HomeMy WebLinkAbout040-1233-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y:
Safety and Buildings Division Count
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)1. 363882
Permit Holder's Name: ❑ City ❑ Village ❑ jJown of: State Plan ID No.:
encl Mark & Peau I Troy Township S fp = 313 10 I
CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.:
' I (�J _6 AA 4&-2 040- 1233 -80 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic p 12 Benchmark D. �.o (10. fSD • o
Dosing I avo Alt. BM
Aeration Bldg. Sewer
Holding St /Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet S!( / Sy
o
TANK TO P/ L WELL BLDG. Aier intake ROAD Dt Inlet P. C l Z 1 7 1 7 , Z$
Septic L3 NA Dt &Ottoll 1 .loo . '(
Dosing NA Header / Man. O o
Aeration NA Dist. Pipe 5 .02_ /.05-.3-0
Holding Bot. System 5'
KAKZ
PUMP / PHON INFORMATION Final Grade
Manufacturer Demand St cover , Z O /6 9.S-0
�o
(0� Model Number p GPM
TDH Liftj,(oo Friction /,90 Syestema S TDH (I,q t oss
V Forcemain Length CS' Dia. HH u Dist. To Well -
SOIL ABSORPTION SYSTEM
E O Width r Len 1 No. O )e hes PIT Of Pits Inside Dia. Liquid Depth
EN IN iO J DIMENSIONS 9 p
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufac
SETBACK CHAMB
INFORMATION Type O (� Model N er:
System: N1� ?� /eo O IT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) v z x Hole Size x Hole Spacing Vent To Air Intake
N S pacing /V 4 k
Length 4•0 Dia. � Length Dia. p g
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/ Tr nch Edges Topsoil s No Yes
e g ops ❑ ❑ ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) nsnection 1: 1�16C f tst>Inspection #2:
Location: 677 Tower Road, Hudson, WI 54016 (NW 1/4 SE 114 3 T28N R19W) - 03.28.19.1164 Countrywood Addn. I -Lot
28
1.) Alt BM Description = -
2.) Bldg sewer length= 3
- amount of cover = '> 1 0 c> Sr► o " `` '
3.) contour= (D�.o (
'4) , F„` ! wk a�-- „,,s,., S- (), ►� � tk” o,,er ,� � 6-a � Q� 1L1a.�setc .
Plan revision required? ❑ Yes DeNo
Use other side for additional information. 6 2S 0p Z �o
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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6 Safety and Buildings Division
Visconsin SANITARY PERMIT AP, {� Am 2 01 W. Washington Avenue
Department of Commerce �� In accord with ILHR 83.05 W is,Adr Code '. - \ P O Box 7302
a
/ Madison, WI 53707 -7302
l A I � L
• Attach complete plans (to the county copy only) for the system, on p Cev�,tgi
than 8 112 x 11 inches in size.,
0
• See reverse side for instructions for completing this applic4 > State`S$nitary Permit Number
4-
36
Personal information you provide may be used for secondary purposes ,
1yry x heck if revision to previous a
[Privacy Law, s. 15.04 (1) (m)]. ��Q ''
�, -S 7—AUR Plan I.D. Number "C
I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATIO6 3
Pr perty Owner Name C,G I Lip- t.
