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HomeMy WebLinkAbout028-1040-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provii a may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344689 Permit Holder's Name: ❑ City ❑ Village Q Town of: tate Plan ID No.: Town of Rush River S ,D¢ = 2 `f 2 (O BM E ev.; Insp. BM Elev.: BM Description: Parcel Tax No.: co 10 r I .0 r -CSI g l 028 TANK INFORMATION ELEVATION DATA TYPE MANYFACTURER CAPACITY STATION BS HI I FS ELEV. Septic (A ) AA411104 Efb'D 6 Benchmark 4 Dosing �j `� Alt. BM M ca.er T•S IDo •Zo Aeration Bldg. Sewer Holding St /Ht Inlet t 9d r l3•�� TANK SETBACK INFORMATION it E)ttt4et TANK TO P/L WELL BLDG. ventto Air Intake ROAD Septic tra - — NA Dt Bottom r qf3 90, Dosing >Soa , NA Header/ Man. 3•So 10. r Aeration NA Dist. Pipe -S r 3. Sa I t)/. 2 Holding Bot. System .3� loo • `f PUMP / SIPHON INFORMATION 1 Final Grade Manufacturer k� Demand St cover O Model Number GPM i I V TDH Lift D;U% �rictio� System TDH 15 Ft Forcemain Length 05 Dia. 2 tl Dist. To Well SOIL ABSORPTION SYSTEM $eD RENCH li VVidth I I Len r No. f renches PIT No. Of P is Inside Dia. Liquid Dept DIMEN 't S DIMENSION SETBACK SYSTE TO P/L BLDG WELL LAKE /STREAM LEACH B G Ma cturer: INFORMATION Type Of M n ',� �Cl OR CHAM T Model Number: System: IA DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent To Air Intake r Lengt h� Dia - Length Dia. _L Spacing �' l tr r, 30 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.) Inspection #1: 1 Inspection #2: --f-• Location: 1829 CHT "M Baldwin, WI (NE1 /4, SWl /4, Section 34 T28N -R17W) - 34.28.17.249A S 7 S.3G Si *s V0 wpo ""'k � �� 5 �" = I ®� a q `��s (0- iD -1 C�)P(o mil) T`.- 1 ' ate Plan revision required? [:]Yes X No U other side f rr additional i formation. d3 ° f l c)I (S 2 �"" wc"' / SB ^n � , pate Inspector's Signature Cert No 10 (R.3/97) Pl� C� I.- ���NR,pd ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e i �m r e r F E ° j e E t i a i e , r a ° m ..,:...... e t ° a E i t a f ° ° r ° r a _ ! 3 � E 3 1 ` e a E e i 1 e } . i a r .. .� ..per r AA. 3 }` 7 em ...5... , Pmm_e ....ate ,.a.Y, ......a � m s r r e E r 3 � r 3 r 4 x .. - m .,,. ...�. °. °� °.... ,mom,. . ®.�.° ...., °.° ... E � a m� c` :e t ° .� ..._ 3 � n e 3 r 1 3, r fl 6 E r Safety and Buildings Division *Isconsin SANITARY PERMIT APPLICATION 201 BoxWas 2ngtonAvenue In accord with ILHR 83.05,Ws. :rode. Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) forth �tg 4, on caper r> tX�ess, county than 8 112 x 11 inches in size. p • See reverse side for instructions for completing this cation =' State Sanitary Permit Number 3 41 4(4 " Personal information you provid ay be used for secondary purpo D I '.' 19919 t— E] Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. l Q2 CT _ � ST CROIX State Plan I.D. Number I. APPLICATION INF ATION - PLEA E PRIN I N ti 'aZ 1 2- "( Propel* -Owner Name ,rope on l�Q�lr1 �`rG °� �� ����� 3 /4,S 3YT�'`�,N,R E(or W Property Owner's Mailin � Address , t u Block Number -! f T 5 Ci , Stat Zip Code Phone Number Subdivision Name or CSM Number 11. TYPE OF BUILDING: (check one) ❑ State Owned ' !t Nearest B ad ,r Public 1 or 2 Family Dwel - No_ of bedrooms vulag OF :' QK A " 111. BUILDING USE (If building type