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HomeMy WebLinkAbout032-2102-30-050 ell p v o ao o N � O N ti U U N I I c _N O 0 0 _ C Z O. +. 7 N E LL c `7 a� CL Q o 3 M Z y rn '', ..; O P z a 0 cn w M m ID rn f- z c c C7 g o z g c � i r c w a 2 O Q Y m F- m a o V m z E - o M N N Q' O O Q O o " ZmZ N 4 _a z � E N C .. m Y O d GN O U — Q d N d T N 0 G 0. 12 C J M> i N H F O U N It tV M a a a *a a 3 (" a 0 00 O 1 � fA .� U o 00,31 CD N y m E W N _ 6 O O N (� CO 1') CL L'r O I (D 7 !�1 O n N C LO �rii C N O C o a) O N =3 N c 2 O Lo (D N N N - 0) _c N c N •- .� N M E ( N 'O fn N • Ia M O O Y N CA tp C U O L O M O N Z Cn cC a C a at L: 0- w rr � � l '�1 A U a M Omv �3 • 3 RECEaV D VOL 27 PAGE 5204 KATHCEf`II H. w REGISTER OF DEEDS ST. CROIX CO., WI 40 MAP RECEIVED FOR RECORD CERTIFikkd 9 05/11/2006 02:20PM LOCATED IN PART OF THE NE 1/4 OOFF THE �QNWW _1/4 AND IN PART OF THE SE 1/4 OF CERTIFIED SURVEY MAP WISCONSIN BEING SECTION do OTC!- 61�"iC1�16%�1lMTYOF SOMERSET. ST, CROIX COUNTY' REC FEE- 13.00 COPY FEE: 3.00 ORTH LINE OF � 4 PAGES: 2 COR SEC. 9 -N6 9'30'1 3'E 2833 N 1 / SEC. �_ SOO45'15'W C.S.M. IN � OL. 10_P_G. 2_7 1 CCESS I _ _ LOT 1 (N es•is� s � - - - - . LOT 2 6 s 2so i uE g AMA v - - - - - 7.4 ' 6 .98'�� i9.0 - - 3 - 3. i C.S.M. N N Z VOL. 9 PG_ 2 k V.E` HousE 4-41 - � ED DRI AY VAR /AB WOTH z � D IvEWAY 'I -PARCEL IN'�'z m — — 7. _ — �� 3 LOT 2 - - - - --- V_O_L 1 1_09_ z� 282 ACRES — — — — 8 — 317,189 SQ. FT. APPARENT I This Certified Survey Map Is a EASEWEEN I: P xr��• replat of Lots 2 & 3 of the mw OIL WAY I SCALE IN FEET 1" = 150' plat of Lally Acres, no AS S YONN ON additional lots are created by PLAT OF LOLLY this instrument. All conditions. ACRES I 150 O 150 restrictions notes. eta listed (: LEGEND on the previous certified survey : i x— FENCE map or plat are applicable unless otherwise Indicated. 336.65' 317.05' I FOUND ALUMINUM COUNTY SECTION N89 30 44 E 853.70 CORNER MONUMENT 8 N (S89 29 - W) FOUND 1' OUTSIDE Q N OIAMEIER IRON PIPE SET t' OUTSIDE DIAMETER e r O BY 16' LONG IRON PIPE. m ry WEIGHING 1.13 LBS. PER EASEMENT AS I LINEAR FOOT N SHOWN ON PLAT I I Q SEPTIC VENT ;w OF OF LOLLY ACRES I ; GARY HOKENSON as SHED C'• — -- - �S I y PREPAR FOR: O HOUSE ON •a• " I ^� 435 230TH AVENUE I ... �•�` I SOMERSET. WI 54025 t- RONALD SKYBERG y' DES wE ' • sOasa 2276 44TH STREET 2 x SOMERSET. W1 54025 LOT 3 • CLEAR LAKE,, d wl �� I m I d I 14.203 ACRES ' % `` q N0 SUr'iVO EACH PARCEL SHOWN ON THIS 618.662 S I Q. FT. ''�.r.. `r MAP IS SUBJECT TO STATE. 1t L4 �.� - a 6 COUNTY AND TOWNSHIP LAWS. RULES AND REGULATIONS (I.E.. r WETLANDS. MINIMUM LOT SIZE. I d r ACCESS TO PARCEL. ETC.) BEFORE \ PURCHASING OR DEVELOPING ANY z Q \ .� PARCEL CONTACT THE ST. CROIX 99 DRIVEWAY ' COUNTY ZONING OFFICE AND THE t TOWN OF SOMERSET FOR ADVICE. /^ ACCESS EASEMENT N v (S89'11'15 "W) TO 447H STREET N89'12'44"E. - • • — - — I! (N8833'12'E) �0. DRAINAGE 166.42 EASEMENT AS y+ i S88'34 41 W 25 / PLA TTEO 57.52-1- LOT 4 g t9 J ' � �'�/ r g g8 i pip pf L12 L1% �.C1j I L 4i6/ ��tih�h *d i r n i , THIS INSTRUMENT �l 6 EASEM CES T DRAFTED BY: �l� 73.8 65.00' WILLI A14E 1 2 ) 28 . 6 I I ' DATE. 04/04 /loos S LOT 5 S88 '%4!411W 558.03 I �r - - - -- i SHEET 1 OF 2 1 Of 2 Vol 21 Pagk- 5264 Labor Wisc and Department Human Relat ons Industry SOIL AND SITE EVALUATION Labor and i Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Page . /. of ; 3 Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and S%, <,eol ) X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all Information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner / Property Location �E!/i� F�E� sG� /f(/E/e Govt. Lot NF_ 1/4 )11/4) )11/4) 1 /4,S p / T21 ,N,R Ir E (or Wo Property Owner's Mailing Address Lot or CSM# t- ✓ ,e _ s o Csy Il City State Zip Code Phone Number Nearest Road sd 54 p>F vL �(.(,� . 