HomeMy WebLinkAbout040-1232-40-000 Wisconsin Department of Industry. SOIL AND SITE EVALUATION REPORT Page 1 of 3
! *:.or and Human Relations ,r
Division of safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
CO
i
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but t • ��
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or L I.D.
dimensioned, north arrow, and location and distance to nearest road. mnft=D tv
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION M16 C /Z 32 4
g1 1995 °
� wU ST PROPERTY OWNER: PROPERTY LOCATION ] Richard Stout OT SE 1/4 SE 1"'Z R or) W
PROPERTY OWNERS MA!IING ADDRESS � �' LOT # LOCK # SUBD. NAM 1353 Awatukee Trl. - na C%IXI
F� A TE ZIP CODE PHONE NU ❑VILLAGE : MOWN NEAREST ROAD
Hudson, Wi. 54016 (715)549 -6731 Troy Tower Rd.
New Construction Use [xi Residential / Number of bedrooms 3 [ j Ad ' 'o �texisbng building
(j Replacement [ j Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpolft • 8 trench, gpolh
Absorption area required 643 bed, n2 563 trench, ft Maximum design loading rate • 7 bed, gpolft - 8 trench, gpolft
Recommended infiltration surface elevation(s) trenches see below ft (as referred to site plan benchmark)
Additional design / site considerations 101.71-99.961-99.311-97.961-96.261-94.26
Parent material stream terrace Flood plain elevation, if applicable na It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ® S ❑ U 0S M U M ❑ U ❑ S ® Ll I ❑ S ®U ❑ S CCU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence lBw day Ro6ts GPD /ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends
1 1 0 -10 10 r4 3 none sl 2m r mfr qw 2f .5 .6
2 10 -19 7.5 r4/4 none sl 2mgr mvfr gw if .5 .6
Ground 3 19 -80 7.5 r4/6 none cos osg na na na .7 .8
elev.
1 00.9 §
Depth to
limiting
factor
+80"
Remarks:
Boring #
1 0 -12 10 r4/3 none sl 2mgr mvfr gw 2f .5 .6
2 12 -82 7.5 r4 6 none cos osg ml na na .7 .8
Ground
104. 7 t i
^ec to
Remarks:
CST Name _ Please Print Gary L. Steel Phone: 715- 246 -6200
� i �-
Address: 1554 200th Ave. New Richmond Wi. 54017 10 -26 -95
Signature: Date: CST Number:
PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page 2 of 3
9 - _
PARCEL 1.0.4 pending
Boring # Horiz5n Depth ,I Dominant Color I Mottles (Texture I Structure Consistence Bourdary Roots GPD /ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed iTmnch
y 3:
1 0 -9 10 r3 3 none sl 2m r mvfr 2f .5 .6
2 9 -82 7.5 r4/6 none cos osq ml na na .7 1.8
Ground ,
elev.
10
Depth to
limiting
Remarks:
Boring #
1 0 -6 10yr3 /3 none 1 2msbk mfr g w 2f .5 ' .6
2 6 - 10yr4 /4 none sicl lfsbk mfr gw if .2 .3
Ground
3 30 -50 7.5yr4/4 none is os mfr na .7 .8
1006 ft 4 50 -80 7.5 r4 6 none cos os ml na .7 .8
Depth to
limiting
factor
+80"
Remarks:
Boring #
�::s >:: 1 0 -10 10 r3 3 none sl 2m r mfr 2f .5 .6
:..ti;, :;:.:.;:;
5 2 10 -19 7.5yr4/4 none is osg mvfr gw if .7 .8
3 19 -80 7.5 r4/6 none cos osg m na na 1 .7 1 .8
Q Grro y und
9 9 1 . -6 ft.
Depth to
limiting
factor
+80"
Remarks:
Boring #
::: » >. >• ::<:;«: 1 0 -6 10yr3/3 none sl 2m r mfr qw 2f .5 .6
2 6 - 15 7.5yr4/4 none is osg mfr qw if .7 .8
Ground 3 15 -80 7.5 r4/6 none cos osg na na na 1 .7 '.8
9 1156 ft. 1
Depth to
limiting
1a +W
Remarks:
SBD- 8330(R.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Richard Stout 1554 200th Ave.
