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HomeMy WebLinkAbout008-1043-80-100 . ZONING DEPART ST. CROIX COUNTY AS BUILT SANITARY REPDRT� Owner a"e, �4�w�ho_r ML Ah&- Property Ad ess City/State a-, Legal Description: Lot Block --- Subdivision/CSM # /Z ,3 02 6 J '/a UW 1 /a, Sec. , T -R)lo W, Town of :n� SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC 0/ Setback from: House 7 We11 Pump manufacturer S Model Alarm location g A-5 + - (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: DL Width �� Length �2 Number of Trenches — Setback from: House /6D Well '710 P/L Zo Vent to fresh air intake ? APP ELEVATIONS Description of benchmark C �+ � M 2 Elevation / 9i b Description of alternate benchmark *9 1,/e-us g �t1 P�4 - F/° Elevation _ /0 2, 2 3 Building Sewer Oa• OJ ST/HT Inlet 90 ST Outlet 9 d • �13 PC Inlet 7a• 2 PC Bottom Header/Manifold //11 7 Top of ST Manhole Cover �� Distribution Lines( Bottom of System {) Final Grade ( Date of installation 9 /2 1 Permit umber �3�� cD j State plan number /6 F `� _ Plumber's signature iceuse number DatelZ / Y Inspector IJ► Complete plot plan p' Y a NOTICE: Please provide the following: • within 100 feet of the s A plan view sketch showing everything p g stem. Y • Two horizontal reference points to center of septic tank manhole cover. \ J) &u. • Show alte nchmark, if applicable. r PLAN VIEW W l� ob Zl� FAA ti $3 INDICATE NORTH ARRO �6u�� 4scontin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT -GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST. CRO X Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 338961 Permit Holder's Name: ❑ City ❑ Village 0 Town of: State Plan ID No.: MCABEE, JAKE & HEATHER I EAU GALLE CST BM Elev., Insp. W Elev.: BM Description: Parcel Tax No.: yZ� 008-1043-80- TANK INFORMATION ELEVATION DATA A9900216 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Zt� BenchQmar d OS 11S.& - 0 (00 Dosing (,l1 60D �J A 1• �Z• O; Z. 2, Aeration Bldg. Sewer C Z I Holding < St/ Ht Inlet L7 lS<<S ,h8 TANK SETBACK INFORMATION St/ Ht Outlet a fif f D, 5/3 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet 5�$ QD „Zg Air Intake Septic '> f&0 ' >60 b d ' -30 - NA Dt Bottom Dosing >t >bv' , e(.S ' NA Header /Man. Aeration NA Dist. Pipe A t1 l. :7 Holding Bot. System a.6 S la o , PUMP / SIPHON INFORMATION Final Grade A .-Z� Manufacturer Dem�nd d f Model Number rn J r - b g GPM (,.30 99• TDH Lift,,Aj L 5ystem�•,s TDH 3(p•� t Forcemain Length 300 Dia. F � Dist. To Well SOIL ABSORPTION SYSTEM '$TES N Width Length No Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION ao ( DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING manuf acturer: INFORMATION Type O f� � / �� Model Number: Syste CHAMBER : ��.a"'�`� I01 OR UNIT DISTRIBUTION SYSTEM Header !Manifold Distribution Pi e(s) # q x Hole Size x Hole Spacing Vent To Air Intake Lengthc� Dia. 2 u Length C Dia. Spacing t k 3y �r 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 code discrepancies, persons present, etc. 3 bt s rfv ;a '( LOCATION: EAq GAL 15. 8.16.223A- 10,SW,NW 2422 COUNTY ROAD N A* a A04 � a Kk � c;� P r 4 - 2 I- gct of JL.,0 + MTV I t (�a } - 'f,t Plan revision required? ❑ Yes W No V\ Use other side for additional information. 