AARK- a /UCH. ((`"' Q 61w6 {f ( S ' s T Z N, R 12 E (or
Propert O ner's Mailing Address Lot Number Block Number
�
I RA ff "Cl CA J9 _�
City tate O� ( Zip Code / 6 ( hone Number Subdivision Name or C�Number 5W fo U +oP— W ei
I. TYPE OF BUILDING: (check one) ❑ State Owned ❑ C it Nearest Road
❑ village
Public f& 1 or 2 Family Dwelling - No. of bedrooms wn OF O
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) ;� , Z fs . 1q. I I b "(
� 1_
1 C] Apartment/ Condo o " L 7--3 — emo
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 Q Office/Factory 13 Q Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. 66 New 2 ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an
- ______ystem ________ System_ _ ___________Tank Only______________ Existing System ________ Existing ----
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
C1, p s
Non- Pressurized Distribution Pressurized Distribution Experimental Other
11 El Seepage Bed 21= Pollound ❑Specify Type 410 Holding Tank
12 ❑ Seepage Trench 22 Q In- Ground Pressure /x 3 / � n 42 Q Pit Privy
13 ❑ Seepage Pit 6�e! 43 ❑ Vault Privy
14 ❑ System -In -Fill Q�, p �hl�
VI. ABSORP SYSTEM INFORMATION:
1. Gallo
ns Per Day 2. Absor .Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Requires . ft.) Proposed (sq. ft.) (Gals/da /sq. ft_) (Min. /inch) Elevation
7 If q ~ Feet Q eet
Capacit VII. TANK in allons Total # of Prefab. Site Fiber- Exper-
INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete st Con ed steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank t�-�. ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon ChaM I t IL ® 1 ❑ 1 Cl ❑ 1 ❑ ❑
VI11. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plum is Name: (Print) Plumb s Signature: amps) r P1NWR59PNo.: Business Phone Number:
o Z Z Z
Plum er's Addr ss (Street, City. State, Zip Code):
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved 4�� itary Permit Fee (includes Groundwater ate Issued I s t a (N Stamps)
Approved ❑Owner Given initial Surcharge Fee)
CM
Adverse Determination a s
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
a � 'Se-� Q.e ?t-- cep.
SBD- 6398 (R.1 DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
1 All revisions to this permit must be approved by the permit issuing authority.
4. Changesin ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county priorto installation
5. Onsite sewage systems must be properly m
necessary, usually every 2 to 3 years. ntained. The septic tank(s) must be pumped by a licensed pumper whenever
`-
-• j
6. If ou have questions concerning our onsite sewage system, contact our local code administrator or the State of
Y q 9Y 9 Y Y
Wisconsin, Safety and Buildings Division, 608- 266 -3151.
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 81/2 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.
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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.
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Safety and Buildings
10541N RANCH ROAD
` HAYWARD WI 54843
TDD #: (608) 264 -8777
isconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
May 12, 2000
CUST ID No.691727 ATTN: POWTS INSPECTOR
ARTHUR L. WEGERER ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/12/2002 Transaction ID N Id N( ati bers
.313101
Site ID No 19128
SITE: Please refer to both identification numbers,
Site ID: 191286, MARK & PEGGY FENCL above, in all correspondence with the agency.
ST CROIX County, Town of TROY; TOWER RD
NW1 /4, SETA, S3, T28N, R19W
FOR: MOUND, 600 GPD o �,f';j
Object Type: POWT System Regulated Object ID No.: 661137 p•
co
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in PARjM�a�T 0
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. OE ty of seal
V j
The following conditions shall be met during construction or installation and prior to occupancy or use: �.
1. This plan action is subject to designer comments on the plan. SEE Gt�stRE
2. The orientation of the mound system must be such that the mound's longest dimension is perpendi ar
to the direction of maximum slope.
3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound.
4. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a).
➢ NOTE: A soil absorption system should be designed as long and narrow as possible. This system has a high
linear loading rate of 9.5 gallons per foot.
CAUTION: Wis.stats 145.135(2)(b) indicates that the approval of a sanitary permit is based on
regulations in force on the date of approval.
The effective date of COMM 83 revisions is expected to be July 1, 2000.
Thus depending on the type of system and your design, this plan approval may not be
eligible for sanitary permit approval if submitted to the issuing agency on or after July 1,
2000.
