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HomeMy WebLinkAbout022-1057-30-200 oca0 0M0', x.00 d ° m f c °.: f ` ° m � CD C m m ^ lo t cn z N z a w= = m O (n r N O h A3 O O fn ..; N 07 07 (n 0 A CD 0 O N O • S a c m O c ((0 CD 0 N N rr CL ° y m `'� w CD z n m p CO o R 0) OND c 0 — (D ro CD CO c oO (n C ^ N N Q- t0 w 0 NO 07 3 a o 3 ! 'i p O d C o l y M o D p vs C D m o CD co a c ( y a C 00 OD Op N 00 O N O co N CD 00 00 0) A A a N O c !V c c w fn °= a 6 T a a (n m cr G C m O_' C m H A N N N ! 0 d d• A N O N �' N A v' 3 _ N CL to IN z z z co z p Q D D O D a CD v Q S a 3 ro ro CD • N CD (D ro rn t►1 c rye 70 (D C C c CD (D a 3 z CD ro O A Z CD ca I O > w cn c ,+ n i` W m (D m � N o a a z 0 3 0 3 p -: 3 3 � O N N z _ < ro CD p A 0) N 0 CD O N d CD CD p7 Q a j '5�. CD p O 0 C 7 0 N C z a " CD z CL p .. p O p .. r 0 CD 0 N O W � ro Q co 0 . 0 Y - 'I ca A CD y �r F CU 6 3 � p S O 0 O O (D O O O 0 O b CD CD p. o to O o O o� CL a 0 ? ƒ 0 / co� / k ƒ k 2 k i \ / ® / — � � U ® f ƒ 2 z A±\ 3 § 8 \ ! a \ / } \ ( \ (\ (\ CD , _ , c 3 q : ;-z- $ ° 2 § § \ \ \ / % § (0 cn § ~ / » ° / > § . E g % o o £ . g U) E 0 = f ¢ . k \ 2 7 C:) : / $ \ / \ ° / } \ \ X \ g 0 c c N) � a / k T T k "w, 0 E 2 2 2 2 k/ J 2 0 C)� / 4 $ 8 / $ / J 2 7 � \ & ° \ D 2 7 2 CL § . z = z 9 z . : > a o w ° . E 7 . m § @ c - A OI Q co z CD cn / \ 2 z $ E , \ c » E § $ _ \ R . m m $ CO 0 \ $ CO 0 k z + % � 7 . I �I»> m . = (+ \\ § \ R� @k CDe �e7 % CD CD )/ 0 cx \k ƒ \0 � }§ # g 0 \ CD � \ m i ; 0 / \ \ Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page \ of Labor and Human Relations 6 ision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY S - r . . C_Ct o LX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICA T FOR TION PLEASE P IN ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION rr GOVP..+&T 5 k3 1/4 SLU 1/4,S ZO T - LB N,R IS E ( .@ PROPERTY OWNER':S MAILING ADDRESS T # BLOCK # SUBD. NAME OR CSM # I 1 �0 3 Qv i�n� -tZ 1ZUt� t7 — — '? CITY, STATE ZIP CODE PHONE NUMBER ❑CITY [ ®TOWN NEAREST ROAD �tUU'NiL h-4LLS W I SLl oz 1S)L1Z.S- Sy hv.9fjlc.\-r4 k3y-') 1 Q Tt4 -" 6 ( New Construction Use [XJ Residential /Number of bedrooms kNO w N [ ] Addition to existing building (] Replacement or commercial describe Code derived dairy fl o LS 0 gpd mm �,,�� Recommended design loading rate ° - bed, gpd/ft 0 • % trench, gpdfft f Absorption area requir Z 1 S bed, ft t $ trench, ft Ma)amum design loading rate o • -? bed, gpd/0 a • S trench, gpo1it Recommended infiltration surface elevations) °t S 3 t It (as referred to site plan benchmark) Additional design / site considerations S� t 'M tJv 51`htt f dJ i �'k6 E' 3 o F 3 Parent material % t'C�O `•f OU rL j tt S N Flood plain elevation, if applicable N - A • ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN Flu HOLDING TANK U= Unsuitable for system I W S ❑ U 10S ❑ U 10S ❑ U ®S ❑ U ®S ❑ U [is (� U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Cordstwm Bour>dary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch 0 -L9 \t�LlQ. 'z, 17. — L G.S GA Win? Z 19 -31 1c,�`4. R _ 313 L Z 3bk v►1 0 - 6�j p. S o. L Ground bFz S o• o•S elev. 19 -2 ft. y 4 Z -90 113 % 1R - Y/� Depth to limiting factor *7 0 1 o'r Remarks: Boring # _ o. S n. tp�� z�Z 1_ 2>n sbk�'� ��" X Vii':: Z Z 1 - I -29 LU 1-trZ 3/3 - L Z�s bh wl�'� Cw o• ... 3 24 -�10 t o `12 31b - S tin s b) W1 \j C- S o y o. S Ground elev e ft. Lj l ijo -q3 I o yR YA — S S M Depth to limiting factor Remarks: T Name: — Please Print Phone: Arthur L. We erer 715 - 425 -0165 V egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: �I 3 ! g- 3 Date: L . Z 3O _ lr CST Numb 00 5 7 6 �_ 0 7 PROPERTY OWNER 0SCkZ C. L SOIL DESCRIPTION REPORT Page?: of 3 ' PARCEL I.D. # • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0 -11 `� xiz �- t 2. �S b12 w1 `F� cw - o, 5 a b Z � -3y I 3/3 - SiI Sbh �n Gti o.S o,6 Ground wt elev. 7 0 g 6.9 ft. y u2 -Ro �o H R Y/6 Depth to limiting factor Remarks: Boring # , } w..:.:':.k; >: ► o -t8 % Z L Z S 2msb Yh ��. Cw 0, n .b o. L 9 lOti 6 sl h vhvih Ground elev. Yt ft. � s5 �fl� — S O - o• ` o Depth to limiting factor $ q , F Remarks: Boring # �'�syR Z[Z st Zm S bk �� Z 30 Ck, Ground 3 3u -DLO Io`-1R 3l6 S) �1titS� >r1 V'Fb cS O - L/ o.S elev, y O S 4 9 — . 1 ft. Depth to limiting factor Remarks: Boring # •3 Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PLOT PLA Page 3 of 3 SCALE s E `m a AT t. -e*&T - 2s , F?.b h S I1 SI-Em tries W�1.1, k 4 4 N SQ •a ai J F-J'NRQ U'r L 1N S 'M 8e n T LMT 5' M m SLI S1 &I M2.&h s . ? u L'1,g96 L'1 q4 ? R• SS —8.1 otv 6'� Hl6ft, Sv ��+t8L M FOR IPO t7tPrL OtA. o uc- pI PE w1wob9 LtkM NAT o LsL 9.3 4 ° S- 5 } f- I I pqq. G t?1. °! 8 9 tTL � 9 d'' � IISR, 3 1 1 4 " b))9• NC Pt Pt w /woau Lk`tN ►�5�1' �U 3"D�A. wuofl RE)vcc Po3T. S ��. `a�`tt►�l Ft Lit. p ��� S`-( n t..o�1�t� SkzpT'CN M cO�, TO I L3 Sj'f\ LLER tiw s`" FOR 3 BD" 1` - OkIE - I2 ' x S B M OR Z -VN-z N C-H-e S , etc H S' k S LONG FbZ Y @ bVLM H t� - ��'�1Z fagb oft, Z- 'i12&jcti kzs, eFkC!! Sw —Sw st -sa, S' X 1S' LU�6. Sl � T S @�R�l 1-}oJt . 