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HomeMy WebLinkAbout040-1190-10-000 Parcel #: 040 - 1190 -10 -000 11/22/2004 11:03 AM PAGE 1OF1 Alt. Parcel #: 4.28.19.840A 040 - TOWN OF TROY Current 1X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): * = Current Owner * TERRY &PATRICIA LOMBARD PETERSON PETERSON, TERRY & PATRICIA LOMBARD 531 MARSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 531 MARSON DR SC 2611 SCH D OF HUDSON SP 1700 WITC I Legal Description: 0.500 Plat: 2569- VALLEY VIEW HEIGHTS SEC 4 T PT NE S LOT 1 XC NLY Block/Condo Bldg: LOT 01 100 F VALLEY VIEW HEIG S UDES P61 K C Tract(s): (Sec- Twn -Rng 401/4 1601/4) 04- 28N -19W kb , NOS Notes: Parcel History: Date Doc # Vol /Page Type 05/09/2001 645027 1635/577 QC 07/23/1997 955/523 QC 07/23/1997 5541127 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 170,000 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 53,200 124,400 177,600 NO I Totals for 2004: General Property 2.000 53,200 124,400 177,600 Woodland 0.000 0 0 Totals for 2003: General Property 2.000 48,400 115,200 163,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 120 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 t Parcel #: 040- 1017 -60 -000 11/22/2004 04:34 PM PAGE 1OF1 Alt. Parcel #: 04.28.19.61 K 040 - TOWN OF TROY Current FX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): " = Current Owner * TERRY &PATRICIA LOMBARD PETERSON PETERSON, TERRY & PATRICIA LOMBARD 531 MARSON DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.500 Plat: N/A -NOT AVAILABLE SEC 4 T28N R19W 1.50AC PT NE SE COM E1/4 Block/Condo Bldg: COR SEC 4 S 741.22'N 85 DEG W 863.87' TO SW COR LOT 4 VALLEYVIEW HEIGHTS, S Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 66.05'N 89 DEG W 200'S 395' -POB S 89 04- 28N -19W DEG E 312.48'S 4 DEG E 4.13'S 26 DEG E 127.05'S 26 DEG E 76.27'N 89 DEG W more... Notes: Parcel History: Date Doc # Vol /Page Type 05/09/2001 645027 1635/577 QC 07/23/1997 955/523 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner 6 �'�P► & A 1.0 Property Address -6 r✓I so.�► �? City /State 1-44-0 so,cl w i 5 /4, Legal Description: // Lot / Block — Subdivision/CSM # "Li.Ey V ILE , Jr t /4 t /4, Sec. A/ , T -R W, Town of I PIN # 0 SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC / ��o Setback from: House 0 Well g5 'P/L 3 r Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Z jc'ic-rpA-rok Width 3 r Length �75� Number of Trenches Setback from: House //9' Well ins" P/L /5' Vent to fresh air intake ELEVATIONS Description of benchmark / "1kaN P, of owl Af0&,?rr / ..0 r Elevation/ Description of alternate benchmark �O oft 0—e TahPEskpca Elevation 9G" 55 Building Sewer ST/HT Inlet ST Outlet 9 2' PC Inlet T4* 4:4 PC Bottom £r /• SV' Header/Manifold Top of ST/PC Manhole Cover Distribution Lines V/) �T- ' ( ) Bottom of System (-) Final Grade (7) /iyFo. /o /• 75 Date of installation j I l iSl 971 Permit number 3 State plan number Plumber's signature License number Date 1,5 7 99 Inspector Complete plot plan � 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 `` /4,-r. f.