is public, check all that apply)Z Si Parcel Tax Number(s) I G y n- /GyO 1 ❑ Apartment / Condo - 7 111 �• 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home fO ❑ 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. g 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 Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 CaWound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure ��Q 42 ❑ Pit Privy 13 ❑ Seepage Pit 5 X �"�" """` 43 ❑ Vault Privy 14 E] System -In -Fill q a . 3 Z:) VI. ABSORPTION SYSTE FORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 1 7. Final Grade Required (sq. ft. Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation , 2 t/eo,3 Feet /U.2.� Ca acl VII. TANK in gallons Total # of r Prefab. Site Fiber- plastic Exper- INFORMATION Gallons Tanks Manufacturer s Name Concrete CO " steel glass App. New Existing strutted Tanks Tanks Septic Tank or Holding Tank + t/ '�,S '� ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber _ y � ❑ 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 Name: (Print) Plumber's Si ature: (No Stamps) MP /MPRSW No.: 7.17 Business Phone Number: j ? 3 �.�c.� 'rte_ C`J J Plumber s ress (Street, City, State, Zip Code)_ IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved nitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature (No Stamps) (Approved [] S Owner Given Initial W Surcharge Fee) p Adverse Determination 3 2 S' 7 —! X. CONDITIONS OF APPROVAL / REASONS FOR ISAP ROV L: _17___f 7/ 3/ f? 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 / 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: L 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. Vill. 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 mainstwater 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. I - Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda I Blanchard, Secretary August 21, 1999 CUST ID No.267341 ATTN Rod Elsinger WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 08/21/2001 Identi&2c be Transaction ID . 24270 Site ID No. 179 2 SITE: Ple r 'dentifi cation numbers, Site ID: 179342 v ' e with Ow agency. St Croix County, Town of Rush River NE1/4 SW1/4 S34 T28N, R17W John & Shelley Monicken FOR: Description: New 3BR Mound Object Type: POWT System Regulated Object ID No.: 486984 The submittal described above has been reviewed for conformance with app "irbre'A#iSc ui istrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED The following conditions shall be met during construction or installation and prior to occupancy or use: 0 A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 08/16/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 Dennis R. Sorenson BALANCE DUE $ 0.00 Wastewater Specialist (608) 785 -9336 dsorenson @commerce.state.wi.us WiSMART 7633. Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE NE 1/4 OF THE SW 1/4 OF SECTION T ZB N, R 17 W, TOWN OF , ST. CRO�X 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 PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR Tpt tiJ nt ) S r3 C1 ^iv SO •Z00 ki1 5gao2 PREPARED BY Wf= Gf= FR. f =fR SO I L . TEST 2 pq AND. F.O. B01 74 421 N. RAIN ST. ,..••"""'•••., rs RIVET? FALLS. VI 54022 y° '•' 715 -42`i -0165 ARTHUR L WEG:i.FvR EiLS ri'OFiTM, SIGl; cl JOB NO. PLOT PLAN Page Z of Scale 1 "= s0' cep � �—i �� • ;1 _ p��v�w • ��' N I SvU.S' 1 �:.