0 o3 99 SBD - 6710 (R.3/97) Date Inspector's Signature Cert. No. M k ADDITIONAL COMMENTS AND SKETCH + SANITARY PERMIT NUMBER: d € i # f t 3 s e i 9 t a , �e w, m. .. P 4 s . i wee 1 c E 3 t E t i 1 [ 3 ,.......... � � a E E a 4 F I s 9 .. e�s a, ._....,. .... w , ...... .. _. .. ._ A. i .a } E , z a i a E s I Safety and Buildings Division N * seons i SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue n In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. C r o, x • See reverse side for instructions for completing this application state sanitary Per1�Number Personal information you provide may be used for secondary purposes 11 Check if revision to pr / ions a cation (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number ad n 1. APPLI ATION INF RMATION - PLEASE PRINT ALL INF RMATI N Prgpl 2y O , Er Nalne Propert Locati I /, 5 Qp N, R / E (or) W �J1 1 /4 �(/' / S T Property Owner's Molih ngAddr s .v, Lot Number Block Number C , State Zip Co Phone Number Subdivision Name or CSM Number E OF BUILDING: (check one) ❑ State Owned itly le Nearest Road Vil Public 1 or 2 Family Dwelling - No. of bedrooms Town OF III BUILDING USE: (If building type is public, check all that apply) Parcel Tax Numbers) 1 Jj, 2 $ . IIp. 2 -- 2-5 A 10 1❑ Apartment/ Condo ©© 9 , r / O 8 O 10 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 Y7(New _ _ - 2 . - ❑ Replacement 3 [] Replacement of 4 E] Reconnection of 5. E] Repair of an �_, __ System __ Tank Only______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 2 itmound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22' ❑'`In- Ground Pressure 42 Q Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade 6 � , � 'y' � Required (sq. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevation 00 �� l Feet Feet VII Capacit TANK i allo s n Total # of r Prefab. Site Fiber- Exper INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank 11R ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ 1 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage syste the attached plans. Plumber's Name: (Print) Plumb 's Signatu o Stamps) MP /MPRSW No Business Phone Number: o �9 - 7/-- ��73 --q-�-4 I �Iff_" _f � Plum a s dres Street, City, State, Zi Code): / r VA 1 COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuin It nature No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination C� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS - 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 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 1 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. Ill. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 Visconsin Tommy G. Thompson, Governor Department of Commerce William J. Mccoshen, Secretary August 24, 1998 CUST ID No.267341 ATTN: POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 r - ?• RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 08/24/2000 Identification Numbers Irghsaction ID No. 138489 "si ID No. 158319 SITE: lease refer to both identification numbers, Site ID: 158319 ' above, in all correspondence with the agency. ST CROIX County, Town of EAU GALLE SWIA, NW1 /4, S15, T28N, R16W JAKE MCABEE FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 419038 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10); Wisconsin Statutes, is responsible for compliance with all code requirements. t . The following conditions shall be met during construction or installation and prior to occupancy or use: ;$ y • A copy of the approved plans, specifications and this letter shall be on -site during construction and open to Co IMP inspection by authorized representatives of the Department, which may include local inspectors. All permits i required by the state or the local municipality shall be obtained prior to commencement of 1 N construction /installation/operation. WAR k" VISION of S{ Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. SEE GOF Sinc ly, DATE RECEIVED 08/19/1998 FEE REQUIRED $ 180.00 ES B QUINLAN , FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (608)266 -3937 Page 1 of 6 MOUND SYSTEM FOR A BEDROOM RESIDENCE f LOCATED IN THE SW 1/4 OF THE NW 1/4 OF SECTION 1 5 ,T ZV N, R 16 W, TOWN OF v COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PA GE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR Sf� Provo 1}FR� H L:nz 1" 1 e Pri 13 6 0 L `T1t N Ve . fli>T. w b BP` Ls-)W1ti� Wl SOOZ ®: y �,� �RcE T OF GOD ILDWGS .FET PREPARED BY .RES ONDENCE WF=CF =FREF� SO I L TEST I NG N� DF =� = f3M E31=f;ZV I CE 411SCOAIS`� F.U. BOX 74 421 K. KAIK ST. i ARTH RIVED. FALLS. VI 54022 W G R ER 715- {[r -0165 K swORm 1 W ttttN JOB NO. — 16 PLOT PLAN • Page Z of Scale 1"= y p ' C DR zo' � PUC l � n�•YttJcA @ L p �� s. 3o�r or- 4 Z Pu may. trLIOB 2 s, � N N / /fir `nip s hi�sA •� � E- / s �r� 1 t�N . X o o - p' ou 1 L 2,6 ove tCL wa b Z 531 Z - 101.6' o�.i 1UPj1 L z,y'` 1t k)Ut r. u. I X O. ►J. L14JE QL c ouo"' N" NOTES — - - •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. tank to be \ gallon capacity manufactured by Y WQ12S - �v M• P `11�k <D A�z 100 O 6A\ _ zs 77W Vr 5. Bench Mark3 3TTz r8oyE� 6. Divert surface water anoundsystem to prevent ponding at the uphill side. I Page 3 Of b Approved Synthetic Covering rygYtr�► C33 Distribution Pipe Medium Sand H �G Topsoil F Elev. , p —J I U - 3 E b 6 % Slope ( Force Main Plowed Trench of 2 " - 2 2" From Pump Layer Aggregate Undisturbed D 1.p Ft. Soil E 1 -3 Ft. Cross Section Of A Mound System Using F O.$ Ft. I Trench For The Absorption Area G 1•� Ft. A S Ft. H I• S Ft. B 100 Ft. I 1S Ft. Linear Loading Rate= GPD /LN FT J Ft. Design Loading Rate= b.3GPD /SQ FT K �_ Ft. _ L Ft. ! t W Z$ Ft. L Force 8 K Mai_ A oPpu s tTF � W Distribution Trench Of T , Pipe AggCegate 1 Observation Permanent Markers Pipes (Anchor securely) Mound Using I Trench For Absorption Area i Page L4 Of J� Perforated Pipe Detail 0. End View ) Perforated End Cop. ot`o ` PVC Pipe l J A i Install permanent at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cap PVC Force Main Distnoution Pipe Lost Hole Should Be Next To End Cap Distribution Pipe Layout P yS)•_L Ft. X IS Inches Y 1 ':" Inches Hole Diameter IAJ Inch Lateral I ) I ZInch(es) Manifold Inches Force Main " Z Inches 1 #of holes /pipe )'1 Invert Elevation of Laterals 111.5 Ft. 39.15 GPKI 4 4 Place lst hole V1 1 t 1from tee with succeeding holes at 35 intervals. Last hole to be next to the end cap. : PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOMS ' PAGE S OF VENT CAP `*c.L VEIJT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE 10' FROM DOOR. JUUCTIOIJ 80X COVER WITH WARNING LABEL � 12�MIU. WIMOOW OR FRESH AIR INTAKE I �. C & SDE i H "MIM. COQDUIT --------- ---- - - - - -- • PROVIDE I INLET _T A►RTIGH7 SEAL APPROVED J OIMT/ A Tank construction shall comply (iy APPROVED JOIWT$ with ILHR 83.15 and ILHR 83.20 I ALARM d . i it C . i - -CLEV. 8� -uo F T __j _t PUMP --� OFF 0 !`L �6 •OD CO UCRETE &LOCK 3" APPWfv RISER EXIT PERMII E:D ONLY IF TANK MAWUFACTURER HAS SUCH APPROVAL gEpp 5PECIFICATIOKIS ___ 33333.......... D05E 7. C6 TAAJK MAU UFACTLIR ER: �NR'y w �' NUMBER OF DOSES: PER D" TAIJK 5IZE : 1 ��� GALLOWS DOSE VOLUME t ALARM MANUFACTURER: S Z � 8\ 1STLYI INCLUDING OACKILOW: Zb �`� GALLONS MODEL WUMBCR: 101 ��'`� CAPACITIES: A = l l I IUCHES OR g lk l' 3 GALLOAIS swITCH TUPG: � eU� �>• B= Z IWCHES OR 1 G�LLONs PUMP MANUFACTURER'. �ZS C= �' IMCHE5 OR Z6t• GALLONS MODEL NUMBER: r'LE SO D- \S INCHESOR 3 Z 6 ' GALLONS SWITCH TYPE: MOTE: PUMP AND ALARM ARE TO OE tAlMIMUM DISCHARGE RATE '� GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEN PUMP OFF AWD_DISTRIBUTION PIPE.. 11S FEET + MINIMUM NETWORK SUPPLY PRESSURE .. . . . .... . . 2 FEET + FEET OF FORCE MAIN X 3 `�_ I f YOFT.FKICTIOU FACTOR.. 0 - Z ' 1 FEET TOTAL OyAIAMIL HEAD = 36 Z � FEET DIAMETER 80" INTERAIAL, DIIALWSIOW� OF TANK: LENGTH — ;WIDTH — ;LIQU10 DEPTH � BOTTOM AREA So - z 7 231= Z-1. 