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032-1061-70-040
• O co . 1 C) 4 O 3 m n d `rl o d f l o m = Ti 3 ^? �• A � � � m � m a W • m 71 < co x m CD 3 CD 3 ,� 3 3 Fi m Z O W Z O N 0 N 0 ej • =. d_ < N O A •0 3 D O of N• 3 j N eic — rn w o. 7 7 o N j - Zr) N CD o N L N • O .», N coN N C '� O N y •< 0 CO ' `S CD - V C1 coD1 N r7 N 7 —1 O � m co C ro c W 0 * m A K ,-•5 C W F N C7) 7 O O3 co CA O N In O 0 = !V N G 7 y m ? cn V D m a cn cn -< D m °- � 1 N (Q A Q.) 0. (2 CD N O. cn 1 N co 3 O 'O .. O a .. 0 0 0 co co 0 O a) Z N 3 •' co 3 �1 COJ L O N is-.) 0 0PIZ co X O O Cn CD 1 CD CO CO CD CO N co O C Cn CD �C O A A -CC co S m co o_ I • o Z OOO 4o O O O a mi A O O -0 C C C N Q -0 -i - * cn < co Z 0 n C �_0) fn Cfl On 3 fn 0) fn 9 > I IV 0 N ° = Q "0 0 0 7 CD CJ O 00 0' 7 (p C .�. N m .'�. D) N 0 I A 7 N N o� CD 1�. f'D A CO — CD'ID cf) DC N CV 3 °' 3 C3 °'7 CD 7 D 7 - W C1 ,.' .� 0 Z CoZ 0 I > m 0 D o 0 a s o 20 o h. 7 N cD q . c N CO CDD = go CO N. C CD N. C 0 CD CD co3 a -o = O cO -, -i cn co I O C) a 7 3 ? 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C CD Ka O co p S N O O� D) O • N A. `< N 1 A 0 0 O 0 (Aq A < cit y>O 1 0 'r yN b co 6 CD I 0 0- 0 0- /* ' Wisoc'nsin Department of Commerce PRIVATE SEWAGE SYSTEM cO5`}tyCroix SafBty and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SapitA y,PlSmitNo.: Personal information you[Novice may be used for secondary purposes[Privacy Ifw,s.15.04(1)(m)].eft .SS L 1 rtni JI )der's Name: ❑ City 9pVl'{lt pfes �f'ownship State Plan ID No.: CST BM Ellev.:- Insp.BM Elev.: BM Description: Parcel Tax No.: 032-1061-70-040 too. 1 am7.D' A.wi( tw -twee_ TANK INFORMATION ELEVATION DATA . TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I \ vr"p Benchmark 7• GO I 0{.(ao 1 tf0 r O r Dosing Alt. BM GA) 1iii.c'{ T• 30 110. VI' Aeration Bldg.Sewer /� / Holding _IIIIII St/Ht Inlet C /06(.IF� TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. vAirenttoIntake ROAD Dt Inlet �^` - a;y Septic r >53' 8 / NA Dt Bottom �--. .„_.-- Dosing __.._------ ) NA Header/Man. �" `)G•� °i3 fi Aeration NA Dist.Pipe D�{ (aO �, Gi•38 Holding __` Bot.System S.2.Z PUMP/SIPHON INFORMATION Final Grade \ StCuver C,'4i �l`i.S-`E L{'2`� ��d 3D/ nufacturer Dema t�-j- • Cep . Mod Number — ( - I 6 •`{3 _,O$• II Friction System TDH 1 5cf 1o�•o r 1 TDH , LifL Loss Head ��44ss / y ..ortemain +Length ia. ism.To Well SOIL UPTION SYSTEM \:o' ci,, �Q,,_i..-a.„�-(.� OC-8/ width I I Length// \ NP Trenches PITNo.Of Pits Inside Dia. Liquid Depth DIME3 6,2•50l `I l3) DIMENSIONS Manufa rer n SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING T ;r.. s.-_St«aw ¢r- SETBACK CHAMBER Model Number INFORMATION Type Of c20,+ + OR UNIT =% -CoAc�ceq System: . DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size ,rle Spacing I Vent To Air Intake _ Length Dia. I ` L gth Dia. — Spacing �— ?SO SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over xx Depth Of xx Seeded/Sodded xx Mulched Depth Over p Topsoil ❑ Yes 0 No ❑ Yes La No I Bed/Trench Center Bed/Trench Edges Inspection #1: obl2.2../n ( Inspection #2: --,'--- / COMMENTS: (Include code discrepancies,persons present,etc.) Location: 2033 60th Street, Somerset, 15 02 (NW 1/4 SW 1/4 23 T31 N R19W) - 233119312E -Lot 3 1.) Alt BM Description = 51430 c4- ^Tvi-v64. 2.) Bldg sewer length = , e�SG5-t+ lC -amount of cover= / ' .),-(. $'kt _ d� Plan revision required? ❑ Yes p No 6,� 1 1 I 11 I Use other side for additional information. "� 131 O" �m ' r ' Cert No Date Inspectors Signature SBD-6710(R.3/97) Sanitary Permit Application Safety&Buildings Division In accord with Comm 83.21,Wis.Adm. Code 201 W.Washington Ave. ` SC0I15in See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison,WI 53707-7302 Department of Commerce if not [Privacy Law,s. 15. 12 a (Submit completed form to county �� r ; state owned.) Attach complete plans(to the county copy only)fo s a e\m,on paper not'l han 8-1/2 x 11 inches in size. County / State n-- Sanitary Permit Number ❑ if revis' q,td evious applica'on State Plan I.D.Number \V 3S4-221 /ItCE! /Frr I.Application Information-Please Print all Information t1 Location: Property Ow er Name / I cn 3 JU t} 5' ,nQ7 Property/ Location /��( \----, GT GAOf, �1 f l/4� 1/4,S T ,N, 9E o y Property Owr s Mailing Address '`' COI. r Lot Number �� /Block Numbe / '�_,, ZOryHVG OFFICE �<O�i z' �5 City, Zip Code Ph 'p,Nuumber:i '- '-y Subdivision/ Name or CSM Num�� 7 < xe',r� � it., 1 t J - �? — ( s- a —� — ( e//G) - / 77? II.Type of Building: (check one) ❑City A 1 or 2 Family Dwelling-No.of Bedrooms: , j 0 Village ❑Public/Commercial(describe use):_ lRI Town of ❑ State-Owned —6 a,E,eS/� Nearest Road`„— .—? /l1 5 arcel Tax Number(s)93..? _id 6/.,O'0.,t2 III.Type of Permit: (Check only one box on line A. Check box on line B if applicable) ,R3 , 3/, Iq. 3/2 [_ A) 1. 0 New 2. JR,Replacement 3. 0 Replacement of 4. 5. 6. ❑Addition to System System Tank Only Existing System B) Permit Number Date Issued X A Sanitary Permit was previously issued ,2-/ ;� _/ 9,/ IV.Type of POWT System: (Check all that apply) ''Zo1a..Q Sii Non-pressurized In-ground Cl Mound 0 Sand Filter ❑Constructed Wetland ❑Pressurized In-ground ❑Holding Tank 0 Single Pass 0 Drip Line ❑At-grade ,^) 3•K ► e „�l Aerobic Treatment Unit 0 Recirculating CI Other: lG Ct 3:PC t� QUJj S V.Dispersal/Treatment Area Information: C_ /�`._� � � .