Loading...
HomeMy WebLinkAbout040-1229-40-000 m > > n 3 A. CD W (D :• �� rr n j O CD� N p CD 3 (D OD «C 111 0 D ° n N O L -I N r•►, A W W C 7 CD N f0 N O ) O O 0 0 a 0 ' c0 O o c � m ai o A+ K CD 3 ro N ai tWii O .. `.7 � C O o D a o C m CD W CD 3 0 0 = 3 CD � L OZ O C\1 N N N ff. N 0 CD o 0 CA R a C 01 3 M N d T'a - 0 d w • o a N U1 OIQ � j CO Q O. CD �► d O p1 N O O N CD d z M a o Z Z O D o O I ° m o m �• N _ N O C O N c S CD w o a w Z CD m cn � cn ° O n 43 A z n n' A z O v CL 0 3 o. c _ wM ��°' a Z ° 0 z G y < A C A a _? Q d N O C N y C O CD C N O N `G y O N � S N O� 1 71 , O G) 6 < A N O V 0 N W O d � A ti ti o It !� CD on a o O e 0 0 CL `' S ti Parcel #: 040 - 1229 -40 -000 03/07/2005 12:54 PM PAGE 1 OF 1 Alt. Parcel #: 16.28.19.1124 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner " JASON R & SUSAN E KELM KELM, JASON R & SUSAN E 350 SOUTHERN PACIFIC RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description " 350 SOUTHERN PACIF RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.124 Plat: 1998 - GLOVER STATION 4TH ADDITION SEC 16 T28N R19W PT SW NE LOT 59 GLOVER Block/Condo Bldg: LOT 59 STATION 4TH ADDITION (FORMERLY LOT 51 GLOVER STATION 3RD ADDITION) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 16- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/07/2000 626007 1524/553 WD 07/23/1997 1232/379 QC 07/23/1997 1204/511 QC 07123/1997 1152/608 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 27903 430,800 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.127 109,000 322,700 431,700 NO Totals for 2004: General Property 2.127 109,000 322,700 431,700 Woodland 0.000 0 0 Totals for 2003: General Property 2.127 99,000 272,700 371,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 040 - 1222 -60 -000 03/07/2005 12:51 PM PAGE 1 OF 1 Alt. Parcel #: 16.28.19.1084 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner " DENNIS R SCHULTZ SCHULTZ, DENNIS R PO BOX 167 RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ' 350 SOUTHERN PACIF RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.837 Plat: 1998 - GLOVER STATION 4TH ADDITION GLOVER STATION 3RD ADDITION LOT 51 NKA Block/Condo Bldg: LOT 59 LOT 59 GLOVER STATION 4TH ADDITION Tract(s): (Sec- Twn -Rng 401/4 1601/4) 16- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1086/422 QC 07/23/1997 1053/01 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/06/1996 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wis ,n epaxnent of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Builc.7ng D;vision ` INSPECTION REPORT Sanitary Permit No: 399561 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: Kelm, Jason R. I Troy Township 040 - 1229 - 40-000 CST SM Elev: linsp. BM Elev: BM Description: // v TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing _ _ - - -- - - - - -- — — Alt. BM Aeration— Bldg. Sewer i ///� CO34 ,e YA6 l ti�t Holding t Inlet 7 J 0 d" t Outlet nQ J /4 TANK SETBACK INFORMATION 3. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic y Dt B Dosing - Header /Man. Aeration Dist. Pipe I , Holding ` Bot. System 0 1/_ 472 8 Final Grade PUMP /SIPHON INFORMATION 7 7 Q cturer Demand St Cover , 3 _ - -- GPM _ Model Number TDH Lift Loss Sy Head TDH Ft rcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 r SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM SF�F{�NG Manufact rer: INFORMATION MB OR tai Type Of System: M odel Number. DISTRIBUTION SYSTEM �qs Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air ke /t Pipe(s) i t/ — Length Dia Length S0 Dia Spacing 7 S / SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over --- ver Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil � Yes [W No [] Yes No COMMENTS (include code discrepencies, persons present, etc.) Inspection #1: / 0 Inspection #2: ! / Location: 350 Southern Pacific Road Unknown (SW 1/4 NE 1/416 T29N R19W) Glover Station Add Parcel No: 16.28.19.1124 1.) Alt BM Description 4-)10-4 4 IV416e 0r Wet qj 0-41 Bldg sewer le = 5 / �'� Giw �. tr a �Gi.. ways GrE ,�( /c k/�`f �'!«j0 {•`,+� A� L LrAr�o �e 2. > g wtS lc;d d�w,.� ms ©kc c(inn•+��✓ Q �oca,�� ;k. p� �° �, <,• %��� - amount of cover= Wi jl 6� y y� `' fit, c( sd+�. <</W�vtr a.+M r11�r G�vtr.6U- Gv�t - G���� l ( [N�e✓ s1�x.74� � �o�pes :tiaf /.e�� ,�.-lt�m � tr„f• s `>� - Plan revi n equlred? Yes No Use other side f �f 3 0 lh' .S 97) Ot B!— /�c� Date [ / /, Insepcto ig nature /� Cert. No. �J �/ SBD -6710 (R l 4e Ohi 1 / e'e '� .>' cee Alai, / / 64*w " A't ')Ce �v(l tv_(� Safety and Buildings Division County �1 201 W. Washington Ave., P.O. Box 7162 V Madison, WI 53707 - 7162 Site Address / De artment of Commerce ��✓' b �c v`�/h c; iF-(c, • • . Sanitary Permit Number Sanitary Permit Application 3�y — l In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision ` c � way be used for sew ses Privacy Law, sl5. 1 m I. Application Information - Please Print All Information State Plan I.D. N r N p. Property Owner's Name Parcel Number ) (� 2 l a / Property Owner's Mailing Address perry Location 307 er y '� F'f;S, T ,90 N R City, State zip Code plyo oar ..` r Lot Number Bloc N umber II 5 . *��•+ ��' Subdivision Name CSM Number d Sa t er Idd. U. Type of Building (check all that apply) < O CT ? U 2001 ; ' City J9 I or 2 Family Dwelling - Number of Bedrooms ST C ROix _L illage ❑ Public/Commercial - Describe Use r COUN r l 0'. v tRTownship 7j} ❑ State Owned ' J'� Nearest Roa III. Type o ermit: (Check only out box on line A (numbering scheme use). Complete line B if applicable) A. 1 R New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use Sy stem Tank Only F;isft System B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) / 44;.Non - Pressurized In -Ground 210 Mound 47 ❑ Sant! Filter 50 ❑ Constructed Wetland _ �v .y f �r'S 22 ❑ Pressurized In - Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D tment Area Information: = DL7 ' - G 's Design Flow (gpd) Dispersal Area Dispersal Arm. Soil Application Percolation Rate System Elevation Final Grade 9d. Required Proposed �' I • Rate(Gals./Days/Sq.Ft.) (Min./Inch) %2, I Elevation bop boo ,U 9 /.y C4 l.s 9�.0 JE �i.o' VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel I Fiber I Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanis Tanks Septic or Holding Tack _ Dosing Chamber W VII. Responsibility Statement I, the , ar his0V@MVt41je POWTS shown on We attached plans. Plumber's Name (Print) 's Signature RS N Business Phone Number Plumber's Address (sweet, City, S ,zip Code) L4,1 f ve 0er /�� W/� s Q�owl VIII. Couun me artment Use Only gApproved ❑ Disapproved ��y Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) _ ❑ Owner Given Initial Adverse Determination IL Conditions of. Approval/Reasons for Disapproval A4.) !o7 I &4 " ✓WAII) j 0119 #A11 f s Ga'f,37 y„-f a.4 f Gf", /a b' t% KJ 2p-eu �G Attach wmpide go tits County only) for the system m paper