6 GAL /INCH AS PER MANUFACTURER - GAL /INCH i 6 ME Series 1/3 through 1 -1/2 HP Effluent Pumps Performance Curve CAPACITY LITERS PER MINUTE 0 50 100 ISO 200 250 300 350 400 450 i 100 2 90 6 BO 24 Il f�. W 70 w h- F /0 20 W 0 Z '- 60 Z a 0 MF > 16 W 50 J = M Q 40 _ sQ l 2 O ~ O H 30 8 20 M � 4 10 39. 0 0 0 10 20 30 40 50 60 70 BO 90 100 110 120 130 CAPACITY GALLONS PER MINUTE M"419 1101 Myers Parkway, Ashland, Ohio 44805 -1923 89 -1144 FAX 419/289 -6658 Telex 98 -7443 K3327 8/92 Printed in U.S.A. wsconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations DhtWon of Safety & Buildngs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site Ian on paper not less than 81/2 x 11 inches in size. Plan must include but S�^. P P horizontal reference point (BM), direction and % of slope, scale or Pe PARCEL I.D. # not Limited to vertical and hori dimensioned, north arrow, and location and distance to nearest road. 0 0B- VdJg3 -100 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED Y DATE PROPERTY OWNER: PROPERTY LOCATION ' P" tz pwj;z \A2R`T1 m "e. seVT4eT SW 1/4 NW 1 /4,S 1 S T Z-B ,N,R 16 E (or W PROPERTY OWNER' :S MAILING ADDRESS LOT # ]_ 616� # SUBD. NAME OR CSM # 13�o b � �v Pmr 6 Z C sm UbI_ NZ 3zbz CITY, STATE ZIP CODE PHONE NUMBER OCITY OVILLAGE .MOWN NEAREST ROAD �PIA- bk11AJ j w SklooZ. hls) 6kV_ 14Z�j � 6 L Uu"-T ' rte`' K New Construction Use [4 Residential / Number of bedrooms Addition to existing building j ] Replacement J ] Public or commercial describe Code derived daily flow t3 og gpd Recommended design loading rate — bed, gpd/ft • trench, gpd/ft Absorption area required S bo bed, ft2 S ob trench, ft Maximum design loading rate • S bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) 1 1 ft (as referred to site plan benchmark) Additional design / site considerations w S 'X- I `J�Ctf . yg W I" L)PI � - Z `' OF Sfo F LL _ Parent material VX)%SS oUTVt. 4 �0_ a - n u_ Flood plain elevation, if applicable Ili A ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S 21 U [as O U ❑ S O U ❑ S OU ❑ S Esau ❑ S i U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boirclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench S aS Z 6 -tb !b`�Ryly Sid Z'�s�k Js1 Ground 3 L b -3Z -1- S V V_ V/y elev. ► tf 32. -1( S` 21 y S 1 SC-J v W, Depth to limiting factor 31 Z 4 Remarks: Boring # a-S S t ������.:.�� }:.. {.:rw:. z sbk &5h �.� .s .L R V/ Ground ) elev. R 31 s st S /b S Q I OM y ,. l �� ,. Depth to r_� % � �• '`' -� limiting �'!r factor Remarks: CST Name : - Please Print Phone: ' Arthur L. We erer 715- 7005- gerer Soil Testing & Design Service -P.O. Box 74 River Falls, Signature: B - ! b, Date: p CST Numb 5 7 6 1� o[. �3 -`JB PROPERTY OWNER I SOIL DESCRIPTION REPORT Page of 3 PARCELI.D.# OU$ Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& 0A vo,-t%Z 3 1' 2 s o4., i - Z Ground 3 Zt 30 - 1 S `i r2Yly elev. 111.3 ft. 3D —�! � -S `iC� -3! — �.S�tZ S�8 Sc.l O� �`�� ►�� -�- Depth to limiting factor 3� h I C I _ Remarks: Boring # Ground elev. ft. Depth to limlting factor Remarks: B.pr'Ing # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev' ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) y PLOT PLAN Pa 3 of 3 D�� SCALE 1 "= yQ ' ee l B. L-Lioe _ 8. B.3 u'(t ISM 'A o o . p' oti ►JM L 26" M oul — �- V4 b 6Rovwz 1vo Zr.." vR -av1v� �ti �S" D�f�. Po4LP�►Z, v 2 IOTMM of i� LL A9 I � 1 � y11 ti , r y ( 715 ) 42q- M 00576 CST Signature Date Signed Telephone No. CST # WiscorWri partrnentofIndustry, SOIL AND SITE EVALUATION REPORT Page � of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wi Adm. Code COUNTY g Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but �• not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. of dimensioned, north arrow, and location and distance to nearest road. 00$ bb%L3- a'V -L 00 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE 9 5 PROPERTY OWNER: PROPERTY LOCATION ='Pc'CCly, R1vZ., ))t h.