- ' 1.Design Flow(gpd) 2.Dispersal Area 3.Dispersal Area 4.Soil Application 5.Percolation Rate 6.System Elevation 7.Final Grade Required Proposed Rate(Gals./day/sq.ft.) (Min./inch) Elevation V Tank Capacity in Total #of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks /)E5e-c- .. CI CI ❑ CI VIII.Responsibility Statement (( I,the and rsigned,assume responsibility for installa on of the POWTS shown on the attached plans. Plumber's a(p 'nt) Plumber's Sign ryr no stamps - , MP/MPRS No. Business Phone Number Plumber' Address(Street,City, te,Zip Code) ,v >ii/c; /,.T �=_ c IX.County/Department Use O()_5-(z-22 0 Disapproved Sanitary Permit Fee(Includes Groundwater Date Issued s ' Agent Sign a(No stamps) ,Approved 0 Owner Given Initial Adverse Surgharge Fee) Determination $ 225- ' 5- e- (it 2co I 44,, X.Conditions of Approval/Reason��pr,�is pprova 4�D,.,U ►e_ -0 b.eiNkc b�- ae- s strsip,,. o - Ana s :fie •k- -- Wc_. , 15 SBD-6398(R.07/00) A I / r _s,�i ,re)J J �, / O/7�i'c-",x/ `:5 v „,,iesw/ e- ll .fit' 7 diz�,e.a:-./�. �/ /0 / A `7r..r;ti" - /le''a /A ,& )C/ //11/ ,yam./,:.) i';;), s%s- i z/ee zs ' J l� a . /Sd.�ys inr� / :c 's4/ ,29- " /fe!_f,,-/ tJ,ts i4fe- 'dust- , 1 :5,-rs,. ,- , ✓,,X ;... is 5A/ • . / ._,, r . __ , . _ ________ ems, , _ . >a a/ • 1 I vt9 1G t--,8 8 � /\ 3 v -- — - —1--1- hpf-) V 1 /I i6 74- y A./e 74 AC_S— ---":4 5/S tl 4.s,,ii_.-:: • J.,' y ��,�� A J//- ' - s.�j�?.3-7�/A/ 9 J b',4c,� //,i.�, Y.�, /,) ,;Jx ; - / Arn.r - , /A ; 4 , /, c ��s I"f 5) �� `/ /'-'�/a 'sca- ,4/; 74 'fir- Arafc,-/ tI s 4e-e- -- ,.) t f 6` V ifiL 7 t).,;,16 / V __ , . r �- - - P 1 1 , -f-;-_, ,_ 1 .), , ,_ - .. ' 40 , , , __......, . , _ _ ...„..-T_______.__/e a' .14r _.__ _ . .—hi- 1 ,94 4"A)A r--5-)1 e i(9 ..57 . r ' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of • Division of Safety and Buildings in accordance with Comm 85,Wis. Adm. Code County //,, Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must • L�- ' include,but not limited to:vertical and horizontal reference point direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location c11 Won a earest road. rj .:;'-•_/4 / —>0� Please print all infor ,tin ' : R sewed by Date µ ' (—Mp t.� Personal information you provide may be used for secoirposes t .15.04j1 (m)). \U — 1 2a0l Property Owner `'/ i" �'� s - Property. cation �„� �j , / cn JU�J Q /�ovt. Lot.,,, it) 1/44'� �1/4 Sm23 T / N R /7 E(or 7 Property Owner's Mailing Address '81# 1. ock# Subd. N me orb__ ST CROtX • --R, ? //) < ` 'TY , Air , 10�/� - /- 773 C Sta Zip Code Pho - wbYNVGOPEI E �+ ` .�Y �Village �Town Nearest Road El New Construction Use:JZI Residential/Number of bedrooms `;j Code derived design flow rate > GPD Replacement Public or commercial-Describe: Parent material /,i.- / • •)4' Flood Plain elevation if applicable Al ft. General comments - and recommendations: ;,., .1/ 9S 15 - / ❑ Boring Boring# IA Pit Ground surface elev. 9 6s— ft. Depth to limiting factor 7//`3" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. C t.Color Gr.Sz.Sh. *Eff#1 *Eff#2 Z /C)*V- /7 / 5/ 2,,,,,sz,/ p,..' n aJ -, 9 /I-.3(v i Z /i% _S / "3- r_,,,i ie 0 cJ c ,,, , .5 i •) l i/� .7.1-,`-.4 /ad1/ ,.s/ .�7„-3a it,//- .'- -- / , .5 , 9 ctt" cis—.(�l vv4/50 Boring# 0 Boring �C �nl Pit Ground surface elev. JO 7 7 ft. Depth to limiting factor}/.: in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. My / Munsell Qu.Sz. Cont.Color Gr. Sz. Sh. *Eff#1 *Eff#2 .. = z,c--xV7 /l'/ S/ �r�xs )./7,)1:: Qi.J -�i., e 5— , %� 3 -s:!s'- //9 2// v .,Z- /�� . ,,, / 1.s A/ . 7 /. .-9 G.e/ice, *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L CST Na e ease rin > ign re / CST Number ,..,,,, ,,i7 Address f�✓/ A ,�� Date Evaluation Conducted Telephone Number z t9 SBD-8330(R07/00) Property Owner Parcel ID# �2-/� /- mil=© Page ,_ of . -) Boring Boring# rm _ S ® Pit Ground surface elev. W/_<ft. Depth to limiting factor s/.,5- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz. Sh. *Eff#1 *Eff#2 O- / riff' .j/ - �y-ZC f -s1,7/✓' t7in/ )/tom . -.5 ,,2 7-}V Aer)(--// /71// ....5--/ , -----;,?1,,5 d ,J74:: d Li) -,_:-_").2)--,- . 5---- , 9 r ////,�- 7s y/ 4 < / r 9.Ss1 7 g I.)le� , - /( ._r , gs/$Y ❑ Boring Boring# ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 0 Boring Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont. Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BODS>30<220 mg/L and TSS>30< 150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) . . ly ,c,...5. A --._sfr,) /- ,5,4,4, 3-77.57/A/-/e)9 kd 7A2 i*;' d c min e s-/-v1 .4 s�m?s �, f// �l/ ,a./',a 1, 4 N�, 4,E 70;ti -,mil61,a A )&1-',00/ -K9XA.7,:.) 1,1,t T. - ien e. - 4 . Le,,,,,,,_/<'_ �`C.6-/ / ,c. 6/ ),,'/ --- --: 1-;70 .-:" G3 G2, 7 ? a iJe,Jriv.Ary •t ,r�;s ),g /use .--- 7 S , J�e - f �- P --f- ,6 30 4 3 6 / w \ j 1 it/ '67, :5 A/ yam, Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow- Peak (gpd) qSo Estimated Flow-Average (gpd) 30"O Septic Tank Capacity (gal) u �, n Y Type Soil Absorption Component Size (ft2) r 4 2 — ter T e of Wastewater Dome tic C�a Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Abso(rtion Component Design Flow - Peak (gpd) •:1� `� '� ` as ' Maximum Influent Particle Size (in) 1/8 Maximum BOD5 (mg/L) 220 Maximum TSS (mg/L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). 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 Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 ST. CROIX COUNTY WISCONSIN ZONING OFFICE -Jo !e U e e III■n■ t6r,.Ur ST. CROIX COUNTY GOVERNMENT CENTER 'Aar _ 1101 Carmichael Road •°�• _; J,ia mot = ''� Hudson, WI 54016-7710 • (715) 386-4680 FAX (715) 386-4686 June 27, 2001 REMAX Team 1 Realty Attn: Stacey 103 Main Street Somerset, WI 54025 RE: Septic Inspection for Jay Geist located at 2033 60th Street, CSM Vol. 10 Pg. 2773 (Lot 3), Somerset Township, St. Croix County, Wisconsin Dear Stacey: A septic inspection of the above referenced property was conducted on 06/22/01 . This property is located in the NW 1/4 SW 1/4 of Section 23, T31N R19W, CSM Vol. 10 Pg. 2773 (Lot 3), 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, (141.A.14N. Kevin Grabau Zoning Technician /sm cc: file Vsc0nsin ar of In , DeptmentdustrySOIL AND SITE EVALUATION REPORT Page / of Division al 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 (0,/1/ 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 PROPERTY OWNER: PROPERTY LOCATION C �� / GOVT.LOT/h) 1/454) 1/4,S 5 T 3� , ,R/9 JZ(or PROP ,ERTY OWNER':S MAILING DRESS K LOT# BLOC # SUBD.NAME OR CSM# // CIT`Y__,STATE 9 /`I ZIP CODE�; ' ,E,HONE NUMBER ['CITY ['VILLAGE MOWN NEAREST ROAD 1 Mil;.e!