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040-1232-70-000
r Wisconsi:i Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506385 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Jakubowicz, Dean R. & Julie I Troy, Town of 040 - 1232 -70 -000 CST BM Elev: Insp. BM lev:� BM Description: Section/Town /Range /Map No: I to , d %P 03.28.19.1153 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / .2oU Z. y X0 2. 1 0e , /Do , v Dosing Alt. BM / PP Aeration Bldg. Sewer 61 7 I 3 3 Holding St/Ht inlet /kt SUHt Outlet TANK SETBACK INFORMATION ^ -S y� 7 S3 Y7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD D�nlet " /� _ 7.67 ?�- ,7Y Septic Dt- Betko+rr 7 4? y - 7/ pa- 5� �/ Header /Man,-7— J, O '� 1 -2S J e Aeration Dist. Pipe � . & 7 Holding Bot. System . f' F Grade PUMP /SIPHON INFORMATION Vf rV O 3 t Manufacturer Demand It Cov er n' , GPM Model Number 3 7 g TDH Lift Friction Loss em ad TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM dlel BED /TRENCH Width Length ' INo. Of Trenches P�IMENSIONS' No. Of Pits Inside Dia. Liquid Depth DIMENSIONS to 3 SETBACK SYSTEM TO P/ BLDG WELL LAKE /STREA LEACHI MapuEa firer: INFORMATION CHAMBER OR T e Of System,�� / UNIT Model Number: DISTRIBUTION SYSTEM Header /Ma i�ld Distribution y x Hole Size I x Hole Spa 'ng Vent to Air Intake �j (/ Pipe(s) '/ i Length Dia Length Dia Spacing SOIL COVER to x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 7 Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Cent i" Bed/Trench Edges Topsoil _ a Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: N _/ t , k_1] Inspection #2: Location: 527 Trillium Lane Hudson, WI 54016 (SW 1/4 SE 1/4 3 T28N R19W) Country Wood Lot 17 J k Parcel No: 03.28.19 . f' 1.) Alt BM Description = S✓ �` j S 2.) Bldg sewer length - amount of cover = Required? es Lie Use other for additional information. No is �) { Y. " Y 16 6 3D - 6710 (R.3/97) Date Insepctor's dtu e Cert. No. commeraeml.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix i sco n s i n Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) Deponent of Commerce 3,Y5- Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental Project Address (if different than mailing address) unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are submitted to the Department of Commerce. Personal information you provide may be used for secondary Same purp oses in accordance with the Privacy Law s. 15. 1 m , Stats. I. A ilcation Information — Please Pr' Property Owner's Name E D Parcel # Dean & Julie Jakubowicz 1 1 040- 1232 -70 -000 Property Owner's Mailing Address Property Location 527 Trillium Lane ST. CROIX COUNTY Govt. Lot City, State Zip Code one Number SW_ /�, SE ' /,, Section 3 (circle one) Hudson, WI 54016 (715 381 -5584 T 28 N R 19 W H. lype of Building (check all that apply) , Lot 1 or 2 Family Dwelling —Number of Bedrooms 4/ & /� /S -n1,J { 17 Subdivision Name `�l /J Block # COLiYI Wood D Public/Commercial — Describe Use Na D City of ❑ State Owned — Describe Use CSM Number D Village of Na D Town of Troy III. Type of Permit: (Check only one bog on line A. C l ine B if applicable) A ' D New System R lamment System D Treatment/Holding Tank Replacement Only D Other Modification to Existing Y ep Y g eP Y g (explain) B. D Permit Renewal ❑p Revision 11 Change of Plumber ❑Permit Transfer to New q List Previous Permit Number and Date Issued Before Expiration Owner ;? W & /9 — 1 G 6 IV. Type of POWTS S stem/Com nent/Device: Check all that apply) ^ ❑ Non- Pressurized In- Ground ❑Pressurized In- Ground ❑�MOUqd �24m. �uiitmable soil El Mound < 24 in. of suitable soil D Holding Tank D Other Dispersal Component V. Dispersal/Treatment Area Informatio • 60 Infiltrator "Q-4 W ' chambers @ 20.0 s .ft EISA / chamber + 3 pair end caps @ 5.8 EISA = 1,217.40 s . ft. Design Flow (gpd) Design Soil Application R pers gp s 1s 600 gpd 0.5 in -situ soil 1,2Q0.00 sq. ft. 1,217.40 sq. ft. 92.00' VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units '.3 � 5 New Tanks Existing Tanks U O c� cg yr v� w c7 a Septic or Holding Tank 1 200 1,200 1 Weeks Concrete X Dosing Chamber VII. Responsibility Statement I, the a ersigaed, assu4te responsibility for inst of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number James K. Thompson S-_ 30021 715 248 -7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 -5413 VIII oun /De artment Use Onl Permit Fee Date Issued Issuing Agent gnat �v n Vo Approved D Disapproved $ ,{ D (honer Given Reason for Denial / � IX "$ t "roval/Reasons for Disapproval - 1 Septic tank, effluent filter and � �, dispersal cell must all be serviced / maintained as per management plan provided by plumber. rl_i 2. All setback requirements must be maintained dS pur applicable L; itless for the system and submit to County only mi paper not 6&%0 1/2 ll ' in sn SBD -6398 (R. 01/07) Valid thru 01/09 v r �,Zo s� S 1044, l x7 /,'e Ta Ku 6 o4c e- / r Sz 7 T L•a 4.0 f 17, fry cvwd, swy� T/o SZ5- E,t, 3&T 0 r oe. /, �p / a3z- 70 -cdo Concr'o�e (/ Pik' ;„� S�rkbs Banc a r D At 7S done-r-c-6C y 6 tdroo.+•, IQ[S, d �NCG �csra�L v W Pc y c Qmcrc�c _ _ EXi3u'n /2 X TZ'di�OtrSte/Ce/% A�lyA , e�•sas SysE�xko = !?2.50 /t.d. of : 7 o7? e y co"Cxc& 6 A r 96. h// 8 � ' - Jcs � _vs o Valve �G`,{ s.T.rr1.3o3S� �,� • , • 82 � 'Jl PI - o POWd C/, p.rsso Cc /� 7 - h r« (g) s ti �a ,,o,4a 7oe ' M Soi /Qda/ccauon�� � E,Yi� u 8ra.de a /ev. v S 644,1 4,7& - 4 /, c Ta, cA 4 oul c zar Sz7 7r; / / :u La ne, •tof /7, P/4 t of Cac, n tr cvwd, slj` l fe - Sic. 3, 7.'28K� � !4w•, T , o,� 7`/"oy, 66. Croy Co., E1�•Sf./ny Feu O / oe. /. 0 0 yo - 123X 70 -000 cene.ro ParKrn� S�.r,.�,bs dancA Wane.. 6 6660", ac s w, Erisfn y 6 �droo.r, IQLS� �araJc , J /-- k3ee.E�s G.nc.�ctc . II .Sye6c banes• 97O Wtc y co " I 5 • _ - 1 5 :s /2x 72 d rs ',4oea/Wl [sass SysEU,4w. - / .b. jo ro �G!'(�C 3,alt,,J�lf: o _. _9lo.o'Contok� Pro,rosed cl'varsror, 5� ",/, s.'f..rl. 3035/ �O • . ' . -- 82 ,j s Pro Posrd d, - ,5 P" - sO 7h sec (3) ErcnCA.c 6 v S �a ST, CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the residence located at: 'S Q ' /4, J '/4, Section 3 _ , Town -8 N, Range _ W, Town of �av St. Croix County Wisconsin. Upon inspecti6n, I certify that I have found the tank (s), to the best of m knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service Did flow back occur from absorption system? Yes t/ No (if no, skip next line.) Approximate volume or length of time: allons minutes Capacity: 4Q Construction: Pre ab Concrete L Steel Other Manufacturer (if known): Acy ank (if known): icensed Plumber Signature) (Print Name) (Tale) (License Number) MP /MPRS 4.9t- (Da Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer R 1 13 Wisconsin Admini strative � Code) 2099 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size County St. Croix include, but not limited to: vertical and horizontal reference point (BM), i �&A parcel I.D. percent slope, scale or dimemsions, north arrow, and location and d' tance to t ro 