1Z'X40' 1311 OR Z 1�cktC'S, ���K d - S'X4y` Lou 6, qy -319 -3 715 ) 425 -n1 h5 _ M00576 CST Signature Date Signed Telephone No. CST # f Wisconsin Department of Industr SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety & Buitdings in accord with ILHR 83.05, Wis. Adm. Code COUNTY S'C' . LIZ -0 lX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 0 S C ft Az C . L GAV�-LET 5 1/4 SW 1/4,S ZO T ZS N,R 18 E (or IN PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 1 OO 3 Q V R1Z-1Z 1 A 1r> — - ? Rt3 \-�:' U 3 ItTb C S t'`'1 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD \'�1vUIN'L F LLS W 1 Synzz 01S) Sy '& -)+ y f,sy (� New Construction Use. M Residential /Number of bedrooms u Q ti-N o w N [ ] Addition to existing building Replacement commerci describe Code derived dairy �SQgpd 'ftQ 1 Recommended design loading rate - bed, gpol(tZ - % trench, gpt,}/ft Absorption area requir 2.1 S bed, ft2 t 71 bench, ft MUM= design loading rate °' - bed, gpoltt ° - $ trench, gpdJft Recommended infiltration surface elevations) Ot S • 3 r ft (as referred to site plan benchmark) Additional design / site considerations sEFIE r-NOXE 'Co w STA _� OK3 iOkiS E 3 o F 3 Parent material S 1`y ` % 4 O u Tw h s tl Rood plain elevation, d applicable lv - A • ft S = Suitable for system cONVENTIONAI_ MOUND IN4ROUND PRESSURE AT-WDE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem DOS ❑ u u ®s ❑ ®S ❑ U - ®s 11 u ®S ❑ u [i I1 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft in. Munsell Qu. Sz. Cora Color Gr. Sz. Sh. Bed Toich o - L 9 \b %-I Q z. ! Z _ L. Zm s b v ct." o - 5 0.6 Z 19 -31 1'�s`2R X13 — L Z gbk v►1'fh - Ground 3 ll - z t t 'Sit. - 51 l wt Sbk wt v S o o• S elev. 9 9.3 ft. y Z -9 o,.� Depth to limiting factor Remarks: Boring # z 1 Z L 2m s bk `�'►- cam, — o. s n. L r a l l , 1 - 1 -Z9 10 `I R. 31 S o- y o- s Ground elev. y 0 -43 I yR y/6 ` 3g. L it. Depth to limiting r facto a to 3" Remarks: CS T Name:---Please Print Arthur L. We erer Pho 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,Wl 54022 Signature: � � y- 3 j q - 3 Date: �- ` CST Nun 00 5 7 6 PROPERTY OWNER _0SC & C. Lte SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BoLndary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench R * 0_1� `o ytz z i z s Z►nsW M i�- cw r,. S a b 11 -3y toyR 3/3 s iI Z gbh v �,, o.S o. Ground 3t1 -tj Z 1 0 K IZ `Mt U O. L/ 1 0-S elev, 9 6.9 ft. y 442.9 1 c, H R Depth to limiting factor Remarks: Boring # O_l$ LO 11Z Z f" 2 t$ - �o `iQ X13 — S� Z'F C,�, o ' L 3 9• 10 2 3/(, wl V �►�t S bh Ground elev. O Sg _ o• 0 7 g 8.9 ft. ' � Depth to limiting factor - 7159 " Remarks: Boring # N S .:.:., Ground 3 3V - u0 ta`-1 R 3lL S wt Sb yn V 'F►. 0-3 elev, y yo_g 1 0 2 Y/6 S O S ►1. j - o. v. a 19 .1 ft. Depth to limiting factor { 7 �0 i Remarks: Boring # , Ground ' elev. ft. Depth to limiting factor I Remarks: SBD•8330(R.05/92) � PLAN PL PLA Page 3 of 3 SCALE 1 "= �p ' SW �NRC UT L W l S lU Fie T) T LMT 3' V pwl SL1 IrGri h t S . t'Lgq 6 4R g• SS —8.1 G 1 °fo ~ %rif'- 1 - t't..100.8. dv I+t61f, 3 1y ' V�1 Folt ltu 1-n f} p I 0 -) C Pt 4E `4Wtl w W WID l k`R1 UST h'I� Sy 37�`.1"tS o '1b ��1rt� Sava; Po�T'. s 'tsc'(!-► mss. = q s. 3' EL 99 s 0 8• S f- I a e-L4 X 40 9 wl (Stf, 31V * b)t)• PvC P ► PE w/w oo Ut 7N N�KY Rl 3`Dii�. F1 esuo' vCZ.f�s S` n L.oc..R'ct0►J St�kTC4{ S T TY 6 5 � 2 I 1 4 tiw -S,', _ Z' S ' Z `C1 -1UC S � I FaR 3 8DR11 ��E 1 x � B ND OR, � H�e , tll�CN i 9 1 �� -Sw S' x s u�ij � . t — a U� sw _s,,j X� s BORN s'xgq` L13 u6, �y -319 -3 ( 715 ) 425 -016.9 1400576 - CST # /'tT Cinnnfurn Date Sinned Telephone No. _ Y:c P� Cn cn = m iJ L1 QW .. P1 i .. JUIV 19 2.001 =OX � � p L•.. �W x' o w��`�W_ `�' �►—' ST. CROIX COUNTY _� �.+ u SURVEYOR S RECORD ►— i tc cn CERTIFIED SURVEY MAP Alan J. Hartleben and Charis S. Hartleben Located in the Southwest 1/4 of the Southwest 1/4 of Section 20, T 28 N, R 18 W, Town of Kinnickinnic, St. Croix County, Wisconsin NOTE - An erosion control plan will be required by the St. Croix County Zoning Office prior to any new construction on this lot. West Quarter Corner OWNERS'ADDRESS Section 20, T 28 N, R 18 W 1003 Quarry Road (Berntsen Aluminum Monument found) River Falls, 47 54022 �' Scale in Feet 1"= 100' 1 � 50 25 0 50 100 150 N Ilearin�s are referenced to the West line of the SW 114 of Section 20, assumed bearing N 00 °0027" W. I UNPLAT�ED LAND$ 3 89 0 4746" E 422.79' 388.22' ar E t loo l *well H 33' 33' C p J J' c ol I� lac Dwelling e��y' �I - i o H ; ,�, 33.09' � � LOT 1 A $ ° ��l I (� 2275 acres or 99,097 sq. Et. p (incl. R/W) N _ 0 ' 2.096 acres or 91,299 sq. ft. 6, `Se'.fcgre' `� �. (excl. RM L QT -a 33 I z g 6 � _ J (� Cg S-UN- eX y.Mdp 33.15' %� N 06 °06'17" * «8.93 page 328 ;• R - N 06°15' _ 33 S 86°1212" W 378.66' 's ,s e S � (R 88 33 MP ND UNPLA 9 NPLA - - - - -- TTED -LANDS s$ , W U _ 0 00000ooppp0p ° mi l a? 0 SG° " ° ° t co{ o Indicates 1" x 24" Iron Pipe Set ° LAURENCE °° o � (Min. Wt. -1.13 lbs./lin. }k) g ° MURPHY" ° O * s 7} ° * B Section Corner Monument IR FA ES, ,o g '•' Southwest Corner 0 (as noted) • °° Zvi. ,° a 0 Section 20, T 28 N, R 18 W 'k;�� • IN— ..... ° °gam ��° ( "PK" nail found) (R =) Recorded as LAND 00� APPROVED ST. CROIX COUNTY Dated: March 6, 2001 Planninq Zoninq and Parks Committee This Instrument Drafted by Mark W. Peavey MAY 2 9 20 SHEET 1 OF 2 Vol ° 15 Page 4092 If not recorded within 30 days of approval date approval shall be null and void CERTIFIED SURVEY MAP LOCATED IWTHE NE1 /4 OF THE NW1 /4 OF SECTION 29 AND THE SE1 /4 OF THE SW1 /4 AND THE NE1 /4 OF THE SW1 /4 OF SECTION 20, ALL IN T28N, R18W, KINNICKINNIC TOWNSHIP, ST. CROIX COUNTY, WISCONSIN. L• w � �( WIA�/ SCALE IN FEET CORNER N1/4 CORNER SECTION 20 SECTION 20 T28N, R18W 0' 300' 600' _ T28N, R18W w N 1- 71 11O O 1� O -i r- w O ° cn z 0 O M H 0� z a 00 tiCb S89 0 37'15 "E 854.73' H z cn z w O `�' , � � � / ,,,Lg`L • w as !� b g o 1 xx N w N � c) W o P4 F-4 Hof N ww r 1 UI� p U w z ccn 1 1 p0 9 A H 0 t 4 '63 ° 1 1 ti ti°r cn I 1 6 06 O6 N '19 W :b';� A z ti � O i u 1 3 w� ,i t�i� W x cn v p` S �G 1 1 0 1 11 0 b r , r o ^ o �x� / � / N 01 > H 1 .