•S.2/C/ IiVL ,S- 2 +w>'�:.^�4'7 :7,47' �)75^ \ l 0',v,/,--"�G, Ze frY c/i ( New Construction Use [ ] Residential/Number of bedrooms [ ] Addition to existing building ( ] Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed,gpd/ft2 trench,gpd/ft2 Absorption area required bed,ft2 trench,ft2 Maximum design loading rate bed,gpd/ft2 trench,gpd/ft2 Recommended infiltration surface elevations ft (as referred to site plan benchmark) Additional design/site considerations � ! c Oe , /), K.�`./-7 Parent material may ./_ ;' Flood plain elevation, if applicable______,,j ft S=Suitable for system CO NTIONAL VI DOD UND PRESSURE AT DE YT M N F HOLDINGTA K U=Unsuitable for system S ❑U O S ❑U S ❑U S ❑U `� ❑S SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure Consistence Bou Roots GPD/ft2 Texture Boring # Horizon in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. nda<y Bed Trends ................. ::: :::::::: / 29.-. /er;"�/I A/ _5-1 /.ice m/ q,s .y 7 ,-4/ , - /-2-e7 7s,'-</ . .1 / /7,s.11 ,iitio.^ c ,-/-1 , c Ground ? lY-9( 5'pr`/ll /s „„)14A /n.is a J.)// ),,', . 7 e elev. ft. S Depth to limiting ' factor 79C Remarks: Boring# / // _ / e)-/-� /f% �// A/ S l/ /?Ca ,I, / 0 S- .��iz-, ,31 , S 4/2,, ,5 ,t1/-',1-c:5,- ).7., / r .) ir , 7, . w Ground / elev. Depth to limiting factor Remarks: CST Name:—Please Print /) Phone: _ Address: S • /'gip= C.2 / , � ,- z,) _S 4 Signature: Dat CST Number - /4 , A,6-J or 3 a069 E � /i/, /v1i .&./ . �, S �� / 1=/o0 ' c=7, S17 23 77// eitIA I 0 ' Sys 9 i Q o (Do a) o N p°� 03 I M C c Op O O h 0 _ to p N ? 3 U N� .MO. CU y Y '0100 j C O '1 O IT •O N N U` CL 0- O� 7L • O p N 10. to a; m a) O _ C N L N C O I � S U N O.= fd d j C N C O N N N CA •- I 00 C E 4D N. N O N> m y y O- CO CL.- _ Z CL 75 Z y3 � 1L O O) N m N L LL O c I •x N y N 3 � � @s c a > o p . 0 0 0 n = �o N Q F- U �NEin E Q YMC-4 I r N N Z y I x y I rn E E �: = = ` 0 E 0 E Z a m ccli l z d m o c z v I m z o o 'v w o c c to F- r CD a N Z c E c @ E - o U d h N 0) I N O) 7 N N O = N a Q. O d w O 0 Q z m z z c Z w N �i co M d -° I V N '° E E m E E_ N o cca` a c o0 IL -0c q6 o cn v� to � I �j (n co to _MI �j o Z (h > N Fy O N LO Fy d O Z •N ;� I�aaa I aaa 3 O N fn J U } u) 0 0 N} N N t -0 Cl) 0 - ESN ? 0 N o O O N 1 0 00 •� O E co O - N m y c l !n y CO c a _ V N N N A cn I � d Q n L ✓ 7 L 7 r O O O O N c O CD Ca N C W 3 CC", M 7 0 o v F- N C I N N V O- 0 0 0 1 y T M N N N V w ' N O N a r 12 N N N L r N ° CO 0 � Z - N N N C c N M .�- f0 y_ CO N N N • M M ci O N N O C O I N 0 O C N N v O N N O Z_ F - C9 M 1 (n 0 `� I I • • I V � .. rA d E a E a r A IL CL ct CL ' rr �i �' L � L M ' �" r _1 A vat NCB O vid I STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER r . ADDRESS -,�� 2z - SUBDIVISION / CSM# /T LOT # SECTION - ?Z N -R Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a� = -yns4 k x INDICATE NORTH A OW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: // 4A 6 v - ALTERNATE BM: AL q,.L4 >� /C SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: � 5 Liquid Capacity: 1A j j Setback from: Wel House Other Pump: Manufacturer Model# Size Float seperation Gallons /cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: /�_ Length — Number of trenches Distance & Direction to nearest prop. line: fr� Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header /Manifold Bottom of system Existing Grade / Final grade DATE OF INSTALLATION: - L1 ,, , PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: � 'ALL) 3/93:jt F r Visconsin Department of Industry PRIVATE SEWAGE SYSTEM County: Labor ancUfUmanRelations ST. CROIX S and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village 1-1 Town of: State Pi lan D o.: GEIST, JAY A. CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic v� Benchmark l Q f,g � q 0 Dosing Aeration Bldg. Sewer Holding St / Ht Inlet Pj , 27 91 .-6-3 TANK SETBACK INFORMATION St/ Ht Outlet 7, 9s " F/ TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet Air Septic NA Dt Bottom IF Dosing _ r NA Header / Man. 75 L ion c/ — NA Dist. Pipe ng A-4 Bot. System �c�, (b t?' /. X0 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand .Z Model Number A I GPM (j TDH Lift L oss riction ystem TDH Ft Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width j Le tb No. Of T enc s PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION �� DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type of � 25 �✓� CHAMBER Model Number: System: v OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole 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.) LOCATION: Somerset.23.31.19W, NW, SW, Lot 3, 60th Street Plan revision required? ❑ Yes ❑ No Use other side for additional information. % Al SBD- 6710(R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code STATE SANI ARY QE M —Attach complete plans (to the county copy only) for the system, on paper not less than /01� ! 0 1 1 L f ( I - T 8% x 11 inches in size. , ❑ Check it revision to previous application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I APPLIC INFORMATION — PLEASE PRINT ALL INFORMATION. PROPE OWNER PROPERTY LOCATION '/4, S T N, R �(or)g PROPER OWNER'S MAILING ADDR SS LOT # BLOCK # CI STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM MBE II. TYPE OF BUILDING: (Check one) ❑ State Owned VI LL AGE • NEAREST ROAD &I Towu ❑ Public 1 or 2 Fam. Dwelling — # of bedrooms •: PARCEL TAX NUMBER(S) Fy 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. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ® Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min.�irich) ELEVATION _1 CAPACITY / Feet Feet VII. TANK Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete strutted Con- Steel glass Plastic App Septic Tank or Holding Tanks Tanks Tank ' Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite wage system shown on the attached plans. Plumber Nam P. lumbe s Si nat e: p MP /MPRSW No.: Business Phone Number: ✓/ S' T Plu ber's Addre (Street, City, St9te, Zip e): XV IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signatur s) Surcharge Fee) c Approved ❑Owner Given Initial 80 r T +� Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD- 6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety A Buildings Division, Owner, Plumber INSTRUCTIONS . 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by 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: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. 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 performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11/88) f� / l Cf 7� Ow �� Ze4a"'" AI io 6 ,1 l36 � i i' PAC. c or • .' � �,` .�rV S � �+ �L 1 011 0 1' ' '•'� -� � -, • . It��A �k UI.Di, As p o���I�.uoll PI . .. • YWww' iLtr<DpsO � •, 1• flaw 40600 v«N P1/• ;101 ►ht O. t1e1 0.60w,� fit 0 Asti$ Of 01•uural� . • 1••••11 III• . • ►••184 4104 ►1v• 6•19v • C"4*1 16.«I.OU•! AI • •a +�+ Of il•1•w soli, Fll.l -' • ©I3TRIBUT101.1 PI►[ APPRO` /C6 S`(WPI[TIC COVC 2 OF �GGKEGAIE --�'�r ` - JMATER14 OR 1 OF S7RAM ELEV. o F L.�.F o'vY ; - t'�t � I%cG 4UYIOAI & O ALJU A I,CAiT0 I TV DC A7 4CA><7 IWCHCS BCLOW ORIC•IWAI •C,!ApC AUU ACHLL OUT 140 MOKC THAW `iZ IAICHES DELLOW ►1►JAl. GitAOC M�Xtrwrl DEPTH OF CIACAVATlpu FKOM OK16VJAL 6R AD W1LI. HEL rvrr,hvM 0EPT1 OF EACAvAT1ow rP, % C1l, I4IWAU GRAPE WILL. 8C � INCHC S • LICCUSC UUM6CIi: — Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and',Human Relations Division -of 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 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL .D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPER OWNER PROPERTY LOCATION s GOVT. LOT 1/4 1 /4,S T N,R E (or) W PROPERTY NER':S MAIL ADDRE S LOT BLO # SUBD. NAME OR CITY STATE ZIP CODE PHONE NUMBER ❑CITY VILLAGE [MOWN NEARE T R0AQ [)(] New Construction Use [xJ Residential ! Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate _ bed, gpd /ft trench, gpd/ft Absorption area required ,3 ;bQ bed, ft ��") trench, ft Maximum design loading rate _,, gi bed, gpd /ft gpd/ft Recommended infiltration surface elevation(s) /, ' It (as referred to site plan benchmark) Additional design / site considerations Parent material ,�T 4/6 �,„ �� Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem IM S O U OS ❑ U Os Cl U ® S ❑ U ❑ S ®U ❑ S [3U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. ont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench .................. ................. ................. �. Ground 7 s � elev. i XL ft. < Depth to 7 LR limiting factor Remarks: Boring # .Ground elev. / ft. Depth to f limiting factor Remarks: CST Name: — Please Print Phone: _ Address : Signature: /^ Date: CST Number: I PROPERTY OWNER SOIL DESCRIPTION REPORT Page,;,Zof PARCEL I.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 Ground 3 r elev. ft. Depth to _ limiting facto > S Remarks: Boring # k i • Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) r �s 86 4 I - I ,p /Jf�O�tASeio of I 0 I � � -•fir �� � i�' i re JA 8� STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Z_h ✓ `iiL /.d�; `' y I MAEUN G ADD � RESS s- •,. L � t . o PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY /STATE _ r C ,t z1 :- -- r •� --- PROPERTY LOCATION rV k-' 1/4, w 1/4, Section -e_3 T :s / N -R � ` W TOWN OF `� ��� �/' ,.r , ST. CROIX COUNTY, WI SUBDIVISION J- LOT NUMBER CERTIFIED SURVEY MAP , VOLUME D PAGE 3�y , LOT NUMBER 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 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 completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: ✓ r a 3 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - loo 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 recordin . g ------------------------------------------------------------------- Owner of property 11 A-> Location of property u 0 1 /4 _ 1/4, Section Z_j ,T ,3 N -R �� W Township Mailingaddress Z' ti /11,4'e ,v4 ,M , y S -so .51 7 Address of site '7�eE. � v's' �-- Subdl i ion name Lot no. Other homes on property? Yes No Previous owner of property Z �'- �:�'. - - ". , t� Total size of property �, �-, 4c -,el -5 Total size of parcel Date parcel was created �y Are all corners and lot lines identifiable? _ Yes No Is this property being developed for (spec house)? Yes _X No Volume c' 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 reviewin g p rocess. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. ' V A 4/ �r-- , 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. Si a re of Applicant Co- plicant 7 73 Date of Signature Date of Signature • c_. —ma I THIS SPACE RESERVED FOR RECORDING DATA . • DOCUMENT NO. WARRANTY DEED STATE BAR OF WISCONSIN FORM 2-1982 a k a Patricia C. Fdrifit --- lidsband "and 'wade - - - - - -- �' Steven A. Parent and Patricia Parent . K�c'xi fbMr �I - - --------------- ------------------------- ------ ....... --- ......................... JUL 5 1994 - - - -- Ja A. Geist and Elizabeth C. Geist 10.00 A conveys a d w rra is to Y .......... ........................... ............ -lusan -- and-- wife1.......... ----- - - - - -- ----- •-- ••-- - - - - -- ...................... ,"a ,.. cp ---------------------------------------------- .... --- - -- --- - - -- - - - -- - - - -- - - - - -- -......_...__._.._...._._..._ _.- _- _.._.._...__..___...._.... __..._.......... _.. _.._. __. <ETUR T fay Elizabeth Geist •---------- •--- •••--- •- • - -... 16178 Manning Trail North - .....................•-- •-- •................-••-- - --St. Croix -- - - - - -- Marin MN 55047 the following described real estate in ........................ ........................ County, State of Wisconsin: Tax Parcel No: Part of NW 1/4 of SW 1/4 of Section 23, Township 31 North, Range 19 West, St. Croix County, Wisconsin, described as follows: Lot 3 of Certified Survey Map filed June 10, 1994, in Vol. 10, page 2773, Doc. No. 517711. i This .... is not homestead property. (is not) Exception to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ` day of .1..112 19.9.. - - - -- ....................... Z_ (SEAL) - ...... (SEAL) ...... S_tev n_.A...Parent - - -• - -- `�... . -. _��t:.% E� � - -------------•--------....... ---- -............ •------------- (SEAL) ....(SEAL) - --• -- --- * Patricia Parent, a /k /a Patricia C. Parent .... - AUTHENTICATION ACKNOWLEDGMENT Signature(s) __ Steven A. Parent ... STATE OF WISCONSIN Patricia Parent a /k /a Patricia C. Parent ss. (,_�� -------------------------------------- County. authenticated this H day af_ - -__ -. -June 19_.94 Personally car:.c before nic thin - ------- -day of --•------ --- -•- -- •- --- ------------------- 19-- -- - - -- the above named * Kristina gla 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. THIS INSTRUMENT WAS DRAFTED BY Kristina 0 land ------ - - - - -- --------------------- - --------------- - - - - -- ----------------------- - ------------- - - - - -- ----------------------------------------- - - - - -- - - - - -- Attorneyat Law .................................... -....... --------------------------- -...... ............................. --- - - - --- Notary Public -------------------- ------ --------- - - - - -- County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: - --- •-- -• - - -- ------ ---------- -- ----- -- ----- - - -- -- 19 - --- -- -- -) 'Names of persons signing in any capacity should be typed or printed below their Signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin legal Blank Co., Inc. FORM No. 2 — 1982 Milwaukee, Wisconsin l� 0l C S FILED g V JUN 10 19940* 0 JAMES O'CONNELL 01 5x.`7"711 � SL Croix C oewi �I IW i N lO �+ r N r ►+ W ►+ r N cn N Un O M CO U7 V ►+ W N V c° — O W QI CO N fi 0 rn a � a v a ao a r a v a ,' °r •y fi 00 tD G y N N N N V1 N G, fC V! N N N o ,ti-f4 t N /D LM. N (4 N to N d N J� M O - O LMIJ (Tl 1--1 (77 1-�1 RI F�l .�?� / • Y , +A �• S 3 'r f) ct C7 'r C7 't n C t CD CD U1 C 7E = Z Z 0 Q.S.M. IN VOL. 7 18(al= 1811 - 0' rt I-0 T 2 LC 11 I m r0* 0 rt I o ° N CD 6QTH STREET N C � = West li of th S Wk of S 23 W in _ M 9'� SOQ 00'0 S00 0 00 I 09 E 882.90 r+. 470.00' 412.90' 1768.54' W 470.00' w 380.00' (D w SOO 00'09 "E o N 850.00' S �c _ N O CO CO 4r CO - ....... .......... CO .................... = h U w ; 100'_..', 0 C) CO r. li — CO o r ... r w ro °_ o o m CO o w � —i i —, r`n o h' (p = Im o o° m i v v, o IC o T o oo CD I� I N ITl �— I� 0 d ME NOO 09"W — 883.98' — I = —� tv C Cl IV — 850.00' ; ID IM ` 'V 470.00' 413.98' 3 N00 00'09 "W 318.14' 151.86' 380.00' CO Irn — 33.98'— 531.86' — ^ r ' — N00 ° 00'09 "W 565.84' — zo D Z M ►�I\I?ILA I EID LANIDS W o CO N Im �cn 'v 7c r .D O O N N N to N W O 0 H °. 4 - . 0 o — 100' ° O r _ 531.85' 35.00' M- �h o 0 N00 0 03 1 08 "E 566.85' vs 33 33' W 5 x N PARCEL ii i V. 76 P. 23 IV n V / ~• o c o _ n rt ' o �e 0 3 1 � �p 0 N .% s a a -c d 0 rt, c Z Bearings are referenced to rt* Oh � C" west.line of the SWI of Section ` p 23, assumed to bear N000001094. Z r o o cn 0 0. VOLUME 10 PAGE 2773 Parcel #: 032 - 1061 -70 -040 05/11/2005 08:03 AM PAGE 1 OF 1 Alt. Parcel M 23.31.19.312E 032 - TOWN OF SOMERSET Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner CARLA M JACOB * JACOB, CARLA M 2033 60TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2033 60TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.670 Plat: N/A -NOT AVAILABLE SEC 23 T31 N R1 9W PT NW SW BEING LOT 3 OF Block/Condo Bldg: CSM 10/2773 4.67 AC (EZ -U- 1108/049) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 23 -31 N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/0912001 650470 1675/614 WD 07/23/1997 1085/319 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.670 56,300 175,600 231,900 NO Totals for 2005: General Property 4.670 56,300 175,600 231,900 Woodland 0.000 0 0 Totals for 2004: General Property 4.670 56,300 175,600 231,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 301 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 WWconsin Department of commerce PRIVATE SEWAGE SYSTEM SWay and Buildings Division °5` Y Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) �StSl ed f P' w s.15.04 1 m Personal iMom�ation you provice may be us a secondary Purposes [ macy (H )1 iL `t, er s Name: City �p g6 l OVnl�n State Plan ID No.: CST BM Elev.: Insp. BM E ev.: BM Description: Pa c Ta N t oo. D I ��`' ,- " � 02 -' Odi -70 -040 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. SepticO Benchmark b p ot{, W // p ` Dosing )�.S T• 3 Aeration Bldg. Sewer Holding St/ Ht Inlet PJi�t TANK SETBACK INFORMATION St/ Ht Outlet T Mod Number GPM ANK TO P / L WELL BLDG. Air i to ntake ROAD Dt Inlet Air I Septic }— r 3 NA Dt Bottom Dosing NA Header /Man. Aeration NA Dist. Pipe D�: Holding Bot. System L • 3 is Z Z PUMP/ SIPHON INFORMATION Final Grade Mb\ nufacturer Dema '5T 3D/ b •�f 3 08 Il TOH Li Friction S stem TDH �as -� OQ'•0 r Loss ead F cemain Length at.TOweu SOIL A ORPTION SYSTEM �p K-19 ENC width I Length / No. Trenches PIT No.Of Pits Inside Dia. Liquid Depth P I MEN Z• 1 I " LEACHING rer n SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM CHAMBER Me a Nu " St INFORMATION Type m er• System: o! C"+ -�- > I OR UNIT AN'. - C-04.2t DISTRIBUTION SYSTEM Header !Mani old Distribution Pipe(s) x _Hole Size! x Hole Spacing Vent To Air Intake Length Dia. th _ 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 Depth /Trench Cen ter Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No nspec ion : M/zzl n f nspection #2: —i / COMMENTS: (Include code discrepancies, persons present, utt. Location: 2033 60th Street, Somerset, 15 02 (NW 114 SW 1/4 23 T31 R1 9W) - 233119312E -Lot 3 1.) Alt BM Description = S 2.) Bldg sewer length = - amount of cover — , / ��, f _ ) coo � w„ Plan revision required? C] Yes �, No Use other side for additional information. 13 M�llll SOD-6710 (R.3/97) Date Inspector sSignature Cert No i a �r�^ � o _.,,, a �- -�' `�� /` Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. Vi sconsin See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 - 7302 Department of Commerce [Privacy Law, S. (Submit completed form to county if not 15. '�? , r � 7 I state owned.) Attach complete plans (to the county copy only) fo s em, on paper not an 8 -1/2 x 11 inches in size. County State Sanitary Permit Number DP f revis 4 ' vious applic; on State Plan I. D. Number I. Application Information - Please Print all Information Location: Property er Name E'ff E, Property Location 1!45 1 /4, S N, E (o ej Property O*ne Mailing Address t Number Block umber ZONiNG OPRC;L �� 3 City, tate Zip Code Ph lr C ' be '� ! ' > Subdivision Name or Numbed _ _ II. Type of Building: (check one) ❑ City 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Village ❑ Public /Commercial (describe use):_ JO Town of ❑ State -Owned -� >,e` Nearest Road / arcel Tax Number(s) III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) q, 3/ F A) 1. ❑ New 2. ,Q Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued )X A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ' Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade i C2)3 ��7 Aerobic Treatment Unit ❑ Recirculating ❑ Other: xR3� S V. Dispersal/Treatment Area Information: _ 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade �-- Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation J !� s / . Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Stat men I, the und assume responsibility for installs on of the POWTS shown on the attached plans. Plumber's a (P 'nt) Plumber's Sign r no stam� MP/MPRS No. Business Phone Number — 1 Plumber' Address (Street City, te, Zip Code) IX. County/Department Use On f y O Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s ' Agent Sign (No stamps) Approved ❑ Owner Given Initial Adverse Surgharge Fee) Determination 1 2Zi5 X. Conditions of Approval /Reason ��p r i pprova :• 1pve.� (c,� tee_ -�•� �►kt� j tle u)-%— SBD -6398 (R. 07/00) y33D � L n r _ I FYI 6 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County - Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must S include, but not limited to: vertical and horizontal reference point direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and loca ' d, groat earest road. _ _ y Please print all infor >:' ' iewed by Date Personal information you provide may be used for seco rposes s. 15.04 01 (m)). 11 Property Owner — Property, ation f JU �w r ovt. Lot,. 1/4 1/4 S T N R E (or Property ner's kTalling Address # ock # Subd. Name o r ST CROIX / %1 COW - Y C1 Sta Zip Code Ph o b i E El Village Town Nearest Road F1 New Construction Use: ,® Residential / Number of bedrooms Code derived design flow rate GPD Replacement Public or commercial - Describe: Parent material /,� �',lY Flood Plain elevation if applicable ft. General comments and recommendations: F Boring # ❑ Boring / [0 pit Ground surface elev. ft. Depth to limiting factor 7//5 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cqnt. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 J gjZ 1A c "ho Boring # I❑ Boring �1 Pit Ground surface elev. f4,2 7 ft. Depth to limiting factor - in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 qs . tp I Z(o * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CS=Nae e` � Z igIn, CST Number Address Date Evaluation Con / ducted Telephone Number SBD -8330 (R07 /00) Property Owner J"' Parcel ID # Page of Boring # Boring ® Pit Ground surface elev. 92/–< -- ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. M unsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R.07 /00) � ,�� ,�,��.�,�.�,'�„� max �- � ,��o_t� "' %Dtv�,� S G.�-. 3e 1 � � � ' � i ., 1 _.. _ �i.. R�� i _. ._ _ . __ _ Y _ __ ... _ _ _. _: _ _ __ _. '. __ ._ i t ' R ' y . Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Z7V Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) tr'U Septic Tank Capacity (gal) UY Soil Absorption Component Size (W) - rft` Type of Wastewater Dome tic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absor Lion Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). 