040- 1232 -70 -000 Please print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy taw, s. 15. Property Owner Property Lo ion Dean & Julie Jakubowicz Govt. Lot SW 1/4 SE 1/4 S 3 T 28 N R 19 W Property Owner's Mailing Addre s Lot # Block # Subd. Name or CSM# 527 Trillium Lane 17 Country Wood City )tate Nl@dhd P540Wmber J City _J Village e Town Nearest Road Hudson 1 1 54016 (715) 381 - 5 4 Troy Trillium Lane J New Construction Use: Residential / Number of beellooms 4 Code derived design flow rate 600 GPD 10 Replacement J Public or commercial - Describe: Parent material Glacial Outwash Flood plain elevation, if applicable na General comments and recommendations: Site suitable for conventional dispersal cell at 0.5 gpd loading rate. Recommended installing 60 0-4 chambers in 3 trenches at elevation 92.00'. Boring # I Boring 0 Pit Ground Surface elev. 96.35 ft. Depth to limiting factor >96" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - 11 10yr3/3 none sil 2fsbk mvfr cs 2f,1vf 0.6 0.8 2 11 -25 10yr5/4 none sil 2fsbk mfr cw 2vf,1f, 0.6 0.8 3 25 -30 7.5yr4/6 none grsl 1msbk mfr cw 1vf 0.4 0.7 4 3 10yr4/4 none gr Is 0 sg ml cw - 0.7 1.6 5 35 -96 1 o e Ifs /Is /s 0 sg na - - 0.5 1.0 H #5 consists of an u sorted mix of 10yr4/6 Ifs r4/4 Is, & 10yr 4/6 s containing ap rox 30% gr & cobble. Loading rate of horizon reduced to reflect p rmiability restriction associated with textural changes. a Boring # I Boring 0 Pit Ground Surface elev. 94.50 ft. Depth to limiting factor >90 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 1 0 -9 10yr3/3 none sil 2fsbk mvfr cs 2f,1vf 0.6 0.8 2 9 -16 10yr5/4 none sil 2fsbk mfr cw 2vf,1f, 0.6 0.8 3 16 -20 7.5yr4/6 none gr sl 2msbk mfr cw 1vf .06 1.0 4 20 -27 10yr4/4 none gr Is 0 sg ml cw - 0.7 1.6 5 27- 10yr4/4 none Ifs/Is /s 0 sg na - - 0.5 1.0 H #5 consists of an unsorted mix of 1 s, r4/4 Is, & 10yr 4/6 s containing approx 30% gr & cobble. Loading rate of horizon reduced to reflect per 'ability restriction associated with textural changes. Effluent #1 = BOD 30 < 220 g /L and TSS 4 < 15 /L Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Sig ture: CST Number James K. Thompson Ste— 3602 Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, sceola, WI 54020 10/26/2007 715 - 248 -7767 Property Owner Dean & Julie Jakubowicz Parcel ID # 040- 1232 -70 -000 Page 2 of 3 a Boring # J Boring Pit Ground Surface elev. 96.28 ft. Depth to limiting factor >99" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - 13 10yr3/3 none sil 2fsbk mvfr cs 2f,1vf 0.6 0.8 2 13 -29 10yr5/4 none sil 2fsbk mfr cw 2vf,1f, 0.6 0.8 3 29 -34 7.5yr4/6 none grsl lmsbk mfr cw 1vf 0.4 0.7 4 34 -39 10yr4/4 none gr Is 0 sg ml cw - 0.7 1.6 5 39-99 10yr4/4 none IfsAs /s 0 sg na - - 0.5 1.0 H #5 consists of an unsorted mix of 10yr4 /6 Ifs, 10yr4 /4 Is, & 10yr 4/6 s containing approx 30% gr & bble. Loading rate of horizon reduced to refle permiability restriction associated with textural changes. F-1 Boring # I Boring ._f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # -� Boring _f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 m /L and TSS >30 < 150 m /L #2 = B D < m /L n TSS 30 m /L s _ g _ g "Effluent O _30 g and < _ 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) A.C.E. Soil & Site Evaluatlons M Soi / Qt/4.�GtGt'u'On�� E,Yist+n� 8ro-d eta AW s ARantT l,•e Tnku6owC.��ei Sz 7 7�','//; u n, ,La c, Lo i 17. 1 0/c of Ca �� Wed 6jj* ,f6* Stc. 3, r'Z6K � /�w•, T . of z60fo- 123X Bmnc a 6 ot`�on ay�'Srol,.