mt leas than Un x u halm m six ✓ SBD -6398 (R. 05101) _ i ' ° 2nd Buildings Division C (Z) ton Ave., P.O. Box 7162 (� U L/1 WI 53707 - 7162 Site Address rr Department of Con 3�✓Osov`�'ie�✓I c ;trL San fi _. tion Sanitary Permit Number �+ is accords w/-13 a ( t ma 4 o1 you proms 0 Check if Revision L Application Informatie 5 _ State Plan I.D. N r N Q. Property Owner's Name Parcel Number , � - &sol 0S sai� /� bm Ad -1ad9- 90-z o - 993 Property Owner's Mailing Address $oPerry Location 3o 7 ZibC'U' � A F'A; S >1 T 1 N. R / Ir City. Stain Zip Code Phone- timber ` Lot Number Bloc Numbe Subdivision Name CSM Number II. Type of Building (check all that apply) OCT 2 b 2001 ' ` tcity JE 1 or 2 Family Dwelling - Number of Bedrooms — .oN ST GPXXX iilage 0 Public/Commercial - Describe Use COUi� % s ISTownship / -- Po ❑ State Owned Neatest R ... M. Type o ermit: (Check only one box on line A (numbering scheme use). Complete line B if applicable) A. 1 ;R New 2 0 Replacement System 3 0 Replacement of 6 ❑ Addition to For County use ste I I Tank Onl System B. 0 Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) / 44;6 Non — Pressurized In -Ground 21❑ Mound 47 0 Sand Filter 50 0 Constructed wetland v f re o, 22 ❑ Pressurized In -Ground 410 Holding Tank 48 ❑ Single Pass 510 Drip Line — 3 7 ' 45 0 At -Grade 46 0 Aerobic Treatment Unit 49 0 Recirculating 30 0 Other V. D' hnent Area Information: — a = o0 — G b . S' ' • 5 Design Flow (gpd) Dispersal Area Dispersal Aim Soft Application Percolation Rate System Elevation � Final Grade 96. b Required Proposed u l • Rate(GahJMys/Sq.Ft.) (Min./Imb) W. i i7 �'v` Elevation b oa 91.W `4 9s.5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing TRAM Tanks Septic or Holding Tank Dosing Chamber w VII. Responsibft Statement- I, the , or POWTS shown on the attached plans. Pi is Name (Print) s Signature nn RS N f Busineesss 'PhonelNumber�/ Ab � V , d� i ( 15 Plumber's Address (Street. City, Stdc. Zip Code) 3 Z f — y Z iL) VIII. Coven /De partment Use Onl Approved 0 Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ? ❑ Owner Given Initial Adverse • �� ��� 0 � Determination -S rX1� UL. Conditions of Approval/Reasons for Disapproval >h %.� !oY' w4-s ✓�•� <� P!N ffe./ Go f,$7� y c.af L(+K ✓e �a b` - -� Aaoch;umpteen (t• me Comty only) for the system an papa• not less On SM a u inch- in she SBD -6398 (R. 05101) — _ l alg -);t I � asan u e rn fat x /ooT I t o o �- cw a G 1M WI 1 13 •Z y 71. 1 � trehe Ps b7 EL X5. N 1�e _ fi o, s = j0, q l q. -!'3 q = f Z .O 3 �'� _ 43 ` 3 4' ? �cx•Fu.r[ � � Cg' $,M. ��+• 9do.b eN a .- �. 699 ra�n� y i aoo al `�� rH I e Q�i WAI f Y i AAGO Nome 1 o wed,( S[ofe F_in)'SkeJ CrJ fo Pre iii n fchd sly "Ng Qui� ern rA, Ito x nor � s sew. --� 92 ► T A q U4 L4 u Z� 8z. 78 � tin EL gst 2g' N , e T �a 9 ,�� 1 ��° t �� ,••• -^ �, A ��/ \ � �dItILQi �� 171• eFo 0 wet � E S 1 a fe. Vin i�k e d C r4a e d Prege rohj' W;,con�inDepaitmentoflndustry SOIL AND SITE EVALUATION REPORT Page 1 of 3 ' '�bor and Human Relations uiv�sion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but S'( G� 1 x not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCELLD. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R lEWEDBY DATE PROPERTY OWNER: PROPERTY LOCATION C b� a`f e E be"fN 1 S S Clt Q LT Z GOVT. LOT S V1 1/4 ►J � 1 /4,S Jb T 2 - a . ,N,R l9 E (oI&W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. {NAME OR CSM # t 1 - i`1F}td�3 9T- S) - O &�QR Sl"w 3 * i' i0N T CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD \Z XL) V�!iZ Z-- L_5 W 5Lj%ZZ. (715) (173 �IJ61 -'�R-O`( PA•zt,Ft [� New Construction Use Residential / Number of bedrooms y [ ] Addi#Qn to existing building j ] Replacement [ ] Public or commercial describe a Code derived daily flow boO god Recommended design loading rate o - 7 bed, gpd/ft Ire / Absorption area required S bed, ft `� S y trench, ft Maximum design loading rate o bed, gpd/ft2 2 Recommended infiltration surface elevation(s) SCI P&G ie 3 0 c 3 ft (as referred to site plan benchm I� N�O 1 .e" Additional design / site considerations SEE' NoT� 1v 1A 3'M M o N 1�� GC 3 c I ~ 3 Parent material S�Vt"t WT ov IM 3F " \> a G 211 U eL Flood plain elevation, d applicable A - "Fox 7==UunisSi4tabf ystem CONVENTIONAL MOUND "ROUND PRESSURE AT GRADE FILL stem ®S 1:1 U ®S ❑ U ®S ❑ U ®S ❑ U �'� U Z SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Con is e Y Roots PD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed T t 1 `ITz -313 S 1 ZT Sbk a Zu o•Sv1, 4' ZiE Z -zo [otiQ 3l6 — sib Z-�Sbk 41 f� CS IUf o S Ground 3 20 -2$ 10 `1 lZ Y/c/ S 1 Z'�' Jl�k `�. CS o• S . 6 elev. Q q • 1 3 ft. ZP41 7• S �ttz 31Y $ C S bk `/'/l U `�1,- r o • S Depth to 5 L11- I b a L o `1 tZ- we - S p S wl 1 - o• 7 limiting factor i > 1D8 ' Remarks: Boring # , o -t0 �t 2 3!3 - s t I Z � s b►z Mn� eS Z�� o.S o . S l 2c Ak wt v'F� cS _ o•Y Ground 3 R-AA to`1 tz v - S ©S yn )I - elev. a d it. Depth to limiting factor � l o be Remarks: TName:- Please Print Arthur L. We erer P 715- 425 - 0165 egerer Soil Testing & Design Service - P.O. Box 74 River Falls,WI 54022 SignaUue: Date: CST Number: ;2 43 -Yy �(- 2S_�t3 M00576 PROPERTY OWNER W-V SCHULj'Z SOIL DESCRIPTION REPORT Page z 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends S 1 - Z'�3bk w� �. cS g - 36 lv �lR 3�6 — s .1 Ground 3 36 -y tOLIQ S c - t i.SHR 51b a., - — elev. ti u3 -S 7PSV(2- 31y Depth to S SZ -It % Ilr -L ft y l6 — S sg I (N.� °• limiting factor ,r �iS �2 1 " ;� 3.0 9 4 'F S�1 S ht f S IC L�1 �3 Rl ZO► l 7 1 016 , Remarks: Boring # 9 - 1o `'L2 313 - S l 2'FS�At 0 - S -2 U'4 (Z'.. - S o• L M, 10 48 Y - S 1 Z 3 Yn `Ftr c 1 U p• S' 0 6 3 » -4. Z toy 3!G - 5� 2 `F S }sIT �H e S O. S o. Ground elev, y 42 -69 \o `1R s13 c�.S�� s1'b St <a 00.3 ft. Depth to limiting factor Remarks: Boring .`# 5: Z cl -Z3 tio `11Z y ly s t 1 Zf 51bk o.s v 6 3 23 -39 �.S`1 3Jy — 1S o S3 h'1 eS 0.1 •'. Ground elev. 39=yj6 to-ty S13 — a os > c`S Z - 1 ft. Depth to S y� -sS 1o ytZ s1j �;.syRSJV s) Ors. 'M cS — limiting S S - IDS �0 I t CL Y/G factor > ►o s " I'rS log �3 uq CY C A S�1S INS tte 3 uw 12! 5 Remarks: Boring # r 0 t o -i 2 3[ 3 — S l Z `FS b1rt In `Tb. S 2u� p. S i U� h }, 6.,Ki 2 cy-zs lo•-t a 'tly — -SO - L F c S w i tai }.• {x... ?:'::: :::.....::.:. 3 2S-6Z --)_ Sy2 31y — S1 1 C sbk y� v '�H C S o• y S Ground elev. Y 6 ) b `9 fZ Y /(, — S S - o• ' v $ � ft. Depth to limiting factor )Y6 Remarks: SBD- 8330(8.05/92) PLOT PLAN Page 3 of � u(3 ' LuT 51 IA 1 s T Wiiscormin Department of Industry SOIL AND SITE EVALUATION REPORT Page � of 3 Labor end Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but GV-3Z, 1 X not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCELLD. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: �R 4 1J�,1/4,S1(� T Za .,N,R \9 E(o�W 0, M 'B`f E 4f �"7JN 1 S SCl 11 Lj Z PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. {NAME OR CSM # 7 l� rJ. M(�UI`1 9T - S 1 — 6L_OQR sl"w 3 �` WbDI' ZKJ CITY, STATE ZIP CODE PHONE NUMBER DCITY []VILLAGE ®TOWN NEAREST ROAD W 1 5 4% J Z. (71S) (1 ZS , 8)C 1 TP.o `f 1 SWT)+eXm P"l,Ftc [x] New Construction Use [kf Residential / Number of bedrooms y [ j Add'ftkn to existing building [ j Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate o - 7 bed, gp(W - trench, gpolft Absorption area required $ Sib bed, ft - 7 S 0 trench, ft Mabmum design loading rate 0 - _-) bed, gpd/ft 0- h trench, gpW Recommended infiltration surface elevation(s) 5 VIE P" L" 3 0 F 3 It (as referred to site plan benchmark) Additional design /side considerations 6 91Z' &X jer To 1 N STtrt. L (M o tit '�Ot GL 3 0 Pt 3 Parent material SHIM OUT W e;_1 3RPvp 0 G MA U eL Rood plain elevation, if applicable N A ft S = Scgae for yySt8m CONVENTIONAL MOUND IN•C10AD PRESSURE AT -GRADE �TM IN Fill. HMDM TANK U= Unsditlefor hem ®S Elul ®S ❑ ® U S ❑U ® S 0 05 EjU []s oil SOIL DESCRIPTION REPORT Boring # Horizon' Depth Dominant Color Mottles Texture Structure Consistence Bard3y Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tiench 1 0 -$ �D`1tZ.313 SO Z� 5 b W, p, e S 2:v S u 6 Z g -ZQo Lo 4 1 CS luf Ground -1!6 R y/ — s i 1 z 3 yn a- 6 elev. g ZP 31y — S I \ csbk Yn.0 C Depth to S W -I o b 1 3`1 [Z_ V/c — S O S ' — 0 -7 ` o- $ limiting factor N > 1D8 Remarks: Boring # p -t0 1tz''t 1 3/3 — St I Z'F vvt`��„ cS 2v '�- o. Z Z jr -_qt jr_-c2 3/6 - S 1 2c sb>2 wt k3iv c S Ground 3 g8 - 1D 10 `1R VA - S s� yn - a7 0. % elev. a ll - o ft Depth to limiting factor Remarks: TName:— Please Print Arthur L. We erer one: 715- 425 -0165 eg rer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: ,/ 9 3 y Date: - 2$_ �'3 CST Num 0 0 5 7 6 PROPERTYOWNER _. SCt}U%-t SOIL DESCRIPTION REPORT Page' Z- '3 ` PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP.D /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench `< b- 1%,)`IR.3 L - 3htiL cS Zu', o - o Ground 3 36-y lo4Q S13 c - h.SLiR 51b — elev. 0 ft. u3 -S SI -M 3!y — S cSbk �r�nv 3.q o•S Depth to S Sz.-Ibt lo`LR Yl6 — S v sg w _ a, o•� limiting factor ,r RS e;Z- " ;�-3 • U'Y a `F a S4 S hlt� 1 S M t-L'h Z31 Rl zAw! 3 Remarks: Boring # 1 0 - -t V- - 3 A - S l 2'�S +►1'F► - c S Zug c,•S I c•� ti`,y... °° Z - - 1' 1 - Z�ahk vn C- S )u� o• s i 6 Ground 3 \ Z. LO y lZ 31G - s ) Z`F5 bk '�(� [� S O , S ! O• �, elev. 4 qz -0 \0`)R S x, 00.3 ft. Depth to i limiting i factor Remarks: Boring # ��: ��•�.,.` � O --9 1.0 `1R 313 _" S 1) Z�S�f� r� fh C S 2u`� V• S # 0. b LM Z Cl - Z tioy�Z4ly s�) Z� s l�k Y1�v^ cs 1u� o,s u•6 3 23 -39 a s _ o.`1i0•$ Ground h of LA lu`12 513 — 91 5 o s C S Depth to S y- S S 1 O 1 R S 1 j • S y R S J% S i limiting SE -IBS vo Y/G - S S�j wt � - 0.7 o•S factor y [ WS y-yWLtLV '3,uq C4 C A SLi c F3E Otis t�L� 3 tx.v 1Z! 'S= Remarks: Boring # r S n. S U• 6 It --tv -. b y — t Z.`� sbk VA 4. G S u o• S o• 4;$ L':•: rc., ! s ............. Ground 3 Ps-6 -?. S `/2 3 !y — s 1 Sbk whv �t^ c S o. y j o. S elev. �! 6z_ly lb'-1fz Y/(, S O 1 3� ft, Depth to limiting factor ) Remarks: SBD- 8330(R.05/92) PLOT' P LAN Page 3 of s0- /� t._ N - uo ' Lc:I s l tJ $Z °fib' 3O`w '2.10 �. vLOQLM XQLOhD I 1 I i i , ' R � 3Y1 �,aS.Z$�o►� �►��rk� A� t�Lt�ttn►rtt-� a ? 