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Home My WebLink About040-1160-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Saf and Br�ildings Division 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)]. 353311 Permit Holder's Name: ❑ City ❑ Village ❑ own of: State Plan ID No.: wanson, Ken Troy Township CST 8M Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 040- 1160 -40 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic t �°-� Benchmark Dosing ) I Cj' )t; I Alt. BM Aeration T b! j°)t L _ Bldg. Sewer Holding /r ' Yf P6' I St/ Ht Inlet TANK SETBACK INFORMATION "= 5)f / let Ventto TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length Dia. He ad Dist.Towell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O f CHAMBER Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: Include cods discrepancigs, personspresent etc.)) Inspection #1: / / Inspection #2: L ocation: 2 Plainview Drive, River Falls, WI 54022 1/4 NW 1/4 25 T28N R20W) - 25.28.20.626A -Lot 1 1.) Alt BM Description= 2.) Bldg sewer length= - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. ITT SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: { a 1 d t R v � v 3 ¢ a F r P_ } a F a z ➢ ° I s .., e v F a f ¢ 3 t 3 a � p � ... , _... , ,. .. ..,-., _ i ,.., ,.. ... ➢,.�.,... ..... z . a ..p .. ..._ _ .. .1. ,..:, 1 .. ......4 M- ., n. t a i f 3 e } f 3 4' t f v � e i r E P P 4 3 g a n i a s s _ L 6 } # t 1 # # c e � a € t g � � s � f F k 'f d a f t f S f f t { «.s. �+v....., , ...... , .. P ¢ x v e t' y s { 1 # t P f t P t n , a ry w r r r , qq vm ,.Fs. ,:..�. s.. d ..p.� m,. '3. .. ,m m <. t Y f L s e F e f L Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Visconsin P O Box 7162 Department of Commerce In accord with Comm 83.05 Wis. Adm. Code Madison WI 53707 -7162 • Attach complete plans (to the county copy only) for the system, on paper not less County , than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Nfirinber 35 1 l Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan Review Transaction Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Name Property Location W �y� /a /a, S T a N, R ,2O E (o W Prop Owner's M Address Lot Number Block Number City, State r Zip Code Phone Number Subdivision Name or CSM Number S Z 5 vu Ir TY PE OF BUILDING: (check one) ❑ State Owned ❑ it Near , Public 1 or 2 Family Dwelling - No. of bedrooms 3 ❑ Vil w 01 j� III BUILDING USE (If building type is public, check all that apply) Parcel Tax Numb s) IQ 1 w 71 ?16 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 Q Campground 7 ❑ Merchandise: Sales/ Repairs 11 Q Restaurant /Bar /Dining r I 1 Se rvic e Stat ion r 4 ❑Chu Chu / Schoo 8 Mobile Home Park 2 ❑ Se Ice Stat o / Ca Was h 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 a A) 1, ❑ New 2. ❑ Replacement 3_ ❑ Replacement of 4 econnection of 5. ❑ Repair of an Sysstem System TankOnl�r •��izisting5ystem Existin System ---- - - - - - - B) ❑ A Sanitary Permit was previously issued. Permit Number 2 Date Issued 1 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 1 '1 ❑ 5e See e Trench 22 P9 ❑ epage Bed 21 E] Mound 30 []Specify Type 41 C] Holding Tank 2 — a In- Ground Pressure 42 [3 Pit Privy 13 ❑ Seepage Pit r 43 ❑ Vault Privy 14 ❑ System -In -Fill 2 S� _ (0 VI. ABSORPTION SYSTEM INFORMAT N: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Require (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /'nch) Elevation Q S / (� U Feet �1,�`" Feet Cap acit y VII. TANK in Ca allo Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin structed Tanksl Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's N e: (Print) Plumber's Si e: (No Stamps) MP /MPRSW No.: Business Phone Num r: Plumber's A dress (StreeR y, State, e)) IX. COUNTY / DEPARTMENT USE ONL ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) A roved �I pp []Owner Given Initial /02,5- 6b Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROV L / REASONS FOR DIS S� p A, c&AL SBD -6398 (R DISTRIBUTION: Original to County, One #py To: of tugs Division, Owner, Plumber INSTRUCTIONS _ 1. A sanitary permit is 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 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. Provideall 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 mutt be submitted:to the county. The plans must. include the followin j: A) plot plan, drawn to scale or with complete ifiir'ension'%lecation - ©f 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) fora riumber of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I LP 24 SEPTIC SYSTEM AND WELL INSPECTION REPORT (To be completed by licensed plumber) TO: I hereby certify that on U707 -C�6 era , I G inspected the septic system inspected the well obtained a drinking water sample Property Owner: Address � As a result of my inspection, I certify that:/g,u� � - In my opinion, the septic system was, on the date of my inspection, in good working order and in compliance with all applicable state and local codes. If not, explain In my opinion, the well was, on the date of my inspection, in good condition and working order and in compliance with all applicable state and local codes. If not, explain In my opinion, the septic system and well were, on the date of my inspection, in good working order but not in compliance with the following state or local codes: Explain I forwarded the water sample to for testing, and a copy of their report is attached hereto. Well LM!g Septic System Year installed: Year installed: Drilled /Bored Septic Tank / Gv �� Dug Driven arc- 11�� ✓z � Other (Please attach sketch showing location of well and septic system in relation to ekc_b other and to the dwelling.) Those atters to wich I ave certified above are statements of my professional opinion. This certification is not a guaranty or warranty, and I disclaim all liability for any loss caused by reliance on this certification, except to t e xtent caused by gross negligence or intentional misrepresentation v certification. ':O'�� - 6 License # ignature of Licensed Plumber Date Rev i - ;ed ,and Rf f ect i ve ?-24 Page 14 ST. CROIX COUNTY WISCONSIN ZONING OFFICE *urs CROIX COUNTY GOVERNMENT CENTER ' 1101 Carmichael Road nV '' y; Februar y y 14, 2002 2:27 PM Hudson, WI 54016 -7710 To- Rod Eslinger (715) 386 -4680 r Fax (715) 386 -4686 Subject: FW: phone call I please handle Steven Fisher Zoning Director St. Croix County, WI phone: (715) 386 -4680 fax: (715) 3864686 stevef @co.saint- croix.wi.us <mailto:stevef @co.saint- croix.wi.us> - - - -- Original Message---- - From: Jane Hansen Sent: Thursday, February 14, 2002 9:57 AM To: Steven Fisher Subject: phone call From Ken Swanson 386 -9725 regarding a permit for a trailer. Sounds like a special exception was granted a few years ago for this trailer. Trailer is now sold to another party, trailer has moved 6 feet, land has not been sold. New trailer owner is asking Mr. Swanson for $500 for the permit .....Town of Troy, end of Plainview Drive. Thanks,Jane —� z is o� -- w, �( ►�( C4- � it C l rtvt � �,� � f� rJ� �e `� f Sul V► . Parcel #: 040- 1160 -40 -000 09/06/2005 11:35 AM PAGE 1 OF 1 Alt. Parcel #: 25.28.20.626A 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): O = Current Owner, C = Current Co -Owner KENNETH E & CHERYL K SWANSON O - SWANSON, KENNETH E & CHERYL K 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 249 PLAINVIEW DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 26.300 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W NW NW NW NW ALSO KNOWN Block/Condo Bldg: AS LOT 1 OF CSM 5/1207 EXC PT TO CSM 12/3350 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25- 28N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/28/1999 607623 1445/106 WD 09/24/1997 565846 1266/71 TI 07/23/1997 994/451 QC 07/23/1997 714/285 2005 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 38,000 26,000 64,000 NO AGRICULTURAL G4 7.000 700 0 700 NO AGRICULTURAL FOREST G5M 17.300 45,450 0 45,450 NO OTHER G7 1.000 10,000 124,300 134,300 NO Totals for 2005: General Property 26.300 94,150 150,300 244,450 Woodland 0.000 0 0 Totals for 2004: General Property 26.300 139,600 150,300 289,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M 140 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 040- 1160 -20 -000 09/06/2005 11:33 AM PAGE 1 OF 1 Alt. Parcel #: 25.28.20.625A 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): O = Current Owner, C = Current Co -Owner KENNETH E & CHERYL K SWANSON O - SWANSON, KENNETH E & CHERYL K 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 245 PLAINVIEW DR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 27.280 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W NE1 /4 OF NW 1/4 EXC PT Block/Condo Bldg: FOR RD AND EXC CSM 5/1298 AND EXC 2.53AC AS DESC IN 835/150 FOR P625C AND EXC PT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) TO CSM 8/2287 25- 28N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 835/150 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 60,500 439,000 499,500 NO AGRICULTURAL G4 25.000 2,500 0 2,500 NO Totals for 2005: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Totals for 2004: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 145 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i Parcel #: 040 - 1160 -30 -100 09/06/2005 11:34 AM PAGE 