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HomeMy WebLinkAbout040-1241-20-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Properly Addre f City /State . e I Ae Lill A,W_ D ga � .hIC � J' .. Legal Description: Lot 0�- Block Subdivision/CSM # noa s ` j 1 /4 1 /4, Sec. -21 , T -RJW, Town o 0 PIN # - M - SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer W , ecl Cr Size ST/PC / etback from: House 0- Well P/L Z � Pump manufacturer M& Model /W e r Alarm location 1 L. o 5 - (HOLDING TANKS ONLY) Setbacks: Service road k Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width <L Length Number of Trenches �— Setback from: House Z C , 2 Well P/L _ 7 Vent to fresh air intake 2s` ELEVATIONS Description of benchmark S 4- eL G Elevation A Description of alternate benchmark tjLoP C LAG Qv x e ,,) Elevation /0 ) &use Building Sewer ;O 96.3 -ST/HT Inlet 9a 'V 5 ST Outlet PC Inlet PC Bottom ? • Header/Manifold l�a g Top of ST/PC Manhole Cover 5g Distribution Lines O I d Z, � Z {) { ) Bottom of System( ) A� /- 3 O ( ) Final Grade O A 3 (} ( ) Date of installation & Permit nulpber State plan number as 14 Z Plumber's signature 4 License number Date jZ/7v/ 9 Inspector Complete plot plan �* IC I p I 4 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 'fi o a INDICATE NORTH ARROW /� ,Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 3389 Perm 9 IX 81 Personal information you provice may be used for secondary purposes [Privacy La I s.15.04 (1 Perri r , ne: DOUGLAS & RENEE E] Cit Town of: State Plan ID No.: . — CST SM Elev ; Insp. BM Elev.: ription: Parcel TUc NQ._1241 -20 —ODD r3v 1 pU T I' // &- C f Q 0U TANK INFORMATION _ ELEVATION DATA TYPE MANUFACTURER CAPACITY 4ft.ON 85 HI FS ELEV. Septic p i C �a�"D e chmark Dosing Aeration Bldg. ewer 5c�t.7 q, g !Q 3 .2 Hold' / TANK SETBACK INFORMATIONt- L1ut1�t TANK TO P/ L WELL BLDG. vent to ROAD Dt Inlet Air Intake Septic > D NA Dt Bottom /$'; g•$ , /(, Dosing tI ` NA Header /Man. l S (c 2•a� Aeration Dist. Pipe /, i p2. je/ Holding " Bot. System jg j 3 4" PUMP / SIPHON INFORMATION �� Final Grade -*- 0 `.� anufacturer S Dem nd � Model Number (,� �I� •� PM '0 0#,4 0 4 ;. TD H Lift 3, Frictiont� 4 f( System y. TDH ��. SFt ead Forcemain Length p Dia. H u Dist. To Well SOIL ABSORPTION SYSTEM BED Width Lengt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth EN 1 N o D IMENSION S SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O , Model Number: System: - OR UNIT DISTRIBUTION SYSTEM Dia. Header / M r}ifold Dia. Le W r , Distribution Pipes �, J xHoeSize x Hole Spacing Vent To Air Intake Lengt 9 g I r Spacing a r1 a y 2 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.) d ?' {- �7t3•!8 ) LOCATION: TROY 21.28.1 58 WYNGATE DRIVE - WYNGATE L 2 . / V 7.' s = 1 00_ 5tc.,�✓ c. > I f 2. � "Cvtr��' /" dd�l o" � � C � Sr 1 t,. G� � (6 w i u r r 2 r'40 4 X - t � t two.�� oue i u ASV- am 4'P -xt ") � C Plan revision required? ❑ Yes ;' No Use other side for additional information. O 1 0 3 &0 6X�t� --•-- `s 2 SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division 201 W. Washington Avenue lVi S ANITARY PERMIT APPLICATION P O Box 7302 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County ^ than 8 112 x 11 inches in size. /C • See reverse side for instructions for completing this application State Sanitary Permit Number 33 Y Personal information you provide may be used for secondary purposes E] Check if revision to p re4ious �lication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number �!1 tP 7� I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N o° 1 Property wne �� operty Location ZS , , WW i4 1i4 5 T N R E or Property Owner's Mailin dd(, TI v V � Lot Number Block mber L V Cit State D / Zip Code Phone Number Subdivision Name or CS Nu�nbgf r N Z ` W � �O II. TYPE OF BUILDING: (check one) ❑ State Owned it Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms o o w a n OF O y W KA P 2 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) .