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HomeMy WebLinkAbout040-1050-10-000 T a°—' 4 rr F Z O In 0 N A • Sr w < < C — W S .°� N Q F•y 3 > > N C 00 O O N o O A O ` 1 \ N N °- O N m y �• O D n'S c W e O c c n �. 6 O 3 N G to p N lV (D t0 A y G O W N O t D O O) N S 0) N N (Q y C CD 0 0 (n .r a Z o 3 CL ao D `° -I v M� CL 3 Cl) a G O = m 7 fD N y y 3 O Z O ZZ K�! o ? D D c No =n a N O c N w < O p 3 CL O (D Ui CD N I II N • O) 7 7 -°p O A 3 y 'a O (D O 6 N O <D y - In C L CA 0 0 fD Q ,p Z 0 O N O CD CO) 2 O 0' .�.. 3 W m N N ° c a Z 2. 3 w D 0 Qo a m Zm 2: a y N 7 y c 3 n a� CD < =r o a 0o y Z CY) ° o n y 4 O o �m ° CD s sp F N a a CL M <X m a m -. o v° CL CD . m Z o ° CD 0 rn w r. v CD oo n A o <n O 6 O CL Parcel #: 040 - 1050 -10 -000 02/18/2011 07:56 AM PAGE 1 OF 1 Alt. Parcel #: 12.28.19.184A 040 - TOWN OF TROY Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner 0 - HAROLDS EAGLE POINT LLC HAROLDS EAGLE POINT LLC 715 BARTOSH LN RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 35.550 Plat: N/A -NOT AVAILABLE SEC 12 T28N R1 9W NE SW (35.55 AC) EXC Block/Condo Bldg: CSM 2 -524 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 02/12/2008 868752 TD 02/20/2007 844900 TI 08/25/2005 804485 2874/445 EZ -CN 10/12/1994 522394 1098/620 QC more... 2010 SUMMARY Bill #: Fair Market Value: Assessed with: 81626 Use Value Assessment Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 55,000 161,900 216,900 NO AGRICULTURAL G4 10.000 1,900 0 1,900 NO UNDEVELOPED G5 2.000 100 0 100 NO AGRICULTURAL FOREST G5M 21.550 86,200 0 86,200 NO OTHER X4 1.880 0 0 0 NO Totals for 2010: General Property 35.550 143,200 161,900 305,100 Woodland 0.000 0 0 Totals for 2009: General Property 35.550 143,200 161,900 305,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 115 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I I OZ /£ /Z - nog( Nueyl •a6essew ay; alalop pue japues ay; 4pou aseeld 'JaJa ul uolss slyl pan aneq nog( ;1 •uolsslwsueil ayl u pouleluoo uollewjo;ul eql ;o slualuoo aql to a6eiols io 'uollnqulslp 'BuiAdoo 'amsoloslp �(ue wa; pejggad Rgouls aie no�('lualdloe papualul aql l ou aie nog( ;l - uollewjo;ul pafiall Alle6al pue lelluapguoo uleluoo Am sluawnoop 6u1�(uedw000e Rue pue uolsslwsuejl flew oluaaloala slgl :30110N .killVliN3(113N00 £ jo £ aELd r 'Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: 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)]. 363875 Permit Holder's Name: ❑ City ❑ Village ❑ j[own of: ate Plan ID No.: Zohl Family Trust Troy Township = 7, (22(0 CST BM Elev.:- Insp. BM Elev.: BM Description: - Parcel Tax No.: . c7 -o' 7tj 2e- 040- 1050 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , C Benchmark 1,0 IU[.� OD. ID r Dosing ) Alt. BM ( 6.1 lee , D' Aeration Bldg. Sewer Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet S.0 TANK TO P / L WELL BLDG. Ae Intake ROAD Dt Inlet Y� 3• IDr Septic f t 5 ° NA Dt Bottom j(.0 S •9s ° Dosing > 100 ? I L o (� ° ti ! NA Header/ Man. (. / 0 �p ° Aeration NA Dist. Pipe To , [ Holding -- Bot. System g.qo PUMP/ SIPHON INFORMATION Final Grade S Manufacturer ,� Demand St cover �a , Model Number 41- d 3� GPM 0 TDH Lift S Friction S stem 6 1 - Ft DH Forcemain Length ° Dia. r Dist. To Well >1(,p S ABSORPTION SYSTEM BED ) T#E=H Width , Length ° No. f PIT No, Of Inside Dia. Liquid Depth EN I N 8 a n DIMEN I N —'" SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING anufac INFORMATION Type O CHAM Model ber: System: > °O'D tqs" 2O ���" O NlT DISTRIBUTION SYSTEM Header / Manifold N Distribution Pipe(s) u _ x Hole Size x Hole Spacing Vent To Air Intake Length S-L Dia 2 Length 4 5 , Dia. ° Z Spacing 5 k ~ 1 A C, 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 E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) t Inspection : DS/ f b/ oo Inspection #2: Location: 842 Coulee Trail, Hudson, WI 54016 (NE 1/4 SW 1/4 12 T28N R19W) - 12.28.19.184A 1.) Alt BM Description = ( L, ; 5.11 � /u4 at 3' ° l Z 2.) Bldg sewer length = f S. 0' 8 - amount of cover ? 3 'f 3.) contour = 9 -4.1' C 5 (et . 3 • to .4 ttz = 10 l ' 6) P:� cxv "La� Plan revisioh requir d? ❑ Yes CR No Use other side for additional information. I° 11 Zeno SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. �+ r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: a. g „ d f.. F � r- e e i i , E 3 E P E E E p E � € a e e E. OTC 3 , i t , E ? g 7 s a s Y E , a ...a ... � .ems ,. ..... .' m...e -: ,.�,.._.. .... _ .. .. .,. 3 j F I s Safety and Buildings Division A sconsin SANITARY PERMIT APPLICATION 2201 B Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis Madison, WI 53707 -7302 , • Attach complete plans (to the county copy only) for the Sys (try paper not less 4ounty than 8 112 x 11 inches in size. • See reverse side for instructions for completing this appl cVon Sta Sanitary Permit Number Personal information you provide may be used for secondary purposes P eck if rev ision to previous application (Privacy Law, s. 15.04 (1) (m)].' ]: ST (-RC)ix State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE P A = - 3 12- S Property Owner Name Prope c bon ep D Tr l 4 /4,Sr f 2- Tad , N, R E (or 11 Property Owner's Mailing Address Oyr4u ^ ej, Block Number r City, State I W Code Phone Number Subdivision Name or CSM Number II. TYPE OF B L ING: (check one) ❑ State Owned ❑ v It� Nea est Road Cj Public or 2 Family Dwelling - No. of b edrooms ° il ag of �64, Tr 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Numb 1 171 Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sates/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1, ❑ New placement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. Q Repair of an - _____System ________ System _____________ Tank Only______________ Existing System _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed nd 30 ❑Specify Type 41 ❑ Holding Tank 12 E] Seepage Trench 2 ❑ In- Ground Pressure r ( 42 ❑ Pit Privy 13 ❑ Seepage Pit f K'c 43 ❑ Vault Privy 14 ❑ System -In -Fill iBx V� VI. ABSORPTION MTEM 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.) Pro osed (sq. ft.) alVlay /sq. ft.) (Min. /inch) Elevation Feet l�2.S - Feet VII. TANK Capacit gall Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin structed j Tanks T nks Septic Tank or Holding Tank QQp ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber l3O ❑ El El 1:1 ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's S ture: (No S MP /MPRSW No.: Business Phone Number: PlZeV ss(Street, City, State Code): L IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S Itary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) � 'Approved E] Surcharge Fee) Owner Given Initial s Adverse Determination :Z X. CONDITION OF APPR VAL / REASONS FOR DISAP AA4111111A� - C da A4 sAA&L� P�- SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber 1 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. 