�►wv►Pr -TO a� DooQ r�+PEso E��v. 9�-ss' GXSTi/1` GXKS - PAlf. CJE<c. �ES 0 JLe C�t+l/4CvE � QRi vE -tY ' gs ,flRop Pox �o It << GRAv,T'y 6,s i4b3HTio-i �Qhd QTY gQr � ��•-�r x157 /000) S j a . 1po ri, Eirs �Roote+�r c / L.��►FfD,v�eV� -u� rn i GJ 77f -P-2 ftFkko � X y : ' As /,AFT CMsbrr�Et 4— L Ll � � r i il,OdQELE�. g1 . �.x�ot^Cl4�po /tPTYL.NE Qov C N M rt+PK— /� o n1 P EE £46V INDICATE NORTH ARROW ` 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 provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353210 Permit Holder's Name: ❑ City ❑ Village [A Town of: State Plan ID No.: Lombard, Patricia Town of Troy CST BM Elev.: Insp. BM Elev.: BM Description: a Parcel Tax No.: t?O.O (90 040- 1190 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C et ? Benchmark Dosing 7-570 Alt. BM ? Aeration Bldg. Sewer Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outle T 2D 2 9< v 3 TANK TO P / L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 0 . Septic > 5D r ql, � ` � , NA Dt Bottom Dosing ) $0 °1 D NA Header /Man. 7­ CAB, Aeration NA Dist. Pipe Holding Bot. System 6,5 PUMP/ SIPHON INFORMATION Final Grade / Manufacturer Demand St cover Model Number W GPM 1 �sd TDH Lift 0 Lrictin., System TDH 10�- Ft ead 2y o5s Forcemain Length Dia. I f Dist. To Well SOIL ABSORPTION SYSTEM IZ � � = 1.7,-v BED /TRENCH Width Leng r No. f Trenches PIT No. Of Pits Inside Dia. Liquid Depth D IMENSION S � DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING I. ian f ctyr�r: INFORMATION Type 0 r �r CHAMBER Mod Numb System: "' /(S '� IZy OR UNIT p u DISTRIBUTION SYSTEM Header /Manifold t( Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Q+� Length ia. Length ia. Spacing SOIL COVER x Pressure Systems Only. xx Mound Or At -Grade Systems Only Depth Over tt Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center ?js Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS Include code discrepancies, persons present, etc.) Inspection #1: // //(* /I? Inspection #2: Location: 531 Marson Drive, Hudsoll (NE1/4, SE1/4, Section 4 T28N - R19W) - 4.28 19.840A 1.) Alt BM Description = -{� VA U. , 0. 40 twAoa � - �. ( O ` & n A ''� 2.) Bldg sewer length= �ct� �; L�, a �p �1Z6+ , LP `` - amount of cover = • C,. g QQ at rV jeCA4&k , t,,44 l �/ Plan revision required? C] Yes ®No fin Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division N sco nsin SANITARY PERMIT APPLICATION 20 E. Washington Ave. i P.O. Box 7969 In accord with ILHR 83.05, Wis. Adm. C;Ogr r "I Department of Commerce I 11 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on -po not less o+ y than 8 1/2 x 11 inches in size. °° � ' x� f t ate S� Permit Number • See reverse side for instructions for completing this applications D 0 The information you provide may be used by other government agency programs a heck if Fev sion to previous application (Privacy Law, s. 15.04 (1) (m)]. $7 0,4 X, e Plinl. . Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF PropeW Owner Name erty Lo LaTrm h r c u4 ©�i5 D T ,2,P , N, R 1 f E (or Propert Owner's Mailing Address Lot Nz ,_. Block Number 531 /17M1 ot/ iD2 City, � tate Zip Code Phone Number Subd ion Name or CSM Number /4%4,0504) 1 6vol(_ (7/5 )3vG 3SS.Z �//✓�c li' E 1 PE OF B IL DING: (check one) ❑ State Owned 0 Cit Nearel Road Public K 1 or 2 Family Dwelling Villag - No_ of bedrooms Town e OF r2 n `� �tP III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) V i - i l 0 A 1 ❑ Apartment/ Condo O O - 1- 1 90 —1/0 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, ❑ New "' Replacement 3_ E] Replacement of 4. ❑ Reconnection of 5, [] Repair of an System Tank Only _______y _____________ y_ stem ___ Existing System ExlstingSystem B) ❑ A Sanitary Permit was previously issued. Permit Num V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution 11 Seepage Bed 21 Mound ! n� m s i ding Tank 12,IK(Seepage Trench 22 ❑ In Ground Pressure pL 0 Privy 13 El Seepage Pit 3 It Privy 14 ❑ System -In -Fill �i�/�![T�/}TO 1 VI. ABSORPTION SYSTEM INFORMATION: `t>\ 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. I 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (G El v,�rl 15 �SO OS lCr !v 3 .� \ v i1i" � ` . ,�Q� � ' l l �l0 Feet VII. TANK Capacity in gallons Total # of c,�'` p � Plastic Exper. INFORMATION Gallons Tanks M i B 'tt°1'`.` New Existin � - App Tanksl Tanks ` Septic Tank or Holding Tank C)Ub X0110 ❑ ❑ Lift Pump Tank /Siphon Chamber 2SO % - b �✓ /c mac• _ ❑ L i VIII. RESPONSIBILITY STATEMENT I; the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plu ber s Name: (Print) Plumb Si at re: 6'S am MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, Cjty, State, Zip Code): 0 T <�r�c SOS 0 �--J r s`f IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sani ary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) O _ Approved []Owner Fee) Owner Given Initial QD Adverse Determination �` CONDITIONS F APP OVAL / REASO S FOR DISAPPROVAL: ii.11lBB) DISTRIBUTION: Original to County. One copy To: Safety 3 Buddings 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 -6393) 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. Provide all information requested for numbers 1 through 7. V11. 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 fo• 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. Instailing 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. I The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards- V I' II e PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VEUT CAP N "C.I. VENT PIPE WEATHER PROOF .APPROVED c-OCKING 2: 25' FROM DOOR, JUMCTION BOX MANHOLL COVER WINDOW OR FRESH 12 "MIU. AIR INTAKE I GRADE I j_ TI8" MIA). CONDUIT -- _ s IAJL..F_ l" PROVIDE ( - - -- �'�"" AIRTIGHT SEAL APPROVED JOINT A I I I APPROVED JOINTS W /C.i. PIPS. I III W /C.I. PIPE EXTtNDIK;C. 3' 1 Ill ALARM E 3' ONTO SOLID SCt1, B I 1I ONTO SOLID SOIL 1 c I 1 ON PUMP 'j OFF 0.00 CONCRETE BLOCK 1 RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL r SPEC.IFI CAT IOKIS SEPTIC AND _ DOSE TANKS MANUFACTURER: GJ��Sc� IJUMBER OF DOSES: � PER DAM TAWK 51ZE : �SO GALLONS DOSE VOLUME A LARM MANUFACTUK t16a4z_r N/�/tr T ,� INCLUDING EACKPLOW: GALLONS i MODEL NUMBER: CAPACITIES: A =/1 INCHES OR 3 00 GALLONS SWITCO TtIPIL: dF r wiz /CLo�T 8 0 2 INCHES OR � GALLONS P o n. i S PUM MANUFACTURER: o?G� IucH s R LLON C � E • GA 5 MODEL NUMBER: 7 kl /'2m D• 8 INCHES OR /S a GALLON& SWITCH TYPE: _'e7 1 o &24r NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHAR(wE RATE .MCP' GPM INSTALLED ON SEPARATE CIRCUITS /8 yERTICAL DIFFERENCE BtYWCEAI PUMP OFF AND DISTRIBUTION PIPE.. FEET + MINIMUM NETWORK SUPPLY P cKE,�,S,�S..URTT.E//.. . . . .. . • . . 