� P � �p G7 � ,QZVLF� Y-�uv. X12." wu� 3BbR.,•'1 • Nrm\j\% `.''•l . Gil.I ' 8 3 �lz�o QOCCpw1 0r — 1ZL�'1JC1F orm ham► V iiOvArE SEWAGE SYSTEM 8 Conditionally a APPROVED DIVISION OF SAFETY AND SIN MHOS SEE CORRESPONDENCE 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. - Septic tank to be \ppp Aoo gallon capacity manufactured by P=o >UQrs - t-vL_ P cY- 1.60 o 5. Bench Mark % mM- LL. - 7oP or- k . i4 u STc-a_ P I pe . g 0 1.1' k K 4 6. Divert surface water around system to prevent.ponding at the uphill side. Page 3 Of `o Approved Synthetic Covering IF)STM c 33 Distribution Pipe Medium Sand _ H_ G Topsoil F Elev. %Z).3 3 E , b 3 J /Z % Slope Force Main Plowed Trench of %2 " -2'2" From Pump Layer Aggregate (undisturbed D \.O Ft. Soil E ``t Ft. Cross Section Of A Mound System Using F O.8 Ft. I Trench For The Absorption Area G N•D Ft. A S Ft. H i S Ft. B Ft. I S Ft. Linear Loading Rate = b Q� GPD /LN FT J Ft. Design Loading Rate= GPD /SQ FT K 11 Ft. L 0 \ - 1 Ft. W z8 Ft. L J Force A 7 L� ; B Z K Mai — ' — — — — — — — — — w �t1JT�� ITT" `c- — oPPO St� Distribution Trench Of 2 - 2 2 Pipe Aggregate 1 Observation Permanent l Pipes Markers (Anchor securely) S'�E wA� ally s� � `�'' - ' n v ED Mound Using I Trench For Absorptio D� i D`ri1S1 SSE C O R SPONpENt✓E Page q Of b Perforated Pipe Detoll End View End Cop ) Perforated Z Ore PVC Pipe -4 "e r . Install permanent at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cap ,!L"AGE SYSTEM PVC Force Moir Conditionally APPROVED Distrbution at Al Pipe Last Hole Should Be �L Next To End Cap SEE CORRESPONDENCE Distribution Pipe_ Layout P 3� 2 S Ft. X 3 O Inches Y 3o Inches Hole Diameter "L ( Inch Lateral l J ' ZInch(es) Force Main Z Inches # of holes /pipe 1S Invert Elevation of Laterals )�3O.b Ft. Place lst hole ZS from tee with succeeding holes at 304 intervals . Last hole to be next to the end cap. Combination Septic;Tank and PUMP CHAMBER CROSS SECTION AND SPECIFICATIOMS ' PAGE S OF - VEUT CAP WEATHER PROOF JUAICT10W Box 4"C.I. VENT PIPE APPROVED LOCKING 110' FROM DOOR„ MANHOLE COVER '-J •.iIUDOW OR FRESH wARtJIA/6 L.P.BEL AtR WTAKE S co�OUrT 6 Mix. � i 18' MIAI. y'�IU S?�T1on7 PIPe PROVIDE i IIJLET AIRTIGHT SEAL. I fII APPROVED JOWT A I I APPROVED JOWT: PIPEOPn Tank construction I II W /C.I. PIPE �P'c � shall comply with i II ALP,RMi LP G LH 83 3.15 and 83.20 O U �� PU C® � LLIV ��' bZ FT _ -� MP OFF y 0 COWCRETE L t --, ;, ___j I f 3" AAPRoyBD �RISE4C EXIT PERM17ED OfJL!J IF TAUK MAIJUFACTURC.R HAS SUCH APPROVAL %EDOINQ SEPTIC F SPECIFICATIOUS DOSE TAWKS MANUFACTURCR: I/J I LIZ 000C. �-"TE NUM5ER OF DOSES: �° PER DAy TAWK :,IZE: GALLONS DOSE VOLUME r ALARM MANUFACTURER: S.S.t?L q Syc y 23 IWCI.UDIUG OACKIFLOW:_ GALLONS MODEL NUMBER: CAPACITIES: A= "PO INCHES OR 'G'`` GALLOIJ5 5WITCH TJFE: 8 = Z WCHES OR G�LLOUS PUMP MANUFACTURCK: Z0ErLL.e Cs 8 I 1- " IUCHE5 OR IyZ o12. GALLOWS MODEL NUMBER: D= IIZ INCHES OR '"' 40 GALLOUS SWITCH TYPE: NOTE: PUMP AMD ALARM ARE TO 5E MINIMUM DISCKARGE RATE S' to GPM IN5TALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AIJO..DI5TRIBUTIOW PIPE.. FEET + MI►.IIMUM NETWORK SUPPLY PRESSURE , , , . , , , , . 