-1 W �� / / -1 r-1 0�1 1 ° 1 Y 00 11 v,' r PL 0 tn 0 NO V w �3s'r O I I M z �^ I i o o O H 0 I r O 0. \`� \ ~, // / ,-1 ° 3w00 o z �z / r c " t1,1 to H M H H / 1 a / r S1 /4 CORNER N89 20 1300.67' ,��/ T28N, R18W NORTH LINE OF W N t ; ; THE NW1/4 OF w _ SECTION 29 O U O to i N O ` 00 N O H M O ° H w N `� N U x c8) .. \ O O �1 3 _ vwi H - o � 1 ° ,n i W r^1 z z n 0 z `� 1 S1 /4 CORNER -1 cn w 244.65' 156.7'x' 338.65' H N z w `8 N88 0 41'35 "W 74'0'.'07 SECTION 29 ° ° �I a H T28N, R18W • W 30 W1/4 CORNER, SECTION 29 T28N, R18W Vol. 6 Page 1601 0� c! con I ° T n 1 X y( x �{ A O j O V) O ° N 00) O ty N o ° +� O N °C • .. t0 n y y $N'm z nm U) -4 °° p AN � � CD Q l o o m w l Dlp 0 a o y c N H g o p cn y D a °o cn N W 0. v N W (n v a a i� W w OD y �° 01 N ° c Al T z 0 0 0 0 0 0 0 EN (06 �3 INS d o IN 5 0 2 �1 9 N O a ol (D � � = � �" ur 3 C. z N I =� D D o D c ! 0 o O N _ (n ib _.• I =. C C (D I z ( (3D c6 —1 N I 2 z o a(o w� �0o C ° J Z ; I (D n n n ? 0 , CD q ~� o d c I o a o ` o a m -M m I y O X o m I Rt Q @ e co ! - (D o I o o 00 0 9 c o b I o 0 o a ti Parcel #: 022 - 1057 -30 -100 01/30/2007 04:34 PM PAGE 1 OF 1 Alt. Parcel #: 20.28.18.315A 022 - TOWN OF KINNICKINNIC Current i X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner ALAN J & CHARIS S HARTLEBEN O - HARTLEBEN, ALAN J & CHARIS S 1005 QUARRY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1003 QUARRY RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 36.725 Plat: N/A -NOT AVAILABLE SEC 20 T28N R18W SW SW EXC .09A TO TOWN Block/Condo Bldg: EXC CSM 15/4092 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 20- 28N -18W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 09/03/1998 586417 1354/337 WD 09/03/1998 586416 1354/336 PR I 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 179132 Use Value Assessment Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 40,000 455,000 495,000 NO AGRICULTURAL G4 24.725 3,400 0 3,400 NO UNDEVELOPED G5 10.000 25,000 0 25,000 NO Totals for 2006: General Property 36.725 68,400 455,000 523,400 Woodland 0.000 0 0 Totals for 2005: General Property 36.725 68,400 455,000 523,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 12/03/2004 Batch #: 581 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 QW n r , 7 + RJ 3 A p ° o laJ LIN 19 2001 • L1 i.1 eu lW 2CC :9 I� g1e� •• w►Wa ` �►— � '—' ST. CROIX CO5777 �zHv °; = SIIRVEYOR'SRECORD �i � • . .� -, .``ems' II I - �Q W }-- 5! i:C UI CERTIFIED SURVEY MAP Alan J. Hartleben and Charis S. Hartleben Located in the Southwest 1/4 of the Southwest 1/4 of Section 20, T 28 N, R 18 W, Town of Kinnickinnic, St. Croix County, Wisconsin NOTE - An erosion control plan will be required by the St. Croix County Zoning Office prior to any new construction on this lot. West Quarter Corner OWNERS'ADDRESS 4 5 Section 20, T 28 N, R 18 W 1003 Quarry Road (Berntsen Aluminum Monument found) Riwer Falls, WL 54022 Scale in Feet 1"= 100' 50 25 0 50 100 150 Bearings are referenced to the West line of the SW 1/4 d of Section 20, assumed bearing N 00 0 0077" W. I UNPI &7p LANQ$ S 89 0 4746" E 422.79' 388.22' etl �S�' I *well acn ' 33' 33' 100 _l °' CA ° z '�l o o 00 ; Dwelling gl Cel i N W i� , a $ _ W 33.09 L OT 1 k N. I 1275 acres it 99,09 aq. ft. $ ° o CY I h =9 Z 6' I Z (DT) i _ /� 2.096 acres or 91,299 sq. Et. Sap C _ _ l._ (excl. RM 19T 5 ��_ C_ err '� I 33 , Vol., R8$Q P 33.15 N 06 °06'17" 1Nt M8.93 _ 33' R = N 06 15 40 ' W) S 86 ° 12'52" W 378.66' - /R 9B ° ' 73 3 h D IANDS UNPLATTED .�9N1� > o I sS8 9 W UNPLATTE_. ._ -- 5 �I 0 00000a00 0 0 0 5 9c 1 Na/ ; ?s ° ti 0 000 LAURENCE o ' o Indicates 1" x 24" Iron Pipe Set W. Min. Wt -1.13 Ibs.Ain. ft 8 >`° MURPHY O `` a Section Corner Monument FA ms ; ° ,o Southwest Corner O (as noted) W 0 o Section 20, T 28 N, R 18 W o a CFO ° ° $� � (PK Hall found) (R =) Recorded as W °D ° °0 LAND 0 0�� APPROVED ST. CROIX COUNTY Dated: March 6, 2001 Planninq Zoninq and Parks Committee This Instrument Drafted by Mark W. Peavey MAY 2 9 Z 0 Q 1 SHEET l OF 2 Vol-15 Page 4092 If not recorded within 30 days of approval date approval shall be null and void e� Form- S T C - 104 j AS BUILT SANITARY SYSTEM REPORT OWNE 1. 1, ,,pp TOWNSHIP ✓ J , �+ � � � Cl�. /%ICI J 1 SEC. ; T � N -R W ADDRESS 6J4 ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE ~- PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ACJ a 'l� gyp �O �alseP�:� rfrePosej a Bed P*ft r -�- INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used SF%✓ tArne j- Elevation of vertical reference point: ��� Proposed slope at site: SEPTIC TANK: Manufacturer: � ''11�WL'S� ! /W*,rt iquid Capacity: OpQ Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: i Number of feet from nearest Road: Front, Side, Rear, O yQQ _r feet From nearest property line Front, (x)Side 1 0 Rear, O .�/p 0 V feet Number of feet from: well ,?DO r buildi�����ntttttt------ g������: It (Include this information of the above plot plan)( 2 reference dimensions to septic tank) Srr �,rvFi��r: ti i nh PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump /Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM J. Bed: X_ -?:5 Trench: n Width: l2 Length: Y - Number of Lines: d Area Built Fill depth to top of pipe: d 0 �• i Number of feet from nearest property line: Front, O Side, Rear, O Ft. wd't Number of feet from well: OD Number of feet from building: 'p (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK ! Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of,feet from nearest road: Alarm Manufacturer: Inspector: Dated: Alk Plumber on job: 4 S 4h License Number 3a 3/84:mj — DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. B&X 7969 t BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL El ALTERNATIVE State Plan 1. D. Number: llf El Holding Tank ❑ In- Ground Pressure ❑ Mound assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Oscar C. Lee Hi ghway 65, River Falls, WT ' r ; 21_ f J "ao �f1J BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: SW SW, Section 20, T28N —R1 Town o f Kinnickinnic Name of Plumb er: MP /MPRSW No.: County: Sanitary Permit Number: Thomas A. Wang 3231 St. Croix 54977 SEPTIC TANK /HOLDING TANK: MANUFACTUR { f LIQUID CAPACITY. TANK INLET ELE V.