CSTM2298 SE 4SE a S3 T28N - R19W New Richmond, WI 54017
MPRSW 3254 town of Troy (715) 246 -6200
lot #59- Country Wood
N
1 " =40'
BM.= top of 1 steel pipe @ el. 100'
Alt. BM.= top of 1 steel pipe C el. 103.4'
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4 1 0
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3�` a _c�
Gary L. Steel
10 -26 -95
I
ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT ? ,
Owner ?(A t(z 1 � (p S � � � I Z. ` � 7
Property Address l '
r�
s '
City /State � �k v) 0
ti (�J'i r �
Legal Description:
Lot 1 Block Subdivision/CSM # C ��� �� W e 00
S - %a S '/4 Sec. T a $ N -R W Town of T2 o PIN # �
.�.� -
3.zV 7�, IeSn
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer Size ST/PCI °0 o / Setback from: House % Well I OOt P/L l
Pump manufacturer '� Model --
Alarm location
(HOLD
Setbacks: Service road Vent to fresh a Wftter Line--
Meter location —�
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: TJ a h o R S Width _ Length 5 L S Number of Trenches
Setback from: House a Well I o ` } P/L 1 06 f Vent to fresh air intake I U Lt
ELEVATIONS
Description of benchmark �' �' Elevation
Description of alternate benchmark Elevation
Building Sewer ST/HT Inlet y J ST Outlet PC Inlet
PC Bottom Header/Manifold ? ( J Top of ST/PC Manhole Cover � 3
Distribution Lines ( ) 8 < < ( )
Bottom of System ()
Final Grade ( ) 1 5 O l ( )
Date of installation ) /u/ 99 Permit number 3 `f`f 62-5 State plan number
Plumber's signature G License number � Date 3 /
Inspector �eU��, Gr�����
Complete plot plan
t ,
NOTICE Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
er o
�s
_
3 �:s�aS
INDICATE NORTH ARROW
` Wiscon'in 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 provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 344625
Permit Holder's Name: ❑ City ❑ Village nn Town of: State Plan ID No.:
`�C
Town of Tro V_
C T BM lev.: Insp. BM Elev.: BM D scriptio Parcel Tax No.:
1 0 7 0, 1cm. 0 V 040-1232-40-000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic w K S Benchma 1 j60 0
Dosing ,
Alt. BM
Aeration Bldg. Sewer
Holding St/ Ht Inlet 60 2, c{O r
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. AirI to ntake ROAD
irl
Septic fo p r ) t� r y I NA Q4 R044QM
Dosing NA Header/ Man. 5b . 01. c/o
Aeration NA Dist. Pipe
Holding Bot. System_ 13- $ • }s
PUMP/ SIPHON INFORMATION Final Grade
Manuf fturer
St cover
Model ku mber M
TDH I Lift Friction 5 stem T Ft
I Fie
Forcem Leng Dist. To well
SOIL ABS RPTION SYSTEM
RENCH Width I Length 1 No. f Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIME • k3 (Z DIMENSION
SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING anuto
SETBACK CHAMBER
INFORMATION Type of r Mod Number:
System: C•y�J, '100 Z ? 10b OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake tf Length Dia. Le Dia. Spacing too �
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 12V91 Inspection #2:
Location: 533 Trillium Lane, Hudson, WI (SE1 /4, SE1 /4, Section 3 T28N -R19W) - 3.28.19.1150
Plan revision required? ❑ Yes X No d � \
Use other side for additional information.
SBD - 6710 (R.3/97) QC
0 3 2Z Ob ' /)
e v t.. Inspector's Signature Cert. No.