2.5U FLET T. + 05 FEET OF FORCE MAIN X L 'H - 1 F Yo FACTOR.. -2-SS FEET TOTAL DIJMkMIG HEAD = �S.Z3 FEET Pump chamber DIAMETER 3 b r JUTERIJAL DIMLWSICIWi OF TAIJK: LENGTH ;WIDTH — ;LIqu1C1 DEPTH BOTTOM AREA -t - 231 GAL /INCH AS PER MANUFACTURER = l b.`12Z GAL /INCH YO �Z-M P J C iF_ e r r� 1n LU W J 3 7/8 6 1/4 —� W HEAD CAPACITY CURVE 3o MODEL "98" 4 5/8 8 3 5/8 = 6 0 i U i } 15- 15 •Z3 O 0 4 4 3/16 p 10 3S.J !- 2 5 1 1/2 -11 1/2 NPT 0 U.S. GALLONS 10 20 30 40 50 60 1 70 80 LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD /FLOW PER MINUTE EFFLU ENTANO OE WATERING CAPACITY 12 HEAD UNITS /MIN FEET METERS GALS LT � 5 1.52 72 273 3 10 3.05 61 231 15 4.57 45 170 4 3/16 20 6.10 25 95 Lock Valve 23. 1_ L44— SK1102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE Standard all models - Weight 39 lbs. - 1 /: H.P. 1. Integral float operated 2 pole mechanical switch, no external control required. i 2. Single piggyback variable level float switch or double piggyback variable level, 98 Series Control Selection float switch. Refer to FM0477. Model Volts -Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10 -0072 or 10 -0075. M98 115 1 Auto 9.4 1 or 1 & 7 — 4. See FM0712, for correct model of Electrical Alternator, E -Pak. N98 115 1 Non 944 2 or 2 & 6 3 or 4 & 5 5. Control switch 10 -0225 used as a control activator, specify duplex (3) or (4) D98 230 1 Auto 4.7 1 or 1 & 7 — float system. 6. Four (4) hole J -Pak, junction box, for watertight connection or wired -in E98 230 1 Non 4.7 2 or 2 & 6 3 or 4 & 5 simplex or duplex operation, 10 -0002. 7. Two (2) hole J -Pak, for watertight connection or splice. CAUTION Forinformation on additional Zoellerproducts referto catalog on Combination Starter, FMO514; Piggyback All installation of controls, protection devices and wiring should be done by a qualified Variable Level Switches, FM0477; ElectricalAltemator, FM0486, Mechanical Alternator, FMO495; Sump/ licensed electrician. All electrical and safety codes should be followed including the most Sewage Basins, FM0487; and Single Phase Simplex Pump Control /Alarm Systems, FM0732. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. AMY MAIL TO: P.O. BOX 16347 ( ff1z-zzJ-ff Louisville, fly 347 Manufacturers of. . � SHIP T0: 3649 Cane ane Run Road p /- Louisville, KY 40111 -1961 r LWI rl )UUMPS S XC£ /9 PUMP L (501) 778 - 1731.1(800) 928 -PUMP FAX (502) 774 -3624 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of - Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than B 112 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 5 /I (I'Qp /,Y percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # j0 2 G APPLICANT INFORMATION - Please print all into Rev wed by Date Personal infomration you provide may be used for secondary purpose ri (t) c n Q /� .9 Property Owner ^ Prope . cation (� LQt' . �/ 1/4 S Cc 1 /4 S _-3q T ��3 N,R % 7 E (or) 4W) Property Owner's Mailing Addr ss # 81 k# Subd. Name or CSM# city State Zip Code Ph u er C Nearest Road city Village © Town 7 3cl�c�C�, Si "J ® New Construction Use: ® Residential / Number dloPrt�s Addition to existing building /Z � El Replacement ❑ Public or commercial - Desc �T �� 7 Code derived daily flow gpd Recommended design loading rate bed, gpd /fl ' S trench, gpd/ft Absorption area required 22 �5� bed, ft2 3 /5 trench ft Maximum design loading rate bed, gpd/ft - trench, gpd/ft Recommended infiltration surface elevation(s) l t �;.1" it (as referred to site plan benchmark) Additional design/site considerations Parent material /Ge i 6e5 Flood plain elevation, if applicable IV ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system ❑ S U [_�7 S❑ U ❑ S p U El S 0 U ❑ S ® U El S Ill U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. / Bed i Trench U 1 7 1 1 2 -31 Z 5�� Ground 3 1 -7) & t Z �'2 �( �� S ,? U �7 _ 3 e ; Depth to limiting factor , aL_in. Remarks: '7`0- /''20/1 Boring # l iL ' ? �r rrl (-J / cc r 2 Z 11 y — 2 t - )s,b m Fr- c_S l M 4/, S 3 32 -cf 5 1, s /c y/ OF /Owe 5c,(" Ic s % 02 v �� c � � . 2 - 3 Ground I W 7,3YIC �Z !— P `�� /Y7 11 t r I vt' 3 7 Depth to limiting factor / �in. Remarks: �?r"/ ZO! (o77�ci />9S G)Je-f �� C�t»pr��e S 4'1 e5 �'UU S6T' CST Name (Please Print) , tP re ' Telephone No. David J. Steel --z 715- 246 -5085 Address Date CST Number 1564 Cty Rd GG, New Richmond, WI 54017 r; S' - `� i' CST #248956 PROPERTY OWNER G1 /LJo�/ 1'G�e�'I SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D.ft 1 � — 2 - C - , Boring # Horizon Depth Dominant Color Mottles Structure 2 $� in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench 0 Nv' : 3 0 -/tr i R �- — s 1-C m,5 rv► �r cC_,� l Go • j -: 4_- 73_W � I1 c� �,C� - -n 56 ,� r c_ 2 e- o ; , S Ground yo n. ; Depth to limiting f ctor , �in. Remarks: i>Zor'I - co/ Glie4/y C c 5ah�Sfa7es Boring # Ground elev. n. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft Depth to limiting factor in. Remarks: Boring # Ground elev. n. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) 1 V� E3 t y) wipe i/eu. 1 v,od 3 �' -- - -- - -- - - -- 00f f our � e ' (3 P), /f 7 e -7 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT P \ Of 3 Labor and Human Relations — Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but C tLo - we' not limited to vertical and horizontal reference point (BW), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. OZ 1 W 0 - ZZ) APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REV DBY DATE 1 8 �8 PROPERTYOWNER: Mf\k z1 j 4 BEyry lvyv� �CI�sN PROPERTY LOCATION 3v� S M V0,1 Mr eOW -tff IUD 1/4 SW 1/4 34 ZZ ,N,R 11 E(ar W PROPERTY OWNER'S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # I `3 - 1 18 ` W ewe-,) VIP - - - CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE ®TOWN NEAREST ROAD 1 s DLO l S h 1 S) G8q- 3 S �i7 V S� r V �1Z s✓`�t '► " [ New Construction Use [ac] Residential /Number of bedrooms 3 [ ] Additigp to eAsting building j ] Replacement [ ] Public or commercial describe Code derived daily flow L I So gpd Recommended design loading rate — bed, gpd/ft • trench, gpd/ft Absorption area required - s1 S bed, ft - -S trench, ft Mabmum design loading rate S bed, gpd/ft2 _ _trench, gpd1ft Recommended infiltration surface elevation(s) "_ 00. `� ' ft (as referred to site plan benchmark) Additional design /site considerations tiv / 5 ' X l 5' l�zeh etF . 