Note: There is a otp ential for a law suit that may delay the effective date of the code so this status
may or may not change.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation /operation.
r
ARTHUR L. WEGERER Page 2 5/12/00
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Since r,�ly, DATE RECEIVED 04/25/2000
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
PATRICIA L SHANDORF , POWTS PLAN REVIEWER BALANCE DUE S 0.00
Integrated Services
(715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM
PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633
cc: MARQUETTE HOMES
Page of 6
MOUND SYSTEM
FOR
A BEDROOM RESIDENCE
LOCATED IN THE Nw 1/4 OF THE S I E 1/4 OF SECTION 3 ,T N, R W,
TOWN OF Sr <°.U\.X COUNTY, WISCONSIN.
LZ7 - OF _ clOv w- nzs f
INDEX
PAGE 1 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW -CROSS SECTION
- PA GE 4 of 6 DISTRIBUTION PIPE LAYOUT
.PAGE 5 of 6 PUMPING CHAMBER
PA GE 6 of 6 PUMP PERFORMANCE CURVE 11 ally
N IE E
GOMM
PREPARED FOR r pNO But ire
y t 1-c Cz �—rt tnr LPL j ;2� C) I
PREPARED BY
WE C EI�<ER SO I L . TEST S NG
AND .
DES I CGN SIE =R'V I CE
P.U. BOX 74 421 N. WAIN ST. 5 /�
RIVES FALLS. VI 54022 j r °• 'ti {
715- 4ri-0165 ,g j ,RTFHJP L
"GERER
S=4 • FyL ' SWORTH,
WS J
. �SiGI3�
��hNf�NNfM
l(..I.I..00.
JOB NO.
• PLOT PLAN Page Z of l'7
°Scale 1 "= So '
Ftur-
Uutzyz
I r
/
g �i -LOi
i
Sp OF {
Z' PVC F•1'`I
I
I i
1
� Cl0 OF 4' RUC
l Iv Sul.p�-� �j2 1'1?.l1ST PR�� j
10'o�4tiPuc� LOT Z�C'i
Wes- To aQ- A LMST So' P:1143 "O U KID
NOTES
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( required)I
3. Install 4" observation pipes with approved caps. ( required)
4. Septic tank to be VL5o gallon capacity manufactured by
W �� �1Z. C.Ut`/ �tZ -�°iE P tzo�UG"� - �u M P �J1z �0 8 � \oo o G Y1�- • W t �s�R -1'n�k Cw� � wood
5. Bench Mark 31�►_ �, 00.0 ` SOP of LLl Pt PE
'� \ VaH - tL W S' CovoJtSL PasT_
6. Divert surface water around mound to prevent ponding at the uphill side.
Page - �Of `o
Approved Synthetic Covering
FIs C 33 Distribution Pipe
Medium Sand
_ H G
Topsoil
F Elev. lu S.O
3 E D
b
`] % Slope
Bed Of 2�— 2 Force Main Plowed
Aggregate From Pump Layer
G \ -0 Ft.
Cross Section Of A Mound System Using E t- S6 17t.
A Bed For The Absorption Area F O_g Ft.
G \•\) Ft.
A Ft. H 1-5 Ft.
Linear Loading Rate =q -S GPD /LN FT B 63 Ft.
Design Loading Rate= o.q .GPD /SQ FT I \- b Ft.
J 7 Ft.
K \. Ft.
lf--, L 5 Ft.
-ForceW 3 Ft.
L
Observation Pipe
B K
-- --
A -
o - - -- ----- - -- - -- ------------------ - - --•I Force Main
Distribution Bed Of % p — 2
2
Pipe Aggregate
Observation Pipe Permanent Markers
(Anchor securely)
Rlan View Of Mound Using A Bed For The Absorption Area
• Page L ) Of b
Perforated Pipe Detail
0
End View
Perforoted
End Cap � t" PVC Pipe
f . Jo
aS Install permanent marker
at end of each lateral
Holes Located On Bottom,
Are Equally Spaced
S
Q
PVC
Manifold Pipe
PVC Force Main
Distri ution
Pipe
Last Hole Should Be
Next To End Cop
End Cop
P L8. S Ft.
Distribution Pipe Layout
S 4 Ft.
