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HomeMy WebLinkAbout026-1018-95-300 ocool E -0 o tz `+1 co v m m A ^ � h z o w 0 a OZ 0 N N � O O Ul N `1 • A A 7 W 1� N tix co CD co W O O� O �-►, O) N p N C '., 3 O O N N a Z U� 0 0 n y O T A7 OD N 3 a O :E O r ' 7 N O O O C < D m a A co CD N a O A m W C)) O -� 14 00 (D N A b Cn CD c0 cD ^p 0 r to N (D� N o c Z I CD ' I � •S rT O z O O O .. A p 0 �_ * * * I — c ai ai ai o ° W D m - N a d d a 0 0 m m y co c+ m :3 CD cn d AO 7 o Nz ° z cco 0 0 0 O D a 3 Z m tr • y X 'a N CD m C CD CD co m a a 3 z m <° ?` Z C I ° A z o v a O Z 1 cn (D o a z 'a o " cn w m w z w CD A I a I m � _ c z C O a CD z n p I P I Ili a I 'Q I I � I N V A � w I o b J CD 5y 0 0 0 ° o i b DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 79 (H63.090) & Chapter '!45.045) LOCATION: SECTION: LOT NO.: BLK. NO.: SUBDIVISION NAME: NM 1�f 1 /4 5 /T30 N/R 18EX r) YV I TOWNSHIP/MDTKIDMLITY: Richmond 3 n/a n/a COUNTY: OWNER'S AME: MAILING ADDRESS: St.. Croix Halle Builders 1767 115th. St., New Richmond, Wi. 54017 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: I [�*esidence n/a n/a New ❑Replace I 7 - 15 - 92 n/a RATING: S= Site suitable for system U= Site unsuitable for system 111 CONVENTIONAL: MOUND: IN_ - GROUND - PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) S ❑U I ® ❑U S CAS 11U ❑ {� S E ❑ S ii] U I conventional If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Class 2 Flo indicate Floodplain elevation: n/a PROFILE DESCRIPTIONS p aw 27 SIB BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WITH ICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER IDEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 86 100.52 none >86 0-10, 10yr3/3, L.; 10 -26 10yr5/4 sil.; 26-67, - 7.5yr4/4, soft sl.,; 67-$6, 7.5yr4/6, co. S. 100.72 0 -9, 10yr3 /3,. L.; 9 -26, 10yr4 /4, sil.; 26 -80,- 8. 2 96 none >96 7.5yr4/4, sl.• 80 -96, 10yr5/4, co. S. B _ 3 96 100.82 none >96 0 -8, 10yr3 /3, L.; 8 -20, 10yr4 /4, sil.; 20 -47,- 5 4 4 sl.• 47 -96 1 5 4 S. B- 4 92 100.52 none >92 0 -10, 10yr3 /2, L.; 10 -26, 10yr5 /4, sil.;; 26 -54,- 7 .5 r4 4.sl;.• 54- 2 7. 6 B _ 5 94 4 100.57 noen >94 0- 8.10yr3/2, L.; 8 -18, 10yr4/4, sil.; 18-36, - B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- P- P- P- P PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. 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 surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 96.02 -- --- I i .. -._._ ..... ......, ,,, y-... ... . F .............. .. _... ._.. _ ., ..,- �_ N ti _ 1 55 _ �_- �1 I *• E C'` € � � E 3 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures a e Qj s e i he 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 (print): TESTS WERE COMPLETED ON: Gary L. Steel 7 -15 -92 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1554 200th. Av.e, New Richmond, tai. 54017 2298 1 715-246-h2_00 CST SIGNAT i DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT 1 t F Owner 4� Property Address �/ / S 7 – City /State acv- Legal Description: Lot Block Subdivision/CSM # _gL� 7 L&::' t /4, Sec. c-, T 3 0 N -R Ik W, Town of PIN # 02 G S' = 3 o a SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer X Size ST/PC /1 � 5° Q/ Setback from: House Well PAL 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: Width li? Length 5_ Number of Trenches Setback from: House W Well PAL /O Vent to fresh air intake ELEVATIONS Description of benchmark o C Elevation �a d Description of alternate benchmar Elevation Building Sewer , 0 ST/HT Inlet ST Outlet g�' G PC Inlet PC Bottom Header/Manifold ` �S� Top of ST/PC Manhole Cover �9• a 9 Distribution Lines Bottom of System Final Grade Date of installation IZ / / F Permit number 3-2 / -/G S 3 State plan number '— Plumber's signs re License number ZZ/</'/ Date Inspector 9 -r-1) Complete plot plan � .r 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 b 39 � xq° INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and 'Buildings Division bT . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita jj e�T3i Al�.: Personal information you provice may be used for secondary purposes (Privacy , s.15.04 (1)(m)]. Permit Name: INC. [if 6& % Town of: State Plan ID No.: HA LDE RS CST BM Elev.: Insp. BM Elev.: BM Description: Parcel 018-95-300 L" G `, TANK INFORMATION ELEVATION DATA A9800582 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B er c o �.ZZ� /1962 Aeration Bldg. Sewer �7 /(, o17 Dr. Holding / Inlet y' j q4 41 TANK SETBACK INFORMATION St/ Outlet /D•ZJ �iG•D7 TANK TO P/ L WELL I BLDG. ° ROAD Dt Inlet Air Intake Septic 4- iq l NA Dt Bottom Dosing NA Header / Man. -10.57 gS Aeration NA Dist. Pipe °•6b 9 -- (0 > Holding Bot. System 7 -p2.. PUMP/ SIPHON INFORMATION Final Grade '"•022 Manufacturer and , �/fij� (, �/'�•2 Model Number GPM TDH I Lift L OSS Ft Force main Length Dist. To well 5 BSORPTION SYSTEM ( Width Q -, Length t No. Of Treches n PIT No. Of Pits Inside Dia. Liquid Depth I N 6 DIMENSION SETBACK SYSTEM TO P/ L BLDG I WELL LAKE /STREAM LEACHING M n INFORMATION TypeO M � � CHAMBER - o Syste4muC4 / � 0s �ll� OR UNIT DISTRIBUTION SYSTEM Header /Manifold y Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length ! a t Dia. Length Dia. Spacing r 1 2 I 4­ 7" 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 : RICHMOND / 5.30.18,NW,SE 1749 105TH STREET 10 �G 1 44 d r ,i mil d /`�, Al . bn -- Tr' 0 "frj cm"-C� 41, kA Plan re llon requi red [] No D �/ Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Ce No t ^^ Safety and Buildings Division r^�•���r'� SANITARY PERMIT APPLICATION Bu reau of BiAldin water s 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County , (,than 8 112 x 11 inches in size. I ST. • ee reverse side for instructions for completing this application State Sanitary Permit Number 3014 1013 T information you provide may be used by other government agency programs ❑ Check if revision to previous application rivacy Law, s. 15.04 (1) (m)]. / 7d/ /0 fL. (��. State Plan I.D. Number 1. APPLICATION IN FORMATION - PLEASE PRINT ALL INFORMATION Location Property ner Prop Lo N e (� ca 7�+c , NA, Zia EZ' 1i4, S 5— T30 , N, R, /8' p'(or) W Property Owner's M fling Add s Lot Nu er T ck Number City, S a Zip Code Phone Number Subdivision N e or CSM Number w Ins vo 7 ()� LZsrC- 69/3 �l - �SYO II. TYPE F BUILDING: (check one) E] State Owned !t� Nearest Road Ej Public 1 or 2 Family Dwelling - No. of bedrooms 3 o Town of re �O� S?' 111 BUILDING USE (If building type is public, check all that apply) o Parcel Tax Number(s) 1 ❑ Apartment / Condo `S 3 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 online B, if applicable) A) 1. $New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only 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 Experiments Other 11 A Seepage Bed 21 ❑ Mound 30 ❑ Specify 41 [n 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) c Elevation -11 9O0 `bp i � /S Z Feet Feet Capacit VII. TANK in Ca allo Total # of Prefab. Site Fiber Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Exist in strutted Tanks Tanks eptic Tan or Holding Tank /OO U OC>p ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ I ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) P s Signature: Stamps) I MPOPRSW o.: Business Phone Number: n�h►a�� ;� /c 2ziy7i P rnber's Address (S�eet, City, State Zip Code): Z / cr lri� SYoo IX. COUNTY / DEPARTMENT USt ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Ag t Sign ture (No S ps Ap Surcharge fee) proved ❑Owner Given Initial pjY,v�� Adverse Determination DCJ r X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety 6 Buildings Division, Owner, Plumber /oT r 2 1 te 2Z /97/ Tw ow r Gov, z Zoe 2 I —? 