2. � 5 ` FEET ♦ 4S � FE OF FORCE MAIM X a L`X_ FACTOR.. A 2J _ FEET . TOTAL DYNAMIC HEAD = FEET IAJTERWAL DIMLWSION& OF TAIJK: LENGTH ;WIDTH LIQUID DEPTH y0� SIGNED LICENSE WUMBER I ? DATE:= .1__.� —117— . ��JcNmrvPr / BQ o�Tf'�f5�O1�0 C1,e- Ex i s rr�16 R4` ���f�"n'/ENT T>rN�l -r 4ys�n Ex STii�¢ ... If . �{ 'PLOT CROSS SECTION PLANS ZAPPA 6808. EXCAVAT94 INC PL UNIT ... PROJECT / /0" .tT c r - 4 Lo-n , 1 , 406 • - /0 �x,6Ti,J� S�prrc Ti�IK '�� B ♦ .y j Sao' T ,�A , e s NE w fl u�rz ��►2 ���� - • � L � �� 'To E�uA -L Y �� ✓c4r��u� B'3 SS , l�,?h Disobu 3 gLoe0a.-I vs„ , I z / s� „�� 7504 � S 4,oAE ?3 .- of aq 15toi eA0# J4tQs o? Akssok"OlnP- 7s` Agee , g N o��iPEAJCte! TfAJ4 S .ai ©QEQ ;(5v to GJZ 5'r • SCAM yiEi,j or 61, - yt� r rr C7 tlrio�l �,0� SIGNED: �PP/�o�,EO VtNT L,�o LICENBE: �Z2 — — I DATE: C I /a' A a\u fimsst1 <- RA4 5 . eaL TEGT"J OV: V� J .0}�SOitI_. 'f o ri n1 5 f 1 r? pE Side View FL - VA'tio.J 14 it Qo tt o rE4 So,c IttbT End View 16' - �i 34' S �t�N �APAcirv' /�I�UEL ., r 388 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the be provided in starter unit. bronze impeller available as without damage. following uses: • Shaft: threaded, 400 series an option. ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Farms • Bearings: ball bearings type for maximum efficiency. construction. • Trailer courts • upper and lower. 2" NPT discharge adaptable ■ Power Cable: Severe du Power cord: 20 foot duty • Motels for slide rail systems. rated, oil and water resistant. • Schools standard length (optional ■ Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). p xy p CARBIDE VS Single phase: . SILICON provides secondary moisture Industry- •' /3 and 1 /2 HP —16/3 SJTO CARBIDE sealing faces, barrier in case of outer jacket •Effluent systems with 115 V or 230 V three Stainless steel metal parts, damage and to prevent oil prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • % - 1 '/2 HP —14/3 STO with ■ Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4 " maximum. • '/ 2 - 1 '/2 HP —14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models — 20 foot on accidental reverse rotation. • ,Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian Standards Association TDH, are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat ( W ) laborato * carbide -rotary seat/silicon FEATURES transfer. P carbide- stationary seat, 300 ■Designed for Continuous series stainless steel metal ■Impeller: Cast iron, semi- Op eration: Pump r atings arts, BUNA -N elastomers. open, non -clog with pump- P p are P out vanes for mechanical seal within the motor manufacturer's Temperature: protection. Balanced for recommended working limits, 104 (40 continuous " 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90 stainless steel. SERIES: 3885 • Capable of running dry 25 80 SIZE: 'W soups %iiE1 �' ++ - RPM: VARIOUS without damage to � .. ................... —► 5 GPM ... . .. �... .... ....... ... _ . 'components. 