$E GOVT-. $ SW 114 NW 1/4,S �S T 7 - b ,N,R 16 E (or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # I SUBO. NAME OR CSM # 131 6 ni PNiz. Fm CSM % L '\7- 3Z6Z CITY, STATE ZIP CODE PHONE NUMBER []CITY (]VILLAGE ,MOWN NEAREST ROAD r "A Po bIjIA! c,�) s�LfloZ ht� 6kV_ LIZ\ - ] �v Gt'ri..�`F, (16Q" N pQ New Construction Use [ Residential / Number of bedrooms �/ () Addition to existing building j ) Replacement [ ] Public or commercial describe Code derived daily flow 6 o n gpd Recommended design loading rate — bed, gpd/ft • trench, gpd/ft Absorption area required S t)o bed, ft2 S ob trench, ft2 Maximum design loading rate • S bed, gpd/ft trench, gpo1ft Recommended infiltration surface elevation(s) W - Q$ ft (as referred to site plan benchmark) Additional design / site considerations "�YJ�� L-J S 'X I %I CJ , $"IVJL" u rn 12. t ' OF FtC.L, Parentmaterial W%� OUP a `T1t.l Flood plain elevation, if applicable 'fJA It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem O S �U [RS 11 U ❑ S ®U ❑ S 0 ❑ S EaU [IS OU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence l3our>�y Roots Bed ITrench s a,S N YA ;:; > «;:�n�� Z 6 -1, I� t oy tZ y�y — s i, Z`�s�k �s1� cl..> > � s • � Ground 3 16 32 - `tV y!y S e t° -Sb1t �^ CS elev, ro ft 3 -qL -S`1 31 �.S4 2S - Scl a yt, '41 Depth to limiting factor 3 2_ Remarks: Boring # 1o"1tZ Lz. 5 a.S . S 3 zz29 �.S VI — sic j ��z Ground f elev. - Y t z /g s e l v�, y,� `� j -- ►•IP Z 1b �i.0 ft. Depth to limiting factor 'ZOl k Remarks: CST Name: - Please Print Arthur L . We e r e r Phone. 715-425-0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022' Signatwe: / �- Date: J X3,9 CST Number: M00576 PROPERTY OWNER �'1� SOIL DESCRIPTION REPORT Page.? of 3 PAMALIM4 OOH • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bcurx Roots GPD /ft In. Munseii Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnerch - -1) 12 -- C� S ac. I Z M • S • (, Z 8 21 t, " -1 R yly -- s 1 Z sbk CL s C k, l • s• 1 . Ground elev. 111•3It. 3 o —%4 — L-S 1-tz —,3! .5 y V. SAS S0-1 Q: ►-" Depth to tlmiting factor 3 0" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Bong # Ground elev. It Depth to limiting factor Remarks: Boring # Ground f eleV. It Depth to iimiling factor 7- Remarks: SBD- 8330(R.05N2) PLOT PLAN g Pa e 3 of :3 k. ` SCALE 1 "= y0 ' 8.2 / 1 3)1 '4- 2 / 2 / N Wr eo'rlpf\ cT Urt b�31�1$ EL�\L3 el GRovty� 1lv �S ° Dt �. PopL �Z. � v 2 s"'�ti -1 0� `�c�1 u' tL �ll,p' ,A t4 mi To • eovyaT{ ` X36 Y L 2 _ ( 715 7 42s -0169 - 14 00576 CST Signature Date Signed Telephone No. CST # 7152737753 02/°19/1995 10:24 7152737753 NELSON PLUMBING PAGE; , 01 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �YG� Mailing Address Property Address'; (Verification regJr from Planning epartment for new construction) City/State ��L �� / /�c� /Z Parcel Identification Number DOS I Na LEGAL ESCRIp JOB T ✓P Property Location ' /., ��1,, Sec., T,N -R W, Town of Subdivision , Lot #, Certified Survey Map # Volume �� , page Warranty Deed #! Volume Spec house O yes Nino Lot lines identifiable es 0 do SYSTEM IN NANCC Improper use and maintenance of your septic system could result in its premature failure to handle wastes Proper III t enancc' KL consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you p t;i t01 tbs:5ystjsa'; can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner,and b -„ master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal ystetrr is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 felt of slUdgc' Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth., herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within