress and egress over the above described parcel, at a location to be determined and described by a surveyor within one year of the date hereof. The Grantor and Grantee hereto agree to execute-an amended easement, if necessary, upon surveyor's completion of the legal description for such easement. 'I ;j I' ji This is homestead property. XX"X Exception to warranties: Easements, restrictions and rights -of -way of record, if any. j Dated this —� day of Octo ber — 19 95 -- (SEAL) (SEAL) 'I ±� Lyle P. Klink Marie A. K1" k ii I� (SEAL) (SEAL) a � I jl AUTHENTICATION ACKNOWLEDGMENT ii Lyle P. Klink, STATE OF WISCONSIN j Signature(s) Marie A. Klink County. authenticated this ! y of October 19 9 5 personally came before me this day of j 19_ the above named i !I Kristine Ogland j i TITLE: MEMBER STATE BAR OF WISCONSIN (If not - -- --__ ! authorized by §706.06, Wis. Stats.) to me known to be the person - -__. who executed the foregoing instrument and acknowledge the same. II THIS INSTRUMENT WAS DRAFTED BY f Kristina Oglan Attorney at La Notary Public _ —__ County, Wis. - -- - - - - -- -- - ----- - -- — (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: j necessarv.) —, 19__- __ - -•) *Names of pr— signing in any capacity should be typeJ or printed heiou their signatures. !j WARRANTI DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc FORM. No. 2 — 1982 Milwaukee. 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