�..� . t4� I223 1 ❑ Apartment/ Condo — Z _ — 0 017 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 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- ffWound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORP SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (s . ft.) (Gals/da /sq. ft.) (Min. /inch) - Elevation 6 0 0 Q IF Q wreet 3 OFeet Capacity VII. TANK in Ca gall Total # of Prefab. Site Fiber Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App New Existin structed Tanks Tanks Septic Tank or Holding Tank 12 Q ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber I J v t C a ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of Ihe onsite sewage system shown on the attached plans. Plumber' e: (Print) Plumber's ignature: (N Sta p) MP /AkPR'fNo.: Business Phone Number: Plumber 'sAddre (street ,Ci C td e) l/wv _�_ �i11 l IX. COUNTY / DEPARTMENT USE ONLY ❑ Surcharge Fee) Disapproved Sanitary Permit Fee (includes Groundwater ate ssue ,. Issuing agent i nat re (No Stamps) � [Approved ❑Owner Given Initial �'y� Adverse Determination X. t CO� ITI S OF APPR / REASO S O� I SAQPRG AL: k- ( " SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 1340 E GREEN BAY ST STE 300 ". SHAWANO WI 54166 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 27, 1999 CUST ID No.267341 ATTN.• POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/27/2001 Identification Numbers Transaction ID No. 221455 Site ID No. 170934 SITE: Please refer to both identification numbers, Site ID: 170934 above, in all corres on the agency. ST CROIX County, Town of TROY; WYNGATE SETA, NE1 /4, S21, T28N, R19W DOUG & RENEE SIGWARTH WYNGATE i ��f ' ^✓� FOR: a '* f ✓j Description: MOUND SYSTEM FOR DOUG AND RENEE SIGWARTH Object Type: POWT System Regulated Object ID No.: 463732 The submittal described above has been reviewed for conformance with applicable Wisocnis Ave and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The chapter 101.01 10 Wisconsin Statutes, is responsible for comp liance with all code re uire° p ( ), P P THIS APPROVAL DOES NOT INCLUDE THE PRIVATE INTERCEPTOR MAIN SEWER, OR ANY PLUMBING UPSTREAM OF THIS COMPONENT. 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 04/19/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 KEI H A WILKINSON, POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 524 -3630, FAX: (715) 524-3633, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE.STATE.WI.US WiSMART code: 7633 - Page of b MOUND SYSTEM RECEIVE A BEDROOMRRESIDENCE APR 'I 9 SAFM sus. ory SE NE ON ZI T 7 2S N, R 19 W, LOCATED IN THE 1/4 OF THE 1/4 OF SECTION TOWN OF COUNTY, WISCONSIN. L 2. O iAj4 tJ 6 kTE r INDEg PAGE 1 ' of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW+CROSS SECTION : O F Mou N N PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER CdZoSS SUT10r SPILLS. PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR �3vRNSVI I.L,F� w►t� 5 S 378 PREPARED BY W'=GEF;cEF - E t3I l....