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 -3151. To be compute 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. ---------------------------------------------------------------------------------------------------- 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. 1 Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 04, 2000 CUST ID No.226900 ATTN: POWTS INSPECTOR ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/04/2002 Ide 3 rs Transaction ID N .312268 Site ID No. 190995 SITE: Please refer to both identification numbers, Site ID: 190995, MARTHA ROHL TRUST, MOUND above, in all correspondence with the agency. ST CROIX County, Town of TROY; COULEE TRAIL, TROY 54022 NEIA, SWIA, S12, T28N, R19W FOR: Object Type: POWT System Regulated Object ID No.: 660423 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 chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: This plan action is subject to designer comments on the plan. #1. Insulate piping per Comm 82.30 (11). #2. Install cleanouts per Comm •82.35 (3). 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. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. f eK Sincerely, DATE RECEIVED 04/24/2000 q FEE RE UIRED $ 180.00 D r VIS10 Pd R1 C , Q FEE RECEIVED $ 180.00 � / J 0, :..AF ., -- WESLEY GRUBE , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services SC-r� G - - '.i it (920)492 -5613 , M -R 7:00 - 16:30, F 7:00 - 11:00 WGRUBE @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: BIRD PLUMBING SHAUN BIRD CHRIS ROHL • PLOT PLAN PROJECT Chris Rohl ADDRESS 473 Countv Rd SS Roberts Wi 54023 NE 1/4 SW 1/4S 12 /T 2$ ' i/R 19 TOWN Troy COUNTY ST. CROIX 7 4/18/00 3 MPR n Bird 2 BEDROOM S S au d 26900 DATE CONVENTIONAL IN -GR UND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XX)OC SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 BED SIZE 8'X 47' BENCHMARK V.R.P. Top of Nail in Tree ASSUME ELEVATION 100 , ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 99 Seale = 1/4 = 15' Basal area was oversized Area 25' downslope of system B - 2 is to remain undisturbed 13 I System is to be installed along the 99.0 contour line B - 1 6% /( Dose tank is to be properly Slope bedded and provided with a lockdown cover with a B M approved warning label 1 , DT B -3 Old system has failed, above Vent ground discharge was found 0— System is to be -n installed along the 98.0 ' Contour line m Existing 1000 Gallon septic tank, Sr / m P was inspected, and baffles were found to be in place and working , ova11 Manufacturer unknown E• , y Well O J -)F COMk!E ,E Existing 3 QTY AND BU INGS bedroom C house SPONDE CE 250' 400' to Coulee Trail P.L. Desigaer Nao Date 4'' Observation Pipe Perforated Non -Woven Filter Fabric Below Filter Fabric ,Distribution Pepe A81?S C -33 Sand ��� ' Topsoil F4 6 — J ` tr ra s r. e►s a L ..,.. V. Slope Bed Of tj -Z:t Force Main ��,Piowed Groin Rock From Pump Layer .p Crass Section Of A Mound Systern Usina / E A Bed For The Absorption Area rp F� 8 c . ©' A Ft. !i 6 Ft. z IG�OFt. J Ft. K./ -2Ft. L 42,1 Ft. w 3_ Ft. L e0bservolion Pips PF a W �«.____ ______-- _ -- ------ ____- __-- __ -_ -• — --- -- -- --- _ ., _,..._ __..