1 OF 1 Alt. Parcel #: 25.28.20.625C 040 - TOWN OF TROY Current *J ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner KENNETH E & CHERYL K SWANSON O - SWANSON, KENNETH E & CHERYL K 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.530 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W NE1 /4 NW1 /4 COM N1/4 Block/Condo Bldg: COR SEC 25,TH N 89 DEG W 1349.92',TH S 1 DEG E 829.48' TO POB,TH S 89 DEG E Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 225',TH S 1 DEG E 490',TH N 89 DEG W 25- 28N -20W 225',TH N 1 DEG W 490 - TO POB 2.53AC Notes: Parcel History: Date Doc # Vol /Page Type 07/28/1999 607623 1445/106 WD 07/23/1997 994/453 QC 07/23/1997 835/150 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 12/02/2002 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 2.530 300 0 300 NO Totals for 2005: General Property 2.530 300 0 300 Woodland 0.000 0 0 Totals for 2004: General Property 2.530 300 0 300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 .. A I FORM - STC - 104 AS DUILT SANITARY SYSTEM REPORT OW14ER /vi If TOWNSHIP_ SECTION 25 N -R -7 0 W ADDRESS N dI-etd _rt . ST. CROIX COUNTY, WISCONSIN w �^ �1 ��. uAz I SUBDIVISION LOT -- LOT SIZE 4 PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM JA#)&wg�" 1 /low !A! • I 3o f e ri uGw01 10 x A p tx1,4 0 INDICATE NORTH ARROW DENCIMARK :Elevation and description: tgo .0 Alternate benchmark SEPTIC TARK:i.ianufacturer: (/CSks Liquid Cap. � V /c ? Rings used: 0 M anhole cover elev: ft t/ Final grade el O Tank inlet elev.: Q8 , o gl Tank outlet elev.: y7, g2— tlo. of feet from nearest road:Front Side , Rear Ft. - 7 - f - v From nearest prop. line :Front , Side_ Rear Ft. Ae No. of feet from: Well &o Wr/ ( , Building: i (Include this information in the above plot plan) �l `► (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model.: Pump /Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons /cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop line: Front —, Side_, Rear,_Ft. Distance from: Well Building SOIL ABSORP`T'ION SYSTEH Bed: ✓ Trench: Seepage Pit: Width: /Z Length S 7 Number of Lines: Z Area Buil Exist. Grade Elev. EEO r Proposed Final Grade Elev. Map � M Fill depth to top of pipe: _r'�'.zL I� No. feet from nearest prop. line:Front , Side , RearFt.j�� welt 110. feet from well: 00 No. feet from building S/ HOLDING TANK Manufacturer: Capacity: I � No. of rings used. Elev ation of bottom tank: Elevation of inlet: No. feet from nearest prop. line :Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: I � INSPECTOR: PLUMBER ON JOB: DATE: ! •Z L1.1 04 LICENSE NUMBER: J? ids 6 /90:cj I SAFETY & BUILDING ' D�PARTME �4T OF INDUSTRY INSPECTION REPORT FOR LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION �Q[�ISON,,.�I,I 11 § . 2 5 , T 2 8 -R20 State Plan l.D. Number: l jvW CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Troy El Hol lingo Tank ❑ In- Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION OA= Barnard Ashback Jr. 247 Plainview Dr. , River Falls W / - BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. P . ELE .: CST REF. PT. c�r•'�'l fA.l� Y 3 Name of Plumber: MP /MPRSW No.: County: Sanitary Permit Number: David Fogerty 3289 St. Croix 128851 SEPTIC TANK/ D MANUFACTURER: LIQUID CAPACITY: TANK IN LEV.: TANK O V.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 97 V3 5r YES ❑ NO ❑ YES X NO BEDDING: VEN+-DIA.: VraWFMATL.: HIGH WAT n NUMBER OF ROAD: PROPERTY WELL ILDING: VENTT ESH C.C). I C C. O - ALARM: mil' FEET FROM _ LINE: AIR INL, T: ED YES NO ❑ YES NO NEAREST MANUFACTURER: I BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP /SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO I � GALLONS PER CYCLE: NO CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YE NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING., or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: ## PITS: LIQUID BED /TRENCH 1 TRENCHES: MATERIAL: DEPTH: DIMENSIONS GRAVEL DEPTH FIL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATER AL: N . STR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOV COV�T : ELEV. INLE ELEV. E q:, a PI ES: LINE: ( AIR INLET: 3 I Y Z"4 ?e FEET FROM NEAREST �� >�� MOUND SYSTEM: a Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXT PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEP OVER TRENCH /BED DEPTH OVER TRENCH /BED HS OF TOPSOIL: SODDED: SEEDED: MULCHED: CE ' EDGES E I � l YES ❑ NO ❑ YES ED NO El YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED /TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRA PTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. I_ fftST9_Z L PE DISTRIBUTION PIPE MATERIAL 8 ARKING: ELEVATION AND ` ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: t DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST —� E�j - ?�� ' o-e4lkv aQ� �-' ain in county file for audit. Sketch System on Reverse Side. URE: TITL SBD -6710 (R. 06/88) Sr� ' SANITARY PERMIT APPLICATION 7-DILHR In accord with ILHR 83.05, Wis. Adm. Code COUNT STATE SANITARY PERMIT # - Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / >jS" 8% x 11 inches in size. if is En to pre sous application -See reverse side for Instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION BERNARD N. ASEBACK IM. NW % NW %, S 25 T 28 , N, R 20 E (or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 247 Pla"view Drive n/a n/a CITY, STATE ZIP CODE Z IA) NE NUMBER SUBDIVISION NAME OR CSM NUMBER River Falls, WI 1 54022 D _ � 5/0-Z 76'2. IL TYPE OF BUILDING: (Check one) ❑ State Owned VILL AGE rr NEA * Vew ❑ Public L121 or Fam. Dwellin"of bedrooms3 PARCEL TAX M R 111. BUILDING USE: (If building type is public, check all that apply) Z 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE PERMIT (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION D I k S / S 7 Feet 7 S Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concret Con- Steel glace Plastic App Tanks Tanks structed Se tic Tank or Holdina Tank O 0 G(/ e Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. P Name (Print): �� Plumber's Signature: (No Stamps) MR/MPRSW No.: Business Phone Number: vr r �� 3�'°�' 7�L9 T6s'� P u s Addre (Street, Ci , State, Z10 Code): w 0 23 IX. TY/ EPARTMENT USE ONLY i a Permit Fee Includes Groundwater Date Issuing gent Signature (No Sta ) Sant Disapproved Sanitary PP Surcharge Fee) Approved ❑ owner Given Initial + s ,� Ad verse r ti X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -8398 (formerly Pib -67) (R. 11/88) 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 the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. : , L ,_ 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pump.er whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings.Division, 608- 266 -3815. To be complete and accurate this sanitary permit application must include: 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. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8'f 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 bythe county; E) soil.test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contaminatidn investigations and establishment of standards. SBD -6398 (R.11/88) APPLICATION FOR SANITARY PERMIT STC -100 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 �Z(" N/<,.�2 /V _ 4,5,IX6 1 �4 "J- Location of Property N vJ Section L , T N -R W Township Mailing Address - y 7 PLA /d Ll Oek 1 y i Address of Site S�G Subdivision Name Lot Number Previous Owner of property __ LO Total Size of Parcel `��s 14 C Ile &75 7 Date Parcel was Created Are all corners and lot lines identifiable? /X Yes No Is this property being developed for resale (spec house) ? Yes ,' No Volume S and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING A Warranty Deed which includes a Document number volume and page number and the Seal of the Register of Deeds In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTy OWNER CERTIFICATIO I (We) eexajy that at statements on thi,6 Jonm ane t ue to the best a6 my (ouh) knowledge; that 1 (we) am (ahe) the owner (.$) o6 the pna pent y dens eh i,b ed in thus in6atmati.on farm, by v iAt ue ob a watvcanty deed neconded in the 04jice o6 the County Reg.vsxen o6 Deedd a3 Document No. ? O S 7 Z and that I (We) pne-s entty own the ptopo.aed site bon the sewage cU po.s .sys em (on I (we) have obtained an easement, to tun with the above duenibed ptopexty, 6o the con6tAuct%on o6 chid .system, and the same has bee duty teco&ded in the 04jice of the County Reg-i.aten a6 Deeds, as Document No. N ). SIGNATURE OF OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOM MINT NO. STATE SAA OF WISCONSIN — FOAM 2 WARRANTY DEED VOL 6J4 PA - f 99 "M W#= r4UWftU FM Ar.49 orlD DATA ,y REGISTERS OFFICE ST. CRO1X CO., WIS. oidn J. Ruemmele and Thomas J. Ruemmele. Recd. for Reaord Nth 2 _ tenants in common 4 day of Oct A. D. 19 Mr1I Aft�wl>rrM1aW Rernard N_ Aahharh, _Ir_ and al 3'10 M. 4 � j Na:01 B. Ashbach. husband and wife- as teeanta Oaa/r <ti "TUM To Fed. Land Bank Assoc. vo laftwkp daaortsa - real estots M St. Croix County, Box 136 �Itls of wiscoealrt: River Falls, WI 54022 NW }NW} together with the following; easement: ¢r A 33 foot Private Roadway easement. for Tax Key No. ingress and egress from a fown Road known v as Plainview Drive to the Fast line of the NWT of the NW; of Section 25, described by the centerline, said easement is 16.5 feet on each side of said centerline as measured at right angles; commencing at the NW corner of said Section 25, thence S. 89 ° 57'31" F. along the North line of the NWT, 1349.92 feet, thence S. 1 °07'59" E. along the East line of the NW} of the NWJ, 162.65 feet to the point "�� `Jr ZR of beginning of the centerline of said easement, thence S. ; r� 84 ° 15'28" E. 139.49 feet, thence N. 67 E. 102.26 feet, thence N. 60 E. 227.24 feet, thence N. 5'i° 30"36" E. 241.47 feet, thence N. 66 '55'52" E. 92.11 feet, thence N. 80 ° 27'33" E. 82.00 feet, thence N. 87 °46'22" F, 233.71 feet, thence N. 8' 0 21'07" E. 7£3.41 feet to the Southerly right of way line of said 'foam Rd. ( Plainview Drive) and the end of said easement, All in Sec. 25- T28N- R2()W. TMs i s n o t tw meagad poverty. EMapOnlsworrontNw Existing highways, easements, rights of way, restrictions of record and any liens or encumbrances created or suffered to be created by the acts or defaults of the parties of the second part. 19L _dayof October 19 (SEAL) r i J, /_ �� r !Z=e__4� C (SEA john Rtipmgzl v (SEAL) r k. (SEAL) +., e Th imjs .I _ Ritr-mmP1e :. AUTHENTICATION ACKNOWLEDGEMENT •lOnattnas &Ahattloatad tMe day of STATE OF WISCONSIN is so. County. 