- TESTING AMID A. DES = CN SIEf�V I CE ®►�\ s. - 1:0 F.O. BOX 74 421 K. KAIN ST. F? O.'W.T.g. RIVEF. FALLS. KI 54022 ARTHUR L WE'ERER Conditionally 715- 4�.r-016J � � EILSK'QRTN , WfS. AP PROVED: T OF COMMERCE DEPARTMENT �IGNE DIVISION OF SAFETY AND ^ BUILDINGS ` s al�� R � I G 14 S CORRESPONDENCE 22t �5s JOB NO. '19-60 PLOT PLAN • Page Z of 6 Scale r= 40 �Qn�wt►n� �.i' eaves o� tn'BuLf�F TyS P�M_ ftu ^\ Zq NAT QM -T C* � try S1tcu. c •g� � �qq � � � \ IV p '' C pRREp�10N NEEprCE h � •� �� ,o g.z UTL �bS• �z- � a z , v) t) , O' ary ?3" v" G H , 311 Di rk - ?\3 C T LP E W/ Ll" - . I✓��S5 SO' F M O U)-� � 9 NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (Y required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be \ ZOol�SO gallon capacity manufactured by Gov � 5. Bench Marks S� ftBoVE 6. Divert surface water around system to prevent.ponding at the uphill side. Page 3 Of t Approved Synthetic Covering IFts c. 33 Distribution Pipe Medium Sand G Topsoi F Elev. vot -3S —1 i p 3 E " b % Slope Bed Of 2 * — 2 %2 Force Main Plowed Aggregate From Pump Layer D l.0 Ft. Cross Section Of A Mound System Using E \ -3Z Ft. A Bed For The Absorption Area F o.% Ft. G VI) Ft. A S Ft. H \-S Ft. Linear Loading Rate =O1 GPD /LN FT B 63 Ft. Design Loading Rate = c� •y.GPD /SQ FT I 11 - Ft. J Ft. K ti Ft. L B S Ft. P nn..;., W 3 Ft. L Observation Pipe g K A I - - - I. - - - --- ---- - - - - W o Force Main Distribution Bed Of 2�— 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page T Of ` Perforated Pipe Detoil 0 End View Perforated End Cap.] �\ 1t PVC Pipe Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main P PVC Manifold Pipe w Distri ution Pipe Last Hole Should Be I Next To End Cap End Cap P 3 p Ft. Distribution Pipe Layout S Ft, X Inches Y U Inches Hole Diameter 11 Y Inch Lateral �_ Inches Manifold Z Inches Force Main 2 Inches # of holes /pipe 8 Invert Elevation of Laterals \ol - &S Ft. I Place 1st hole from center of manifold with succeeding holes at qV intervals. Last hole to be next to the end cap. I Combination Sep. tic;Tank and PUMP CHAMBER CROSS SECTIOW. AND SPECIFICATIONS' PAGE S OF VE T CAP WFAT14FK PROOF C JUIJCTIOU BOX 4"c.I. VELIT PIPE APPROVED LOCKING 2!. ' FROM ROM DOOR. MANHOLE COVER AJIV '.WINDOW OR FRESH wARtJ1 L P49E1... AIR S aor�DuIT r I 6 ,I 18' MI11. L -- --- - - - - -- y " IUs� *1710" 'PIPE =— PROVIDE i J4 AIRTIGHT SEAL AF>=Lss I I I APPROVED JOIIJT A I I I APPROVED JOIIJT: R I III w /C.I. PIPE��c w C.I. PIPEa Tank construction I II ALARM shall comply with 111 ILHR ()3.15 and 33.20 a I I I I ow C 1 I $8 I LLEV, fT. PUMP ---�- - -i OFF. 0 COIJCKETE BLOCK 3" APPRotic RISER EXIT PERMITTED 0►JLy IF TAWK MAIJUFACTURFK HAS SUCH APPROVAL BEDDING SEPTIC E SPECIFICATIC)KJS DOSE 3, LZ TAIJK MANUFACTURER: IJUMBER OF DOSES: PER QAy TAWK 51ZL : -150 &ALLOWS DOSE VOLUME 1 S �� S` 1SCt�"1S INCLUDING 6ACK(LOW: `� GA LLONS ALAR MAIJUFACTURCR: MODEL WUMBER: l� t HW CAPACITIES: A= S INCHES OR 4 )3- GALLOUs SWITCH T7PE: Y'1��1ZCS.�@� B = IuCHWOR 37- 3 GpLLOLIS PUMP MANUFACTURER: C.= � C� 1 INCHES OR 1-11 Y GALLOUS MODEL NUMBER: I� E 40 0- -1 INCHES OR ' \-I S- GALLOUS 5WITCH TYPE: UOTE: PUMP AMD ALARM AR TO 15L Z MIMIMUM DISCHARGE RATE 31' GPM IN5TALLED ON SEPARATE CIRCUITS VERTICAL p►FFEKEIJCE DETWEEU PUMP OFF AU0.13I5TRIBUTIOW PIPE.. ,1 '' I S ) FEET + MI- u�tmuM MCTWORK SUPPLY PRESSURE Z•S O FEE T i FEET OF FORCE MAIN X i F 00fl.FRICTIOIJ FACTOR -. �'O1Z FEET .._ TOTAL DyUAMIG HEAD = � SZ FEET Pum chamber DIAMETER - p _ L4 i I&ITERIJAL. DIMEIJ610W OF TAWK: LEI.IGTH ;WIDTH i LIQUID DEPTH BOTTOM AREA _ 231= GAL /INCH AS PER MANUFACTURER - l�j,t3 GAL /INCH �r I M E40 Series MYWW 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 to W 30 W cr LL W H 25 8 E Z Q H 20 6 Q 1'1.52 3: 15 J ' a 15 a t•- O 4 O 0 10 2 5 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER.MINUTE 1101 Myers Parkway. Ashland. Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. Safety and Buildings 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 TDD #: (608) 264 -8777 N*hsconsin www.commerce.state.wi.us Department of Commerce Tommy G Thompson, Governor Brenda J. Blanchard, Secretary May 07, 1999 CUST ED No.267341 ATTN.• Plumbing INSPECTOR WEGERER SOIL TESTING & DESIGN MUNICIPAL CLERK 421 N MAIN ST TOWN OF TROY PO BOX 74 706 COULEE TRL RIVER FALLS WI 54022 HUDSON WI 54016 -8211 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 05!07/2001 Identification Numbers Transaction ID No. 221472 Site ID No. 170934 SITE: Please refer =boqnfific bers, Site ID: 170934 above, in all n nc . ST CROIX County, Town of TROY; WYNGATE DR SETA, NEIA, S21, T28N, R19W DOUG & RENEE SIGWARTH WYNGATE FOR: Description: Private Interceptor Main 1 Object Type: Sanitary Drain & Vent System Regulated Object ID No.: 46376TI; r The submittal described above has been reviewed for conformance with applicable Wisconsiltdittisitai�vg- des and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, asis ed in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: A COPY OF THE APPROVAL LETTER MUST REMAIN ATTACHED TO THE PLAN. 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 04/19/1999 FEE REQUIRED $ 80.00 FEE RECEIVED $ 80.00 CURT WENDORFF , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715)526-9056, M -R 7:15 - 17:00, F 7:15 - 11:15 CWENDORFF@COMMERCE.STATE.WI.US WiSMART code: 7657 cc: THOMAS L BRAUN, PLUMBING CONSULTANT, (715) 634 -3026, MON. 7:45 -4:30 DOUG SIGWARTH T'1T'tE SL^T Page 1 of '2 PRIVATE INTERCEPTOR MAIN SEWER RECEIVED FOR - F4 4 b�D%I- 1 H 3m ;E �)Mo a erg ', - APR 19 1999 "QcDG F=c1�Z rn.E o�Ep-!s' uSE.- SAFETY 8 BLptiS, pIV. LOCATED IN THE SE 1/4 OF THE NQ-: 1/4 OF SECTION 2A ,T -2 8 N, R Ll W, TOWN OF CRX11X COUNTY, WISCONSIN. LoT' Z. o� w�c1v Gq- INDEX PAGE 1 of 2 TITLE SHEET PAGE 2 of 2 PLOT PLAN PREPARED FOR �C)U G �►W 2E , 3 E t—r S ! G W ArtZTI� �l 1 Z 1 wtt rrE �Zz c►z �2LOP-� Cmid itiOnaliy 13 V \�N S V l�l,E MN S f-tbl ulrZACE DIVISION Of S�fiF rY gUiLDING SEE CC)RRESPO CE PREPARED" BY WECCEFZEFZ S3 C3 I L TEST I 1-4 (E; AND. 00 I]ES Z (31 I CE P.U. 8QX 74 Sgt K. MIK ST. '�� '/•� ARTHUR 4 RIVER FALLS. MI 54022 WEGERER 715- 422r � -01b5 s P �ewuRTN, g MIS � 'llin JOB NO. ..r PLOT PLA Page Z of Z SCALE V= qO ' 1hIG �Vl . ilZG.3b' r " �'Y'st'�'Pftn� L1,Z" epv�yt o R ��vgvL� R- p� e OeF l bp tNOT QAv prr -T nR i 3wi 1� � .cam FVypLC S . 2yA � e 8S' y \ \ \ •y5 g -Z / tfL W S �� Bb's a z � a n or Z�"MIGEl 311 btA- PVC PLQE WZL^ ", .. C3_�it? . 