- From Pump p Oislrlbution Bed Of Pipe Drain Rock I � 4 0b =erY0tiOr1 pipe Permanenl Marker PI pe or Rods P I O n View Of Mound U6inq A Bed For The Absorption Area PACE - or...._ Perforated Pi pe Detail ad View �Perlfa•af�ei E * 4 Cep P P•pe ty0lfe LOC411d Wt WtfT, All E*Yday $"%*f ♦ P PVC force Maw itR111 V4" sfa csnnec }Yln PVC klofofow Pipe Disyt.w�t,eay PIOf 1.def Mote she ld se most TO En Cep End coo � DFsfnOY P ipt Layout P 4 / 5 - R 5" Ft, x 3/6 i nch es ' 1 Signed: Y -.- Inches K O ? ® Di amete r Inch License Number: p o Lateral " ..1 f �L Inch Manifold � n Oate: — p v , I Force Mai " off• Inches N of holes/pipe1� Invert Elevation of Laterals Ft. $'A I GF PUMP CHAMBER CROSS SECTtCf•.i ANJG SPECIFICk'i i0��5 '✓CQ CAP " C.i Vt.'11' PIPE i ! WCATHERDROOF �! APPROVED LC?L OW = RO h ROOF. i JUIJ;C.TIO�.1 BOY MAtJHOL E COVER WINDOW 09 FRC5M � �2 "Miu. AiR iWTAKC I I I GRAOE J I 18 MflU. \ ..•' -- �� rruL.ET PAOu'CE I — ' - T AlR7lGNT SEAL I " A I A4.ARPA 1 C *APPROVED I ! ors JOINTS WITH I s f LLEV 6 FT - APPROVED PIPE p �� _�� I I 3 ONTO � �- OFF D SOLID SOIL COLICKETE CLOCK RISER EX PER.M!TTED pb}Ly IF TAWK MAWUFACTURT.R, HAS Sl – APPROVAL SEPTIC E _ ATiQ1�1S -=4 f'ac DOSE TAWKS MAWLIFACTUREK' Z4,1119-gh .kJUM8ER OF DOSES: Y —PER DAtl TAWK SIZE pQ 6 _ GAL.L0WS DOSE 'VOLUME ALARM MA4IUFACT & , 0 - S �Ewu, INCL.UOING BACKIRLOW: /.3<5 4M.I.ONS --- CAPACITIES: A - 9� <AiCHE5 OR aGL�. GALL.Ow. SWITCH TyPR :.- '�" r gam? IIJC►11<S OR - Y - 6 GAI.LOAi$ DUMP MAkiUFACTiJR>aR: .Q OR 1��d MODE � t'�ALLOtJS L. i�71lMDEIL: -S_ �U iNG H£S CR GALLOfJS SWITCH TyPE: - S�/y�'... -.�.� 9n__i�� 70 b nIOTE: Plir+v A1JU ALARM ARE [ MINIMUM DISCNARGC RATE .S GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL CIFPEKENCF CETWEEw PUMP OFF AA,ID 013TRI&LITIom PIPE.. FEET Mlk IMUM IkJETWORK SUPPL.j P�RES�S 2,5 FEET +- �� FEET OF roRCE mAIN X !`� `� , FRICTIO►s fFA loofa cro R.. Z- - , 5 — / — FE T E — ' TOTAL DtfWAMIC HEAD L_ FfE.Er oe 1.11 // WTERAJAL DIMEWSIOAJ OF TAW . LENGTH � ,_ ;WIDTH __.! ... ;LIQUID DEPTH 51 GhSEG' / c GEQSF A.ILMeER: �,._!902 UAT , i En g i neering 1 • r I r Performance Data 40 i 30 i Pam Ch aracteri sti cs JiNl otor Will Sete S 20 ! i G maw Modals SW401li W14016 Aulem art, Mu WHOM SW40A2 _ Hx ww 4410 Fa! load Amt 1Y ft.S N N _ %mdod Mr 4 Pole Is" 0 10 20 30 40 SO 60 70 Phase 19 Gp 3* •S Volt e t t S 230 TOW "*ad (few) 1 7$ 30 33 I Hart: 60 (m} 8.0 4.3 , 5.Z ^+' 6.1� T.b " 8.5 8.8 10.7 1aa er� aturo 12 F Mao. Field Tog. NFMA Dot' u A GPM (US G PM) 70 60 so i 40 _ X 20 j 10 0 ►rswtotlon Goes A ( aecj .4 3' ��J .0 173 .4 — C -- D;,r sloe 111rr Nor Dimensional Data l Sends ttandWfe r .� w yveyl 26 A& 3.9 sea" (168,271 1,110 Amensions It. btthes. Work for Power Cord 13 MV _ t°e e't1sr1 - inlltrl0#ional use). (3V qfboQ 7W 2. Component dimensions may Materials of Construction ta'a vary t 1/8 inch. adie _ 1t1 ±11lRL HO 3. Not for construction purpose � .— " —.--" . 718" �. JiSCkAFiWE rk 0 { � . 04 s2� •1/2° NPT Nniess certified. a gg LEd + "FLOAT i ' N SWITCH 4, DIM411Sior4 and weights are Pump Cosine . _ �tus apprattlrnate, St all .mod...._ .....,.... Meraankat Ud Feaet (Who/Wadt 5 . We reserve the ri to make swt Seat sad stair: IWaodfaad Sled revisions io our product and their StallpMu Sigel I �� specifitations without motke. Wgr I r,•3re� >w�„8• N le fto Pl ate i Poivester WW 11 1d 1 s iast t dllj;JoeL_.._.. Less Fsgiaeered TbatMePlaflk i ._ + b 149Ei orro umas, A,shtard, Ohio. A1, Rights Row" I � HYDROMATIC `� t - �r:xec locci {)istrflw •• � t V11911d, Ohio 44805 TO 4i9'289.V42 W 419 - 781.408 f� .,..