19t Personally came before no, this day of October `TREE MEMBER STATE BAR OF WISCONSIN the above nrmod .._ (1t not. eWhorm" by 1 706.06. Wis. Stats.) J J , R u e mme 1 e and )'homes ,1, Ruemmele V This Instrument was drafted by Attorney David J. Estr r w.. 619 2nd St.. Hudson , W T to me known to he person 1 wfw executed the foregoing In- strument now (od same. J (Slpftatum Ale be autfanI"od or Acknowledged. SOIh are not Notary Publ(ll Ac sln h County. Wis. •Ii"w eer WAS in say uPAG" sw" M HWNO Or MwMM "wow th" Siva ws. . . My Comm) Mi not. state eapwatbn date '' sM i1tlCR 1N► 1 A.: DOCUMENT NO. STATE BAR OF WISCONSIN FORM 3-1982 THIS SPACE RESERVED FOR RECORDING DATA QUIT CLAIM DEED 402752 va 714 PAGE 28 iREGISTERS OFFICL Hazel B. Ashbach 5T. CROIX CO., WIS. ------------------------------------------------------------------------ - --------------------------- ......... ............................-.... ................................................................................ vl`d, for R ecord this 17th -------- - - - --- ----- -------------- ... .... ........... . — . quit-clai ms __ to - ___B - ernard __ N . . .- As - hbach . , - J r . - ................................... o of I June A.D. 19 85 ......................................... - ---------------------------------------------- t 8 :30 A ---------------------------------------------------------------------------------------- -------------- --------- ------------------------------------------- -------------- ................ -------------- ---------------- ------------------------------------------------------------------------------------- ..................••...•... ------------------------------------------------------------------------------------------------ ................ the following described real estate in ..... 5:tj�._QX�Qix ........ ------------ County, State of Wisconsin: RETURN TO Certified Survey Map in Volume 5, Page 1207, Northwest of Northwest of Section 25, Town- Tax Parcel No: .............................. ship 28, Range 20. More specifically described as: * parcel of land located in the NW 1/4 of the NW 1/4, Section 25, T 28 N, * 20 W, Town of Troy, St. Croix County, Wisconsin, further described as follows: Commencing.at the NW corner of Section 25, said NW corner of Section 25 is also the point of beginning of this description; thence S 1 E, along the West line of the NW 1/4, 1313.04 feet; thence S 89 E along the South line of the NW 1/4 of the NTIA7 1/4, 1332.12 feet; thence�� N 1 W along the East line of the NW 1/4 of the NW 1/4, 1319.48 feet; thence N 89 W along the North line of the NW 1/4, 1349.92! feet to the point of beginning. This deed is executed for the purpose of terminating the joint tenancy in the property, and divesting the grantor herein of all right, title, and interest to said property. This ....18 ---- - -- : homestead property. (is) (is not) Dated thi - ---------_------------ / day of --------- Ma - y --------- --------------------- 19.19.85 -.. ------------------ 19�_ -- ------------------- .. ...... ... -w-. -------- - -- --------------- .•.•..•...........•.......... ...................... (SEAL) L . - HAZ L ... B.....AS ...................... ........ ------------------------------------------------------ ......... (SEAL) ------------- ................................................... (SEAL) ................ ....................................... .... ............. .................................................... AUTHENTICATION ACKNOWLEDGMENT Signature(s) ..... ... Ashbach STATE OF WISCONSIN ..................................... ---------------------------- ---------- --------------------------------------- -------------------------------------- County. authentiqate(L �4a of 1 ................. Personally came before me this ................ day 01 ............ .............................. 19 -------- the above named ----- ..... ....... . ..... .......... ...................................... ---------------------------------------- --------------------------------------- KARK% J. H RTY ----------------------- - -------- ........•....•• ...• .• ...•..•...• ....•. ......................................................................... iTITLE: aMEMBEATE BAR OF WISCONSIN --- -- -------------------------------- - --------------------------------------- (If not ............................................................ authorized by § 706.06, Wis. Stats.) to me known to be the person ------------ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ................................................................................ -MarK.J.-Gherty .................................. .•.• ..... ........ ................................................................... GHERTY AND DUNLAP .. .......................................................... .................. Public ..... .................................... ty, (Signatures may be authenticated or acknowledged. Both My Notar Co mmission is permanent. (If not, state Coun expirat are not necessary.) date: ................. ....................................... 19 --------- H ` H a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z t7 a OWNE BUYER ,jC ��2 D /V . 46 A,4 c1 •T ( � ROUTE /BOX NUMBER i�7 �� JJ �i C-00 pv2 Fire Numbe Lf 7 .CITY /STATE l.L S ZIP 4_YG 2,7 PROPERTY LOCATION: N v 'k, p w 14, Section s T �_F N, R o'Z-D W, Town of G: 0 y , St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con - sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic'tank.is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I /WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - 'v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNE DATE St. Croix County Zoning Office P.O. 'Box 981 Hammond, WI 54015 715 -7.96 -2239 or 715- 425 -8363 Sign, "date and return to above address. w spa si n do ,o �o • i " 4.19 d W P f'I b 586 4 su,(do ' qua isa, ,awwn (0 4 I •Dul 'S2 Msnand dVW G?JOd?i3O2! •suoi�7npo,da, ,o saido7 yens 6ui)ow uos,ad ,a t ti Auo,o ,aidoDo4oyd ',alui,d /(uo so 119M SO '100q siyl }o s,asn 11y of sailddo sy •snn01 4y6uAdo7 ayl �o Iiwtl ayi of patnDaso,d aq llinn uoi�o�o�n y7ns AL `�• •apow aq uo±h o npo,da, Di do,6o�ot /gun ,ou pa�uuda, 'paDo,4 'paido� aq �(ow )ooq jold siyl ui l,od ui , ajoynn • p wali ON •ay6i,Adoo ayt Aq papajo,d a,o 1009 jojd siya ui AdoD,aylo puo sdow 331ION y sM Ffu�o ° D /s it! 61 - a , ,l < —i1! OZ iY p 9 sax: n 11 N/JOJ 37t13/d >uj s/9 d d✓ /✓ o�a�° �s / © " oB • x 9b` �Di. a�am 0l .•�,.�� JJC%° / /od' p a as 31p. (p F7F / • d 00YM7/ • �^ c © G OJYM7l'11VV Y' 's erg- • • 5:21J o / 0 asri u e 'P r. 1 • b J 9/ • f 2s Je siragazria j o J . .. • P! se ou�ss i 1. C S AX �� I' ..:. dU KY4f 7.�v • Q ♦ ♦♦ I . tD� A b• 5/7Dyou/aJ 9rr > � � � � � �. ;� y 7� 1 urn �17 F 6th A n. o st aL sn3 I i J u ^ /FJ o6� z Cn � 9 iu /�,v aFyS ssa � rn 1DU tios� oai 9 .,J19 ° 9 0 770H 9 4 `iJror v 09 d /aILM/a/l � I 7 E m %FFaoyor - 2� /![ran 0 o , s; FFFF �y 9a�y o4 a {f � { ' I , oo .'Y6' siixi�i r p c 1 � w`c • .o�� 3 J z • y I � O d ff y f.� C 00 nl y� said � ro o }? nu sr6u - V tij � 0 � Jj1i/y rdTag �; � uo }� /� e si �/ F �r✓� �r an 6n� � Uasya /rte vb a ' Crt'(XX� L� ° • T LaS o n p N ai V f. • ' e ° ��b • dj ttt `ao /u� a z/ /oi sioN n %6 ' si & w 3J/ 6' 7 d Ct e J SZ 395'd 33s u �Yw N16 l� g� • � � N .�. Jl GH DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY; DIVISION LABOR HUMAN A ND MADISON PERCOLATION TESTS (115 MADISON WI 79 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP / 1A1_" ., ^ „�.. LOT NO.: BLK. Ndl SUBDIVISION NAME: COUNTY: OWNER'S AILING ADDRE US E C. 7s 0 P� DATES 6EISERVATIONS MADE ,--,� O. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER O ATION TESTS: LTJResidence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: - GR OUND - PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) CAS ❑u CC'SCAS ❑u CAS ❑u aSLu If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: M4 l- Floodplain, indicate Floodptain elevation: �! PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSE E ST. HIGHEST TO BEDROCK IF OBSERV (SEE ABBRV. ON BACK.) B- 1_ 73 73 jr cu Zn Geo B- ;� // / ' � r ' t• � r i � ZI B r J 7 i 13 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P _ 1 P- P- P- is c 3 P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYS EM ELEVATION p I Li tN T 1 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in th� Wis nsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. V NAME (print): DAVE FOGERTY PLUMBING TESTS WERE COMPLETED ON: Licensed Perk Tester & Plumber . C J” e ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): Fogerty Heights Road ROBERTS, WISCONSIN W23 Phone 749.3656 CST SI TURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — i j q DAVE FOGERTY PLUMBING Licensed Perk Tester & Plumber Fogerty Heights Road ROBERTS, WISCONSIN 64023 Phone 749 -3666 zbfg— --� - '0r9 6 *" 43 i 11 = for f rSwor /ad.o � Jia of �asr ,ff�T v D = perk 3I' 1 4e --�. k ♦ • I i 1 � u Nll v 565437 JVT - 7 1997 '" N �RVE�YOR' RECORD �� FILED 1 6 1997 CERTIFIED SURVEY MAP KATHLEEN H.WALSH 0 0� w0u; LOCATED IN PART OF THE SW1 14 OF THE SW1 14 0 RegislerofDeeds SL N � w iv SECTION 24, AND PART OF THE NW 1 /4 OF THE NW 1 /4 5, 0 0 OF SECTION 25, ALL IN T28N, R20W, TOWN OF TROY, S . CROIX COUNTY, WISCONSIN, ALSO BEING A PART OF LOT 1 0 co C.S.M. VOL. 5, PG. 1207 & LOT 29 OF C.S.M. VOL. 7, PG. 1851. Z % W Z w � 18 G� wpm OWNE D4- O: Q a f nn ,eS w Bernard N. Ashbach i� DOUGGLAS ,1• w o 247 Plainview Drive try ZAHIL R l7. Q ww River Falls, WI 54022; J Z Q mZN C.S.M. ; I ' 1 S - ---- - -- -- 1 U N P LA TTED LANDS ��` 9y 1 1 VOL. 7 „ � LQt -_ 14 PG . 185 ---- ------ ; N19 28 27 E �� 64.47' PLA1NVIEW —DRIVE S89'54'42 "E 819.36' — i 3 I PROPOSED j/ . CroixRidge DRI ,N Pole i ��' cb 10 Lot 24 1 Lot 23 d : Shed I � ry - ---__ i > N I .. I � co - I S89 54 42 "E 1 ' 1348.33' S89 54 - 42 "E 1145.21' ;. North line of the N 1 RECORDED AS N89.57'31 "W Sou�fi ('sn the�9 4, 4 Se 89'54 "E3 —� TN Corner LOT / 202.92• N1 /4 Corner 0 Section 25 ction 25 r- w S1/4 Corner S Corner Q'' --• ° O ^ Section 24 Section 24 `� 16.80 Acres z O N U) I (/A O Garage �v� 731,805 Sq. F Q O aN0 zI C3 00 � �'� z < Cq W V. 0 t —A to 1 y \ = 0 ice, LLJ 1 ca EXISTING DRIVE_ -. _._ _ v ~ House `— — - -'� �� .' Shed N89 54'42 "W S8 Z QJ O Deck w 281.38' 182.40 z A Z 0 Al ! rn car -1 o N UN.PLATTED LAND N ;.P N89'54'42 "W 457.00' S t ,97 UNPLATTED LANDS ,osft C711iiy�. u�l ;w LEGEND ALUMINUM COUNTY SECTION CORNER IiSaraXrxs�Mad MONUMENT FOUND xMim &N&of iff 2 IRON PIPE FOUND 4pp a mmuW e"Ca tmi m llim Q 1" X 24" IRON PIPE SET WEIGHING w � l '� , �`� d ' 1.68 LBS. PER LINEAR FOOT 100 ROADWAY SETBACK LINE SCALE IN FEET 1" = 200' O 2" X 30" IRON PIPE SET WEIGHING 100 0 -. 100 200 300 3.65 LBS. PER LINEAR FOOT Well , m Septic Vent THIS INSTRUMENT DRAFTED BY Michael J. 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Parcel #: 25.28.20.625A 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): O = Current Owner, C = Current Co -Owner KENNETH E & CHERYL K SWANSON 0 - SWANSON, KENNETH E & CHERYL K 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 245 PLAINVIEW DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 27.280 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W NE1 /4 OF NW 1/4 EXC PT Block/Condo Bldg: FOR RD AND EXC CSM 5/1298 AND EXC 2.53AC AS DESC IN 835/150 FOR P625C AND EXC PT Tract(s): (Sec- Twn -Rng 40 1/4 160 114) TO CSM 8/2287 25- 28N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 835/150 2007 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations Last Changed: 07121/2004 Description l �0"" Class Acres Land Improve Total State Reason RESIDENTIAL C " Y G1 2.000 60,500 439,000 499,500 NO AGRICULTURAL G4 25.000 2,500 0 2,500 NO Totals for 2007: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Totals for 2006: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 145 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 t ` 0 (A p' C �£ 3m C C rl v m e� C/) m O N O W j F n D Cn O N S a N o x CD 7 CD N 000 CO N 7 fD Cai Pr co N Q j p 0 01 CD CD I Cl CD CA 7 cn r D O 3 N 3 g y m oo G A y y a t0 C N a v{ D A c L cn C D a co e m 'p CD cn Q m 0 N N CL v_ C c (D y CD c Q _ 3 0 — �g I 3 r oorD. CD ,,` -` N v ! ` W O f Q- < CD Z 0 0 CD 3 Mvv�l 000CCD o OOOv, I o --1� < z Ott �3 ca 0 fA � l � � 3 CO) N N � � D X IC W 0 x N CD N A lV O I 3 d N o� a PQ ~ I a V `\ z z o z o D c'D o O I o O D o O CD 0 - 7 � ' I 7 ' y l� ID CD y C (DD C c fl N c N N w W a w m a Z CD cn z Z A n C A Z a O EY 0 w co o I a Z '! O ' Z p N z y Z CD f I I I p7 = o° D I �•g � cn � a O to n � 3 7 d 1 O° ° °°'�a�zv'o'm_ o w n O z a CO CD CD d N I <! i 0 'm� N I Nw o �� ° N CD CD CD ar Lc. 5 , 0) 0 a y C CL c a l (0 a N _ _. N y Er n C71 j d 7 C 8 S N Q I CD O I N = CD X Er .fly N 21 0 2 6 a CAD N O O ! N Q J< CD p1 N N y .0 CD = a X N qb CD x .+ y 0 • p V CD ro R V EA 0 EA 0 W 0 :E O * C I ° o CL ° o a N Z REPORT OF INSPbCTl0N lUVlVIDUAt SEWAGE SYSTEM Sani ta4y Pemni t 0�.3 Stat'Q S e p,ti / NAME 4 lei —iv T w .c � v n h p 5.�, C�.a.cx 4UL �ty Eaaa�ttivK W �! r SeC#�. 'f , � SEPTIC TANK S.Eze OOO��atton4. Mwmben o� Compantmwn•�4� ` p,i.a.tancQ Fnom� W et • !✓ �•t. 1 an _9nea.ten 44 ope_,,,,,,,_,.._b# DISPOSAL SYSTEM D.iotance roams Weft ,t. b .:12# wn 9�eaten 4 tope.��.t. 4td�.n9,,,t.►e.ttand4 F#. FIE�.D DIMENSIONS; W.i.dth v �• .tnench b.t. Depth o 6 no ck Oct—ow, .t.i.4et 0 Length egch 4#s' 45 4. pP,p 0 6 tra ck oue4 ti.te_ in. Numb en .v6 .�.•%n &4 Depth o j -t44e betow 94adeli—t—�4e TQ tat ten9th 444e4 it. Stvpe o f trench pe.n 10:0 fit. D.i.etance between .n4_.t• ep•th ta'bednock To 464 Q4k -4tvn aaea 4$ ' Depth to 840undwa.te % i t$ .. Requ4.4ed 44ga ,, t Typo 0 6 Co Pa pea a , PIT DIMENSIONS: Nuaib.en Q� p�.#.o G e around .i..ta 4 . o4•ta {d.e d1�.ameate�. $. ��,�vw �•nte.t____„_,,,,�,,,�.t• ToUt 464 vnbuon a bt 2 •. Area Uga,449d its m INSPECTED THE APPROVED FATE S • REIECTED VATI" 1 7 ,,,_.• Us V; 1 0 4 4k, 3� 34 V. I fF LA i ON ,... r a : t Gas l � "NN EH 115 d WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ` DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS a o . /9 S7 LOCATION ;.0 ;U,/ /4, Section , T.2AN, R — p (or) W, Township or Municipality r ° I Subdivision Name u o Lot No. ,Block No. County G Owner's Name: 1I P�_,�� etn ct n / � / . . p � -' Mailing Address: 33 _ all 4Wct SS° Feud LZ/ . 5 'S /�' TYPE OF OCCUPANCY: Residence No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW V/ ADDITION REPLACEMENT U Q 8� DATES OBSERVATIONS MADE: SOIL BORINGS � PERCOLATION TESTS � pia SOIL MAP SHEET g/ SOILTYPE 5alOC 5114 10er*r. PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE CHARACTER OF SOIL SINCE HOLE HOLE AFTER INTERVAL NUM- INCHES THICKNESS IN INCHES MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 i P- 3 .2 Odl SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, S NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSO I r B 96 A. m �- S /0 8 7 ' a rQ f" T r. /02 " �% 7 S �: \ a c A:7 B _ 6 /0F 7 /ff PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.)'! i Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. 61 'C 4P ''I' - = /,;Z 3a o ' Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. S '+ 15 I .z ;les Q A rc s i X 8 r% ve qre ro N x ' s t X X •' d Q a.' a / i �� f I, the undersigned, hereby certify t'Fa teh soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belie-- f . �— j Name (print) X04 �e 1 7-42 / Certification No. 6T - / Address a ��Q C Name of installer if known CST Signature � A COPY A — LOCAL AUTHORITY II I State and County State Permit # P LB 6 7 Permit Application County Permit # d 9 3 Pp for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # \ A. OWNER OF PROPERTY Mailing Address: K � -3 WO od. 5Sa T. Pau m ilulu B. LOCATION: %, Section , T N, R� J9(or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Towns w nQ IR C. TYPE OF OCCU ANCY: Commercial *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK PACITY Total gallons No. of tanks Prefab concrete Poured -in -Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) E. EFFLUE T DISPOSAL SYSTEM: Percolation Rate Total Absorb Area- 5 sq. ft. New Re lacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. 4 1 1 7 _Width. _Depth _ ile depth (top t o. of Trenches Seepage Bed: Length Width Depth Tile depth (top No. of Line Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land Distance from critical slope WATER SUPPLY: Private X Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than p owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that 1 have sized the effluent disposal system from the EH -115 prepared by the Certified oil Tester '.�"� NAME O l C.S.T. # 2 and other information obtained from (owner /builder). Plumber's Signature M /MPRSW# IMPAS QSP hone # iKW - agoo Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. s � r ` E r E ; E � Cry a m. ....7 r m� - m E ( . _ i n I I a _m .. �.. E d 4 Do Not Write in S Space Below - FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application 6 - 3 440 Fees Paid: State /S, 0 Count � —% 0"i� Date `.A3 �U Permit Issued /Rejected (date) 6 - a 3 - &U Issuing Agent Name � Z Inspection Yes Y _No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI '53701 fate (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 �H ,7.15 , a WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH �A 1 198' P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SO L BORINGS AND PERCOLATION TESTS �— �/ d ,�! �o f I LOCATIOIW"' � L__� /a, Section -?KS, TUN, R, E (or) W, Township or Municipality /PQ r' Lot No. Block No. —, County SZ. 62.