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 f t . i Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering within the septic or other a confined space. The atmosphere p 9 P treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every years. three The inspection shall include recording the levels of ponding, if any, in p the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or action over this impossible to repair until weather conditions improve. In general, soil compaction component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 4isconsin Departmentof Ee IVATE SEWAGE SYSTEM County: Laaor and. H'Lman Relatio ST. CROIX Safety and Buildings Divi INSPECTION REPO RT '"' (ATTACH TO PERMIT) Sanitary Permit No.: GENCRAL INF Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan o.: 9 GEIST, JAY A. CST BM Elev.: p. BM Elev.: BM Description: Parcel Tax No.: Ins TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS H1 FS ELEV. Septic l/r� Benchmark Dosing Aeration Bldg. Sewer Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/L WELL BLDG. Ventto Air Intake ROAD Dt Inlet Septic — NA Dt Bottom _ Dosing NA Header /Man. 9ls }-t 75 Aeration NA Dist. Pipe Holding A Bot. System �0, (c PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand 95.2 Model Number GPM TDH I Lift Friction stem TDH Ft Loss ead Forcemain Length Did. Dist. To Wetl SOIL ABSORPTION SYSTEM BED/TRENCH Width 1- �1i No. Of T en s PIT No. Of Pits inside Dia. Liquid Depth DIMENSION ( � DIMENSION SYSTEM TO P / L I BLDG WELL LAKE /STREAM LEACHING Manu acturer: SETBACK CHAMBER INFORMATION Type O Qs z c /.�- Moe Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipes x Hole Size x Hole 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.) LOCATION: Somerset.23.31.19W, NW, SW, Lot 3, 60th Street Plan revision required? ❑ Yes ❑ No ` Use other side for additional information. SBD- 6710(R 05/91) Date Inspector's Signature Cert.No. STC — 104 AS BUILT SANITARY SYSTEM REPORT OWNER .�.�`s� ` • F. ADDRESS SUBDIVISION / CSM# LOT # SECTION 2� -R _ , Z . � _ W, Town of 4 e.res,/ ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET'OF SYSTEM isQ x INDICATE NORTH A OW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. I I BENCHMARK: ALTERNATE BM:. Z61 SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION -Manufacturer: S Liquid Capacity: Setback from: Wel House Other Pump: Manufacturer Model# Size Float seperation Gallons /cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: /W_ Length _ - Number of trenches Distance & Direction to nearest prop. line: fr� Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold_ Bottom of system Existing Grade 4 Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: ' 3/93:jt f M {� ♦ M. �..,{ Lie. ry. « • 40 9 93 _ { E 5� 11 /3037 a ,. C. S._ LOT , 4 y 2 312 C t Q (7• w to 4 34.0f lk= NW l/4 - S. W / 4 409.4 r ; 312 E LOT 4 928 �P v 40d ��� �,..;'�.• 444 e2 0 LOT 3 I ti v \ ro 9 27 0 � 3 808.64' r� ° 313 in I � LOT 2 926 SW114 �1 1101 Carmichael Road, Hudson, WI (715) 386 -4680 (715) 386 -4686 - fax St. Croix County Z oning O ffice Fcix To:/`(h From: Fax: oGl 3G aa-- Pages: �--� Phone: Date: Re: C CC: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle • Comments: ST. CROIX COUNTY �. WISCONSIN _ _ _`' ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER da 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 I ' June 27, 2001 REMAX Team 1 Realty Attn: Stacey 103 Main Street Somerset, WI 54025 RE: Septic Inspection for Jay Geist located at 2033 60th Street, CSM Vol. 10 Pg. 2773 (Lot 3), Somerset Township, St. Croix County, Wisconsin Dear Stacey: A septic inspection of the above referenced property was conducted on 06/22/01 . This property is located in the NW 1/4 SW 1/4 of Section 23, T31N R19W, CSM Vol. 10 Pg. 2773 (Lot 3), 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 /sm cc: file MsconsinDepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division efSafety & Buildings in accord with ILHR 83.05, Wis. Adm. Code FPAARCEI NTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM) direction and % of slope, scale or LD. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY 0 ER: PROPERTY LOCATION GOVT. LOT 114 114,S T R or (1 s PROPERTY OWNER':S MAILING DRESS LOT # BLOCr # SUBD. N ME OR CSM # CITY STATE ZIP C w° f ONE NUMBER ❑CITY ❑VILLAGE OTOWN NEAREST ROAD (New Construction Use [ ] Residential / Number of bedrooms [ ] Addition to existing building [ ] 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 ft (as referred to site plan benchmark) Additional design / site considerations ! ` - - >. Parent material - Flood plain elevation, if applicable ft S= Suitable for system 0 NTIONAL MO D I UND PRESSURE A DE Y M N F HOLDING T K U= Unsuitable fors stem S❑ U S❑ U S❑ U AS ❑ U ❑ S emb SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bour>daty Roots Bed Tmr& :`` Ground elev. ft. Depth to limiting factor >9C Remarks: Boring # s G round / 9 elev. ft. Depth to limiting factor y9l Remarks: CST Name: — Please Print Phone: Address: 21 Signature: Datg,,,/ 9 CST Number- PROPERTY OWNER SOIL DESCRIPTION REPORT iot PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. - 1, — Depth to limiting factor Remarks: Boring # /t Z 47 S r s G round 7 elev. 94 / _ IYZ ft. Depth to limiting factor ? �C r Remarks: Boring # Ground f elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) i i 6 I � 3r0 i i r - s FILED g JUN 1 0 1994- 0 51 JAMES O'CONNELL Register of Deeds SL Croix Co„ WI I r I O r _ N m r w w f- �2 N Ln ✓y r 2 Cn ° N rt O v ` - o w O O w to p to ro ti ev -3 w Co n • y rt a w a N to c e; ,' (D rn H rt ( j a N . 0 (L �, ti rt V� -1G1_= III .