�q. V 6 e�oo.►, Q tS�dc Mu �araVL v DtcK u3ee.l's ee.,c.���t - " EXi:SWing /2 x 71' d,s Ce/% v 910. Con+Eocti Elegy r 98.z�' ' - 64- -- - -- - - - - 6z v h �b I Sou `� !ot /fnti/�tnc� / %ne. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ 1Pa., -� $` �P _i(fu to d:24�1 Z - - Mailing Address l r /l aal Property Address ;�A� (Veri cation required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number © $ / A3� 7d LEGAL (DESCRIPTION Property Location 540 t/ , .S 1/ , Sec. 3 , T N R,� _W, Town of 7i�O V Subdivision C ��v _6f� - 3 ;t Certified Survey Map # Volume Warranty Deed # �/ �P yU , Volume /�� l age # A3 7 Spec house ypno Lot lines identifiable es SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 wastewater disposal 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. Uwe, 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 Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. N Der of bedroo `7 / (� 1,4 /� /�-!�z NA O APPLIC (S) DATE ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08!05) Conventional Septic System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD- 10705 -P (N.01 /01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Ton Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleansed as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes 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 individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October - February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Effluent flow shall be alternated between dispersal cells on a two -year schedule by use of a diversion valve. Valve to be switched diverting effluent from dispersal cell currently in use to resting cell on a two -year cycle coinciding with septic tank inspection and maintenance. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber or the County Zoning Department. ] nocvms~`*p � ^,^r�e^*opvv/^`ow*u'o*M'-/mm -'`°^`'~'°"`'»'"~°E`"""°`"~'^ i' vv�n*�mr�osso -'---^_ | - --- 5:'1- f'����� } ^ .. This Deed.~' -Rig-bard -1� -_ Jakubowicz and Julie husband --------'------------' - ---- --� « U Witnemweth That .^= said Grantor. .~"""m°oe"°"=^°,at.= `o"..' St°.,°~~`.~... '| | � Lot 17 Plat of Country wood Town of Troy, ro | St. Croix County, Wisconsin. i f TRANSFER � � � U � � | r^ nrop=*, To with ail and sin the ^ereo'mm°"'" and appurtenances '^=°""/ � \ wa rran t s that the title /s good, indefeasible m lea ^.m»`oa"^ free and clear u,e"pu""o,a":,oexcept ) easements, restriLctiouo and rights-of-way of record, if any. � and will warrant and defend the same. Dated this -___-___�,". July �� c 11 ss��` ___-_-__--_--_-_-_-_____'_-_'"scAL) ' -------- --------- if ms^u � ^^`Hs*r,cx`mw ^cnmoWLsoo,mew` vr^`supWISCONSIN _St. _Croix _men ,, �= � .1uthen""°'edw.°- ^^,"' p~=".""" came- before m°m.s_-3.rd_ - -n,,"' 190-6----the above named R _ TITLE M STATE BA- OF W- SII " '01 -------- - — - -' -- ' " k4wn to be th- � | ." ' s�.° , ' "="^ U ~"'"= ""° ^"`�r°' /~ ' / �mmmt�.��nm� -- ' VV ��4W1� oo6n///.�/ ~ � , ��. ".�~ ; �-�~-'---.._ .---' ._- - "^°^~.~"^c" ����c'°'�"9°~~ su�o ,,f�v�"nn^im . ` . � SHEET - LINE i rL S O 4 ° 39'23 "w . \ 419 ;3' / '�F o F w A` 7 =� LL M N W _ M z 9 �- s 1 � N I � � N 0 M L� r U) n w C� LL, LL Lr 6 v U) GO Q N - J I M N M ti M d M co M d M 0 O1 M 0 (4 O 3 m n tz O a) ° I z at I M d m ^ C ° N ° w N a O a V R O coo M O = (D IV O U1 O o �l O N CD O !