3�V "DtA PvC c 3 Z 9�i1� S �7 1�iPC w /��7Nvb.l E� -..Ro - - W E (3 E E E F;: S Q I t_ TEST I tV G F.O. BOX 74 421 N. MAIN ST. AND RIVER FALLS. WI 54022 • I7 E S I Ct�t S E t� fir! I C E 715- 4LJ'016J V ATTN: " ;DATE - 3� �- S • a < `CC: SUBJECT: 4 WE ARE ENCLOSING THE FOLLOWING ITEMS: N0. OF COPIES DESCRIPTION SENT TO YOU FOR THE FOLLOWING REASONS: ❑ FOR APPROVAL []APPROVED AS SUBMITTED ❑ INFORMATION DESIRED 0- YOUR USE ❑ APPROVED AS NOT ❑ RETURN COPIES ❑ NOT APPROVED ❑ FOR REVIEW AND COMMENT ❑ 1 L��r S9 13 6r0 FLi�--- t) Loy s I OF � l_C)l� 12 � U� � �% � 1J •1 `C C��� SJ�i L O�IU�S . WEGERER SOIL TESTING AND DESIGN SERVICE POWTS O WNER 'S MANUAL 6L PLft1Nr+ vcr - .a.4r& • ""s - 'NF$RMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity /boo gal ❑ NA Permit # 39� ( Septic Tank Manufacturer ❑ NA Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS 13 NA Number of Bedrooms 4 ❑ NA. Effluent Filter Model ' 412) D Number of Commercial units NA Pump Tank Capacity gal Estimated flow (average) V (3 gal /day Pump Tank Manufacturer [3 Design flow (peak), (Estimated x 1.5) X00 gal /day Pump Manufacturer ff'NA Soil Application Rate pr �day /ft Pump Model A Pretreatment Unit ❑ NA Monthly average* Influent/Effluent Quality ❑ Sand /Gravel Filter ❑ Peat Filter Fats, Oil St Grease (FOG) :530 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids ( TSS) <_ 150 mg /L Manufacturer Pretreated Effluent Quality , ❑ NA Monthly average* * Dispersal Cell(s) Biochemical Oxygen Demand (BODs) :_30 mg/L C�7�(n- ground (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) :530 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) :_10 cfu /100m1 ❑ Drip -line ❑ Other: Maximum Effluent Particle Size A inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency ❑months year(s� (Maxiimam 3 yrs.) Inspect condition of tank(s) At least once every Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume Inspect dispersal cell(s) At least once every ❑ months W- year(s) 74MaAmum 3 yrs.) Clean effluent filter At least once every ❑ months ,a year(s) 1 Inspect pump, pump controls at:alarm At least once every ❑ months ❑ year(s) ETN Flush laterals and pressure test At least once every ❑ months ❑ year(s) ETNA Other: At least once every ❑ months ❑ year(s) l3'NA Other: At least once every ❑ months ❑ year(s) t7-NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall bemad bae ; POWTS WTS M'aintainerf cert Septage Servicing Operator. Tank inspectio Plumber; Master Plumber Restricted Sewer, PO ken hardware, any cracks or leaks, measure t must include a visual inspection of the tank(s) to identify any missing or bro 1 g of effluent the ground surface. The dispersal b volume of combined sludge and scum and to check for any p o cell(s) shall be visually inspected to check the effluent le vels m indicate p and f any ponding of effluent requires the immediate the ground surface. The ponding of effluent on the ground surface may notification of the local regulatory authority. the entire When the combined accumulation of sludge and scum In a n y tank equals o disposed o in accordance e ch. 113, Wiscon contents of the tank shall be removed y P g Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatm ea�cell(s)f o if high concentrations l rations are detected have the conte that may impede the treatment process and/or damage the disp ^ r the ran{r(sl ramovPd by,; sent;we servicing opera prior to use. Date -of System start up shall not occur when soil condltlons are frozen at the infiltrative surface. During power outages pump tanks may fill above normal hlghwater levels. When power Is restored the excess