95'Js PO�6Se 1 II I 3i6� �-7 11/18/98 WED 16;43 FAX 715 386 4686 ST CRX CO ZONING 00 "i r ftoth Air 1011.1111 And Observation Pipe (^ - AW*ved Vow Cs, MYdaWe IZ &e#Ye F111e1 grade 20 • Alt' AD&v■ Pipe _ 4 ' Cap Iran To Final gfea• Venl PIPI . Mere& Ilet Or 9WnMtic Cher11111 Yln Q Ageregele Over PIP# detrieyilen 71111 _ Pipe — fieMNe Pi p e 0 0 0 6' olk Pip e a Perlarate4 PIP& 11410" — cowl&q Tareninafing 41 Aet1cm Of System . SOIL FILL 01STR1 PIPE APPFbvE0 Sv(vtEtIG COVER • r,• rf, • �---•MATERIIIL O0. q'09 ST OF A`OREWE - -!� OR MARSW %A,4 • I:0t P-'I, AGGRCGATt :I_QV. �'SiZ .Wye, F T E� DI.S' PIPE T(p DE A? L7=AS7 IIJCKES BELOW ORIC,'10AL GaAO£ AVt) AT LEAST LO IA3CNE3 BUT Ito m0pr_ 7ftAU 42 IaCWES 6£LOW FIA3AL GRADE 1'1IUcIMUM MTH OF EXCAVATI60 FR OM O R I &W AI 6KAtiF. WILL 6L Wr_14E NNNIMUM WTIH OF FKCAVATIOM FFoNt O'116I1wlgL 6Ri49E WILL of — Ir rcta� SIGuro: LICEUSC DUMBER; 2 ; /77 D AT E Misconsin Department of Commerce SOIL AND SITE EVALUATION / Diviiion of Safety and Buildings Page ` of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 5 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # d Z 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)). Property O r Property Location A V//pp- S Govt. Lot Nw 114si5 1/4,S $ T 3, ,N,R 4< or) W ProperYy Owner's Mailing Address Lot # Block# Subd. Name or CSM# /l 13 3 7- 7- 2.5 City / State Zip Code Phone Number ❑ City C� Village ® Town Nearest Road 9-New Construction Use: Residential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 4 gpd Recommended design loading rate . s bed, gpd /ft trench, gpd /ft Absorption area required gi cc,,,, bed, ft 7s trench, ft Maximum design loading rate i•� bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure T AT -Grade System in Fill Holding Tank U = Unsuitable for system �`s El 4 S 11 U 'n S ❑ U S ® U ❑ S ® U ❑ S a U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench i o. /o IvYf3f3 4 ICC44e oo Ground 3 76 {V fs ele . 9 ft. Depth to limiting factor :7in. Remarks: Boring # oZ Z z -36 �y y 99 Rsi 4 / S L Ground eele 7Rr-;�ft. Depth to limiting ?� f for in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number SOIL DESCRIPTION REPORT -� PROPERTY OWNER Page � of 3 ' PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench O 2 Y3 aYfyr4-' s,L If sde p 3 Ground Depth to limiting fact { if in. Remarks: Boring # y /Q icYesl 4 s , Z- 3 Ground Depth to limiting factor /Zo in. / �- J - /O Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. SS Bed Trench Boring # 4er'5, Jr Ground Depth to limiting facto N � ���--- lll��� Remarks: Boring # f � , Vde /Ulf . �e . Ground Depth to limiting �1 4 actor D in. Remarks: SBD -8330 (R. 07/96) L IVY S�"5�.,�T'3o Kk'18' dam/ / D s I � � 303, y Sy 6 ol i S ST CROIX COUNTY SfiPTIC ;'ANK MAjNTIr1VANCE AGREEMENT AM) OWP, ERSHIP CE.R'TIFICATION FORM Chutier/Buyer Mailing Address Property Address d S 7 (Verification required fr i Planning Department for new consttuetion)___ it pity /State Parcel Identification Number _QZ ( , /O /X- ` j 3 30 O L EG AL QESCRIPTIQ 1 'I Proper - ty LooationN�� _ W Town of Subdivision Lot # Certified Survey Map # �I�B�'6 y _ 'Volume __ Page # ms S✓ D _ O Warraniy Deed # Volume Page # Spec douse 0 