142.x' aN td < wit L Zb 13F t�T LP- - V�`v So' F M o U)-ib . l 1 s l S Wisconsin Department oflndushy, SOIL AND SITE EVALUATION REPORT Page � of 3 I aborand Human Relations DivlZ of Safety & Buildings in accord with ILHR 83.05, Wi Adm. Code • / COUNTY V S� 0% L::. S . C< ` Attach complete paper not less than 81/2 x 11 inches in size. Plan must include, but P) site plan on P Pe o PARCEL I.D. # to vertical and horizontal reference point BM direction and /o of slope, le or not limited Po ( ), p , scale dimensioned, north arrow, and location and distance to nearest road. 00- 1 Z �4 - Z0 APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY S DATE PROPERTY OWNER: PROPERTY LOCATION T>OV G G 1,1 M-Z- Qe1fT -L F S Q: 1/4 NZ 114,S Z ! T 2-8 ,N,R E ( W PROPERTY OWNER':S MAILING ADDRESS • LOT # BLOCK # SUBD. NAME OR CSM # �`-L - kJW1, �UCk 2 a P Z I — w `{ t'r CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE NrOWN NEAREST ROAD QUzNg ts`L ESnb (61Z) Ll3Z -S - bz' 20 LV�tfJ6frl T� (><] New Construction Use Residential / Number of bedrooms [ J Addition to existing building j J Replacement (J Public or commercial describe Code derived daily flow b rs o gpd Recommended design loading rate _ bed, gpd/ft ' trench, gpd/ft Absorption area required Sou bed, ft '&O\:) trench, ft Maximum design loading rate • S bed, gpd/ft • 6 trench, gpd/ft Recommended infiltration surface elevation(s) \ 3 S ft (as referred to site plan benchmark) Additional design / site considerations Moves w / 8'x ( 3 �' Aq , M )til MUM 1 z" o\ - SfVMt P+ L's. Parent material o y trZ - V*'�)c3\ u m tTZ: Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S O U 0S ❑ U EIS ISU [IS ®U EIS NIU ❑ S Q U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence BourrJary Roots Bed Trench 1p)4 2 31 Z - st 1 Z Sbk m Ft- cS - S .� ws Z -2J f st6 — S1 2F Y>z��'� CS S Ground in elev. a - ft �( 3I - (O ti (3 — �S@R — N Depth to limiting factor` 4 Remarks: Boring # -$ �OYR �s/L — s[ 1 Z�Sbk 1M�r eS s 3 lq -3 f 1 S `y Ii 3/Y Ground elev. if 0�•5 It J J • Depth to r i i' , i Imb factor - ., ti3 Remarks: CST Name: - Please Print Phone: Arthur L. We erer 715 165 g rer Soil Testing & Design Service -P.O.. Box 74 River Fall * � Date: Number: _. � Sgnature: << �9 220254 PROPERTY OWNER S1 G� "�� SOIL DESCRIPTION REPORT Page Z of �' 3 — PARCEL I.D, L t> l 0 - Consistence Boundary Roots Texture Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz, Cont. Color Gr, Sz. Sh. Bed Trench ,� �s - :<: <: Z 9 -Z S 1b 1 -1 fl- 3!L — s z l Z` a - 4 M T!- c S •S •L, Ground 3 2s -3Z `� S`�2 Sly — S10 l l es�k h� � cS •z - 3 elev. 0 1 0 1 • � ft. tj 3Z- 10 `t 2 / 3 — LS b Z Depth to limiting fact h r Remarks: Boring # Ground elev. ft. Depth to limiting { factor Remarks: Boring # . , ..., Yx ,`y i Ground elev. ft. Depth to limiting factor i Remarks: Boring # KM Ground elev. ft. Depth to limiting factor F Remarks: cnn 01 11 -0, — PL P Page 3 of 3 SCALE 1 "= qO ' ��. I* MCI "- prrcT Olt • �qg a V iNjSTuR$ �1 S PIR" v � e S • •✓ � 4 plc C i / 11,S.�t• s# z a A' OIQ `c3 31 q ''- IZ51A- FM C PLPE WILt�TH 'PtT L &�37 S0' F-mm M 0U�-Jb _ l 9 sP l sue° -tS -9 `j ( 715 ) 425 -0169 I4 00576 CST Signature Date Signed Telephone No. CST # I - Wmconsin Department of Industry, SOIL AND S I TE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety 8 Buifdngs 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 ST C\ - vertical and horizontal reference point B direction and % of slo pe, not limited to erq po (Ivt), scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. O U A- ZO- APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R BY DATE PROPERTY OWNER: PROPERTY LOCATION - r- - ) rj\3 G [j hT,7 �Z ���1 S l G ki pS R_ ... 00Vf - 0T S Qr 114 f 1!4,S Z 1 T ? ,N,R \1 E PROPERTY OWNER':S MAILING ADDRESS • LOT BLOCK # SUBD. NAME OR CSM # y 1 Z 1 tNL�t C� wCk �" Z -- w �( t� 6l'c'CE, CITY, STATE ZIP CODE PHONE NUMBER E CITY ❑VILLAGE arOWN NEAREST ROAD �3v�- >`►svttL - > TS3 (blv L132!