••' 3 7 41 ill O C Z N N D m o- v m co D (n C, 3 N W _. I 0 co 00 CD co co N CD N rn rn 2 y rr c N a CL Z o m 0 07 "-A n o o_ cn y y ° N v 3 m a g a Z3 0 CD 0 m d N ° 17 N 3 m a z r Z z ril o ZCDo I v O D a° Z I s Fr CD ( CD CD N 70 W CD D N aQ (D IV CD I w m °- z CD 0 t° Azm ° Cl) o n 3 v A z 3 I a � 0 U) -1 Cl) m N 00 Q z 3 a °p . c O m I y Z CD N a °° a Il, c° o" - v c !I m z a - o 0 I � N I x C` m ° a 2 ti I v � N o 0 o ° CD w o w ° o :- I Wiscorisin ,gepartmentofIndustry PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) SanitaryZ68619 GENERAL INFORMATION Permit Holder's Name: 1 1+ R O Y city [] Village Town of: State Plan ID No.: JAKUBOWICZ DEAN CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 6 %o , off '�-- TANK INFORMATION ELEVATION DATA A9600319 �' 6 TYPE MANUFACTURER CAPACITY STATION tB HI FS ELEV. Septic (�� S �; Benchmark Dosi n Aeration Bldg. Sewer Holding' St /Ht Inlet / 5,7 � TANK SETBACK INFORMATION St/ Ht Outlet ( v�� T TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet ir Septic /G� 2 NA Dt Bottom Dosing NA Header 7, /a Aeration Dist. Pipe y am' Holding' Bot. System PUMP/ SIPHON INFORMATION Final Grade S,ob Manufacturer Demand Mode, umber GPM TDH I Lift I Lricti S��TDH Ft Forcemain gth I Dia. Dist. To Well SOIL SORPTION SYSTEM (D 3 BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Depth DIMENSION DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHIN anufacturer: SETBACK CHA ER INFORMATION TypeO — Y) l , y Model Number: System: IJ; NIT DISTRIBUTION SYSTEM Header /Me Distribution Pipe(s)� , x Hole Size x Hole Spacin Vent To Air Intake Length Dia. Length 1�?R Dia. Spacing C // SOIL COVER x Pressure Systems Only xx Mound Or - rade Systems On y Depth Over Depth Over xx Depth xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Tops oi ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, )etc.) LOCATION: TROY. 3.28.19W, SW SE, TOWER ROAD ' `'„ - 01rr _�Pj 0 X V ".t.� -" P Z �7 v Plan revision required? ElHes Use other side for additional information. S (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: d � po , e � q � , � 3 J < e Safety and Buildings Division. r.••`■�Ir• SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County n_ I i than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check if Isoii to previo�s abplication (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Ow r Name Property Location l �I /4 — v4, 5 T , N, R E Property wner's Mailin Address f Lot Number Block Number 0 ee C ,State Zip Code P e umber Subdivision Name or CSM Nu ber /t p `J oZ c n �j7 ®® II. TYPE OF IL E] : (check one) State Owned [] i Nearest Road El E] Public 1 or 2 Family Dwelling - No. of bedrooms v o w a n OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Numbers) or 1 F1 Apartment/ Condo 4 1 4 eI� 7 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 box on line A. Check box on line B, if applicable) A) 1 g rNew 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ______System -------- ------------- _____________Tank Only______________ Existing System ------- --------- -- ----- ------ B) B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 1 10 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. Pert. Rate 6. System Elev. 7- Final Grade Required (sq. ft.) Proposed (s q. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 41 4� 7:�A, .2 Feet Feet Ca acit VII. TANK in gallo S Total # Of Prefab. Site Fiber- Plastic Exper INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existin strutted Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. _ Plumber's Name: (Print) Plumb ignature: (No Stamps) MP /MPRSW No.: Business Phone Number: Plum er's Address (Street, City State, Zip Coder f� IX. COUNTY / DEPARTMENT USE O NLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Datjss Issui n Agent Signature (No Stamps) A roved Surcharge Fee) 11X pp ❑ Owner Given Initial � p� - Adverse Determin p X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings N-Ion, Owner, Plumber INSTRUCTIONS r 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 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 and Buildings Division, 608 - 266 -3815_ To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one 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 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 8 112 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 contamination investigations and establishment of standards. ti STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS u SUBDIVISION / CSMI G � � / > LOT SECTION Town of f- ST. CROIX COUNTY, WISCONSIN a� 5 PLAN VIEW SHOW EVERYTHING WITHIN 100 EET OF SYSTEM a �10 3 �� INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to cent- -r r BENCHMARK: p ALTERNATE BM: TIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: - - - - Liquid Capacity: d 7� q Setback from: Well 4 1 / House � Other Z Pump: Manufacturer Model$ Size Float seperation Gallons /cycle Alarm Location - :SOIL ABSORPTION SYSTEM Width: � Len th � g Number of trenches Distance & Direction to nearest ro - 6 P p• line- J Setback from: well: t H ouse � Other ELEVATIONS Building Sewer ST Inlet: o ST outlet G PC inlet PC bottom Pump off Header /Manifold b Bottom of system �- 0 2 Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 77 BENCHMARK- p e2- ALTERNATE BM- TIC TANK / 'PUMP CILAM13ER / HOLDING TANK INFORMATION Manufacturer: / Liquid Capacity: Setback from: Well House �tf Other �a Pump: Manufacturer Modell Size Float seperation Gallons /cycle Alarm Location :SOIL ABSORPTION SYSTEM Width- Length /1" / Number of trenches Distance & Direction to nearest prop. line: Setback from: well -�S� /I t -__ .House - " '; 7 Other ELEVATIONS Building Sewer ' ST Inlet: ST outlet PC inlet PC bottom Pump Off Header /Manifold b Bottom of system Existing Grade Final grade t DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of Division of safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Atiach 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), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location &�'Con 1-9 P Govt. Lot � � 1/41 1/4,S T N,R f E Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# lel d_d City / State Zip Code Phone Ndrnber ,/ ❑ City ❑ village J4 Town Nearest Road - New Construction Use: CaResidential /Number of bedrooms 4 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 5'7 bed, ft2 ftt�2ij Maximum design loading rate =Z bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) .7.• It (as referred to site plan benchmark) Additional design /site considerations Parent material `�`L �� t�/u Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S El j, S U J Z S El JZ S ❑ U ❑ S [` U ❑ S JO U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench l.� / ~ - Ground _ l ° e " v. .