�. W16 Si'e' wwx, feltiOlrNUlRp rfYlriys + r:w a,FMS IN All MAJOR (ITC AND COUNTRIES C st 1 r'Ir pug.y al goal ytri:n4 fli +CC!9ry inr yoof locos DI$Iribulel i i l3� C0 e V Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of Labor and Human Relations Division fSafety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST_ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but e.24v 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. 0 4 O - 1 p S O - I v APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REWED X DATE r /9 PROPERTY OWNER: M PrV_'nt - 0, W1tf'L. 2U 8T PROPERTY LOCATION C_< O C t wl_s R s'tkLl G04 1 4M X11~ 114 SW 1 /4,S 't ZT Z-Z ,N,R t E PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # q C.°'0QKJ�/ h S S " _ _ CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑1/ILLAGE ®TOWN NEAREST ROAD tZba��rS k11 S Flu 1.-3 (7 151 42S - �-� c4.�U LLWV_z ` VLt1L. New Construction Use [ Residential / Number of bedrooms [ j AdditiQn to existing building Replacement [ ] Public or commercial describe Code derived daily flow k- SCS gpd Recommended design loading rate bed, gpd/ft ` trench, gpd/ft Absorption area required _2 S bed, ft 3 - 1S trench, ft Maximum design loading rate bed, gpd /ft - 5 trench, gpd/ft Recommended infiltration surface elevation(s) °f cl - (3 ft (as referred to site plan benchmark) Additional design / site considerations M�)yKA w / £3 x �7 � ZOG:) . M' t " U " ZZ y vr- Spq\� 1=rL'L_ I Parent material s oy �_-n - n Flood plain elevation, if applicable ry A ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem F-1 S IK U ® S El El ®U ❑ S 0 U EIS ZU ❑ S KU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench o -M si ... Z Z„U -yI to `t ti .316 — S t e.Jsbk >n 1Y CYO 'y •S Ground 3 4 41 - 1 0 10 V/ _'�. S y Q S/8 s I C-J o +^-� Yr►'F1- - tip . Z elev. to e.>3 ft. Depth to limiting fac L Remarks: Boring # J I Iu «. Z• Z -1 lU `L iZ 3! 6 3 3Z-S3 lb�t V& 5 `1tzS /b SLc ov,. y>' F►- e r.�p -Z Ground elev. S 1 -6o , S '`t It- 3L ft. c) w, Yet . q1•D .; r Depth to r limiting factor ST C 1 Remarks: !A/G CST Name. — Please Print Arthur L. We erer Phone: 7 15 - 45 egerer Soil T sting & Design Service -P.O. Box 74 River Falls, 2 Signature: Date: c CST Number: q�? -SO -� z.� 22 PROPERTY OWNER �� SOIL DESCRIPTION REPORT Page Z of .3 PARCEL I.D. # OqQ. - LO SO — LO Boring # Horizon Texture Consistence Boundary Roots Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0 10 z L Z _ sL 1 Z`F 'F►- Cg — S ,(, S l b >r k4 '�- C� . _ 6 Ground 3o s`( 10 `M_ 316 f � -S�-1 R S1� s L caw, y,,'Ft- 0- Z elev. 4 S. y ft. sy - z S `t R Y/ - s l a wr U . p _ , 3 ; • Y Depth to limiting factor OA _ 7 i Remarks: Boring # 13 I i { Ground elev. ft. Depth to limiting factor Remarks: Boring # <t i Ground elev. ft. Depth to limiting factor I I Remarks: Boring # Ground efev. ft Depth to limiting factor Remarks: ___ PLOT P LAN Page 3 of 3 $.z 0 5/r 6" � i 7qqJ r ' - J e u1S _ C 3 u'rl'o►� -t o t= 3 Lt. - i X TI�CI\!rt � k t . � n X t _ gq_so - 71S y z s_ o 16 s z zo 2 s L CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of Labor and Human Relations Division 61 Safety a Wldfirgs 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 ST. C.Q4 LX not fimited 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 