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ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Safety and Buildings Division
% 6=4& r SANITARY PERMIT AP 1n ON P o Box 7 Avenue
Department of Commerce In accord with ILHR 83.0 is. dd'
1b 1 , Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the syst , on e�Rrnot le ounty
than 81/2 x 11 inches in size. v pm
• See reverse side for instructions for completing this apoitt�itio941/6
F � to Sanitary Permit Number
Personal information you provide may be used for secondary purposes r : 5T OIX 99
he it revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. Z C%ivTY S ate Plan I.D. Number Na
I. APPLICATION INFORMATION - PLEASE PRINT AL two RM0191.
Property Owner Name ,� ' Pro o n
,A 15 / /4 S 3 T a , N, R 9 E (or) W
Property Owner's Mailing Add re s L er Block Number
13 ;t �a e /
NA
City, Statg Zip Code Phone Number Su division Name or CSM mber
I pu N S O 2 b
11. P BUILDING: (check one) E] State Owned i Nearest Road
❑ V
age �
Public 12 1 or 2 Family Dwelling - No. of bedrooms Town OF Rd �Ril LAW
III BUILDING USE (if building type is public, check all that apply) Parcel TaxNumber(s) 2 11 tlsa
1 ❑ Apartment/ 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 OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. aNew 2. E] Replacement 3_ C] Replacementof 4_ E] Reconnection of 5. E] Repair of an
ystem - __ - _ - System -- Tank O -------------- 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 [Seepage Trench 22 ❑ In-Ground Pressure t 42 ❑ Pit Privy
13 ❑ Seepage Pit Z X LS 43 ❑ Vault Privy
14 ❑ System -In -Fill - Z. L
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
f � Re red (sq. ft.) Proposed (sq_ ft (Gals/da /sq. ft.) (Mi Inch) Elevation
`� (J _ $ 7- 7 Feet � •5 Feet
VI Cap acct I TANK in gallons Total # of Prefab. Site Fiber- Exper.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
New Exist in strutted
Tanks Tanks
eptic an IngTank ou(i ❑ ❑ ❑ 1 ❑ ❑
Li on mber I ❑ I ❑ I ❑ I ❑ ❑ ❑
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 Sign ture:(NoSta ps) MP /MPRSWNo.: Business Phone Number:
I� �m t - 38(4 7 - ' �Q
Plumber's Address ( treet, tit ,State, 4ip Code V +n
10. IX. COUNTY / DEPARTMENT USE ONLY
)4 ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Issuing Agent nature (No Stamps)
A :Issued pproved E] Owner Given Initial surcharge Fee)
Adverse Determination
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 / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
S. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by 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. 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.
Vlll. 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 1/2 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.
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"WisconsioDepartmentofCommerce SOIL AND SITE EVALUATION Page 1 of 3
Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County
include, but not limited to. vertical and horizontal reference pant (BM), direction and St. Croix
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.#
D Ai 'It4l1 - n, 040- 1231 -60 -0 00
APPLICANT INFORMATION -
Personal information you mAde ma he u r v v ._.,_
Yo pr y ry p irposeg l , Reviewed By Date
Law s. 15.04 (t) (m)).
Property Owner n Property Location
Patricia Schultz ����'°�� +� Govt. Lot SE 1/4 SE 1/4 S 3 T 28 N,R 19 W
Property Owner's Mailing Address n 1 C + Lot # Block # Subd. Name or CS
1329 Juneau Ave.'`` ° '
9 14 Plat OfCountrywood
City Zip Coke_ f4d�YVumber ;', . ( ❑City El Village ❑Town Nearest Road
Saint Paul 5 � ; '` Troy Trillium Lane
I r rooms 3 ❑Addition to existing building
❑ New Construction Use:
E] Replacement ° describe
Code Derived daily flow 450 gpd Recommended design loading rate •7 bed, gpd/ft .8 trench, gpolft
Absorption area required 643 bed, ft 562 trench, ft- Maximum design loading rate .7 bed, gpd/ft .8 trench, gpdff
Recommended infiltration surface elevation(s) 87 : � r: �., ft (as referred to site plan benchmark)
Additional design / site considerations Install trenches using high capacity infiltratork Dosing kquired to reach replacement system location.