X 36 Inches
Y 16 Inches
Hole Diameter Inch
Lateral lIII/ Inches)
Manifold Z Inches
Force Main " Z Inches
# of. holes /pipe l p
Invert Elevation of Laterals S Ft.
SOX
Place 1st hole L$ from center of manifold with succeeding holes
at 3 b` intervals. Last hole to be next to the end cap.
PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOMS PAGE 5 OF b
• vENT CAP
4 "C.Z. VENT PIPC
fr WEATHER PROOF APPROVED LOCKING MANHOLE
2: 10' FROM DOOR, 7 JUWC,TIOU BOX COVER WITH WARNING LABEL
WINDOW OR FRESH I2�MW•
Alit I NTAKE
GRADE T\
�L 1 OV s 4 Mlu.
CONDUIT
PROVIDE -- --
IlllLET AIRTIGHT SEAL
14 I ` v
APPROVED JOINT A Tank construction shall comply i i j APFROYLD .IOIUTS
with COMM 83.15 and COMM 83.20
I ALARM
b I � I I
I
ON
C
CLEV. F1 PUMP -� -'�
,� OFF
a
EL Or), tjo CONCRETE BLOCK
3" APPROKED
RISER EXIT PERMI1fED ONLY IF TAWK MANUFACTURER HAS SUCH APPROVAL B&DOING
SPECIFICATIOAIS
� 005E
TANK MA M UFACTURCR. � � �� �1Ve� � NUMBER OF DOSES: 3 '�g PER OAy
TANK 5IZE: Z�OD GALLONS DOSE VOLUME z 16�•�
ALARM 1!kWJF4CTUKER: C '"Z ZL�RO SqZ rtf . -S IKICLUDING DACKFLOW: GALLONS
MODEL I.IUMBCR: 19 1 Hw CAPACITIES A= Ib ITCHES OR L l '4 S GALLONS
SWITCH TSPC: g = T - INCHES OR SS GfLLOUS
PUMP MANUFACTURER: L 1 ff T C = 6 INCHES OR 1V1' O GALLOWS
MODEL NUMBER: Y"1 40 D= �Z 1AICHESOR 3Z. 4 '" 0 GALLONS
SWITCH TUPE: WOTE: PUMP AND ALARM ARE TO DE
MIW DISCHARGE RATE A R- 90 GPM IN5TALLED OIJ SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD.DISTRIBUTIOW PIPE.. `1 - So FEET
+ MINIMUM NETWORK SUPPLY PRESSURE .. . . . .. .. 2 FEET
+ S 0 FEET OF FORCE MAIN X 3 "� F3j/0or r.FRICTIOW FACTOR 1 ' 1 FEET
TOTAL OtiWAMIC HEAD = �' FEET
DIAMETER
INTERNAL. DIMLWSION� OF TANK: LENbTH _ ;WIDTH ;LIQUID DEPTH fi b_
BOTTOM AREA - 231= r GAL /INCH
AS PER MANUFACTURER -- ��. ,$ 3.. GAL /INCH
OF-
M E40 Series M "M
- 4/10 HP Effluent
and Drain Water Pumps
Performance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40
12
35
��.... 10 En
W 30 W
!L W
Z 25 8 f
Z
p H
2 20 6 []
0
F a. 15
I 4
10 !-
`` 5 46.8 2
0 Li I I I 1 0
0 10 20 30 40 50 60 70 80 90 100
CAPACITY GALLONS PER MINUTE
1101 Myers Parkway, Ashland, Ohio 44805 -1923
i
419/289 -1144 FAX 419/289 -6658 Telex 98 -7443
K3326 7/91 Printed in U.S.A.
f
Wisconsin Department of Mdustry, SOIL AND SITE EVALUATION REPORT a`g 1 of 3
Labor and Human Relations
L vision c�afety & Buildings /
in accord with ILHR 83.05, Wis. Adm. Code
• � � • ;
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 5t. Croi�`
not limited to vertical and horizontal reference point (BIM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. -': pending'
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION ;WED BY; 4 „':.',` DATQ
AN 1 a -
PROPERTY OWNER: PROPERTY LOCATION �_ , -° •,
Richard Stout GOVT. LOT NW 1/4 Se 1/4,S'`�Tf ^$ for) W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM
1353 Awatukee Trl. �- 2 na ` =`" c6dfif Wood
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE EFOWN NEAREST ROAD
Hudson, WI. 54016 (715)549 -6731 Troy I Twoer Rd.