1'x'1 �U l mum I L' OF FILL, Parent material S M kr Qt , JT OUL�Z S'PCM -f Uy*rjvR31¢ Flood plain elevation, if applicable ti • ft S = Suitable for System CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FlLL HOLDING TANK U= Unsuitable for stem ❑ S RI U WS ❑ U ❑ S O U ❑ S ®U ❑ S O U [IS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench } I o -9 Ip` -ltZ 31 - sil ZV'IS M 0S 1 •S -b Z 9 -Z► lz 311. _ Gr s t l Z wl s SIT vh '( CS • S - � Ground 3 2 - 1 -3S S`1R Sly — Gr Sl 0 -SUIT mu'` - c-S - 04 ' S elev. -� ft y 35 - 7.s`11Z31y �s�SZ 3)j Gl C�`n� wl �►� - NP .Z Depth to D'Z.1 /v S ,v5 w� L limiting factor S o �-S . 3S" Remarks: Boring # 1 - �UKIZ StI - LM Sbh VK 3J Z 0 1 _L1 �o�� 3t. ` — s ! 1 Zrnstih WV FI. cg • S •` 3 zj - S9 - I•.5'1rL31 - lz 0- SU1t ��f�- c g •1 €,� Ground Z elev. y 39 -6� 1.S `1tL 3 t. S 4 t- 31 S I f' �'�- 3 •y C O-3 ft. Depth to limiting = I factor Remarks: vAaA CS T Name--Please Print Arthur L. We a re r Phone. 715 " 5 ='Ql 6{vv► �o rer Soi Testing & Design Service - P.O. Box 74 River Falls Wl / Z2 - � Signature: / `,� {l ;� �_ 3 Date: M00 5 7 6 PROPERTYOWNER SOIL DESCRIPTION REPORT Page Z of PARCEL I.D.# o io t40 - Z Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell CQu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench r i o -F -1 t - — sit Zms bk m eS . S •b 2 $ -emu 10� 2 N s ► 1 Zw� s bk vn • s Ground 3 1Z - • S Y IZ 3 ly M U` v C- • �� • S elev. .� Z 600.9 ft. Y 3S -6Z S `t 2 Sly 5 y 2 w U `Q-I, Depth to limiting factor Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # r Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330 (R.05 /92) PLOT PLAN Page 3 of 3 SCALE 1 "= `1Z' Fx e�T fts SN%&i w C T l � o.3wti t� 0 0 M i i eL483 \\ ILI 8• .� ` ►,,or o►Z Ir \ 1 STU \LQ T{ 1 S lz •" , g S, \o ,v\ $•3 �*L l00 9 �tnuF Q V per) 0� �,� 9 9 <`? k � o , o °o- Np'nr•G �M W - C�L.lO6.p' ON gly i6►A• QUC PlI PE wlLArT)I r-) -Ik 2 - 03.8' oKv lv n o F STEt Feiv C ti P o s7 ; 1rjv sE Zl +3E pr7 Ls1t�T Z S' vn.0 . - Iv �,� �.c t 1 y SD � ♦ y � - (715 14 00576 CST Signature ^ Date Signed Telephone No. CST # Wisconsin DeparbZ of Indusby, L,abgranaHumanRelations SOIL AND SITE EVALUATION REPORT Page � of 3 D'nnsion of safety a Buildrgs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BNt), direction and % of slope, scale or PARCEL I.D. 0 dimensioned, north arrow, and location and distance to nearest road. L OV 1J - ZO APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION BY DATE PROPERTY OWNER: M%j)y ti gp" PROPERTY LOCATION 3v\-tQTL_-_ SOttiN 1"t G6YftOT IVY 1/4 SW 1/4,S 3yT Z$ ,N,R 1 E( W PROPERTY OWNER'.S MAIUNG ADDRESS LOT # I BLOCK 0 I SUED. NAME OR CSM 0 18 - 1 18 `n pNe'N v1. - - - CITY, STATE ZIP CODE PHONE NUMBER C]CITY OVILLAGE ®TOWN NEAREST ROAD R1hW� O►� �J I S x(01 S (� I S► 6 $ �{- 3 S,-1,7 U S k 4 X21 U t_El Z-ni ' t" � " [�Q New Construction Use [M Residential /Number of bedrooms 3 [ ] Add�n to e)as&V building j ] Replacement [) Public or commercial describe Code derived daily flow q So gpd Recommended design loading rate bed, gVW ' 3 trench, gpdtyt Absorption area required 31 S bed, ft trench, ft hUmum design loading rate S bed, gpd$ b trench, gpolft Recommended infiltration surface elevation(s) t00.O ft (as referred to site plan benchmark) Additional design /site considerations `N\ o v�V) w / 5 ' X 1 S' `ltz eta . m W i m y" l _L 4 c)P S A'Mp Fr u-. Parent material S M \MeJT oUL ' P9M y oUVI-vorSli Flood plain elevation if applicable tQ A • It S = Suitable for System COM/ENnomL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fof sys tern ❑ S Ea u [a ❑ U I ❑ S ®U ❑ S IO U [IS ®U I [IS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color tulotties Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed tench 'Sa ZM AhT W1 0--s Z o -Z I 1 O ' 31 L Cif^ S l ` z W1 S Vk W1 fl- C S - • S Ground 3 LI -3 S S `7 R 3 L y — Cyr S 1 0 S b1 m U cS • y - S elev. 3 ft 4 3S -60 S`112 -31Y � 3l 61-s Depth to ny VkO2 Z0\3 V o F- ftLL- & 0,?1Iv 4 uS limiting factory 1-S . 35 Remarks: Boring # E °t - Zt ►1z- 3 I ` s t 1 Zv� m �t c g • 5 `. 3 Z/ -39 �..s 'Ztz 31 W,U - is �sb� cs - •� Ground elev. y 39 -loo Z .S ` 3 ! S t= L 3 S Ohs Y» G -3 ft ,t< _ - Depth 10 ° limiting r` factor V 1. TYI 8 Ln Remarks: - ST Rol T Name.— Please Print Phone: 1 ` Z I FFICIE Arthur L. We erer 71 ' 2S ��� firer Soil Testing & Design Service -P.O. Box 74 River Fa Sigrtadre: l �4 � � -)` 3 a. M Date. Z _) M00 5 7 6 PROPERTYOWNER 1101J�C�zE_1V SOIL DESCRIPTION REPORT Page Z of PARCEL I.D. # O Zg — 10 Ll 0- Z O Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 0 -8 10`-fvz- -3 — Si1 2.MI bVC w,� (aS • S J. Ground 3 7A -35 . S Li 31Y elev. Z X00 ft. Lt R 3 1y s Li iZ w► U 'f t.. — y Depth to limiting factor �5 Remarks: E3 Boring # i i Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev, ft. Depth to limiting factor Remarks: Boring # . V Ground elev. ft. Depth to limiting factor Remarks: SBO- 8330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1 "= L1�' �xa�T firs s°ti;WN N - F gEw cam- QtT PR4Pl�Py Um-. 0 lo a n t art *Z bo DoT- c- O�PRtr opt y \ 9S 9 e1 9s a S•3 L'Z tpp ! t n.r E Q "Z 9 0 ° o ti o - Ivo•�s •. M.10t•o' oN 7' W(J" 6IA. P UC I - IPE wlLAIW. t o3 .g' c>'v )v P c Fev C( P o sr. -- s F - IN) %3 F Rr Us* r Z S ' hu, jkj ��.L K l t y Soy ♦ k � .._. �z - 7 c 71.5 ) 1,4 00 576 CST Signature date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNMHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address I g ag �- Y- (vairm(ia nquhvd from Ph=4 Dot for euvr awstdc Pared Tdewtifimtion Numbcr e-� - / 0 G � SAL DES Property Location /, �� y .S - 4 Ste. T 2 L N -R L2 W, Town of Subdivision Lot # fiifud Sucvey map # YoLtmc P880 # Warranty Deed 9 Yokme , ------ =.r�.� Pages Spot hom 0 Ya Pno Lot lines idenfi abk yes O- no c onsism �scsa+ itna�uxa�ynaoraap6cs�mc�n�dcm�sia�e�a�ocoa �e..Pmpa�aa�aoe . P 8aft du tm* cmydearyaacr= nmifmc&dby =dp=pm WLstympatJm&c caft4rcadeaftcamofder:scjdetaicas.a sftaiafwashp Mc.pmpetV'cw aragars merobu&i St:Croat7.aftD:# '- en titMacro,signedby � phm9aOrlv0c WP=Pcz "(06cansl0c osslsys6:&- in 0pcmdo9c0=ld aaod►arm afr = dparaoIing_Cd'ncve .dic otcis iesslbsa v3�t of ge. .� � 3�e- satiddtc tbore aogoiaea�saadsg�oxbo msia�siat�wePdrime s+e�ngedisposal sys0�mw�e flicsemd�ds setfoeQi. oetfydar DepamacaetafQamnar�oeanddeeDepeaUmKntdKen iim m mSideafW muda. won msbeeama' wdmrdmastbecoa�pt�cmdaadrem :aedtodseSt:t�+acc.OonmdtYZo 30 ddr. Y 0 DATE r 4 t t MCA oN {we) cccffy an this f+acm are tone to. dc bcst of my (oar) Iaawk dge, I (we) am (arc) duo owascl(s) of bs► vidso of a waersa[y flood r+000cdod in Rmmdm of Daods Ofce, THE OF APPUCAmr DATE '`'` 11nq► � t6at