Parent material Outwash s & gr. Flood plai n elevation, if applicable NA ft
S# for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank
U= Unsuitable for system ® S❑ u ® S❑ u ❑ S u z S❑ u F S❑ u ❑ S® u
SOIL DESCRIPTION REPORT`
Depth Dominant Color Mottles Structure GPDlftz '
Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench
I
1 1 0 -9 10yr3 /2 None sl 2fcr mvfr cs 2f 0.5 i 0.6 C-,
2 9 -20 10yr4 /2 None sil 2msbk ds cs 2f 0.5 0.6
Ground 3 20 -53 10 y r4/4 None sill 2msbk dsh aw if 0.5 0.6
elev _
92.68' ft 4 53 -79 10yr4/6 None s 0 sg dl gs - 0.7 0.8
Depth to 5 79 -115 10yr6 /4 None s 0 sg dl - - 0.7 0.8
limiting
factor
>115'
Remarks:
NN
2 1 0 -9 10yr3 /2 None sl 2fcr mvfr cs 2f 0.5 0. ,
2 9 -28 7.5yr4/6 None is 0 sg ml cs if ''
Ground 3 28 -70 10yr4/6 None s 0 sg dl gs If � -T _
elev
92.81' ft 4 70 -109 10yr6 /4 None s 0 sg dl - - 0.7 0.8
Depth to Z
limiting
factor
>109'
Remarks:
CST Name (Please Print) Sign Telephone No.
James K. Thompson rte, - 715- 248 -7767
Address A.C.E. Soil & Site Evaluations Date CST Number Ref #
340 Paulson Lake Lane, Osceola, WI 54020 8/4/99 3602 1080
PROPERTYOWNER: Patricia SOmhz SOIL DESCRIPTION REPORT toso page 2 of 3
PARCEL LU 040 -1 231. 60-000 ACE. Soil & Site Evaluations
Depth Dominant Color Mottles Structure GPDM a
Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. sistence Boundary Roots w.,
Bed Trench
1 0 -13 10yr3 /2 None sl 2fcr 7ds 7gs 2f 0.5 0.6
2 13 -27 10yr5/4 None s1 2msbk 2 f 0.5 0.6
Ground
elev 3 27 -36 7.5yr4/6 None sl 2msbk dsh cw if 0.5 j 0.6
y a
93.75' ft 4 36 -47 7.5yr4/6 None Is 0 Sg dl gS - 0.7 0.8 t
F,
limiting 5 47 -119 10yr6 /4 None s 0 Sg dl - - 0.7 0.8
factor
>119' 7�
Remarks:
4 1 0 -6 10yr3 /2 None gr. sl 2fcr mvfr cs 2f 0.5 0
2 6 -21 7.5yr4/6 None Is 0 Sg ml cs 1 f --
Ground - r
elev 3 21 -40 7.5yr4/6 None s 0 Sg dl gs 0. -
97.02 ft 4 40 -69 10yr5 /6 None s 0 Sg dl gs - 0.7 0.8
Depth to 5 69 -116 10yr5/4 None S 0 Sg dl - - 0.7 0.8
limiting
factor
>116'
Remarks:
5 1 0 -11 10yr3/2 None Sl 2fcr mvfr cs 2f 0.5 0.6
2 11 -22 10yr4/2 None sil 2msbk ds cs 2f 0.5 i 0.6
Ground
elev 3 22 -30 7.5yr4/6 None Sl 2msbk dsh aw if 0.5 0.6
96.70' ft 4 30 -71 7.5yr4/6 None s 0 Sg dl gs - 0.7 0.8
Depth to 5 71 -113 10yr5/6 None s 0 Sg dl - - 0.7 0.8
limiting
factor
>113'
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks
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WnscsrrsirrDapartneMd>1Comnuaoe SOIL AND SITE EVALUATION Page I of 3
Dwislonol'SellalyandIN011diry in accord with Comm 83.05, W is. Adm. Code A.C.H. Sail & sae Evahadoos
Attach complete sae plan on paper not less than 834 x 11 inches in size, Plan must mi
. include, tut not I1nd0d to: vertical and horkontai reference point (BNB, direc tim ant St. Cro
percent sioM scale or dirmamsion s, north arrow, and location and distance to rowsm road. Parcel I.D.#
APPLICANT INFORMATION - Please print all Inhwnu Uon. 040-1231.60 -000
Personal htonrtaeon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Dale
I
Properly Owner Property Locatim►