70 — E1 — 5� __ Motor o 20 i , ,Single phase: = s0 • % HP, 115 V, 200 V, 230 V, w�Eo 15- 50 I -- 60 Hz, 1750 RPM; 1 /2 HP, Z : ....................i.... ._..... �....... .. 115 V, 60 Hz, 3500 RPM; 0 40 i.', .-%HP-1% HP, 230 V, < _ .f _ -_ _.._ __. _- - -.. -.. __ __ IN 60 Hz 3500 RPM. 0 10 30 s4,•,Built-in overload with r automatic reset. 5 2 • Class B insulation. _ ....... ......... . _ Three phase: 10 - - !'/ HP -1'/2 HP 200/230/ o o _ # 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM _ , Class B insulation. ' 0 10 20 30 m /h NP caPACITy ®1995 Goulds Pumps, Inc. Effective May, 1995 r 11 83885 Wisconsin Department of Commerce SOIL AND SITE EVALUATION division of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and `S•— Cad i x percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Pro erty Owner M Property Location Govt. Lot NE 1 /4j�" 1 /4,S T N,R E (or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# f City State Zip Code Phone Number City ❑ _/ ❑ Ci Village Town Nearest Road /� AYi t i (/ - S9 l -Rd I /h d ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement Public or commercial - Describe: Code derived daily flow 4so gpd Recommended design loading rate 6- S bed, gpd/ft O.6 trench, gpd/ft Absorption area required gi bed, ft2 ��o trench, ft Ma 'mum design loading rate 7 bed, gpd/ft 0 g trench, gpd/11 Recommended infiltration surface elevation(s) " S — / •Z �O •'4 9 7 It (as referred to site plan benchmark) Additional design /site co/n'siderations 7 -;,LL _C,C, i9 Parent material �ic/ac� dl- Flood plain elevation, if applicable N4 It S = Suitable for system I Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ( S ❑ U S❑ U 9S O U 9 S ❑ U K S ❑ U EIS kf u SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench sb r Z1h O q d.S 6 5 L. f tk s bK f Ground YR4 S `JCI S :� elev. Depth to limiting fact Remarks: Boring # r -16 %ml?,3 rr, Sb r' S Zm 6A 6 _S 1 - Z B� - ,oy 44 I-Dyk-41f S- 4h Ground elev. 17 Depth to limiting > /A fact r ire Remarks: CST ;7o\/&Y a (Please Print) Si a Telephone No. JO>'vNS� 6� o 0 AcKess Date CST Number 91 S -17-9 9 _ zzZ $7 SOIL DESCRIPTION REPORT l PROPERTY OWNER Page � not PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. ' Depth to limiting factor in. Remarks: Boring # A O -a 123 3 L. 1 rh sbK rn 5 D.� $� Z - /QY►24 3 —' S,L M sbK �r s 1� $z - .S YA 1 _ 6 , 9 Ground 8 -12 7S YQ 4 P � 6 elev. Ott. q Depth to limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) 7 U-1 h ,+ o M 41 CO W 1 \J I as 1 cne � r Z 4 O qCl w r a vi uj a a ►� N .3t���� 1�►as�p r - ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ; A L o „y, I �, v - u Mailing Address S3 1 w o( b Property Address � 31 VVl bk s 0,-, D 4 ,J s (� l �� 0 /6 (Verification required from Planning Department for new construction) City /State 1 C" 6(s L � (,�-J 1- Parcel Identification Number ODD - 1190 - /a LEGAL DESCRIPTION I Property Location IV '/4, S F ' /4, Sec. , T ? LN -R_W, Town of / o� � // J Subdivision �� a l� t W L w rl e' T , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # .= t�yy��� s , Volume ASS% , Page # Spec house ❑ yes ® no Lot lines identifiable 6.9 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 wastewater disposal 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. I/we, 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 o Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that yow septic system has been dined must be completed and returned to the St. Croix County Zoning Office within 30 "y . f three ear expiration date. i SIGNATURE 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. SIGNATURE 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 i � 4tJCUbYCu� 81aA`1'i B" 47 WISCONSIN PDam $--M" rat+ ir.cr aetw+ixs ron ,�afo�e +«a wrt QWT CU1 m OLVE0 �. VOL _ 4sL - :aad .P.aXacl n•. ,,,. .......�... Z per tr... S�cb�sisidea�, .a. a fngle�..p,eelxzn . JUN 8 IM l tzicIA-LambsrA. 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C �- •'��_k = , �.. +� "::...,."�'"��.�,:,�� 3'" 'ye -.e -ya �., ;�+" `"`» � �, n • .a �,- _. . . yjy,' �'.. pw+ `+••r�F.A,.}Yy�XS......bY.�Nili �.;.AJ�Mrnrr...�.r.�r'.'�' {. �, ._ .. - id4Yn .rira�llM .•ra 1 �s a E f1taIMr. ;_ ` w aid " PAS " � '"f` `�"L�a«eu TM i - 4 f .H "a� � A_. ljaMMa•�`�l a .w'. err r i,a'�' -,fi" a �^' g,� � $"'�, �t`i � ,•zlk �., -^-- � - ,�. ., ,M . ? , �, t so- �� ,� t ` .?.i 1rr �_+ f , t .' f . �� � �� F .! h J'"� ry ��, � . � '`� k 3 � . � .. -. i ��� .:F: ��� �, VALLEY VIE LOCATED IN THE NORTHEAST 114 SECTION 4, TOWNSHIP 28 N TOWN OF TROY, ST • CROI' I ssoo �' \ F4? '�� UNPLATTED 33 33' - ° S 850301, p — 0 "C 396.791 N 138.731 66 �y 191. 20 9s, 80 O O I O o 3 16 0-480 9 ~6 u0i a c c 41 I 0 01, 0 3 y ' s N - O 167.34 = 190 ° / 3 6 I 33' 33 5 z I m 175.53 s� / 1 •Op. 69.491 9p 1 82.261 I O 5 200.00' S 85.3 UNPLATTED i S 89.56' 00 "E Ln LANDS CD o UNPLATTED LANDS I o I o I N I N � 0 ' I o CD CURVE LOT RADIUS CHOF NO. NO- LENGTH LENC '- 2-- 1 550.17 234 I ° 4 " 62• _ 3 550.17 173 200.00' 3- 4 270. 13 116 5- 6 336.13 120• S 89'56'00 "E 7- 8 1490.71 399 STREET '• 1 66• 7 1490.71 225• I 1 N N i 1 N m ! I N I O W I ! i 00 19 o p 0 I AT 00. I 66 I .001 ej 200.00' I S 83'56'00"E I t UNPLATTED LANDS SURVEYOR'S CERTIFICATE I• RONALD G• PEMBER, SURVEYOR, HEREBY CERTIFY- THAT I HAVE SURVEYED, DIVIDED AND MAPPED THE PLAT OF VALLEY\VIEW H IN THE NORTHEAST 114 OF THE SOUTHEAST 1/4 OF SECTION 4, TOWNSHIP 28 NORTH, R, Tm.w OF TRnY. gATNT ('RnTX rni INTV Iit Cr' nni(- T 11 klr)lr E I/4 COR. 414.96' 426.50' SEC. 4 ,\ 6 2C 61C Opa 61A 61A10 0 r 61G CD M LOT I LOT 2 62 D C. S. M. VOL. 8 PAGE 2213 61 D 302.01' 3 4 160.48 7 M 250.03' 5 6 .143 _ ,� 61 F M VALL Y 843 8 44 84 50 0 846 AGE 1 - 842 _ EIGHT I " LOT I 'i r 62 J2 - - 182.26' 140.55' 6 . 22984' 200' f 356.82 305.00' 61 B 2 - SE //4 W - 61 J LOT I o 841 ` Q I I 61 I 61 M 61 E 2 C. S. M: v_. 6, pg. 1628 y 200' I y 354. 40' - 277' 7740 g 840 B _ I L L " LOT I _ Lo 61 H 61 'L 840 61K \ 1 200' 1 - - — I 274.44 539.09/Oi Jf�Q(9j � 64 D C. M. � C �� 1 VO .5, PG_. 1458_ \ LOT 2 a 599/ 166 J 199.66 - LaT 2 64 I ° 30.27 - 0D �- 14S LOT I ( gi p 64 J 04 N ^+ 1 33 J 64 B 64 8 " K _ r Y ppII APPARENT OVERLAP +Y Er L2 0 m C. S. M _ 101 2833_ OD N 2 f . - -- ,�- T 64 L M PC 3 vo 64 G S� 64 H 64 E I �. F 1/ E 114 - SE l/4 i 613/123 456.82' a 64 A - 10 456.06 1001/93 1001/95 1 6 64 A 3 D N 1139/03 g SE COR. 3z5 SEC, 4 411.93' 750.76