- Subdivision Name Owner's Name: Ire n n 9 - m '�_ s Mailing Address: - 3 6 Oev a S Q A TYPE OF OCCUPANCY: Residence d No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW 6 ADDITION REPLACEMENT 9 DATES OBSERVATIONS MADE: SOIL BORINGS �� `�� " g g a PERCOLATION TESTS AD o pkn SOIL MAP SHEET a 9 SOIL TYPE <.r Aar� PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) /v 8 ' s _ 9l- A? S PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the locationand square feet of suitable areas. Indicate nwiPer of square feet of absorption area needed for building type and occupancy. 6•I.S 4 -z 2 /2 3y Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 9� s .f t v f r p s t N } x a' A. a l4 X ' ® z e i 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) I O Certification No. SS Address a u- Name of installer if known CST Signature �� COPY A —LOCAL AUTHORITY�� `JAN 1 2 19 _ -.- A � Iv - 9"mun4 9'f - f — - - -- - -- -- - pe R �. cal -'�" - �--r y�N - { � � " -'s r - A N At - i Q .2o` � 77, r ` ke MV9L so/u, N _. _. - - -- - - - - - -- -- - - - - -- -- — — qyf -- W RA 0 q/ - - - - - -- - - - - - -- -- -- - - -- -- - -- - - -- -- = -- - - -- -r 0 ►�ade� - - -- - - j -s- - - - - -- - - -- - - -- - - \ j Form S T C 104 M AS BUILT SANITARY SYSTE REPORT OWNER �s1�ba�h r q �, TOWNSHIP UJ_ sl TqQ� a& SEC._ T :20 N-R o�O W TR©g ADDRESS ST. CROIX COUNTY, WISCONSIN v eR Fa Its U» S4d as SUBDIVISION LOT Pi 0 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of M HR 83 � SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 STA b e f� Ys° 4 41, r 0 t O 10 1 I N a Req I I I l t INDICATE NORTH AR;'AW 1 BENCHMARK: Lescribe the vertical reference point used So•'t'h t C ©RN of _ 6'rMe bo at si i Ng Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: W 1 eSeR Liquid Capacity: Qd_ Number of rings used: Tank manhole cover elevation: - I Tank Inlet Elevation: (73,7 9 Tank Outlet Elevation: 1S i'+0 'all d Number of feet from nearest Road: Front 1 0 Side 0 Rear, O OY R fool feet � s,a °S From nearest property line Front 1 0 Side 1 0 Rear, 0 oVeR loo al l feet Number of feet from: well ©l + , building: s _ Qndude this ii formation of the above plot plan)( 2 reference dimensions to septic tanD SEF. FFVERS S IDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump /Siphon Manufacturer: Pump Size Elevation of inlet: IN a Bottom of tank elevation: 9 Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: 8 Alarm Switch Type: N Number of feet from nearest property line: Front, /@ Side, ® Rear, Ft.� Number of feet from well: N a Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: �� r Length: ( Number of Lines: Area Built: dO S p Fill depth to top of pipe: H a oven. too aTl ae,5 Number of feet from nearest property line: Front, O Side, Rear,0 Pt. Number of feet from well: r 00 r Number of feet from building: (Include distances on plot plan). SEEPAGE PIT n 1 Q Size: N I' Number of pits: Diameter: Liquid depth: � Bottom of seepage pit elevation: ro A Area Built: N fr Has either a drop box a or distribution box & been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: N Capacity: O R Number of rings used: Elevation of bottom of tank: N Elevation of inlet: N& Number of feet from nearest property line: Front, aSide, &ear, Number of feet from well: Number of feet from building: N� Number of feet from nearest road: N T' Alarm Manufacturer: N n Inspector: Dated: 1 Plumber on j ob: License Number: 11► PRs 3d 3/84:mj DFPARTWNT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR &HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLLUMBING P.O. BOX 7969 � 5 MADISON, WI 3707 NW 4, N, W NW—R20W ❑ ❑ MONVENTIONAL ❑ALTERNATIVE StateP�� lit — Town of Troy NAME Holding Tank ❑ In-Ground Pressure Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ashbach Farms Route 2, Box 87F, River Falls, WI 54022 / • J o BENCH MARK (Permanent reference ponO DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. Name of Plumber: J MPtMPRSW No.: J C-umY. Samwy Permit Number'. Rick Troff 3225 St. Croix 102784 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED PROVIDED ❑YES ONO DYES ONO BEDDING I VENT MATE. HIGH WATE NUMBER OF ROAD: PROPERTY WELL: BUILDING. JVENTT LINE: AIR INLEE T ALARM FEET FROM DYES ❑NO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP /SIPHON MANUFACTURER WARNINO LABEL LOCKING COVER PROVIDED: PROVIDED. DYES ❑NO DYES ONO DYES ONO GALLON S PER CYCLE: J PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING Or excavation. (If soil can be rolled into a wire, construction shall Cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: ' WIDTH I LENGTH OF NO =11ACINC COV R INSIDE DIA �PITS LIQUID BED /TRENCH' �L TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH J DISTRPI L PE 7 DIERIAL. NO. DISTR. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV.IN ELEV. END' PIPES FEET FROM LINE AIR INLET NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand, TIONS MEASURED. 1:1 YES ONO SOIL COVER TEXTURE PERMANENT MARKERS OHSERVATION WELLS DYES ❑NO 1:1 YES ONO DEPTH OVER TRENCHiBED DEPTH OVER TRENCH /B EP ED DTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE J MANIIOLDMATIRIAL NO DISTR DISTR PIPE DISTRIBUTION PIPE MATERIAL & MARKINI', ELEV. ELEV.. DIA. ELEV.. PIPES ELEVATION AND DISTRIBUTION VERT INFORMATION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL PLAN ICAL LIFT CORRESPONDS TO APPROVED DYES ❑NO I DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING (, FEET FROM LINE: n ❑ YES ❑ NO l DYES ❑ NO EAREST LA 5 ioz �-1 Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE Zoning Administrator iI DILHR SBD 6710 (R. 01/82) f — SANITARY PERMIT APPLICATION COUNTY OILHR In accord with ILHR 83.05, Wis. Adm. Code � x MEMO •�� -- ^�^�^EM STATE SANITARY P RMIT ## / 7'8 —Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8'/ x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ' R NO PROPERTY OWNER PROPERTY LOCATION W' /a pj U) %, S QS Tab, N, Rao 0(or) P OPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME wis 13o)(87 if R iveg Falls aff SWoaa N N ft N A CITY, STATE ZIP CODE PHOfqE NUMBER CITY Pas o NEAREST ROAD, LAKE OR LANDMARK (,� O �S / ❑ VILLAGE : O - T0( h. II. TYPE OF BUILDING OR USE SERVED: • /0. U y 1142 0 Number of Bedrooms if 1 or 2 Family ST lB i e OR P blic (Specify): III. PURPOSE OF APPLICATION: (Check only one in ##1. Check ## 2 f applicable) 1. a. 2 New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit ## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In -Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ See a e Bed b. 9 Seepage Trench c. ❑ seepage Pit 2. PERCOLATION RATE 3, ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 610 S 125' `75 a .3 3 Feet X Private [:]joint ❑ Public CAPACITY VI. TANK Site in gallons Total 0 of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New Existing Gallons Tanks oncrete glass App. Tanks Tanks structed Septic Tank or Holding Tank $O , LU 1 E Lift Pump Tank/Siphon Chamber VII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): P ber's Signature: No Stamps) K* /MPRSW No.: Business Phone Number: R' ,� ff 67 Sass ( _- 90C Pluber's Address (Street, City, State, Zip Code): N e of esigner: R a BOX /7 00 DeAproA UZ _ VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST ## W I OC e CST's DRESS (Street, City, State, Zip Code) Phone Number: i+- Q D CRO NJ 00 8 715 a tog --? 979 IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) A roved Owner Given Initial �ad> Cat S rcharge Fee RP ❑ CID �l •Gb / o�D�B / t Adverse Determination /� X. COMMENTS /REASONS FOR DISAPPROVAL: 1 cu, C4 ra&cl bL SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION s TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6, If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; il. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; Ili. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1 -6; VI. Tank information: Fill in the capacity of every new and /or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift /siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County /Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/z 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; dosing or pumping chambers; 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 arldd, pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. ------------------------------------------------------------------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiatioi and public debate. The groundwater bill Grounc included the creation of surcharges (fees) for a number of regulated practices which Wiscorf�in`s. a rar effect groundwater, The surcharge took effect on July 1, 1984. All of the water that buried reasurt~ is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank pumper. 0 The ,?onles :_ ollected through these ..,,a riiarges ..re credited to the groundwater fond adrninis- ° ,,:,re- by the Department of l'�atur,l R �so,,;rces. These funds are used for raon'lorin( g -ourd- i atf groundwater contamination in and establishment of standards aro ,,, ,worth protecting. 