is mFs- tgcraadodmay amlt Iat �a aoitsq► PcAnit 6ciag i+ev�olaod by tttc 7oniug Dcpadmad.' i t Jndmdc t[Ith lets applics� a VjmtW ry mty dmd from the ftift of Dach oW= a OVT of ft oWWood to m mp ifrefee m is stuck in the waYanty flood i LANK CON WRAC I h'0HI_FEN H. WALSH Document Number Form 11 Rt.GIi.IF:R OF DEEDS F - - 51. CROIX CO. WI CONTRACT, by and between Betty E. Monicken, a single person, RECEIVED FOR RECORD ( "Vendor ", whether one or more) and John M. Monicken and Shelley E. 05 -10 -1999 10:00 AM Monicken, husband and wife, holding as survivorship marital property ( "Purchaser", whether one or more). Vendor sells and agrees to convey LAN Fl.i M CONTRACT t,KT q to Purchaser, upon the prompt and full performance of this contract by FE',T COPY FEE: Purchaser, the following property, together with the rents, profits, fixtures UTY FEE: and other appurtenant interests (all called the "Property "), in St. Croix rPOSFER FEE: 236.70 County, State of Wisconsin: F,FCORDING FEE: 12.00 PAl1s: 2 Reconfinj Are Name and Return Address Tfi 1 028 - 1010- 20/028 - 1040 -50 (Parcel Identification Number) East Half of Southwest Quarter (E % of SW %) of Section Thirty -four (34), Townsiiip Twenty -eight (28) North, Range Seventeen (17) West, EXCEPT Lot One (1) of Certified Survey Maps filed March _ 1999, in Volume 12 of Certified Survey Maps, at Page 3439, as Document No. 578080, office of the Register of Deeds for St. Croix County, Wisconsin. i i I I ' I i i i 1 � i r;s is nol i;.Imeslead property. i Purchaser agrees to purchase the Property and to pay to Vendor at a place designated by vendor the %.;m of $78,830.00 in the following manner: (a) $8,300.00 at the execution of this Contract, and (b) the balance of $70,53000, together wtlh n:tt -est from date hereof on the balance Outstanding from time to time at the rate of 6% percent per annum until paid in full, as follows Monthly payments of $500.00 commencing one month from date hereof and on the same chit; of earth nu;nlh thereafter. Provided, however, the entire outstanding balance shall be paid in full on or before five years from date tua,eof (the maturity date). Following any default in payment, interest shall accrue at the rate of N /A'X. per annum on the (:w,,, in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reason. anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor. Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessme and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law Payments shall be applied first to interest on tie unpaid balance at the rate specified and th r, to r , ^e,pal. There may be no prepayment of principal without permission of Vendor.' In the event of any prepayment, this contract shall not be treated as in default with resp• ct to r +yrr the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated a np aui r ss than the amount that said rndet redness would have been had the monthly payments been made as first specified ahove p! ­, nihiy payments shall be. contrnupd in the event of credit of any proceeds of insurance or condemnation, the condemned r thereafter excluded herefrom Pl,!rchaser states that Purchaser is satisfied with the title as shown by the title evid°rtc; submit.- for examination