yes Q no Lot tines identifiable �9 yes ❑ no SYSTEM MAMENXKCE Improper use and maintettanceof your sel pc systaom could result in its premature failure to handle wastes. Proper maiutenance consists of pumping out the septic tank every thri a years or sooner, if treeded by a licensed pumper. What you put into the system can affect the function of the eeptie tank ag a trefl �meut stage itt thr, waste disposal system. ! � 'i The property owner agrees to submit to 5t, Croix Zoning Deputtrignt a corfifloatiun form, signed by the mmer and by a !' master pluznbor, Journeyman plumber, restrictedpk untber or a lice- imtApuxaper verifying that (1) the ott -site wastawaterdisposal system IS in proper aperatiug condition and/or (2) after iR �ectiott apd pumping (if necessary), the septic talc is less than 113 full of sludge. 'k I Ilwe, the undersigned have read the above requires tzants and agpeo to artaintain . the private sewage disposal systern with the standards set forth. herein, as set by the Department of Come` a and the Department of Natural ResoueaeR, Stato of Wisaonslu. (;E Yti datian st4ting that your septic systtem has been maintainer I must be completed and ratu-ned to the St. Croix County Zoning Office Within 30 days of the three ye expiration date. NA OF APPI,ICAM17 DATE OW NER CERTIFI _ I (we) certify that all statements on this # iv n axe tract to the best of my (our) l mowledge. I ( we) am (are) the owner(s) of the LpiWerty describe ov , virtue of a warra ity deed recorde,l irk Regitter of Deeds Oi'fice. GN k Op A PPLIC; I DATE E • " {" "" Any information that is ruis representcd re ay result in the sanitary permit being revoked by the Zoning Department. "••" •` Include with this application- a stamped wan•lttty deed from the Register of .needs office, a copy of the a rtified survey rn ap if reference is ,trade in the warranty deed 4881.4 n.:.ahi #..' ni...ei.;...i .n...q ,t ...,,... .�«. .• ,. .., - ✓. ,.. ...,"k.4. w.F•: {r' ..... ..o CERTIFIED SURVEY MAP i. O ... _ Located in part of the NWh of the SE4 of Section 5, C. )M T30N, R18W, Town of Richmond, St. Croix County, y Wisconsin. o; N} Corner �C,4'�90 ^S4iQ1iy� v z Section 5 APPROVED w C S ._N C. �� A A 4j O N O I 7! c I� u SEP 115'921 w °' �o� a ,, 'ro 1 _- , i HUDSOI , r m ...,w�.. ti,.. .:ra +..aresw ,. :4.r.�eMy w.: Wu.. l,.A r .M - iri lam (..: '�•'Z. ►.1 �. 1vi ls.y.t,fpJ!:r.�I�3,(rj, i 11 �' c: r• t: S�' . CROIX COUNTY '` �•., '"" �.•`` • ;omprehansive Planning Zoning and PsrkslCommittee UNPL nT I A Ir%S if -fiot recorded wcithirn30'days of s s I s' East -West } line of Section 5 approval•dato I I S89 311.32 s' 2255.91 E} Corner approvai•shaq be I ti S89 Section 5 W14 void I LOT 1 0 Ln i 2.20 Acres 0 95,988 Sq. Ft. ►= I( �� . `' 66 Foot Wide m jl Iy i — Private Road Easement ;T I -G o = I o I? O I �- .- 311.32 S89 316.771 I --{ I� I = o , 053 32 628.09 i - � OUTLOT S89 628.09' 1 I I I H w : 311.32 1 316.771 ° ir- Z> LOT 2 c LOT 3 ;2> 2.19 Acres c ° 2.19 Acres w i? ���, ; ;95,347 Sq. Ft.� 95,347 Sq. Ft. ro i o r co w w m w I33 33' � 0 1100 311.28 316.72 1 OUTLOT 1 AREA � q. I•• 1 S89008 628.001 41,448 S Ft. I 'FILED 0.95 Acres p SEPa e 1992.. N . 89 08 JAUEs O'CONNELL = E GEND ft*sf of Deeds °o OWNER L 6 SL Crdx C o'Wi tS � c Halle Builders e _ Aluminum County Section Monument 6� w Cl 1767 115th St. Found _ °- New Richmond WI 54011 ' 0 _ 111 x 24 Iron Pipe Set, weighing 1.68 lbs. per linear foot — - Fenceline ......••• - Roadway setback line => - Proposed Drive Location S} Corner Section 5 SCALE IN FEET This instrument drafted by Craig Nukert Job no. 87 - 27 - 192 0 100 200 400 Vol. 9 Page 2540