311 (R.03/86) PLOT PLAN existing stable N 1250 gallon Wieser septic -2 � Fence_ tank 0 WNER BM 100 A shba ch Farms ( bl • b 4 R 4 3 Box 87F I 1 pl River Falls W1 .540f2 1 - 386 - 7509 NW /4 ' /4 �q,S25,T2�N,R2PW —35: 9 b3 SYSTEM i PLUMBER ELEVATION 92,33 I � � Rick Troff mprs 1225 5� R #2 Box 170 A b2• • b5 Derond a WI 5400 1-715-268 -2800 I 10/19/87 6 - 12 % Slope Scale �4 = 5 A Bench Mark = B M Boring = b • Perc Test = P No well within 100 of the system 1 PAGE OF• " C. r uSS zc'lor O A Sy to en I . Frdcb Air IAleti And Obiarvallon Pipd --- Approved Vent Cup Minimum 12' ADOw Final Grua• I I 20- 42' Above Pipe _ 4" Cost Iron To Final Grade Vent Pipe hash Hoy Or Synthetic Covering Wn 2" Aggregate - Over Pipe OIe1rlDullon Pi o 0 0 — Tea 6� Aggregol• w� 0 Perloreled Pipe Below yp►M Beneath Pipe _ COg TwminO►Ing At m Bottom 01 Syele d 99,33 33 P rp oSeD �lna q r� , t SOIL FILL DISTKIBLj: PIPE APPROVED SIIWT 4ETIC COVCR ~— MAUKIAX OR 9" OF STRAW 2" OF AG63E ?F OR MARSM NAY 90f�33 e to�OF %2 - 2 1 2 AGGREGATE E �EV.OF F EET —2 —— - -2 - - - — — -— 5` — —— OISTR15UTIOKI PIPE TU BE AT LEAST . BELOW ORIGIUAL GRADE AMU AT LEA.STZC IWCHLL BUT i„i(; mc)4(9 - rHFIti 42 IN CHES BELOW FWPI GRADE MMWIUM O EM OF EXOAVAT1 FROM OKIGINAI. 6KADF, WILL BE 3 t IAICHES PUNIMUM ®Ef" of E FROM Olklt,IbAL CaR49f- WILL BE 3 a INCHES SIGUCO: LICE IJUMBER: m - P R S 3aa DATE: �� ! !9 9 �7 DUTR ENT OF RE PORT ON SOIL BORINGS AN D SAFETY & B DIIVISION L A BOR'AND PERCOLATION TESTS (115 P.O. MADISON W 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: O I MU ICIP I LOT NO.: BLK. NO.: SUBDIVISION NAME: /.U�� 10 o� s T-7 � ° �lor) lll2,f P (�o /f/ COUNTY: WNRV UYE R'SNAM S M 3ADD x. �� e� S ll — *p Z2 � c f7 / I I a USE DATES OBSERVATIONS MADE O. BEDRMS.: COMMERCIAL DESCRIPTION: PPOFILE DES 1PTIONS: PERCOLATION TESTS: ❑Residence c 6 e ❑New ❑Replace 87 9- -87 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM- IN- FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) 2] S ❑U 2] S ❑U © S ❑U ❑ S DU ❑ S X❑U nve n M ena / If Percolation Tests are NOT required DESIGN RATE: If an portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 29 a B ! �0 V,33 /t/o > `�° 59 .o r p d - IQ ,F 17 / /;L - S.2 J - 0 9r SA - .1 - -< e5rz S6 9© B- `l' o / .'2' ./�� 7 9 S" r o -ro 8IE / �* S r sF8 6y / 8 -85� S B 3 8 `F �. 3 /�0 7 `t� d r B 4 96,8 ' ,t/o , Qd ° -/� 6/rs / / - .z� �� / S a7 -5-d ,� s�9r S4 g2 B- S o - 7 Al ;-, 7 -1V d, 5 ! —,?� / 3 -R-1'7 Sy`q 9 ov' A/0 7 8� ` -.S3 G' l Sz - y 5' , e g'. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ / 48 0 6 d G -Zo . r • �. P- 7 `� /l/o 6 6 6 S u P- 3 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION o e Sfa 6le - , O Rerc- s � - s� P •�ou /� o v¢ r a� e N aC� e A X. I 9 r 06 . 3 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the pro r and memOds specific / 4 r ,4he Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge an I 7 NAME (print): TESTS WERE COMPLE `P -A - -,/La // �F f 9 -30 -87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): /' c4, IV/? S 1 1 - d o 0 (fSTo o a. 3 0 7 7 1 211- ,26 - f -79 79 CST SIG URE:� DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 10183) — OVER — 0 . INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 5395 To be `a completaa and accurate soil test, ,Four, report must include; 1. Complete legal description, 2, Tla� use section must clearly medicate wh ther this is; a'residenc.e or commercial project; 3' MAXIMUM number of bedrooms or commercial use planned; 4. is this a new or repla merit system; S. Completes tl a suit €iraility rating boxes. A SITE IS SUITABLE FOR A HOLDING TANS: ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; B. PLEASE Lase the abbe eviat ions shown here for writing profile descriptions and completing the plot plan; 7, MAKE A LEGIBLE diagrarn accurately locating your test locations. Drawing to scale is preferred. A separate. sheet may be used if desk 0d; 8, Make sure your benchniark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate= boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain; eleva't'ion) does not apply; place N.A. in the appiopriate box; 11, Sign the dorm and place your current address and your certifirat: on number: 12. Make legible copies and distrib as required. ALL SOIL- TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS, FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10 ") BR - Bedrock cob Cobble (3 - 10 ") SS Sandstone gr - Gravel (under 3 ") LS - Limestone w s Sand FaGW High Groundwater €.s - Coarse Sand Pere - Percolation Date med s (Medium Sand W -- Well fs - Fine Sand Bldg Building Is - Loamy Sand - Greater Than ,.s1 - Sandy L€mr .._... Less Than "I Loam Bn Brown %;l Silt Loam BI - Black si -Silt G _..... Gray * cl Clay Loam Y - Yellow scl -- Sandy Clay Loam R - Red sicl .- Silty'Clay Loam naot - mottles se Sandy Clay wl v ith sic;, - Silty Clay fff - few, fine, faint *c Clay cc - common, coarse pt , - Peat mrn - Many, medium rn - Muck d distinct p -... prominent 1 High water level, Six general Soil textures surface watet for liquid waste disposal BM - Bench Mark VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. i I DEPARTMENT.OF 0 46S. ANDUSTRY r ,< at LAWR A.Na PEn^ 1 TIQ `S .. . HUMAN RELATIONS . .._�� , , . � � f HR 83 011,F *' fir j '+tiZ�t,_ _ Nxli rctttY? T kki" IT-2 ON/Vo f AY IwOUNTY: U NA Pi USE DATES OW!VfA -T1 4�€, _ E GO M IA L D I T R O �' �r 't" Residence }� Z Qt�teery OFtepkac8 L AATfNG; S- Site suitable for system U— Site unsuitable for system rc nt ivTi ral :m k k- UFtpi�i� IN -FIL k TANKI'aE rr l' r tzoot s Q CCU C y + " iIf Percolation Tests are NOT required ESIGN RATE: if any portsbn i 1lbas tested V0914 in the L nder s ILHR 8 3. 09(5 )(b), indicate Ftoodpkaan Q 1 1 i , 1 1 t?I PROF C1EGRPPTIS , BOR,FNG TUTA R U INCH H A FL W Ri 4 iifT l II:, - A Q H NUN .R fiN, ELEVATION 5 V Fi T Rf}Oi4 F.O$tr V6Q' FtV. 0 =kl `�° '176,33 X/O � q'r C - - , _ _ g- n1 �.�� a�� • Q6' m :ter r 1 1 F a •pT J a c' /C/ 8'i� - 7 >> PERCOLATION TESTS E, i D9,PTH WATER IN HOLE EST TIME - ' L rV AIRFt INCHES AFTER-SWELLI:NG INTERVAL-MIN. I 1 -1a F4'IM H e -6 L, sec. ® 2_ F,,O'T'PLAN: Show locations of percolation tests, soil borings and the dimensions of suita�e soil aro . lndid scale -tar distances: Describe what are tha hori- runt ;l and vertical elevation reference points and show their Jt anon on the plot plan. S tcrsr. Ow lltircoolt at 0 bnrlaalls and tfa* direeti?A and pardant land slope.. SYSTEM ELEVAT , ie UP jx J/ .�`• y' A 1 + �. .y +e .. .. . ...... ...,. I r ' 3; _.� P `9 � ` , the undersigned, hereby certify that the soil tests reported on this form were made by me in aemill wath th �� durat/�� irs +:ts fit-(I rrr, rr + �,d, a, t lmir r4tratPVe Code, sand that the data recorded and the location of the tests are correct to tkte heal raf'any knn Ilya am ltee 'A AME ( rin0 jKl) R E S� 9 ERTIF1 N UMBER: l ��iloptTdr�all: L)ISTRtBVTiON: Original and one copy to Local Authority, Property Owner and Soil Testae. 1)lL.H'R•S8D -6395 (R. 10/83) - OVER – ' H N 9 ST C- 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d OWNER /BUYER R _S� b e-h FaRms ROUTE /BOX NUMBER :# d 8 _7 F Fire Number Cb CITY /STATE R ;)te.R WX ZIP 5Lj o a.D �-- tnl PROPERTY LOCATION: fl)w ;4, N UJ !4, Section a- T N, R aO W, ?owNSh� p b Town of �@ pt 0i � , St. Croix County, Subdivision N Lot number N fr Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con - sists of pumping out the septic tank every three years or sooner, f if needed, by a licensed septic tank pumper What you put into I ! the system can affect the function of the septic tank as a treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. a I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days (o of the three year expiration date. SIGNE / J 9 DATE m _i7 St. Croix County Zoning Office P.O. Box 98- 70 Hammond, WI 54015 0 715- 796 -2239 or 715 - 425 -8363 Sign, date and return to above address. Emma I-A F 7 7 "7 ....... .......... N" a" or vilocomm Vfts- "w' W" GMWTM ow ..... ............... ................. ------- or R*Mubd" • '` T r ' �,� �''�Y<. aria Y 3•i ,, • .... } ;fir.. 'P AfC!" `° ��° .. ..ate, F �� - . � � �'� + �s� ,': �a. ""` '�'a • + 71 , `�,;�� ''�`�P .a� � • � t �� $e—i .- .. #sue - ...�y�l.•„y .. ,,..%fit -1 - ° ��F� t f. �t''o' , =ss ,.�,.. t • . if..: fi fie t K 7 5 , `r- S poi 1 ... � .. i :� �� r fi ,�, ,• � ��;� 1. r '. A>it on the 1`14 f ' M�Iqtsir y imos supariofr to ' b Was11n�t *af�►er eweeoys a" lift.N�wi� a� Zia rlil� vendAw w�11 M ua es4eRiM #�l1i1G ilt ; trrs' and ieirm: of an tho sit or et k • +ft} MwiFM.M�y1N41w 4• • .. ....... y.