R IEWEDBY DATE PROPERTY OWNER: M frV_X "R �?Ztft ' ST PROPERTY LOCATION C_/0 C N G=. M t� 1/4 Sw 1 /4,S t Z.T Z-"Li ,N,Ft 1 E PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM 9 CITY, STATE ZIP CODE PHONE NUMBER []CITY [31/ILLAGE ®TOWN NEAREST ROAD W► SL ril-3 NS)gZS -SSZO New Construction Use [ Residential / Number of bedrooms [ ] AddiliQn to existing building j Replacement (J Public or commercial describe Code derived daily. flow `150 gpd Recommended design loading rate bed, gpd1ft - trench, gpd/ft Absorption area required 3ZS bed, ft 3 -1 S trench, ft Maximum design loading rate bed, gpd /ft • 5 trench, gpd/ft Recommended infiltration surface elevation(s) °t" - O ft (as referred to site plan benchmark) Additional design/ site considerations w / Es X X1`1 " ZS> . >-i i ti., L ) -t u xi \ Z " o F s Pq 1=i LA_ Parent material Flood plain elevation, if applicable >v A It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE 7AT-GRADE SYSTEM IN FlLL HOLDING TANK U= Unsuitable fors stem O S El U O S O U ❑ S ®U MU O S XU O S P[U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Boring # Horizon Texture Consistence BcuxJary Roots Sed Trt�h Z . z Cy S► ` Z'F S bk ►n `Fh v 1 a i {`:: Z -yI 10`1 IZ .316 — s e l 7 ansbk`�►- • S Grou 3 ill - 10'112 V l �'1 • S `1 R SIB 51 vv\ Z elev. too.a Depth to limiting factor Remarks: Boring # J I 7- t0`-lR 3Lz st, Z- '�S�tt Y �l �S - •S `' Z• 2 3! (, .5`.6 ... 3 3Z.S� L0�-t R yl6 �� •s ktz s��i sl.c1 0w 1n '�I- e w tiP • 2 Ground elev. S3 -W 1. . S %F4. 3t y Yvl CC - ).0 ft Depth to limiting factor Remarks: CST Name: - Please Print Pine Arthur L. We erer 715- 425 -0165 40ress: egerer Soil T sting & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: Date• 2 - CST Numb gg -SO 3 �°/ 22 0254 i PROPERTY OWNER SOIL DESCRIPTION REPORT Z Page s of �- PARCEL I.D. # SO — �O Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITW& loLcV. zt sii Z. +sbk M Cg Z oLl2 313 s,1 Z.�s k6 'fl, 0-,�, Ground 3o S`( 10 `-L1Z 316 -e- 1.$`� R 5 y,�.�`y. Chi elev. — 4 s: u ft. y SV -6L - 1 -S - i P - Y/ _ s Depth to limiting factor h � t Remarks: Boring # 13 Ground elev. , ft. ' Depth to limiting ! factor t , Remarks: Boeing # U i ! i Ground S elev. ft. Depth to limiting { factor j Remarks: Boring # Ground efev. ft. . Depth to limiting factor Remarks: 1 PLOT PLAN Page 3 of 3 S OWN y 0 ' g.z L�.LOO 8 0• � y EL . l00 . p� o►v o� i , . •o OAS 0 EL C[ Q i x 3 BDQ.� ST CROIX COUNTY SEPTIC "TANK MAINTENANCE AGREEMENT` AND... OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 3 �oi, .5 Lt/� S V Z.3 4 Property Address (Verification required from Planning Department for new construction) :2Q City/State _ Parcel Identification Number I LEGAL DESCRIPTION 3S Property Location/ ^ � %,, Ste /,, Sec. /� T R.��W, Town of Subdivision Lot # Certified Survey Map # . Volume . Page # Warranty Deed # -�-�G , Volume 7` Page # e, ` 2 y Spec house ❑ ye--no Lot lines identifiab�ees ❑ 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, restrictedplumber 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 Zoning Office within 30 days of tbz three year expiration date. 1 Z�z- -5 l- NATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro described above, by virtu of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF PLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with 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 i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I h ve inspected the septic tank presently serving the v� ��� residence located at: Section �2 TZZN, R W, Town of - 7 4 1 -0 Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. ,ast time serviced: I)id flow back occur from absorption system? Yes TG No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete Steel Other Manufacturer: (If known) :`!