days of a three year a irati datc_ �- 5IGNATURB QF APPLICANT DAT OWNER CERU ICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner($) of the property describ abov , by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE Any information that is mis- represented may result in the sanity ry permit being revoked by the Zoning Dcparfrn4ttt '• Include with this appliextion: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ` J6�9.7V 1 1 STATE BAR OF WISCONSIN FORM 2 — 1982 WARRANTY DEED DOCUMENT NO. _ AEGIS «R lrr $T CROIX C TY., Wl �j Larry Albrightson and Beverly Allirigh 4 w = li husband and wir 1 I JUN 14 199 t '' ai 11:30 A!N cone and warrants to Jacob B. McAbee and Heather i * L.'4" 1 M. Thom, as joint te and not as H a tenants -in- common TN* SPACE RESERVED FAR RECORDING DATA i E ANO RETURN ADDRESS the followin described real estate in St . CYO x County, /W 6p �^/1 tit C 1 g State of Wisconsin: PARCEL iDENTIFICATION NUMBER f Part of the Southwest Quarter of the Northwest Quarter f (gtd of NWT) of Section Fifteen (15), Township Twenty -eight (28) North, Range Sixteen (16) West, Town of Eau Gaile, , i� St. Croix County, Wisconsin, more particularly described as I Lot Two (2) of Certified Survey Map, filed Mar 28 , 1997, in Volume 12 of Certified Survey Maps, at Page 3262 as Document No. 560005 office of the Register of Deeds for i 1� St. Croix County, Wisconsin. This _ is s not homestead property. (is not) Exception to warranties: Easements and restrictions of record. h~ ,A.D., l9 97 Dated this D day of ( (SEAL) (SEAL) -Larry Alb ightson s (SEAL) f (SEAL) y .Beverly Albri�at on a i AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, Signature(s) _ . SS. ' ., St Croix Count authenticated this day of __ . 19,. Personally came before me this _ day of 19 . the above named ij Wight son and v , g ibrightson ti E BAR OF WISCONSIN TITLE: MEMEER STATE y it {� (if not, \ ; ' authorized by $106.06, Wis, Stats.) to me known to be the n S wh ?�x�,cuheoregoing ` instrument and ackn ge the same. a i t THIS INSTRUMENT WAS DRAFTED BY -- Thomas A. McCormack Baldwin, WI 54002 f Notary Public, County, Wis. (Signatures may be authenticated or acknowledged. Bott: are not My commission is permanent. (if not state expiration ate: necessary) • Na .ks a persons signing in any capxuy should by typed or printed below their signatures. w6consin Le¢Y k Co Inc. q:< STATE BAR OF WISCCOV IN wwaUke. WIS. WARRANTY DEED Form No. 2 — 1961 _ nom' - - -- .. 9 MAY 2 8 1997 � 56i0005 CERTIFIED SURVEY MAP LARRY AND BEVERLY ALBRIGHTSON Part of the Southwest 1/4 of the Northwest 1/4 of Section 15, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, Wisconsin. Owner's Address: 507 South Side Drive This instrument drafted by Laurence W. Murphy Woodville, WI 54028 Indicates 1" x 24" iron pipe weighing 1.13 lbs/lin. ft. set. +- #Indicates fence. 8 b UN T IED L ANDS E L /NE SW 114 NW 114 2 + S 00' /4'37 "W 736.71' 2 703. 47' I M N 33.24' ` - 3 I O O 2 Q: O N 1- c 1 3 Q a a 21 N Q Z V h t , W t Q h U I ? O N g Q q 4 n, b 0 A b v O M j 01 b h V~ Q Q O q a O w g w W O yf O WATERCOURSE I h � V k QI 500 683. 49 � � 3 /� , ,,•� {I��I,,, O 6 52. 2 3' 33. 4 A* Iv s 1%F N 3 1 Q .%b� Vy � (4 o Jf `LAU N , ac Z o �m W RP Y: o .. I "1 S 1713 %.. 3 = W IV FALLS,; O o w O b 2 4 � ••••' S� �, M Imo. Q caNv t Q: ' °a a ° rence W. Murphy h m ° M q °� c Registered Land Surveyor k; y z w m t O a 3 S 00.14' 43 "W 330.00' O S 87.23'03 " E Dated: March 12, 1997 a. 00' " M h' 21st day of w 500 43 W270.ss ' Revised this y 1321.24' -- � — � 69/./O' May, 1997. r 630. / 4 ' a C. T. N. ��BB ��� NO "E 26 42.48' i _ M W LIME NW //4 U NPL A TI L SHEET 1 OF 2 Vol. 12 Page 3262