Patricia Schultz L � n n Govt. Lot SE 1/4 SE 1/4 S 3 T 28 N,R 19 W
Property Ownner's Hsiang Address LEI # Block Subd. Name or CSM#
1329 Juneau Ave. 14 I Plat Of Countrywood
City Stile Zip Code um City ❑ Village ® Town Nearest Road
Sai t Paul MN 55116 Troy I Triffim Lane
® New Construction Use Residential / Number o f bedrooms 3 ❑Additiort to a*" burg
❑ waoement ❑ Public or commercial describe
Code Derived daily flow 450 gpd Recommended design loading rate •7 bed, gpolff .8 trench, gptflft=
u rea required 643 bed, ftz 562 trench, fp Maximum design loading rate .7 bed, gpdff? .8 trench, ow
Recomtrterlded infiltration surkce elevallon(s) 87.75' ft (as referred to site plan bendNrtairk)
Additional design / site consideration Install trenches using high capacity infiltrators. Dosing required to reach replacement * lodxtirnr.
Parent matte Outwash s & Flood elevation if NA ft
S=Suthable for g Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
t>=lk>SWi(able for system ES Q U ®S Q u ®S Q U ® S Q U ®S Q U E I S BI U
SOIL DESCRIPTION REPORT
fig# Horizon Dominant nsel Qu. Sz. cont Color Texture Gr. Sz, Sh. Consistence Boundary Roots Bed Try
1 1 0 -9 10yr3/2 None sl 2fcr mvfr cs 2f 0.5 0.6
2 9 -20 10yr4/2 None sit 2msbk ds cs 2f 0.5 0.6
Ground 3 20 -53 10yr4/4 None sill 2msbk dsh aw if 0.5 0.6
Slav
92.t18'R 4 53 -79 1 0yr4 /6 None s 0 S di gs - 0.7 0.8
Depth to 5 79 -115 10yr6 /4 None s 0 sg dl - - 0.7 0.8
fad4w
ftterrarfcs:
Z 1 0 -9 10yr3/2 None sl 21ct mvfr cs 2f 0.5 0.6
1
2 9 -28 7.5yr4/6 "None is 0 sg ml cs if 0.5 0.6
1
Ground 3 28 -70 10yr4 /6 None s 0 sg dl gs If 0.5 0.6
Slav
92.81' ft 4 70.109 10yr6 /4 None s 0 sg dl - 0.7 0.8
D90 to
amifang
factor
>1W
Rerrnrks:
CST Name (Please Print) Signature: Telephone No.
Janes K Thompson 715 -248 -7767
Address A.C.E. Soul & Site EvakMiDns Date CST Number Roll
340 Paulson Lake Lace, Osceola, Wf 54020 8/4/99 3602 1080
�oeo page 2 of 3
CRIP'T "N SPORT _ _ spa & s;� fi
SOIL DES CipC11ft�
VEMY
� Sguchue Boundary R00b Bed Tt
Dominant Cola M ores Gr- Sz. •
Texture Sh
wo in. Mansell Qu. S7, Cont Cola' i o.6
mvfr cs 2f 0.5
2fcr 0.6
OWAM 2f
None sl 0.5
1 0 -13 10yr3 /2 2msbk l 2msbk dsh ds gs 0.6
3 None sl
2 13 -27 10yr5 /4 cw if 0.5
s
Ground 7 5 4l6 None _ 0.7 0.8
dev 3 27 -36 n. 0 sg dl Ss
None is 0.7 0.8
93.76 ft 4 36 -47 7.Syr4/6 dl - "
None
S
0 sg
Depth to 5 47 -119 10yr6 /4
limiUng�
factor
W9'
Remarks: mvfr 0. 5 0.6
cs 2f 0.5 � 0.6
2fcr
0 -6 1pyr3/2 None gr. sl if
1 ml cs
Is 0 sg
6 -21 .5yr4/6 None 0.6
4 7
2 0 sg dl g s if 0.5
0.8
None s _ p,7
elev ';
Ground 3 21 -40 7.5yr4/6 d l gs
S 0 sg
None 0,7 ; 0.8
97.02 it 4 40 -69 10yr5 /6 dl _ -
0 sg
r5/4 None
s
Depth to 5 69 -116 10 Y
limwng
factor
W6
0.5 0.6
sl 2fcr mvfr' cs
Remarks: 2f
None 2 f 0,5 �, 0.6
1 0 -11 10yr3/2 ds cs
5 None sil 2msbk
2 11 -22 1 pyc4 /2 2msbk
dsh aw if 0.5 � 0.6
None sl 0,7 �, 0.8
Ground 3 22 -30 7.5yr4/ dl gs
elev s 0 sg
7.5yr4/6 None - _ 0.7 0.8
96.79 it 4 30 -71 0 sg dl
Depihb 5 71 -113 10yr516
None s
GmNing
factor
AiT
4
Remarks:
x ,
Ground
`.4 elev
Depth to
Amiting
�,.. factor
x
i r
Remarks:
ION.