- �3GAJ btZ_ I� New Construction Use (ICJ Residential / Number of bedrooms y [ j AddifiT to existing building Replacement [ j Public or commercial describe Code derived daily flow b o O gpd Recommended design loading rate _ bed, gpdgtt trench, gpolft Absorption area required Sou bed, ft Suv trench, ft Maximum design loading rate • 5 bed, gpd/fl � trench, gpolft Recommended infiltration surface elevation(s) 10 S ft (as referred to site plan benchmark) Additional design / site considerations Mou►.^3 w J 8 6 ?A ' Be'U , y - 1 ttv I M UM 1 Z L o.= Sff" G t -t_ _ Parent material LA q,� © v tr rat t Flood plain elevation, if applicable It S = Suitable for system COM!ENVONAL I MOUND "ROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for sy stem ❑ S O U OS O U [] S [Y O S ®U ❑ S ®.0 EI S Q U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Bandary Roots in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed rftd ..,.: y O -8 VZ4 t1 - 31 Z si 1 Z Sbtz wt fit- CS - -S .� # .} 1 31 � 5 l Z�' S 6k N� fit- CS l Ground 3 Z1 -31 S `t tZ -31 S IC.` 1 e-Sb c yn elev. _ q q.3 ft Depth to limiting factor , Remarks: Boring # _ $ t o 3 1.°I -3t 1 S�IZ.3 /Y � r, 3 Ground ft k4 31 -V0 1(3-t R- !I D - epth to sr ,� =J r 1 t factor ct Remarks:, ? CS T NameleasePrint Arthur L. We erer Phone. 715 -425 -0165 egeirer Soil Testing & Design Service-P. O...Box 74 River.Falls,W 54022 Sgnattxe " ` Date c CST Number: _. tt qq -60 �. - -99 220254 PROPERTY OWNER St 6wf\'}j SOIL DESCRIPTION REPORT Page of PARCELI.D.;7 y`IO lLy i - zo Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boxday Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed, Trench € Z 9 -Z S I 1 -t 1z ��� s > I Z`F Yn Tt- C_ S\ Ground 3 2s -32 `7 -S`12 3Ly — St�� lcsb►z y�,�'r cs .Z = 3 elev. 9 9.3 ft. t t 3 2_ l0 `i2 6 V3 — LS?1Z Depth to ! limiting i faCt�o Z h f t y Remarks: t Boring # 1 Y}s I i Ground t elev. ft. - i Depth to i limiting factor 1 Remarks: Boring # Ground elev. ft. I l Depth to limiting i factor I Remarks: Boring # t j ':. x ! Ground I elev. ' ft. Depth to limiting factor Remarks: — .7nf\ 0 ^'In r , .)C n.- P PLAN Page 3 of 3 SCALE I . I ' N by WzsT eA*'%'?rTcT Ovt o 0 p 6e� v q \ \ 9 ?� �6S.lt• %3 Vt 2 l a^ B "HtG0, - 1114 bi - Y�1C 1�'lPE W/L^."_ � 9 c l ��. /� .� ( 715 ) 425 - 14 00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND / ,p OWNERSHIP CERTIFICATION FORM OwnerBuycr JOOtnQ /uS Mailing Address _16 o O Y k� , Cjj fi ✓-e_ _ o, �/CS+ f�t�a►^� M , 4/ �Z Property Address s (Venfication required from Planning Departmelil for new construction)__ City /State /Voy ___/ Parcel Identification Number V_ Z —20 JJ —000 `� 1 �'l__ LE GAL DESCRIPTION Property Location S1E ' /,, AIF %, Sec. 2 T N -R_ _.W, Town of _�Vo__ - - - -_ Subdivision -- °i , Lot 9 - — Certified Survey Map is Volume Page Warranty Deed # _ Z Volume _ I l ^, Page # 3o Spec house O yes no Lot lines identifiable yes L no SYSTEM MAINTENA Improper use and maintenanceof your septic system could result in its premature failure to handle wastes Proper rnaintenance consists of pumping out the septic tank every three yearn or sooner, if needed by a licensed pumper What you put into the systcrn 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 Depwtmcnt a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensedpumM verifying that (1) the on -site wastewater disposal systcrn 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 pnvate sewage disposal system with the standaTdt set