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COV R �A�.C. 4 g � GI / �— PIDED: PROVI D: @I J I L 1 YES ONO ES ONO BEDDING: VENT DIA.: �E�MATL. ] HIGH WATE NUMBER ROAD: PROP RTV WELL BUILD( ENT TO FRESH ALARM: j FEET FRO 7 LIN . fI AIR INLET: OYES O z ❑Y 5 NO I NEAREST R — � DOSING CHAMBER' MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP /SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO ❑YES ONO I OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY I WELL. BUILDING. JVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: ` ..ii��' � WIDTH. LENGTH. I NC , OF DISTR. PIPE SPACING: COYER INSIDE DIA.. # PITS. LIQUID ° F..Oit`BM(� TR EMGH ES. f MA RI�L' PIT DEPTH. L. GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DI T NUMBER O F PR PERTV WELL: BUILDING: VENT TO FRESH BELOW PI ES. ABOVE COVER ELEV. INLET ELEV. END. PIPES FEET FR}M L E AIR INLET: �7 2 `1 NEAREST— MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER I TEXTURI J PERMANENT MARKERS ED OBSERVATION WELLS ❑YES ONO 11 YES LINO DEPTH OVER TRENCH /B DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED: CENTER. EDGES. DYES 1:1 NO 1:1 YES 11 NO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. } MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: J NODISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.. ELEV.: PIPES: DI A.. QIBIOi nF" HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: OYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER O F LI ERTY WELL: BUILDING: FEI ❑ YES ❑ NO ❑ YES 1 NO I MEAREST x ,35 ; f) ��_ --- - S.1z I of Sketch System on t Retain in county file for audit. Reverse Side. 5 SIGNAT I SBD 6710 (R. 01 Wisco APPLICATION FOR SANITARY PERMIT .Z A I L H R COUNTY � oEPRRTmEI"IT OF (P« 67) UNIFORM SANITARY PERMIT # inOUSTRV, LRB0R & HUMRn RELRT10nS Sy 9 7 — Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8 %x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROP RTY OWNER MAILING ADDR SS S tq ir (� t eie IIN I I ;� f I' ve /- 1,4 PROPERTY LOCATION CITY: U LL 1/4S L01/4, S ��. To�N, R /,E (o � W N E. ' ;C 1C ! h f C LOT NUMBER I BLOCK NUMBER SUBDIVISION NAME l wlom EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. N BER TYPE OF BUILDING OR USE SERVED Oaa-- X 1 or 2 Family Number of Bedrooms: ❑ ublic (Specify): THIS PERMIT IS FOR 9 New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. 54 Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity �p Lift Pump Tank /Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump /Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Sign at MP /MPRSW No.: Phone Number: 3PY 1 0 /s , ) Sias Plum er's Address: Name of esigner: ZOIAG l 0 1 l� 1 COUNTY /DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ) ❑ Disapproved A roved ❑ Owner Given Initial i pP Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. � w f i APPLICATION FOR SANITARY PERMIT I S'TC -100 i This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor,( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with-the a o ri ppr p .ate deed recording. Owner of Property Location of PropertyL�k G✓' Section 7 , T N - R W r Township Mailing Address Subdivision Name 1/ 4 1`' L� Lot Number Z Previous Owner of Property Total Size of Parcel �© Date Parcel was Created It-ft tel - 7 Are all corners and lot lines identifi ble7 r t 'S Ye No Is this property being developed for resale (spec house) ? Yes .t' No Volume and Page Number as:recorded with the Register of Deeds i INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: j 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office X "� i " "' •' r In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also-be required. nr PROPERTV OWNER CERTIFICATION 1 (We) eentigy that att statements on this Jonm wte ttnue to the best of my (out) knowledge; that I (we) am (ahe) the owneA (s) o6 the pnopeA ty des c4ibed in •in6o4mati•on 6oAm, by vi tu.e ob a wwvuznty deed econded in the 0jjice of the County RegiAten o6 Deede ab Document No. � j S and that 1 (we) pnesentey own the pnoposed A to bon. the sewage poaa_, aybtem (on I (we) have gb•tai•ned an Basement, to 4un with the above dac ibed pnopehty, 6oA the - con,6t.0 cti.on o6 said system, and the same h as been duty xeconded in the 0 aj the County Reg.cs.ten o6 Deedd, as Document No. ) SIGNATURE OF OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE) ZZ 'DATE SIGNED DATE SIGNED H H ST C- 105 r ' � 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z t7 OWNER /BUYER aQQV he (:f ROUTE /BOX NUMBER E j �� X fly Fire Number CITY /STATE C �r ZIP Sya �d PROPERTY LOCATION: 5'&j �L, S&\.) Z, Section a , T a b N , R � _W, Town of , St. Croiic County, Subdivision r -- , Lot number Improper use dnd maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Crolx.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- f y g in that 1 the on-.site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than I/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H o I /WE, the undersigned, have read the above requirements and agree W to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart - �v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration d'ate. L� SIGNED DATE —`— St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715 - 796 -2239 or 715 -425 -8363 Sign, date and return to above address. _v y n x 2 a r El O N 7 m -� K O O �/ � a .off ��w� Er 3 z' a z v=cN �NNf Ila m m c x( l w CD w 6 ? rte ?