- V 7— Depth to limiting ; factor �r in. 3 -� Remarks: Boring # e Or Ground elev. De to limiting factor 7 ;'�in. Remarks: CST Name (Pleas. Print) Sig re Telephone No. Address Date CST Number 3 Dominant Color Mottles Structure Dominant Color Mottles Strwtum �3 - � � MIS /�i� r1-V1 r LNIV PROJECT ' Pic/'! ,,Ja �6arv< <,4 ADDRESSIF o , f�J 1/4 1/4/S /T N/R / W TOWN i V CO NTY h _ Grai MPRS Byron .Bird Jr. 3318 DATE BEDROOM CLASS PERC CONVENTIONAI,�f IN -GRO PRESSURE CONVENTI NAL LIFTS MOUND_ HOLDING TANK SEPTIC TANK SIZE �„�� LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE 7 _ BED SIZE Benchmark V.R.P. Assume El Lion 100' Location of Benchmark w * H.R.P. 4 M Borehole Q Well Scale = Feet 0 Perc Hole System Elevation _ ��/• � Uent 12" TYPAR COVERING -- - r 12" 3' 4 6' O 3' 3' O 3' r I M Sewer Rock 6 it 12' 18' 15 4A an Soil Test Plot PI Project Name ... Z— Byro ird Jr. Address 0 5' X7/ R ✓� Br.i r} s• i'� % C 3479 Lot 4LSOclivislon, Date r 1/4 1/4 S, I TXN /R W Township 0 Boring O Well PL Property Line Cou �7l L BM 'or VRP Assume Elevation 100 ft. System Elevation *HRP o'- J4 1 Pu b. e 3 0� y `ms ---- S6619: 1/4 .10 Ft.' When dimensions aren't stated f STC -105 SEPTIC TANK MAINTENANCE AGREEMENT S ro County OWNER/BUYER W L MAILING ADDRESS i% PROPERTY ADDRESS S oz ' 1 (location of septic system) Please obtain from the Planning Dept. CITY /STATE (,( SD S PROPERTY LOCATION 1/4, !� 1/4, Section �3 T . J(' N -RW TOWN OF /�"�� ST. CROIX COUNTY, WI SUBDIVISION G�G� �_rl �o c LOT NUMBER CERTIFIEDSURVEY MAP VOLUME , PAGE , 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 pnd returned to the St. Croix County Zoning Officer within 30 days of the three 4yeaxpirationi dat . SIGNED: DATE: o , ( ✓ St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 sTC - to ' This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate" deed recording. --------------------------------//----------------------------------- Owner of property Location of property :! tZ 1/4 1/4, section _ , T "N -R Township eoy Mailing address f670 S' 4 d n � /� ✓' � c�G �v 7 O�6 Address of siteu Subdivision name Lot no. Other homes on property? _Yes No Previous owner of property , ;44 e., Sf cg 7� Total size of property ee- �5 Total size of parcel v /4,�S Date parcel was created Are all corners and lot lines identifiable? _Yes No Is this property being developed for (spec house) ? Yes No Volume and Page Number C 2, Z7 as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owners) 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. �� /�`�L� 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. ,1 gnatu f Ap cant Co- Applicant 44� Date f Signature / Date of Signature I i W,6RRANTY DEED VOL 1 189 PPI 237 ST. C� Z This Deed Richard Q. Stout JUL 10 I99/6 at 11:30 A.' __Qen R. ,Iakubawicz, an_d_. ,Iul ie S Jakubowicz, husband and wife_ Witnesseth, - -- - -- St. Croix Lot 17, Plat of Country Wood, Town of Troy, J R • St. Croix County, Wisconsin. R J TRANSFER a l i i not_ ,,- ,,,,,,�•: a� �. ,. . r ,r,�. •n ai, are � r ; , A - 1 Richard O. Stout - Nclr li n!S {h 3: 'ho 11f �C•s�1i3Od ,n(:Cte d��.(2 ^ ..° 5• easements, restrictions, and rights -of -way of record, if any. ,anrf n,iF,ry +'rant an7,le IheSdrne 96 ' July 3rd _ — Dar• rhos_ __ _ _ SEAL _R-ichard O. Stout ' ;SEALS j AUTHENTICATION ACKNOWLEDGMENT .'.ISCUNS!N � I { SiQnatwo l51 .-- -- . _ - St_ Croix AAGG 3rd 'a =t I eu!hent�caie�.]fh -s clay 0. - � ._. _. __ - -- _ _..D Lit y 4` Richard Q. Stout _ TITLE: MEMBER STATE BAR OF WISCONSIN ! If refit _ _- _. .. r - �'i� c, - �i z ytl P. Stout -- - Count' at##'TI` - - � udso�353 A UR CA 016 - - -- C` L. � .� ><.:, , Hn. 1 54 �r i7 Unr!