[xj New Construction Use Residential / Number of bedrooms 3 [ [ Addition to existing building
j I Replacement [ ] Public or commercial describe
Code derived daily flow 450 9pd Recommended design loading rate Y 5 bed, gpd/ft2 y 6 trench, gpolft
Absorption area required 375 bed n2 375 trench, ft Maximum design loading rate _ - 5 bed, gpd/ft2 6 trench, gpdm
Recommended infiltration surface elevation(s) 104.65' ft (as referred to site plan benchmark)
Additional design / site considerations system el. based on contour line of 103.65'
Parent material limestone uplands 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 C3 S ® U :0 S O u ❑ S 91 U ❑ S t3 U ❑ S ®u ❑ S ® u
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure ConsistencelBoundary Roots GPD /ft
in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed I Trertd�
1 0 -14 10yr3 /3 none 1 2msbk mfr cs 2f
1
<ti 2 14 -29 10yr4/4 none sicl 2smbk mfr gw if .4 .5
Ground 3 29 -38 10yr4 /4 none scl 2msbk mvfr gw na .4 .5
elev.
10 4 38 -55 10yr6/4 none fractured limestone
Depth to
limiting
factor
Remarks:
Boring # 1 0 -15 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6
2<> 2 15 -26 10yr4 /4 none sicl 2msbk mfr gw if .4 .5
U
3 26 -40 10yr4 /4 none scl 2msbk mvfr gw na .4 .5
Ground
el 4 40 -60 10yr7 /2 none frac ured lime tonO
104 ft
Depth to
limiting
fact&,
Remarks:
CST Name: Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Ave., New = Ricbmo d, WI. 54017 10 -19 -95 cstm 02298
Signature: Date: CST Number:
PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page 2 OP
PARCEL I.D. # pending
s ..
g Depth Dominant Color Mottles I I Structure Bourd3y GPD /ft
Boring # Horizon Texture Consistence Roots Bed iTmnch
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
1 0-14 10yr3 /3 none 1 2msbk mfr cs 2f .5 .6
.,..;3...... 2 4 -22 10yr4 /4 none sit 2msbk mfr gw l f .5 i .6
Ground
3 2 -38 10yr4 /4 none sicl 2msbk mfr gw na .4 ..5
elev.
101 ft. 4 9,-60 10yr7 /3 none fractured lime tone
Depth to
limiting
factor
38 1,
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
:i4 \AV4iu:!•:
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev. i
ft.
i
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Richard Stout 1554 200th Ave.
CSTM2298 NW S3- T28N -R19W New Richmond, WI 54017
MPRSW 3254 town of Troy (715) 246 -6200
/ lot #38 -c entry Wood
A 11 =40'
Am.= top of 1 steel pipe C el. 100'
Alt. fin.= top of corner post @ el.
��
� 4z-z
VIC 6-
Gary L. Steel
10 -19 -95
r U1! UL 1 7J'J VO. Y1 / 1'JL + J7 +'JJ IVCI -SUIV rLVIIL111V1a (�{ -1l]t, bj
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnertBuyer � K rEJU C /a M AA- 9L Lr- H,5
Mailing Address `1 rc QP, 4+L LA W( j Q�
Property Address 7 7. A
(Verification required from Planning Department for new construction)
City /State ��d �� � P arcel Identification Number LZ 3i3 90 —00
LEGAL RESCRIPTION
Property Location /V— '/., %., Sec., T� -R W, Town of g 0
Subdivision Co U AJT Z l , Lot it .