wastewater will be discharged to the dispersal cell(:) In one large dose, overloading the cell(s) and may result In the backup or surface discharge of e ffluent. ower to the effluent or contact h a Plumber s r POWTS MjIntalner o assist In pe ying operating the pump cont rob to P restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells Do not drive or park over, or otherwise disturb or compact the area within 15 feet down slope of any mound or at-grade soli absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POWTS: antibiotics; baoy wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; tat; foundation draln (sump pump) water; fruit and vegetable peelings] gasoline; grease; herbicides; meat scraps; medications; oil painting croducu: pesticides: sanitary navkins: tamponsi and water softener brine. ARAN DON EM ENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and plu shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space fllled with soil, g: or another Inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to prov14e a code compliant replacement system: tB'A suitable replacement area has been evaluated and may be utilized foe the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be Infringed upon by required setbacks from. existing and proposed structure, lot (Ines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a sultaNe replacement area. Replacement systems must comply with the rules In effect at that time. O A suitable replacement area Is not available due to setback and /or soll limitaticins. Barring advancts in POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. O The site has not been evaluated to identify a suitable repbcernOt area. Upon fallure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area b available a holding tank may be Installed as a last resort to replace the failed POWTS. O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the inflitra0ve surface. Reconswalorts of such systems must.comp(y with Ot rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE OF A PERSON FROM TK-9 INTERIOR OF A TANK MAY BE DIFFICULT OR IMpk1�CIR1 i. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER E_ Name h/A N C-7 Na me A� 1L W L` ` t C- Phone S — L - q� Phone SEPTAGE SERVICING OPERATOR (PUMPER ) LOCAL R>r4ULATORY AUTHORITY F ame nnf j >pnc)' `5 , (,(L0 l /- CWrj� Its h hop 6 6 � ' ST CROIX COUNTY SEPTIC TANK MAINMANCE AGREEMENT AND OWNERSHIP CERTIFICATION [CORM Owner/Buyer Mailing Address Pmpc y Address b (Vuificatioa requircd from Phaaiog Dcpufmc at for new construction) fD /Zea l cit3 State 1/�Y �s ► �/�(� Pawl Identification Number 04Q ?. ?�9 — 4�0 X13 LEGAL b N Go J lao7` pro (30 Location S %, y�, sm T.2RI R J W, Town of Subdivision Lot it CertMed survey Map # Volume . Page # Warranty Deed # ' volume 2_ , Page # SpoG.house 0 yes no Lot lines idcat£tableX yes 0. no SYS13.�ItIaNf�A'II���'�N� - • Imaasesads�ramo0c�mbeafy ,oer�ldaemt�tmiis coQSisCs of ctol�icwist�s .Propermaabcaan�oe eanaffccti bcct "waoftb e GCifirecdCdb y aYnoc � o d yo¢p�mboQrc � c �atcxs . =�gelatbeta�te&sposats�bcar, .. - - . acistrxp � t0 m�"tW St Inc 7'°amtg D �'° Enna. sig�mod 6Y ffi�e ooearx,�ud ty: ism �Ps�dodpbDmbaac :Tcxasod that (1)8reoa�antcvradisposalsps� °P acedlorg after d gC¢ Y).