`i 1t. I•,� �d P �. pi liiOn S qn ir r c - , Ge •i rih h,a!eA ^.r Y a k e iyed Bnth r , T J ]a / ._ .. � � t i drP nr ! r o ssary 58 tC - -- NO ry `+TF � L �1 WAHRANTYrJEEO STATE BAR OFW _ grate iTf �Vx�vnsitt FORM Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT 9 1 a 1 of 3 Labor and Human Relations Division of Safety ri< Buildings in accord with ILHR 83.05, Wis. Adm. Code >> 7 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but R � not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or L I.*U. Ono 1995 dimensioned, north arrow, and location and distance to nearest road. M E �i APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION WED BYST CPQX p COWITY PROPERTY OWNER: PROPERTY LOCATION s Richard Stout GOVT. LOT W 1/4 SE 1/4,S or) W ; '"" PROPERTY OWNERS MAILING ADDRESS t�4; LOT # BL CK # SUBD. NAME OR CS 1353 Awatukee Trl. .So& a Country Wood CITY, STATE ZIP CODE PHONE NUMBER VILLAGE (MOWN NEAREST ROAD Hudson, WI. 54016 (715 549 -6731 Troy Tower Rd. J New Construction Use [ Residential / Number of bedrooms 3 [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ft .8 trench, gpd/ft Absorption area required 643 bed, ft2 563 trench, ft Maximum design loading rate - 7 bed, gpd/ft - trench, gpd/ft Recommended infiltration surface elevation(s) 96.31 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material stream terrace Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S O U ®S O U ® S 0 U 9 O U CIS ®U I 0S q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 1 0 -15 10yr2 /2 none 1 2msbk mfr 9W 2f .5 .6 2 15 -37 10yr4 /4 none sicl lfsbk mfr if .2 .3 Ground 3 37 -57 7.5yr4/4 none is osg mvfr 9W na . 7 .8 elev. 100 ft. 4 57 -84 7.5yr4/6 none s osg ml na na .7.8 Depth to limiting factor +84" Remarks: Boring # 1 0 -13 10yr2 /2 none 1 2msbk mfr qw 2f . 5 .6 .w 2 . 2 13 -28 10yr4 /4 none sicl lfsbk mfr if .2 : : : .3 3 28 -50 7.5yr4/4 none is osq mvfr 9W na 1 .7'•..8 Ground 99. ev- ft. 4 50 -84 7.5 r4/6 none s osg ml na na Depth to limiting factor +84" Remarks: CST Name _ Please Print Gary L. Steel Phone. 715 - 246 -6200 Address: 1554 200th Ave. New Richmond Wi. 54 10 -26 -95 cstMO2298 Signature: Date: CST Number: PROPERTYQWNER Richard Stout SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL t.0. I pendinct 'Depth Dominant Color Mottles GPDift Structure Boring # Hnnz" ' I I Texture Consistence Bo ndary I Roots Bed !Trench in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. 3 :i' 1 0 =13 10yr2 /2 none 1 2msbk mfr gw 2f .5;.6 'k<.» 2 13 -30 10yr4/4 none sicl lfsbk mfr gw if .21 .3 Ground L3 30 -55 7.5yr4/4 none is osa mvfr gy na .7!.8 elev. 99 ft. 4 55 -84 7.5 r4/6 none s osq ml na na .7;.8 Depth to limiting factor +84" Remarks: Boring # ffl —W' 1 0 -14 10 r2/2 none 1 2msbk mfr Cfw 2f .5 .6 4 2 14 -29 10yr4 /4 none sicl lfsbk mfr 3 29 -42 7.5yr4/4 none is I osg mvfr gw na .7.8 Ground 9'9"l 4 42 -82 7.5yr4/6 none s os ml na na .7.8 Depth to limiting factor +82" Remarks: Boring # 1 0 -10 10yr2 /2 none 1 2msbk mfr gw if .5 .6 ;5 >< 2 10 -28 10yr4 /4 none sicl lfsbk mfr gw if .2 .3 .;.;; 3 28 -40 7.5yr3/4 none sl lmsbk mfr gw na .4 .5 Ground l 4 40-88 10yr5 /4 none c s Osg ml na na .7 .8 99.en ft. Depth to limiting factor + 88" Remarks: Boring # :64 wny : {• } iiii: Ground elev. j ft. Depth to limiting factor i Remarks: SBD- 8330(8.05/92) " STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 SW4SE4 S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 lot #56- Country Wood N 1 =40' ,&M.= top of 1" steel pipe @ el. 100' Alt. BM.= top of steel fence post @ el. 103.4' 2 to0 Zo ( moo` Gary L. Steel 10 -26 -95