�y u•' I Mj rj em- to of the ereaea aad in ease et Aftftilt in tie pa � !ear of fte o . em"imom, or promises of . , � then vender aw. ep • � __ Vendor's do n, d .. .... aft marwAm" eaaadlmr. sad' fire l a�oa•hts betas• as rwtsf of sail rrrendsea 4 us liquidated for ON* tai> 1 alld0� ahsA tbs'thwith aM without notice have the tight o! ro•Oaltr>; • - perdwar, notifv beft hereby expressly wai ved. the wbde aawrat of �. :. and payalie. in essa suchopb on i 1 bo atoamelsad, the nooid p g € nsy k bs�o beesi by �endair Ra hereis iosstJwrised with sia4 }! eoilastilia i or by fereaketre of this . hal l,ee. lea 46 tiara whet any 04h dotault ; jai tRterir�lf, all tine #turn% ao disbursed with ' iterest ss a! wbod mr flbsted or not. all ozpenasa, ir_cludil" f i. *0 as 6iearsod, sal in came of }od at ahaU L'" a jmg tsoja�ty of any Ac4loa of foreclosure of this CQatraes ' -' sd interest» to coomet the"nts. '. ,+ `! snetl �rstroo, aid sneh e�isndt. an3 ProQts whA► sa ou11 ' ' 1 Kam, shall br w1d i o! to the benefits of the r the Property the a t owfl ' eta in t%e 'subj Property and agr-s to joie; •) mttrfeY to the Ipur at and fzhs>ycra � �iwt,. ac • S' af•�t. +�in8 oii� ' a bgdl t ,X ' 1 ! " • co tlfrlrtL e y Rape e the porf>�f�isfrs,� tfyqather with an ea t>rt fo>r. ..putt s < -to bo ou said MW and to 5 , $ ' ;hs iirou* sk*tch asRta an nE a t s owing Y, vak $hc?s. 205 f Dotter'' r �'�. -'.'• r'x :.Tf '� '' J44 °qF •,+I�TL"'a1ArA yy }� J Y 5, y x :Xi • y7i'•....r 1. REMni D R -I�y"�', •�_.iR +-- ._.a,+w.3+r .s ! SAM S ASHMt$ 1p •^c r • _ •..__._ . f V k 9 p• £.. } fey Y^ + 60111 ... ........... dal of STATE OFISCON832i ,..., f.+.R�N 111..,_....• u . :. $t. Croix w a x .� ..p....,,...... y cave before rne, : 9 1980 the abo ri , mt r aM01C is 1fA! 41r �V19CQYSIPI %.w I-to. - Aft p ><l�..8•.._Albtacs yy a a I was ortAMZ s11 to wit known to be the pefrom It r sire iotlio: instrumcat aond seharlldgjt time . SAW k or aekawia�el. Cloth l�sh0e i`titDi3 ', tai �_ Car+uetlAm.+isn is M Mertmot t� limit, ^ Wft § ` a Of immomm + �2 :gtt:cort 40 to W .'. 7n= I I APPLICATION FOR SANITARY PERMIT STC - 100 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 _� 5I1 6a � Ectams Location of Property k J W _ 1 s, Section s , T :98 H -R paO W Township (� C.S� n D KT ©f r�2 OTo A; ro Nailing Address R # 3 Ro 8 7 F 13 ; ve R Fa lk IJII L -IT Lf4a42 Address of Site yn_ Subdivision Rase N R .Lot Number N Previous Owner of Property K U 1_7-;4� Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes (__ No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number volume and page number and the Seal of the Register of Deeds In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATIO I Wel CeAti6y that a t h.tatement�s on this ohm cute tAu¢ to the but o6 my (ouh hnowtedge; that I (we) am (ahe) .the owneh(,sf o the ho eh.t dens ' b to ma.Li. 6 p P y c�cc ed in .th,ca oh 6oAm, by viAtue o6 a waAAan.ty deed hecokde.d in the 066.ice o6 the County RegihteA o6 Deedhass Document No. ; and .that I (We) pheeentty aun tl�e phopod¢d ect¢ 6oh the sewage duspob ayes em (on I (we) have obtained an Casement, to nun with the above de+s c&tbed pkopeJr ty, 6oh the condthuc.Lion o6 eaid SyAtem and the game hae been duty necohded .tn the 066tee o6 the County Reg•ieten. o6 Vetch, as Voc me tt No. ) . SIGNATURE OI► OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE) LIZ DATE SIGNED DATE SIGNED 1 r 385478 ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE 1/4 OF THE NW 1/4 OF SECTION 25, T 28 N, R 20 W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. ro PLAINVIEW DRIVE '•• � ' •• ................... .- •---- ._........._._._..._.... CRQIXR /OGE SUBDIVISION N.19 57' 31" W. THE NORTH LINE OF THE W 11 OF SECT /ON 25-26-20 256.13' i ..) ................... . Z NW CORNER ER a PLATTE SECT /ON 25 -26 -20 COUNTY MONUMENT KENNETH SWANSON RURAL ROUTE 3, BOX 876 RIVER FALLS, WISCONSIN 540 �' �,'' 0'R J N Q ' ® �N�� SCALE: ON CH EQUALS ONE RED FIFTY FEET $ g N O Z y V Q) Z J W 100' 0 100' 200' 300' 400' ':' L E D O O JUN2 Wo 11983 � z a�� LEGEND O °O of � N T.' 1 - 0 I "X 24" IRON PIPE SET WEIGHING 1.68 LBS. /LIN. F N • 2" IRON PIPE FOUND '` N THE EAST LINE OF THE NORTHWEST QUARTER OF '$ SECTION 25 - 28 - 20 IS ASSUMED TO BEA - p S. 0 21' 25" E - w 2- 0) 0) N y ti ti W E cv p 3 w • O o to 10 S N N b0� 00 - Z 3 w w w 3 w 0 0 0 AP PROVED W o i� ao - ALLEN C. °.. 0 0 1 W z N N r- i� N ' NYHAGEN z N z a N °° "' N S -1407 JUN 1 1983 W Q W 0 0 0 0 0 0 0 ~ m ° c ° w 0 HUDSON, ui vi W I5. A ST. CROIX COUNTY k z z vi vi , r� 3 _ c ��. �COMUEHENSIVE PARKS PLANNI II w H ti ° � ° p NO •�"" �i y AND ZONING COMMITTEE t� � z N Lo co ® � ® O . 00 5 W III ro 0 r0 O V J (V N j � = Z N Br PLATTER 0 v N (V 296.97' 1 66. o' 297.03 3' w w S. 89 39' 38" E 660.00' - O Q 'n to Wi 0 W w ZI 4 0 X� N11 j m 0 0 - co in OI K) 0 O I M M O OI v N r- �� LOT = t w z w ;� 217,784 SQ. FT. MOOD ACRES) to to W� N (\I V p Q M N N kI . N N y V �1 Q Lo Lo al ° 0 to 0 W Lo N m ° Al N. 89 39' 38" W. 660.00' O $ O 1.3 TH SOUTH LINE OF THE NE 114 OF THE NW //4 16.5' Z III N N SMA�� LR -i NOTE A .FOUND /" IRON PIPE LIES > of N M N. 14 16'06" E., 3.36' FROM SET PIPE. S I/4 CORNER NOTE A FOUND / IRON P /PE L /ES SECT /ON 25-28-20 N. 69 04' 30 "E., 3.20' FRaw SET PIPE. COUNTf' MONUMENT SIGNED C DATE _y/ Z—,Ig > 5 129 VOLUME ,PAGE ALLEN C. NYHAGE6f R.L.S. 1407 CERTIFIED SURVEY MAPS ED �4 ov, , °� 1990.* 463822 AMA �'CONNELL �'' � & �Ceeds: •' 2 zo . WI V) � �( CERTIFIED SURVEY MAP V LOCATED IN THE NE 1/4 OF THE NW 1/4 OF SECTION 25, T28Nj OF TROY, ST. CROIX CO. 1lN , W1. I OWNED BY: KENNETH SON I ( R T. 3 B yY 6 • RIVER / FW "L'S, WI_ "54022 i R i X ' \ •., \ NORTH LINE OF THE! /NW CORNER SECTION 26 \\ . W,1 /4 (COUNTY MONUMENT' FOUND)- + � 3 - I}- P L A I N VT ` T— ,� S 6 8• S 7' 3 1" �.,r+� ` .'� a kp 9 9. B 4' _ -'^ D R I V E. • - - -..- -- - _:M. .... _ ._......__. . mot � .� 6 89 °0414 E '^ 4 144. 22'� N114 CORNER OF SEC,TIbN EXISTING EASEMENT t/ (R•144.24 ) -SEE CURVE DATA 25, T28N, R30W. (COUNTY;, ON SHEET2OF2. -/ / 41MONUMEN7 FOUND). Fn ix a ° 1 OuAu y } W ,r I PROPOSED DRIVE ii a EXISTING 33' 33'I LOCATION 1 " o EASEMENT ��► •1 a LL C I N r n ; x O 0i (•) 1' ;j V V . .. Z Q �I Ol ILJ i WF• e 0 I LOT I 4 c..: x , I w a KW W N 7.72 ACRES ° w a (314, 371 SO. FT.) Ny `; aJ 0. C 6.44 AC. EXC. R.O.W. / 1 or 4 W I 1280., 665 S0, FT.) xW O Q: in U O il_ • C, o w m' z ww $ N Tn � N J L 4 x ^ 0.' N •° ct:: O fr W c c � /fin IA I hh w i z o: V 02. 199D " S T, C ROIX COUNTY 3 W ° x C9�Ti1� '1tp1)BVITVEPAl2KSftl•:4Ny!Nx� v w AND ZONING (,0m i1tLL m a FIWF a SCALE I��r 15Q' ° a 0 I N 2 W O 33.00' 2 O 75' 150 300 ... ........•..•...'......,........ 297.03' N89 39'38 "W 330.03',. 2 . PS-R t l` C...f J 1 M • . 9 v ; « w . WIS d R 4 Z : °9 abalao�o�d e � JAMES M. WEBER S -1804 �. DATE. S 114 COR. SEC. 2 5 ( COUNTY At ON. FOUND), SHEET I Of' 2. 88 - 251 THIS INSTRUMENT DRAFTED BY IrAT t7MT? 0 Parcel #: 040 - 1160 -20 -000 04/16/2008 04:16 PM PAGE 1 OF 1 Alt. Parcel #: 25.28.20.625A 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): O = Current Owner, C = Current Co -Owner 0 - SWANSON, KENNETH E & CHERYL K KENNETH E & CHERYL K SWANSON 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 245 PLAINVIEW DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 27.280 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W NE1 /4 OF NW 1/4 EXC PT Block/Condo Bldg: FOR RD AND EXC CSM 5/1298 AND EXC 2.53AC AS DESC IN 835/150 FOR P625C AND EXC PT Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) TO CSM 8/2287 25- 28N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 835/150 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 60,500 439,000 499,500 NO AGRICULTURAL G4 25.000 2,500 0 2,500 NO Totals for 2008: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Totals for 2007: General Property 27.000 63,000 439,000 502,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 145 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Q ° 3 0 h O ec ° 'd x c ap I I • Nt N O I, N M M �, O M . n C — 00 N 0 En co U 0 c co O 3 3L Y o (nL UY 3� a? cm iE o d�� — a o ° m m 3 ° O N Cl O O fl_ N Z -o In `p 0 N (n 3 m m £ 3 LL C° N U U l9 to to -p (0 0 0 . 0 0 C _ O f0 10 11 Q N d cu N d i 3 M Z y N Z O N F- Z m I', I c f9 O Z d ',' c v I o 0 N H r 0) N E I 0 0 E I N a ID 7 N r y N I N N • �. CL U L 1 c O O d Q 0 Z h Z N I'. N -;j c Nr1 -0 ',' _ i .. .5 C. R w V LL F F •ti a m m ►�i a U ) o0 r% J U 3 rn co °) } c N toy E N LO 0 d N ^ LO m M i � Y � O N N C 6 Lo O r N N C Y 0 C i O 6 O O C ` f c M � - 0 Z ch 00 ry ~ N 00 T N 0 Oi E C N _ L • >> 0 ° 3 O co ° y ° C%li E L t ° a w • a E i 1 St. Croix County Board of Adjustment Hearing Date. February 24, 2000 Applicant: Ken Swanson Mailing Address: 245 Plainview Drive Property Address: Same as above Property ID: 040 - 1160 -40 -000, 25.28.20.626A Location: NW % of the NW %a, Sec. 25, T28N -R20W, Town of Troy Zoning: Ag- Residential Request: The applicant is applying for a special exception to operate a riding and boarding stable for 50 horses and to exceed the one animal unit per acre of land suitable for animal waste disposal requirement. Zoning Ordinance Requirements: St. Croix County Zoning Ordinance — Agricultural Residential District 17.15 (6) Special Exceptions: (m) Limited commercial recreational activities and (o) Livestock operations in excess of one animal unit per acre of land suitable for animal waste disposal. BACKGROUND: The applicant requests to operate a stable for 50 horses. The stable will offer trail riding, boarding and private training lessons. The applicant proposes to have a trainer onsite who will oversee the daily operations such as; giving lessons, feeding, cleaning and managing the horses. The applicant plans to lease the facility to Don Jackelen. The applicant owns 79.55 acres, which will be used for pasturing of the horses and trail riding. There is not land suitable (tillable land) to dispose of the animal waste onsite; therefore the waste will be hauled to