�u��tantcis icss�aa tt3#ultofslaafgG. �. Lea+ � asoctb3► maDet �mdQ�eDqucem�cofN�algs�v�o� ;statcofFri9ooa�iu.. fica d'itS*w'V6csYstaubasbocama iatzaoodmastbc coar�dandreb�=cdto tbc SLOui �ridua 30 the txCouaty7dllboe Y�datc r 1 SIGNAIM OF APPLICANT DATE (w "c* that ill Adt=C1ft on this form am tone to the bat of my (omc) bwwkdge. I (we) am (are) the owncx(s) of 7OF by virtue of a wattaatjr flood m000rdod is itcgistcx of Roods Office. PTICMT DATE ssas4s , iafotm d(at that is mis red = twit in rho unitary Permit bcing revoked by the Zoniag Dvarbmmt.' * * * ** " Indade "Idt this aPPH xtion: a ttaa * wumaaty flood fim the g,gister of Doody office a Copy of the ccdMcd turwcy asap if td=v= is made is the waa[aaty dcod i0 .. �. wi.1524PA6:553 STATE BAR Of WISCONSIN FORM t • 19" t626d70? KATHLEEN H. WALSH WARRANTY DEED BocaneatNsabet REGISTER OF DEEDS ST. CROIX CO., III T16 D@4 mats between Da rmak IL A Sandra G S halts W EIVO Fat iIECRRI Rerarabie Tkud Deal R �, ,� 07.97 -2000 9130 AN 1101210" KEO G rastor, sad Jaaoem L Ken amd Sono L KAn htd6 d msd wih as EXERT I =a" — COU COPY FEE: Vol COP► FEEL TRN19FE11 FEEL 149.71 RECOR1I11O FEE: 10.00 Grantee. Mot I Grantor, for a valuable oatsidetatimt, convoys to Grantee the following described real estate in SL Crab County. State of Wisconsin (if more space is "Wed. please attach 6 7 Reeordisp Ara LOT FIFTY NINE (39). GLOVER STATION FOURTH ADDITION, Naae ad Return Address 2 TOWN OF TROY. WESTCONSIN CREDIT UNION TOGETHER WITH shared driveway easensent over Lot 60 m shown RI aox LL RIVER FALLS WI 54022 on said plat. GM•122A 4/•1/04/1! parcel Waufieatios Nuber (TIN) Together with all appunwaot ftbts, tick and interests. This le sat koaeauad propsny. lid (it +ot) Graatar wamda that the tide In the Ytapetty is `sod. indefensible in fee simple and free and clew of enaaabranoes except eaaesnents, restrictions, ad rTomod way of record. Dated tlis aBACt day of MOL q 3900 It. A Sides addle • Tnwaes. • lt..dks C. Schaft, T*wd e • AUTSINTICATION ACKNOWLRDGM =NT SiasatrraU) STATE OF WISCONSIN ) ss. ST. CROIX County authenticated this .,_day of Personally cane before me this c;3/td day of - Tyl .,( 2111 the above asset Dads lt. surd Satwhra C» 8ehniR TITLE: MEMBER STATE BAR OF W ISCONSIN of not to me known to be the person(s) who esseYied Illb- psoia8 authorised by 1 706.06. W is. Stars.) inatrom t sod know ladled the same. ".„ THIS INSTRUMBNT WAS DRAFTED BY simmiLGOdEAaoragat LOW _ Notary Public. State o /Wiaconsi6 My Commission is permanent. (Its (Sissamem may be uWstiaad of st adviodled. Book an not aoceanry.) 3 - / 1 ' • Noses of persess sipiaS Is say opacity asp be typed or printed below *sir dpamre. cWWq. nW4#j1A&ex r WARRANTY Ban $TAT& BAR O /WISCONSIN roam No. I • IM C 71 6 �� J1 00 of 5 �g A 1 2 3 of �� I N S Z �� I �1 F- I I ca nl 'n Li 0 Ol I ¢ I �I �00 Q I n v1 O a J _ _X (jl I zl u • n_I? �0 0_ J WI SZ'lyy M ,.OF i N 6 N \ U of I of ° O I. ��� LLJ Z �" W I n N , w �rn I L► \ U I ti of 3 :' N O LO' @9S 4 J I co ° w 69 I �0321YH3 AYM S I � @0'ZOL I a 0j 1 N3wasv3 _ - 0 „ Of ,£4.L0 w 0 i 00'4L4 N OI 1/ Z L LL I ! jf L O I b � M • 6Ol W �. < to u V• I� b � N :I Ana �i0 V , m 17 W N q I ,99 ^n W N mN Z N F— N0 X11 •• { NF <� t--' WO WZIL' l; rY••• LL.J 1GN W x � I z U ao '� 1 Y w= 3 3Nn NOUO3S t/L HIMS — HttlON Z i " o Z i LIJ 3: a #: Q \ Z N LL to N \ 00'OS£ 3 ..9E ,f0.10 S a- Z 8'£ Z 3 9£ SOLO S .f0 N WI :... ..... .........................:....: AWOL ....... L I s E8'SEf I (n = of :1 ° _j� Ld _ S Ll 3 7 7 <N a m t ;1 (0C W Li � coo r CO fito UP ,. '' .a „vsxM n „„� #;w a 5 .. ;• # `If1'.iLY . ,.4?',