� �- m 0 6 -+ A O m N I w o A � Q O ..-sm W O C 0 w O_ A p o < C- cm w d N N N O m w � N (gyp- Or.a -� � N w f; s A (D C, C - J G) A N 0 � M w A w 0 '040 4 w O 1 O H -aN w �tG M v Z to z w � ���a CL N m , N A 0? N ..� CL oa ? ° cm 0 M .� Q N O N N? C.tC w N 0 0 C; w a ac A f m C 171 oQv 3�°° v =aS? m (�- ~am w NS _ 0, ;6 C C m O N N ^ m V W A a O F w c C a m O m w � w acD N o �� Nod aa Qm� ?0� 0 .0 = m o c .� cD C cD i >a c C 0 N ?w A �� c =cm = O j V O 3 0 O °� m a 0 0 0 3 `0 C N CO OL ° CD v x " c DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115 P.O. BOX 7969 HUMAN RELATION'S MADISON, WI 53707 L (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP /M ICIPALITY: OT NO.: BLK. NO.: SUBDIVISION NAME: Sto 1 /4W/4 90 /TAN /R $�E (or -- - TOW1�J_ER NA� MAI �G A �ESS:�1 f WI S7��� USE DATES OBSERVATIONS MADE 'TT11�1 6 !� NO. BE[ :COMMERCIAL DESCRIPTION: PROF LED S IPTIONS: A ION TESTS: L Residence —.. 24New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED YST M:(optional) i NS ❑U RS ❑U ®S ❑U ❑S ©U ❑S ©U y ia 44 d If Percolation Tests are NOT required DESIGN RATE: Q If any portion of the tested area is in the under s.H63.09(5)(b), indicate: '� Flo i Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER - INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- o /,s O X 6.0 .2- o it 00 o B 1 s� B- a 6.00 161, s' 0 N -10 a. 00 l Z. 610 9 3. Z4 0 1512 r B- 3 1 6 -0 0 / o o �6_ Do . �o S V B - 2.o S d Y B- .6 0.)!5 oo ,nA . oo /4 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERT D 1 PER D2 PERIOD PER INCH P_ P_ P- P P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil ar s. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the sace elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION Tj Sf o'ne - cif _Cren7_ I , , e � _ IN in z , , _. _� __a _. _ -a ' Vl E , , , l 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WEFJE CO PLETED ON: o�I S /9 l/ �'y ADDRESS: CERTIFI ATI N NUMBER: PHON NU BER( optional): a� ��� CST SIGN E: 1 / tip / DISTRIBLITIO.N: Original an t one ropy to Local Authority, P: , );)e"y O an.:i Soil Tester. r i INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 8395 y I To be a complete and accurate soil test, your report must include, I 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use planned; 4, Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 0. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. [CAKE A LEGIBLE diagram accurately locating Your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 3, Make sure your benchmark and vestic.al elevation reference point are clearly shosvii, and are permanent; 9, Complete all appropriate boxes as to dates, names, addresses, flood plain clata, percolation test, exemp- tion, if appropriate; I(1. 14, 'he information (such as flood plain, elevation) does not apply, Glace N A. in the box; 11. Sign the forrn and place your current address and your certification nunibcr; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY VVITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Sail Separates and Textures Other Symbols s t Stone (Over 10") BR - Bedrock coh — C c bhle (3 - 10 ") SS — Sandstone gi _ Gravel (under 3 ") LS Linwstoii# _ r .S'In 3 perc, P rcolAi n 3' t } t'Sp: { if Sal I d t3!dq E3ta ld,l ,l d olsmy Salyd — Calcc�tF�r stE �t L.o ;art lira — ? o /tt Si b ;it _ t 1.31;nt E31 _ ca �,t ;x V i C „ ..... C y — r�,u - iv t -oan '`r –_ Yluil W Rly Cl iy Loan) R f .1 ( It C y a - ,.il - ". 7 ,t 1wit�`yt S.oain r. i'(�iv ;t� ( — �x �.�:";<€It ml (tq: .� Cl t dst€, lit >lat?�t;�, ��it – 1'3tr t� t'.40 ''a i TO THE OWNER: 1 . =5 sza34 .r. st report: is t1 w first st('p in securinci e, sanit. i y t�uM ;t. , 4, c,r,unty Oar P,,= i epi_rtm May r ~(Juest ,C !ic,- t3t1?1 w this soi test it the fie p i'll 1rl per, 1 t A € ;C33?'l Z1Ir # ;yet id, l,lan f3 the ; :}t - ivate e 4v'ii {l�; sySf and ii IFQ,."Pm s pr)lk rrnist l:)(; siti rmitcd to ifte appioprr,is local awhot iiy it; (t der to 3 ai. Ed t)w"i il' T he Sprit ,wry pNrlin: rm is` l.)f' ot).a' wld dw(l pos (`Slid' ki ih start C,l any CE,t7st; "'t�1i 3r1, i l _ I ds�a►� �.ee /oo W 4 0w rk � a y 3 y`' Perf Pv�, rk ta 'x 3�' Sep fropoe� 1,00o da >ax3�' 6c� 7d k y�o -OCA,� D i� O Lt O ��I �4+�►�{ e � -Ko Pr eS�e►1� �. n Far Im /Doi 8� 7� step, � 5 From �rjf :re slope o• J t� i r ST. CROIX COUNTY ZONING DEPARTMENT ,! AS BUILT SANITARY REPORT Owner ex, Address `, ���� r�c7�x City /State e Legal Description: Lot Block Subdivision/CSM # '/4 5 r y' /4 aLLt Sec. 2 C� TAN -R[JW, Town of PIN # OQ� f SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer ...Size ST/PC /c�Z/ 8C -Setback from: House R-5 Well I /L f16 c5 Pump manufacturer l ,- ?,�, Model P o ' f 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: flACu,- -C-L Width Length 6 3r Number of Trenches `— Setback from: House 1o2 ` Well Z�� r P/L -g Vent to fresh air intake ELEVATIONS Description of benchmark r Elevation Description of alternate benchmark Elevation t, % A Building Sewer y� d A ST/HT Inlet 3, l s _ ST Outlet �y�3 PC Inlet PC Bottom _ Header/Manifold r _3 -5 Top of ST/PC Manhole Cover 61 S� Distribution Lines O 5 _3. O .52.32 Bottom of System Final Grade Date of installation / � /j Permit number 3 , State plan number IF Plumber's signs ure License number C' :� Date /Y / 961 Inspector�i,� l Complete plot plan I 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 INDICATE NORTH ARROW S Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County 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 La s.15.04 (1)(m)). 