Certified Survey Map # , Volume , Page #
Warranty Deed #
V o lu me 0 ,Page # Z
Spec house p yes 19- no Lot lines identifiable f9 yes O no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensedpttmper 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
9Uting t your sep ' syste has been maintained must be completed and returned to the St. Croix County Zoning Office within 3Q
days of a thr, yep e'x on date.
�
SIG A Oiz APPLICANT DATE
U ER1'IFi('ATION
tNATUU e) Certify that statements on this form arc true to the best of my (our) knowledge. l (we) am (are) the owners) of
thd 4A"P o , by virtue of a warranty deed recorded in Register of Deeds Office,
SI O DATE
0000 Any information that is mis- represent tray result in the sanitary permit being revoked by the Zoning Department. 000000
Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
STATE BAR OF WISCONSIN FORM 2 - 1998 K 6ZE 426 H
WARRANTY DEED REGISTER OF DEEDS
Y'i 1503MCE428 ST. CROIX CO., WI
Document Number - _ - RECEIVED FOR RECORD
This Deed, made between _ —_ - -- 09-17 -2000 3:15 PM
R1CHARD 0- vmn.,m — — YRRRANTY DEED
- - - -- EXE?PT R
Grantor, CERT COPY FEE:
and MARK A FEN17T.- aX4_MA' f!t RF�-,>+t .fi - - --
COPY FEE:
TRANSFER FEE: 131.70
hu hand and _ wi f e, -- . - - - -- RECORDING FEE: 10.00
Grantee.
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate in _ St C`rni x County, State of Wisconsin:
aea:ru; a.rsa
Lot 28, Plat of Country Wood, Town of Troy, Name and Return Address
St, Croix County, Wisconsin TITLE ONE
RE7U
RN TO:
70619TH STREET SOUTH
HUDSON, WI 54016
040 - 1233 -80 -000
Parcel tdentification Number (PINT
This is not homestead property.
(is) (is not)
Exceptions towarranties: easements, restrictions, rights-of-way and covenants
of record.
12th day Aril 2000
Dated this y of
(SEAL)
(SEAL)
- Richard 0. Stout
(SEAL) (SEAL)
AUTHENTICATION
ACKNOWLEDGMENT
Signature(s) State of Wisconsin,
ss.
St. Croix County.
authenticated this day of Personally came before me this 1 th day of
April 2 ,the above named
Richard O. Stout
Te RY PI I SN6 __ to
TITLE: MEMBER STATE BAR OF WISCONSIN �. �IUI d the fore g oing
Qf not, me known to r g � g
Instrument and ack
authorized by 5706.06. Wis. Stats.J " T e BA ST
THIS INSTRUMENT WAS DRAFTED BY
Janet P. Stout
1353 Awatukee Tr. --
Hudson, WI 54016 No Public, State of i onsin
My comma ion is permanent. (If not, state expiration on
(Signatures may be authenticated or acknowledged. Both are not
"Q 95ySC� •)
necessary.)
Names of persons signing in any capacity muss be typed or printed b6,o their signature. toga] gl BlanCo. k Co, In.
c
STATE BAR OF WISCONSIN Wa] Blmk Co . I n .
WARRANTY DEED FORM No. 2 - 1998
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�S' CSAYIPIC�T6 OP D�TCATr[1EE i
As owners, we hereby certify that we caused the land dercvibed on this plat •
to bs surveyed, divided, napped and dedicated as represented on this plat.
we also certify that thi■ plat is required by 236.10 or S236.12 to be
submitted to the following '
for approval or objection: St. Croix County
Platning and De"l
opsient Committee and the Yore of Troy. :1
t
WIT S the hand aqd seal of said owners this_ day of
L Iq�Ct►e pre enCe - f � � �. � i at�.l _ '
Witness Ric!)nrd O. Stout
�—Anet P. Stout
State of Wisconsin) 3S i
County of St. Cmic) r
_day 4= _ _ ^ 1921, �