forth, herein, as set by the Department of Commerce and the Dcpa=cnt of Natural Resources, State of Wisconsin Ceinficancm stating that yotu septic system has been mauitained must be completed and returned to the St. Croix County Zoning Office within 3U days of the three yeat expiration date. 54�� 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) ani (are) the ownei(s) of the F19PCrty described above, by virtue of a warranty deed recorded in Register of Decd- Office 9 � O SIGN OF APPLICANT DATE Any information that is mis- representod may result in the sanitary permit being revoked by the Zoning Dcpartrncnt " Include with this applicatlon: a stamped warranty deed from the Register of Deeds office a c of the certified copy survey map if reference y p is made 1 n the warranty decd 6U4�99 DOCUMENT NO. WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS rG_ .�1PAG'. ST. CROIX CO., WI RECEIVED FOR RECORD Donald O. Rodahl and Joyce J. Rodahl, husband and wife, Grantor, conveys and warrants to Douglas F. Sigwarth and Rene€ S. Sigwarth 06 -03 -1999 1 :30 PM husband and wife as survivorship marital property, Grantee, the following described real estate in St. Croix County, State of WARRANTY DEED Wisconsin: EXEMPT E CERT COPY FEE: Lot Two (2), Plat of Wyngate, Town of Troy. COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 This deed is given in full satisfaction of the Land Contract between PAGES: 1 the parties dated March 5, 1998, recorded March 26, 1998 in Volume 1309, Page 125 as Document Number 575812. . . . . . . . . . . . . . . . . . . . . . . NAME AND RETURN ADDRESS SL CROIX VAt V 7111E SEW= INC. PO Box 750 109 N. MAIN ST. tdUER FALLS, VA 54M 040- 1241 -20 -000 This is not homestead property. Parcel Identification Number (PIN) Exception to warranties: All easements, restrictions and rights -of -way of record, if any. J 17 Dated this day of June, 1999. ( SEAL ) i C` �1� (SEAL) Donald O. Rodahl (SEAL) �-� � � (SEAL) Joybe J. RodahT AUTHENTICATION ACKNOWLEDGMENT Signature(s) ST TE OF WISCONSIN ) ) ss. COUNTY ) authenticated this day of 19_ Personally ame before me thi c �} day of U-o r- , 19 1 I the above named Donald O. Rodahl and Joyce J. Rodahl Notary Public to me known to be the person (s) who executed the State of Wisconsin forgoing instrument and acknowledge the same. * ' TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ^^�(-' t- authorized by §706.06, Wis. Stats.) * •JLLL -iF- THIS INSTRUMENT WAS DRAFTED BY: Notary Public I� � County, Wis. My commission is permanent. (If not, expiration date: Joseph D. Boles Rodli, Beskar, Boles & Krueger, S.C. - ZOO I) P.O. Box 138 River Falls, WI 54022 S & N LAND SURVEYING, INC. HUDSON, WI 54016 (715) 386 -2007 SITE PLAN PREPARED FOR: ALEXANDER HOMES SIGWARTH RESIDENCE PLAT OF WYNGATE ---------------- - - - - -- 1 „ 100' LOT 1 Z --- - -____ S84.32 06 E ' ' 1 Ji -- _ - - -� -- 4 , GAF, aGE ca I ' v PLAT OF WYNGATE `off ° Li 1 / ------ ---------- - - - - -- �► LOT 2 HOUSE: OCi� Zp' O; o / zE 00 I 1 26.00 Sbb•3� ` i N90 // /^ S89 "26'09 "W 165.12' I 18.00' / - - - - -- - - -J /� it PLAT ❑- WYNGATE ---------------------- X 1 11 qqL '1 Z� /tea LOT 3 PLAT OF WYNGATE O_ 1 , ✓ D rr i w �N fn v r r� p nr " A •!h `i �5 Z w A ^�1 f tea ARM 1 49 z r � rn p ,r y n Q UI!InLATTED, LANDS Q Y � PDX o ff ` j ti r N 00 l l' 4B'f 56?. 20' A� �m I I I � I I I u• O$ // .4� ♦ �i it r o y II QW X AA r z A= y v 4 Q I yam,.. •'�.... 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