324623 ft &mekLAN ❑,ftfi1j!/jllaae Jgyvn of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel T6, 12.1057- 30-000 1 CPiG' iGt dv lJ l L TANK INFORMATION ELEVATIO14 DATA A9800522 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. f osptic r Bench i ng Aera ' Bldg. Sewer Holding Stt t inlet TANK SETBACK INFORMATION St /49% Outlet TANK TO P / L WELL BLDG. Airi to ntake ROAD Dt Inlet Air I eptic D / /vl„ NA Dt Bottom Dosing j° a 4 �� NA Header /Man. � •$� �S�3S Aeration A Dist. Pipe G%S . 3� Holding Bot. System GJ.c PUMP/ SIPHON INFORMATION ��p Final Grade Manufacturer O � De and C �<ra Model Number Cie DH Lift Friction 99' Systerr�.s TDH9.� Ft Forcemain Length / Dia. FFff "" Dist. To Well S L ABSORPTION SYSTEM BENCH Width I I Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid D EN I N DIMENSION SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING nufactu,er: SETBACK CHAMBE INFORMATION Type O w ? $ �' OR UNIT Moe Num System: DISTRIBUTION SYSTEM Header / Manifold M Distribution Pipel, i e I x Hole Size x Hole Spacing Vent To Air Intake IL Length ( Dia. Length , tr g g Dia. A I Spacing 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.) LOCATION: KINNICKINNIC 20.28.18.315,SW,SW 1003 QUARRY ROAD f, bfJ\ff,w � 31 vw� ��V f u }v r� ��f ;� �u,s 0 �SSLct,' I n O A 4 ,rm-(a Plan revision required? €] Yes [TNo Use other side for additional information. SBD -6710 (8.3/97) Date Inspector's Sig tu Cert. No r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i u Vi sconsin Safety and Buildings Division SANITARY PERMIT APPLICATION Po E. W ashington Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less Count r than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number The information you provide may be used by other government programs ❑ Check if revision to previous a lication (Privacy Law, s. 15.04 (t) (m)). S State Plan I.D.,Nr rZ 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION T J Propert O vier Name Property Location �/ ci_�� - .5lNti S W 1 / 4 , S Q T , N, R l (or) W Property Owner's Mailing Address Lot Number Block Number Cit State Z' ode Phone Number Subdivision Name or CSM Number (u dffi 1(7 /,57) la5 II. TYPE OF BUILDING: (check one) ❑ State Owned o !t Nearest Road p Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 111. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Numbers) 1 E] Apartment/ , 9 0 . AS ' 1 b 31,57 — / 0 ` 5 7 — ,3 C 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_ 'C Replacement 3_ ❑ Replacement of 4 E] Reconnection of 5. E] Repair of an _____System ________System _____________Tank Only_____ ________ Existing System ________ ExastanqSystem 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 C] 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. 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 / Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 6 00 1 L5_0 0 5 Q J_3�eet Feet VII. TANK Capacity g allon s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks ept CC Tank or Holding Tank Q El El El ❑ 1:1 lift Pump Tank iphon Chamber ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ VI NSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' N m : (Priht) Plumber's atur No St P PRSW No.: Business Phone Number: Cl �s Plum er's Address (Street, City, State, Zi de): — T IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Approved [I Owner Fee) / Owner Given Initial 7 1 Adverse Determination �, � .;Z1, '701 pw,�� X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: �o O.r L4 Ax v1_V 1� SBD-6M (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety 6 Buildings Division, Owner, Plumber t 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: I. Property owner's name and mailing address. Provide the legal description ar]d 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. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 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 thelocation..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 I i Safety and Buildings 2226 ROSE ST ' LA CROSSE WI 54603 -1905 I SCO1 ■SIl l Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Commerce October 06, 1998 CUST ID No.267341 ATTN.• POWTSINSPECTOR WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 0 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/06 /2000 �� ti: " � Identification Numbers ti r n �_, " Transaction ID No. 149933 RE v �! ED rte ID N 161212 SITE• Please refex to both identification numbers, C above, m all corres ndence with the ST CROIX Site ID: 1612128 p f� r ag St. Croix County, Town of Kinnickirip r, COUNTY SW1 /4, SW1 /4, S20, T28N, R18W �` ' ZONiNGOFFICE Alan & Charis Hartleben FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 428056 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative 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: • 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. Stats. • 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, whicii may include local inspectors. Ail 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. Oerard rel DATE RECEIVED 09/28/1998 FEE REQUIRED $ 180.00 M. swim FEE RECEIVED $ 180.00 POWTS Plan reviewer - Integrated Services BALANCE DUE $ 0.00 (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim ,commerce. state. wi.us i Page of 6 t MOUND SYSTEM FOR A y BEDROOM RESIDENCE LOCATED IN THE SW 1/4 OF THE S LV 1/4 OF SECTION , T N, R 1S W, TOWN OF COUNTY, WISCONSIN. f < cp INDEX 484 198 6 S, PA GE 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 r' .0.0�l9.T.s - C oll d itionally 1 Q V �c1Z �( 2UR'D F R I B J\ E '�Z `U ot. �I.LS, vJl S �� 1yE` raR�MEN-1 OF AO VI5i SA ETY �. ' pENGE SEE GURRE PREPARED BY WECGEIZER SO S L TEST S 1V ( AND DES I c3M S1EF:zV ICE ��c01v ' F.O. BOX 74 421 K. KAIK ST. RIVER FALLS. KI 54022 w "' 715-4 D-915 euRTN, was. 9 - Z6 - JOB NO. PLOT PLAN Page ?