� CC/) N O N 7 D = Li z w 64TH STREET ° S00 ° 00'0 9 "F ____� -We_ s_t lin of th e S of S 2 3 0 S00 °00'09 "E 882 90 — 0 1768.541 470.00' w 470.00' 412.90' rt - , w � I � - Co o S00 ° 00'09 "E o 380.00 ( D ti i-U U Co 850.00' �. N Co rt II w o..., ID .r r•Y' 4' 100' —� rt i W �O Z r W f'h rn 0o m h ♦ 00 o N I,Iv o o w V woo `cc° Il v I�- D T ID Z IQ I /- rt a IZ ° °' � IU1 ��51 N• M 850.00 — 883.98 o - I= I —I t 3 I 470.00' Ln N00 00'09 "W 318.14' 413.98' _ �D �r_j w d 151.86' 380.00' Im I � m ° — 531.86' — 33.981- N IZ TED ���rv�DJ o — N00 00' 09 "W 565.84' — : w Co W Im ID z a N �: oo 0 v m N o N 0 r � rt _ S ° O r 100 - ► E ° O ---- — 531.85' 35.00' „ O N00 °03 " E 566.85' _ � � a CI] i 33' 33' .z = x �. c� �'1 T CIS LAI`dl� ° (D a, N y ' H z r•. t7 Fak..E` 1ti V. 752 P. 231 m d N 7 7 O N N = s i 1+ O S C O li GG�II 0 ro z _ k. H O `�[] tp rt rt � v � O G Bearings are referenced to the r west line of the SW} of Section 0 23, assumed to bear N00 °00'09 "W• o � N• N VOLUME 10 PAGE 2 773 0 0 IlViscoQsin Department ofIndus", SOIL AND SITE EVALUATION REPORT Page /of � ` Labs and Human Relations Division of 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 '� Je 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 PROPERTY WNER: PROPERTY LOCATION GOVT. LOT I d 1/4 �/ 1/4 � T N,R EI(0 } PROPERTY OWNER':S MAILING PDRESS LOT # BLOC # SUBD. NAME OR CSM # CITY STATE ZIP CODE PHONE NUMBER ❑CITY VILLAGE OWN NEAREST ROAR s ( s s �` s [X] New Construction Use [ Residential I Number of bedrooms [ j Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow sn gpd Recommended design loading rate z — bed, gpd /ft trench, gpd 1ft Absorption area required �_ bed, ft <ZS tr nch, ft Maximum design loading rate ,7—bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material , , _ 41z /!2 h,, , 1 Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem OS ❑ U z S ❑ U ®S ❑ U ® S ❑ U ❑ S ®U EIS O U 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 Trench Ground elev. / ft. — — Depth to limiting factor } Remarks: Boring # J _ A 1 1 4 :b ArIJ Ground` r elev. s - - 2Xg ft. Depth to ' limiting factor L t . Remarks: CST Name:— Please Print / Phone: T rke Address: N c Signature: Date: _ T�, PROPERTY OWNER SOIL DESCRIPTION REPORT Page,—_�of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Coot Color Gr. Sz. Sh. Bed Trench Ground elev. Depth to limiting factor > ,ql Remarks: Boring # 4111 /71C )2 9 9" 4 ,v .... Ground ` / ,6 elev. zf Eli Depth to Ze limiting fact Remarks: Boring # :t : t;:.. 4 � • \ . / • i ... ........ti....., Ground ' elev. ft. Depth to limiting factor y� Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) r - ��� �c�0'` �� �V6J �y S�J ��, See �� i 3��✓, �s�/9�� �SIIJ461,e A40 IA/ as �� tv 0 � psi gG - 34 r /r i 3 I 3�� ` I i 3s i G y i I i .R ICO 00 o r cn -j w c7 V w w C" .-• r co .. � o .• w w tv v o •. O .. ; . .t.. N t71 CO) Q 1a r - to C O -4 �. O N rt O 9 V a V a t0 A F a v a ■ tT N F A iT n •-. n r A w n CO l'f '7 N IV N CO N t9 to N N A in nl N iD d'� ,.'.. •rY" "' " ? N C:, L! N A N A H A N A N A N� �• �''•�.. rt rt CD rn rn w -M x T a - n x - n s• a 3 # r1" 't7 Pl e eb RC OC MC me 2C r LM C to S. M. i N ` OL.7, l AK 1811 0' N fn 0 2C L�� I ' I ID =W m o a n E N Q QTN 5TBEET A� w w O �_� li ne of th e SW of Sec 23 _ n, SOOo00'09'�— S00000109 11 E 882.90' rt 470.00' 412.90' 91 Ir 1768.54' 410.00' ea 380,00' (D w Cn SOO "E o y 850.00' 6 a N .......... ............•........ ...•.........i� O C� N li _ w 100 ►-h M rt ID ►. O F ►-• F ill j —� = C O O CO CO O N —I o it o CL 10 CO CO U 0 CD a. Iz — N00 ° 00'09 "W 883.98' — I —� N c 850.00' — o Irj i(T� w 470.00' 413.98' Q I< IU m N00 00'09 "W 318.14' 151.86' 380.00' �_ Iz Ir w — S — 531.86' — 33.98 N I� ID Li PLA kW C — N00 ° 00'09 "W 565.84' — N I(T1 h Z y ,aT T EI� LANDS o - w , r r t, N O N �D ° m - to x Z o N_ w O r � rt o P 0 �. p , 0 100' —r; 0 0 -n r 531.85' 35.00' ° 0 "'N00 ° 03'08 "E 566.85' 0 Cn C" 0 33 33 M, 5 �.... a ti n _ (D a y r c [rJ vN ELt 1 T ED LAND- �, K s x ■� � t w (A Z [) ' - C i t�t� 7• n P n t O N �l�RV l{V J. w 5 L� F . L� 1 rt ft ►• Cr a O C O n w a #+ 0 w rf x ^� v 1c pi �• r -n v to I-j n CO rt A r o F+. 0 Co me 3C • = I c (D 0 to C. ° (D O o rr o rh t � O � o � Bearings are referenced to the ,� o. west line of the SW} of Section ` ° 23, assumed to bear N00 "W. o o 0 O N• Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page _ of 3 Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY • Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but '� no' 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 PROPERTY WNER: PROPERTY LOCATION GOVT. LOT 114 1/4 T N,R PROPERTY OWNER':S MAILING DRESS LOT If BLOC # SUBD. NAME OR CSM # CITY STATE ZIP CODE PHONE NUMBER ❑CITY E]VILLAGE EPOWN NEAREST ROAR (,r] New Construction Use [A Residential /Number of bedrooms Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow : gpd Recommended design loading rate gy bed, gpd /ft gpolft Absorption area required bed, ft tr nch, ft Maximum design loading rate __, --bed, gpolft ,trench, gpd/11 Recommended infiltration surface elevation(s) 2Y2 ft (as referred to site plan benchmark) Additional design / site considerations Parent material ,� . � 4 9,,11 f Flood plain elevation, if applicable A ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U .I S ❑ U ®S ❑ U ®S ❑ U ❑ S ®U El S ® U 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 Traxh Ground elev. ft. S JeZ S 11- 1� 4 1." Depth to limiting factor Remarks: Boring # > - :: r Ground elev. ft. e Depth to limiting factor Remarks: CST Name:— Please Print J Phone: A ddress: Signature: Date: CST Number: PROPERTYOWNER SOIL DESCRIPTION REPORT Page PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo rc* Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITmr& Ground elev. / ft. c S 17 — Depth to limiting factor > y: Remarks: Boring # `� , - i va:\��..ti� i Ground elev. �L ft. ZZ Depth to limiting 9 factor Remarks: Boring # v. \ I Ground elev. Depth to limiting factor y`• Remarks: Boring # Ground elev. ft. 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