/ITi i- t�vc�/l✓ Age of Tank (If k (S' n tur (Name) Please print 2, u (Title) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - -- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name �`� signature MP MPRS g / �� • � I ut.,_':r tit: 5TAIE I"kit I!Y LL "lr+'ll.`:�IV FtlttJl a - 1;ti2 .. ,. .,.,:,,.,w r- k,, c.•. QUIT CLAIM DEED •. it. t_ d ; Cynthia R. Klecker, Gerard A. Rohl, Leo V. Rohl, P.it� M. Spi.le, Christopher J. Rohl, Herbert M. __. Rohl and Patricia A. Wolf, as tenants in comir,on an CCT 1 2 1994 un one= seventh interest each gait- ulamis to . 1 Martha A. Rohl Family Trust, Cynthia R. Klecker, 8 : 30 _ A. Gerard A. Rohl and Patricia A. Wolf, Co - Trustees, Herbert M. Rohl, 1st Alternat ive Trustee, having .full power to sell and encumber, the fol!owin, de,ctihed real estate in St. Croix C,?untp, State , i W sc•)nsin o Tax P:ICrci `"o: - Northeast Quarter of Southwest Quarter (NE 1/4 of SW 1/4) EXCEPT Vo'ume 2 of Certified Survey Maps, page 524, Section Twelve (12), Township Twenty Eight (28) North, Range Nineteen (19) West. �z a , This . is ot _ n _ -. homestead pr. >perty. XXX Os not) Dated this 3rd _ d of _ octobe / Iy 94 _ SEAL ��` ✓` I Cy is ed . _ .- (SEAL) .0 stgp �� _ (SEAL) e rd A. Ro l rbert M. Rohl v'Y ; (SEAL) Le _P A c�a . � - (SEAL) W R a M. pill (SEAL) I s. AUTHENTICATION ACKNOWLEDGMENT Signature s) of - R. Klecker :� - - - -_ --- -- , - STATE OWISCONSIN ? N Rohl, Leo . Ro , Rit M. S i I ss lsto her R 1' ohi xer9ert "W. 1 .' ,. an Patricia C ��. -- __.___Count;. ` f. authenticated this . of ... October 19 94 Pc.sonaLy came before me this � - - -- day o; �u. C1 -_ ..... -. __ , 19-- the abov med `"" A4 A Cynthia R. Kl ...... , Gerard na A. - - -. Rohl Leo H_. Rohl, Rit S a M. itle,, TITLE: MEMBER STATE BAR OF WI .'O ?a� Christo her -------- J. Rohl Herbert M (If not, .... .. Rohl and Patricia A. Wolf authorized b - s _. - _... - '--... -_ _ - - y i0fi.06, Nis. S at. ---0� ti -• t ` nown to be the per.. -ons _ who execute *I the � {" of P ugL'� 'ote ng in<,trur. and ae cledze the same. THIS INSTRUMENT WAS CRAFTEC BY �9r - sh - Leo A. Beskar, Attorney OF W1gC ROOLI, BESKAR & BOLES 219- -North Main $tie t tiotrrc P �.��� - _Comty, <is. g .. 1Xeir Fa11bs JI 54 - 03j3 S tSt� a u m nutY e'aa aenticated or ac nuwle(ed. Both Sic Commi,sion Is permanent. i it not . tale ex (ration are not ruccsar}.) date: C ) — v U I • Y ' ,.,.T LUAI:H DEED sT � rF. IMI OF' WISCONSIN N n f •• ¢al R'enk ('n. Inc. FORM Nu. 't — 19tl= >L: »u6.•. W.e. ST. CROIX COUNTY WISCONSIN - ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax (715) 386 -4686 April 6, 2000 Mel and Kathy McElwain 568 CTH "U" Hudson, WI 54016 Dear Mr. and Mrs. McElwain: Enclosed please find a copy of the St. Croix County Nonmetallic Mining and Reclamation Ordinance. Heidi Helgeson, with the Town of Troy, requested that I send these provisions to you. Sincer , Steve Fisher Zoning Director /dz Enclosure ,� j