- of 6 I Scale 1"= 1-ki' � � ���� k sePl-► e �k o N — �'1f'n►�ftt�J `N111�• 60" �u ea v�w� `t oR t�v Sv FoT F-tzosT ��`t�`nory ..e ep o � a o � S . 90 o �S p �'dF Z`Pve �wi. v SS rn ° x ,o °T cote cT o\ - � \S'�R8 I 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 \ 2 , wu /Boo gallon capacity manufactured by 5. Bench Mark g1M _ �t�, 1p6, p • oQ eoQ e Gwr� (3r\6 IaTP' z4p„ 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of 6 Approved Synthetic Covering Distribution Pipe S M'1 C 3 3 T �- Medium Sand To soil _ H - – ___ s= G P ,= F Elev. q'y.SS 3 E - b �o % Slope Bed Of Z�– 2 %2 Force Main Plowed Aggregate From Pump Layer D Ft. Cross Section Of A Mound System Using E 1 -U% Ft. A Bed For The Absorption Area F (.,% Ft. G `- o Ft. A 8 Ft. H \-S Ft. Linear Loading Rate= ( Ix S GPD /LN FT B b3 Ft. Design Loading Rate= O /SQ FT j \ , o Ft. J S Ft. K \1 Ft. 4' 4�e Position L O Ft. of Force Main W 32 Ft. L 7 — r — Observation Pipe —,, A i --- - - - - -- -- - - - - -- t Fe, s �a 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 I � - Pa y Of Perforated Pipe Detail 0 End View Perforated End Cap,) a PVC Pipe Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S Q PVC Manifold Pipe f. PVC Force Main Disfrition Pipe Lost Hole Should Be I Next To End Cap End Cop P 3 p Ft. Distribution Pipe_ Layout S _ Ft. X Y Inches Y '4B Inches Hole Diameter "Y Inch Lateral Illy Inches) Manifold Z Inches Force Main Inches # of holes /pipe �3 Invert Elevation of Laterals 9 5 -6S Ft. %Y_ -X)= 9.3bxV= Place lst hole Z �4 from center of manifold with succeeding holes at V?->' intervals. Last hole to be next to the end cap. - Combination Septic;Tank and PUMP CHAMBER CROSS SECTIOIJ ARID SPECIFICATICIMS ' PAGE S OF 6 - NEWT CAP WEATHER PKOOI JuIJCTIOIJ bOX 4'C.Z. VENT PIP 1: APPROVED LOCKING 110' FROM DOOR, M&WHOLE COVER KXV 'di1JDOW OR FRESH � �H(Z.fJIfJG ALR JUTAKE t S a0siDulr r I , faRA _ I `(" MIM. 18' MIIJ. u ora plPt — — 41 PROVIDE I - - - -- INLET AIRTIGHT SEAL I I I I v APPROVED JOIUT egPFL�S A ! I I APPROVED JOIIJT: C.I. PIPE I II I W /C.I. PIPE w / Tank construction ALARM shall comply with ILHR ('33.15 and 33.20 J3 I I I I ow C CLEY. FT. PUMP -� -'� OFF D CONCRETE BLOCK 3" APPRmmE RISER EXIT PERMITTED OWLy IF TAWK MAWFACTURCR HAS SUCH APPROVAL BEDDtNCO SEPTIC f SPECIFICATIC)US DOS�EK MAWUFACTURCR: 'All WUMBER OF DOSES: 3.22 PER DAy TANK tdZC: �Z ` 900 GALLOWS DOSE VOLUME I l�q S ALARM MANUFACTURER: S'S' `t�`(1Z0 S �S 1 `? S IAICLUDIAJG OACKFLOW: GAL LONS MODEL 1JUM5ER: �' l3 CAPACITIES: A= `9 IMCHE5 OF, ����'� GALLOAJS SWITCH TAPE: '"1 L °lJy_'_( 5= Z IWCHES`OR L41- \ G( LLOAIS PUMP MANUFACTURCIt' �jOU` DS C IIJCHES OR t "'S CALLOUS MODEL WUMDER: �'a y D- g IMCHES OR 1 b8 `y GALLOWG SWITCH TJPE: Y--) k�?e�Z� MOTE: PUMP AUD ALARM ARE TO DE MIW DISCHARGE RATE ; -GPM INSTALLED OW 5EPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEN PUMP OFF AQ0.015TRIBUTION PIPE.. �_ FEET t MIIJIMUM METWORK SUPPLY PRESSURE .. .. 2.50 FE.ET -F Zp F OF FORCE MAIW X 3 2 F � o rr.FKICTIOU FACTOR_. FEET TOTAL 0%JAMIC. HEAD = ` y3 FEET DIAMETER Pump chamber IIJTERIJAL DIMLWSIOIJl OF TAWK: LENGTH ;WIDTH _ ;LIQUID DEPTH BOTTOM AREA _ 231= T GAL /INCH AS PER MANUFACTURER = 1 OS GAL /INCH .' Goulds Submersible Effluent Pump C� 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle Motor: and float switch attachment EPO4 Single P, •Farms • e: 0.4 H manual operation. Automatic points. • Heavy duty sump 115 or 230 V, 60 e: 0.4 H0 models include Mechanical • Water transfer Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /4 " maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING � • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding ■ • Discharge size: 1 NPT. plug. Optional 20 foot s Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastitic c enclosed design for end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 ► , components. Pump: EP05 " • Solids handling capability: 0 25 %" maximum. a 7 — w • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. ' I • Discharge size: lYz "NPT. Z 5 - -- • Mechanical seal: carbon- 0 15 rotary/ceramic - stationary, a 4 BUNA -N elastomers. o - ±- ES ' �� Temperature: 3 10 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. 2 - -r — - - -- - Y EPO4 5 � � UA! 0 0 ! 0 10 20 30 40 50 GPM L _L L 0 2 4 6 8 10 12 ml /h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 83871 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor 4nd 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 x4l, inches in size. Plan must include, but St. Croix not limited to vertical and horizontal referen iih (B, y, ilirre' c"A' and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location, dls ee to nearest, livid, 022- 1057 -30 APPLICANT INFORMATION -PL �/PRIN ORMAT,ION DATE L�, Z3 9 PROPERTY OWNER: ; '; PROPERTY LOCATION S i ;-? t i GOVT. LOT SW 1/4 SW 1/4,S20 T 28 N,R 1-9 kor) W Alan Hartleben fp PROPERTY OWNER':S MAILING ADDR -0, ST CAqix f LOT # I BLOCK # I SUBD. NAME OR CSM # 1003 Quarry Rd. 1, C)UN; / na na na CITY, STATE ZIP 0 U8ER11 ; ;' []CITY ❑VILLAGE OTOWN NEAREST ROAD River Falls, WI. 54 2 " - ; 1715) 4 '6 07' Kinnickinnic Q uarry Rd. existing j New Construction Use [)] Residential / Irulnbet°ofitiedrooms 4 [ ] Addition to g buildin g jx] Replacement [ ] Public or commercial describe Code derived daily flow 600 g pd Recommended design loading rate .5 bed, gpd /ft trench, gpd /ft Absorption area required 500 bed, ft 500 trench, ft Maximum design loading rate . 