to � � ■ So�� ptis�'+�
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��JZS"
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer
Mailing Address 3a J� N lbl� V P• SAl, P p�� 1 r� N'
Property Address .33 YL L ,4, j p
(Verification required from Planning Department for new construction)
City/State Parcel Identification Number 0 - 143 - 6/ -C: ��
LEGAL DESCRIPTION
Property Location 5F_ %a, %, Sec. 3 , TB.N -R19W, Town of �! _
Subdivision , Lot #_.
Certified Survey Map # Volume , Page #
Warranty Deed # Volume /,?Z' ,Page #
Spec house ❑ yes ® no Lot lines identifiable M yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days a three year expiration date.
SIJ§NATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above by virtue of a warranty deed recorded in Register of Deeds Office.
e 7
S NATURE OF APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
1a
VOL 131 p4a 5'? i
59 ®59'1 STATE GAR OF WISCONSIN FORM 2 — 1982
WARRANTY DEED
DOCUMENT NO.
RICHARD 0. __a j tjUT FtM_Kf R'S OFFICE
ST. CROIX Co., W)
Res "d fet Ilseord
conveys and warrants to PA J SCHU LTZ_ ,_ a sin NOV 0 3 1998
per son..
g:oo
-.� THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETURN ADDRESS
the following described real estate in St. Croix �. County.
State of Wisconsin: rF Le
I 14, Plat of Country Wood, Town of Troy,
St. Croix County, Wisconsin.
04071232 - -00
PARCEL IDENTIFICATION NUMBER
TRANSFER
r -
FEE
This i S n-0 -t- _ homestead property.
(is) (is not
Exce tion to warranties: easements, restrictions, rights -of -way and covenants
of 2ecord.
Dated this 29th day of October A.D.,
Richard O. St-out (SEAL) (SEAL)
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature {s) State of Wisconsin,
ss.
St. Croix
" - Cuur + t y .
authenticated this _ day of __.. _ 19 Persunalh• came before me this _._29 day of
_ October 19 98 , the above named
Richard G. Stout _
TITLE: MEMBER STATE BAR OF WISCONSIN ^_
(if nut,
authorized b §70F.06, Wis. StatsJ t _A�. 4�b >>C S to me kn to be the person __ who execute) the foregoing
instrume d acknowledge the sa e.
THIS INSTRUMENT WAS nuAFTED BY
Janet P. Stout Stalle
H Wi. 54016 _. Na bhc, _ �_. County, Wis.
(SIgr.aure� may I)e authenticated or acknrn+dedg<d. fkah are rot My ommrssio ; is permanent (If not, /Q ex ation ee
Nam.. of persons signlnA it p. :y sh..+uld by aprd or print d below Ihe,r v�nmures-
rTATF BAR OF WISCO NSIN `.v�xCnVnLeq� ;M
WAR!_X'N" D1,10 Form No. 2 - 1941 Wwau ee Vis
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