another farm. The applicant is currently working with a crop consultant from Precision Ag. in New Richmond on a 590 nutrient management plan. The Land and Water Conservation Department will have to review this plan to ensure that over application does not occur. The facility will be open to the public during the daytime hours. The applicant proposes to have a 12 square foot sign at the entrance off of Plainview Road. Staff conducted an onsite inspection of the property on February 9, 2000, and observed a mobile home already onsite and it appeared to be occupied. A reconnection sanitary permit is required prior to connecting the mobile home to the existing system. The existing system must meet the provisions of the state sanitary code before a sanitary permit can be issued. A local township permit is required for the mobile home. The applicant's exhibits are as follows: 1) Application for special exception with narrative, 2) Land and Water Conservation's response 3) Zoning map, 4) Plat map. SITE REVIEW: The surrounding land uses of this area are single family homes. The site is located approximately 5 miles south of the City of Hudson. Access to the site is off of Plainview Road. This access is a shared driveway and is paved. i i TOWN BOARD RECOMMENDATION: A recommendation from the town will be available for the hearing. STAFF SUMMARY: The Board of Adjustment must stipulate findings to support their special exception decision (for approval or denial). The Board of Adjustments may want to consider the some of the following conditions if the permit is granted: 1) This approval is for a riding and boarding stable for 50 horses. 2) The applicant shall submit a 590 nutrient management plan to be reviewed by the Land and Water Conservation Department. The animal waste must be applied to those agricultural parcels identified in the 590 plan. A change in the waste disposal may require a new nutrient management plan. 3) Applicant shall secure a reconnection sanitary permit from the Zoning Office prior to connecting the mobile home (trainers residence) to the existing septic system. 4) The total signage on the property shall be limited to 32- square feet. The applicant shall submit a sign plan for staff's review to ensure compliance with the provisions of the Zoning Ordinance. 5) The applicant shall limit the travel -- related to the stable -- on Plainview Road from 6:00 am to a half an hour after sundown, Monday — Sunday. 6) No onsite sales (such as clothing apparel, riding equipment, hats, and boots) are permitted. 7 The applicant shall secure all necessary town approvals. pP ry pp 8) The applicant shall have one (1) year from the issuance of the Special Exception permit to act on the Special Exception Permit. Failure to commence the horse operation in this timeframe shall result in the expiration of this Special Exception permit. If the Special Exception permit expires, the applicant will be required to secure a new Special Exception permit before P pp q P commencing the business operation. 9) Any minor change (or addition) in expansion of the project, including but not limited to signage, hours of operation, 590 nutrient management plan shall require review and approval by the zoning administrator. Any major change and /or addition to the originally approved plan will go through the special exception approval process, where applicable, as stated in the ordinance. (Expansion of the facility) Parcel #: 040- 1160 -60 -000 12/13/2005 09:48 AM PAGE 1 OF 1 Alt. Parcel M 25.28.20.627B 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): O = Current Owner, C = Current Co -Owner KENNETH E & CHERYL K SWANSON O - SWANSON, KENNETH E & CHERYL K 245 PLAINVIEW DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 8.302 Plat: N/A -NOT AVAILABLE SEC 25 T28N R20W SE NW 8.302A W1/4 OF SW Block/Condo Bldg: NW EXC CSM 1/67 & CSM 2/526 NOW KNOWN AS LOT 1 CSM 7/1852 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 25- 28N -20W Notes: Parcel History: Date Doc # Vol /Page Type 07/28/1999 607623 1445/106 WD 07123/1997 994/451 QC 07/23/1997 785/110 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 103284 4,300 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 8.302 4,100 0 4,100 NO Totals for 2005: General Property 8.302 4,100 0 4,100 Woodland 0.000 0 0 Totals for 2004: General Property 8.302 4,100 0 4,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 TROY W PLAT T-28-Nis R 19 -20 W a G Farm & Home Publishers, Ltd. See Pages 115.116 For Additional Names. R20W JRM 9W HUDSO PAGE 26 ih b rd3, Swtt � 1 40 Lee 40 i TS RI , 2 x27 LAKE 2 0 3 2 3 ABRICAT(3RS INC. ST cROlx YM CA ,�� `H"o'B°oow I s Greater a 41 LL St Paul Jobn, Colleen, x BC Pam 1 TROY 234 3 M'r L�n° e 69 40 TnWt 40 f the top ten BEACH -- 3 i COUN 3 - - , &;1 @ companies in St. PARK, ' 3 = � 2 13 2 ' and styli g rowing . STAG James& BRICK «m =2 = 2 1 222 9 g' I LEAP Margaret RD 2 = W iepends on our I LN 154 W . druff �7B 3 3 3 3 = 1 WHISPERING I we hire the 2 1 e 20 an INES RD Norman & Shirlee at them like it! 2 WM CD 6 1 PG& eyerelsen Genle z 102 3 Arablans EW G&M Inc 45 14 Offe . . WT L 72 2 2 z _142 3 3 = 3 Ronald 1 85 Gagnon /� 40 ' C t ssupp o rtive 10 , 3 MG Q &Edna @Lana 13 Perri Ton meat 20 Carpenter I& ?A) , I Foundatto' MK E9 86 � 120 13d�evau `7@a 14 N 13, @B6 4 G 82 3 M 1 G o &IM 'I ili 1 1 RW1 3 4 S I IM 13 imunication in James & 1 3 4 1 3 aeLl a �nS St 2 n COVE I I 10 1 eA SH S Margaret 0 RD 55 2 P 145 druff — Q j{ z n s breer 17 F U John N aard I `� W 3fiectS your 47 1 ra performance KPor@ �ergman 64 1 Trust Bah. JCol tte I ROLLING i 0 2 3 25 i1 1 57mmele i MEADOW benefbenef 3 80 DR 120 i•1V 1 arhidge 4 156 ��• Tllamat t& ' i 1 oathm &Renee Nat 2 4 C kmie Pamode Simenaon Brenda &B 2 38 40 3 �f 1 6 4 Donald W I S wage With- a er 12 C T &N 4 �� 2 &Lois 61� Brown i 2 r 3 Cernohous 137 lea Ig commute ni'me a� 1 60 Imn tYUat 112 M& 2 3 3p 3 ti 2 2 SN 33 3 1&B D @S x tl 3 Q.4 V, i`�i, LM amen I 3 Mlrhde wanaon 2 I&333 H 1� i t ��i �I 14 an4 o e. 3 A(Vill 3 1 "dO i 2 a w & D &3 „ & Lynn I Cernohlu eaoa wm n ��+a 1 Q Nanc v E JC o in Stot k Trust Cadma GV 2 +� unaau Pame &1 Stock 7 1 155 l a P ° 1 ck n 15 ao G &s 2 4 Ba0ard Z12 2 39 80 Pride ir) I 3 C&K x PaW & ' Glen. �� 1 3 110 Dd ont phlne 1 E & 0,3 m 4 3 2 �, Johnw Frank & work, &M 1 Gerald LOIS ST 2 r6 at M ' 2 2 1 o rnnt3743 Armbruster Cernohous CR OIX ®LE , Robert obert SKY- z z 2 : a 3 1 157 156 i , i RIVER _ � 9 R S cich 40 DR _r 54 zz z 4 3 12 — — Hahn J r&e RM Da Rosa 11 T&B 31 MM Jam & A udrey Wllllam Jr Farms R& 2g Glenn & HIM I ]3 J I 1 31 &1 Rauphusman & R � Inc 78 11 3 Geor a 7 ebecca l'>I 6 74 » Eubank I 2 z Ja Holier g 2 2 187 Jennifer 3 1 Trust 160 35 UP Jennings lor Ea ston 73 3 3 S 3 RELANDER J 1 lohn & , 3 �' D Brothers I,DaW6 3 N ILW RD w. I Nancy �.Iy on-line Clauam 1 Fi I&A Paul & rwt s ts a` fill] SC eg 80 Marilyn � 1 Rosemary 40 (Jennings 40 1 k�nnlrin K m I Duseek William Leroy ]r 80 Ga lobe & g G 4' 192 , e _I iWo &Betsy & Nancy I aa_ i G..eOradOe • `�7B ' 1987 JUL1 � 4028033 CERTIFIED SURVEY MAP Located in the SW1/4 of the NW1/4 of Section 25, T28N, R20W, Town of Troy, St. Croix County, Wisconsin. NW CORNER OWNER Alex Kosa SECTION 2 4 325 Vine. Street Hudson, Wi 54016 _ LEGEND -� County Section Corner Monument, Berntsen Cap UN L ANDS • 1" Iron Pipe Found ,V 141911 10"W W 351.46' n l A C aI NI „I Q W d = I n t SCALE IN FEET Y1 WI - W LOT - W � 41 no 0 100 200 40 0 ^ I 4 > N _ _ 361,649 SO. FT. H y , WI W O 5.702 ACRES Z WI a1 W o W1 >I DESCRIPTION CC z o u1 — A parcel of land located in the SW1/4 W of the NW1/4 of Section 25, T28N, R20W, L6 ; I Wd Town of Troy, St. Croix County, Wiscon- sin, described as follows: N = W N NI X at the W1/4 corner of Section W� t ka _ `f" 25; thence S89 °23 "E (bearings 0 1 Y referenced to that Certified Survey ZI W W �� - 3 —Q/ ^/ Map recorded in Volume 1, Page 67) �I °' o \p " i W 100.00' along the South line of the U. M ) \� %-I �� 4 of said Section 25; thence Wj o n NW1 ( W a / • °- '^ ,�`(� , Z `I N 1 ° 53' 20 "W 100.00'; thence N 30 ° 00' 00 "E `I Z C� r� y% ' 180.00'; the N15 ° 07' 22 "E 199.35 0 0 W� th ence N30 ° 00'00 "E 185.00'; thence D� 10 4 i N 1 ° 21' 36 "W 145- o thence N f2 ° %'9 38 "�� U. ! �� 214,28'; thence N4 21 5?_ E 350.77 W ? — '~ thence N89 ° 45'10 "W 351 .40' to the West _ W line of the NW1/4 of said Section 25; W gy p` thence S1 0 53'20 "E 1313.57' along said ^ West line to the point of beginning, n containing 361,649 square feet (8.302 = Acres), more or less, and being sub - ,.I. ject to all easements, restrictions 0 o and covenants of record. POINT OF 3 ��`�-`�� / BEGINNING o N I EI /4 CORNER • W I/4 CORNER 100.00' z • JO S ' E SECTION 25 SECTION 25 • S89 °'2313 " I • S" UNPLATTED SANDS - SOUTH LINE OF THE NWI /4 7 <,9 0..�. Ile -7 so NOTE; This rriap is prepared pursuant to Sl;ction 18.02 (q) (h) 3, Of t1W . N St. Croix County Zoning Ordinance, (sale or exchange of parcels between owners of adjoining property. Volume 7 Page 1852 n w r w b (\I U I < � � m N I _ N Q 0. 1 N a N p N J (D I co S M ,09Z A e tzu LI' 96" 10£ OD OD I OD Ni N W t \ N (p aI - m - i o o N oI Ol I � >) vi I 1 � Ljl 1 \ \ 1 �\ �\ L U) I N v v v 06V 1 1 N <i In N 4v C\j i ,06 t' cl k, 1 1131 Q. cli N► � ) o 1 N 05 4I M y w � " - ySyY, w� KW r J Ga! v ,vol £1£I — �0 ON U W ZU)