5 bed, gpd /0 .6 trench, gpd 1ft Recommended infiltration surface elevation(s) 94.55 ft (as referred to site plan benchmark) Additional design/ site considerations system el. based on contour line of el. 93.55' Parent material pitted outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND 7 7IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system ❑ S I N S ❑ U [Is [:iU I ❑ S F7 U ❑ S f) U EIS f7 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed jTmr& 1 0 -15 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2 15 -36 10yr4 /3 none sl lcsbk mfr gw if .4 .5 Ground 3 36 -42 10yr4 /6 none sl 2mgr mvfr gw if .5 .6 ele .9 4 42 -50 10yr4 /6 c2d 7.5yr5/8 scl M na gw na np .2 Depth to 5 50 -60 10yr6 /2 c2p 7.5yr5/8 sandstone residuum na na np np limiting factor 42 " Remarks: Boring # 1 0 -15 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2 -`< 2 15 -36 10yr4 /3 none sl lcsbk mfr gw if .4 .5 3 36 -50 10yr7 /2 none vfs Osg mvfr gw na .4 .5 Ground elev. 4 50 -64 10yr6 /2 c2p 7.5ry5/8 sans one resid um na na np np 95 ft. Depth to limiting factor 50" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 -246 -6200 Address: 1554 200t1j Ave. New R'c and WI 54017 Signature: Date: 9_10_98 CST Number: m02298 . �=� zch!�l PROPERTY OWNER A hartleben SOIL DESCRIPTION REPORT Page of 3 PARCELI.D.# 022- 1057 -30 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 0 -13 10yr3 /3 none 1 2msbk mgr gw 2f .5 .6 3 2 13 -33 10yr4 /3 none sl lcsbk mfr gw 1f .4 .5 Ground 3 33 -45 7.5yr4/4 none scl lcsbk mfr gw if .2 .3 .4 elev. 4 45 -60 7.5 r4/4 c2 7.5 r5/8 sicl M na na na n .2 92 ft. Y P Y P Depth to limiting factor 45" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # ............... Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Alan Hartleben New Richmond, WI 54017 MPRSW - 3254 SW4SW4 S20- T28N - R 19W (715) 246 -6200 town of Kinnickinnic N 1 =40' BM.= top of concrete garage apron @ el. 100' Alt. BM.= top of bottom step C el. 101.65' E �( U��GG /VI a te N *O4W�r 1 `1 ' I h 3.S �* �5 c1a w -� s !dP�' 6-1 5 I Of ki v% Gary L. Steel 9 -10 -98 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 1 7 U %Yy( -� C. 7l(' � ' a J G G c10 Z Z (Verification required from Planning Department for new constructioa) CitAtate 9i ice" ��1-51 a* Parcel Identification Number LEGAL DESCRIPTION OL 2 l O.S 7 — ,30 Property Location S lJ y, 'Su " Sec. . T-2-8 N -R j W, Town of (,J V) ! kt ri IC, Subdivision ,Iy Lot # Certified Survey Map # _/ Volume �- . Page # Warranty Deed # 1� y f Volume Page # 3 3 Spec house ❑ yes Ano Lot Imes identifiable 0 yes ❑. no SYSTEMI- fARMNANCE Imprommendmandcna=ofyoursepticqstemeouldresdtiafts premata+ Waretobandlewastes Propermamtenaaoe Of pumping out dee septic tank every three years or sooner, if nee ed censed can affect-&e fimctioa of the �' a licensed What you Put into the system septic tank a trataieat:tage is flee vastcdisposaLsystem. The property owner agrees to submit to St. Croix Zoning Department a certification, form, signed by die owner. and by a P ] aPlamber; restrictedpluml=or a licensedpmmperverifying that (I) the on -site wastewaterdisposal system is in Proper operating condition and/or (2) after inspection and pamping_Of necessary), the scptiatank is less than U3 full of sludge. Uwe, dee undersigned have read dw above vxfakeme and agree to maintain lice private sewage disposal system with dic standards set fordi. herein, as set by die Department of Commence and the Department of Natural Resources, State of Wisconsin.. Certification stating drat YOM septic system has beta maintained must be completed and retained to die St. Croix.County Zoning Office within 30 der 7fthe three year expiration dae. r SIGNATURE F APPLICANT �G' �`'' , ' 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 flee above, b of a way ty deed recordod in Register of Deeds Office. / SIGNATURE 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 col 1151; Document Number WARRANTY DEED' * :a REGtYS?'''5 Orp" �t� This Deed, made between Oscar C. Lee, Sr a single C ER ; C E parson, Grantor, and Alan I Hartleben and Charis S. "' W• ° �_� u Hartleben, husband and wife as survivorship marital SEP 0 $ i9 property, Grantees. Witnesseth, That ti l9 said Grantor, for a valuable consideration conveys to Grantees the follow *ng described Re ,l., of oe•,a real estate in St. C 'x County, State of Wisconsin. Recor Area Southwest Quarter of the Southwest Nsme and Return Addrers Quarter (SW4 of SWh) cf Section 20, s Township 28 North, Range 18 West. (Parcel :&rttiRcation Number) R f� TRANSFER g EE This is homestead property. Together with all and singular hereditaments and appurtenances thereunto belonging; And Oscar C. Lee, Sr. warr that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants, restrictions, and rights -of -way of ,~ record, if any, and will warrant and defend the same r x� Dated this 2 7th day of Aug t 1998. s S ' r C. ee, "Sr. 1 •! i AUTHENTICATION ACKNOWLEDGMENT `. Signature(s) STATE OF WISCONSIN ST CROIX COUNTY "i Personally came before me thts2 7th '998, the above named Lee °` a authenticated this day of 1998. tw person who execyt€� e f ` n ° atScn ge me. 4 signature C L Ga o type or print name �4 Nlotary Publi ,Pierce County, State.of Wisconsin ' TITLE MEMBER STATE BAR OF WISCONSIN commsston 5 permanent (If not, +tames of persons s ca ti706.06, Wis. Stats.) asst Ana res � m an Y s101'w be types at printed below authorized by t, THIS INSTRUMENT WAS DRAFTED BY C. L. Gaylord, Attorney at Law s River Falls, Wl 54022 , =i� (Signatures may be authenticated or ackrKwAedged. Both are not necessary 1 #t 'tc —twn ACID -655 -:021 jP