550 7 S (Cvi� -) y52; - i 2,ln ❑ Ci f s il� [ Town -3 [D ' New Construction Use: ❑ Residential / Number of bedrooms ' ' � o I V Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: yS o - ,/ Code derived dally flow Sr 00 gpd Recommended design loading rate _ bed, gpd/ft - 7 trench, gpd /fl Absorption area required i / _ bed, ft / 0D trench, ft 2 Maximum design loading rate S 9 9 _ bed, gpd/ft trench, gpdht Recommended infiltration surface elevations -� ( S P e. ' 3 tt (as referred to site plan benchmark) Additional design /site considerations u 5 L O J &- NAIPj?Ow 7-,4E,0441$ p d S10 C dE� Parent material 5 1r0 . Si LT SE1J j%Yf✓7:5 Flood plain elevation, if applicable ft v S = Suitable for system Conventional Moun In- GrogpdPressure AT -Grad U System in Fill Holdi Tank U unsuitable for system ��❑ U S ❑ U S El U s ❑ s 2 El 2`6 X Ndl �CD�n �"� SOIL DESCRIPTION REPORT N lk = ,voT Boring At Horizon Depth Dominant Color Mottles Structure In. Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots GPD /ft2 Gr. Sz. Sh. Bed , Trench YW 313 .s�/ l fSAe 4-H {,e 0 2 v R , 5 Ground '7. $ J�� �7e S�Jjl —60 N 5 elev �"' /0 / b ft. r r �T1 . Depth to limiting factor JT Remarks: Boring # / ©4 / o Yee 313 s// /7SAA- ,�,�,� s z f ,,e ' , s z z /" �0 si /. ' -&_ ;� v Ground - 7. S - S/ S GT •wrFi2 1a elev. ~ S Depth to limiting factor � In. Remarks: CST Name (Please Print) Signature l� . Telephone No. �'oaiE - R T 71 �E' /C�irT PYx•Crt3� i 7iS Address Date CST Number �/- 95 Private Sewage Consultants 655 O'Neil Rd. 2 OT 3 c-s m 3, eux s I 3 r /0& /D I B y X3,4 t!�l�re �i•TS � � Sc9CT(�EST�D ���J�•C� /� 3 /�J 3 rt £,v �-l��s 1 ' Lowtr c,4, Tif �� T -f'e V al, 7 l? i 7? E e-C, 1 021 0 eo-v ra 04 . i i c _ FILED JAN 4 1996 �' I L KATHLM It WXM FEB 2 7 19� Re�er�f Deeds St Crok ca. m ST. CROIX COUNTY 0) SURVEYOR'S RECORD CERTIFIED SURVEY MAP Located in part of the NEJ of the NWj of Section 9, T31N, R19W, Town of Somerset, St. Croix County, Wisconsin. OWNER Kevin Fleischauer 256 First Ave. South South St. Paul, MN 55075 J i4 PLA AT i'Q LA iJ S 0 Z z E1 i I-I AV r- ____=North li of the NWk S89 ° 29'15 ° W o , „ W S89 0 29'15 ° W n — a , S89 29 15 W w 312.42 v W 1642.94' O S89 °29 15" W W 660.20' n T p z a T 279.41' z o I z (D M \ 33' 33' M r o c 0) y ILZ 41 CD I� g ` 0 (n � o g � L _ I> LOT 3 � N Imo, i� c �r m I —I o W r) I(D 10 1 N �' - 1 � - 1 -1 0 0 0 ICJ 3.83 AC. INC. R/W W 0o c. 166,895 S0. FT. o m Irk N -h �oyo o _ D i o cr 3.21 AC. EXC. R/W Ln m G, f7 ? W - N o 140,041 SO. FT. I ' • IE- (n Z I(7 C+ I v w p - � 0) - � I Ui B IC7 rn 66 � - o, C v �c M a a c L 279.41' J3.O l 0 N89 0 29'15 ° E 312.42' �._ Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labc-r and Human Relations ._ t►asro of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 lax,11inches in size. Plan must include, but St. croi not limited to vertical and horizontal reference poifitv(f3fu�, and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distanGet�ltr# 032- 1023 -50 I APPLICANT INFORMATION - PLEASE PRINT ALIM R N REVIEWED BY AT PROPERTY OWNER: A,I 7 P IC PROPERTY LOCATI Kevin Fleischauer ., GOVT. LOT NE 1/ 1 /4,S 9 T 31 N,Rl �(or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. N 256 First Ave. ��` na na csm endin Lei CITY, STATE ZIP C P NUMBER []CITY ❑VILLAGE MOWN NEAREST ROAD 3 S. St. Paul, MN. 5507 :I _121`450- Somerset 1 230th. Ave. [ New Construction UseTx] Residential/N6 s 3 [ ] Addition to existing building (] Replacement [ ] Public or commercial describe 3 03 Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft •5 trench, gpd/ft Absorption area required 1125 bed, ft2 900 trench, ft Maximum design loading rate • 4 bed, gpd/ft • trench, gpd/ft Recommended infiltration surface elevation(s) 102.45 ft (as referred to site plan benchmark) Addiuona; des -Ign / site considerauons na Parent material ground morains pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem Z S ❑ U � S ❑ U IB ❑ U iR S ❑ U ❑ S iR U I EIS IO U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Botrxiary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. —B—WT—rend 1 1 0 -8 10 r4/3 none 1 2msbk mfr Crw 2f .5 .6 t. . rg 2 8 -24 10yr4 /4 none sil 2msbk mfr 9w if .5 .6 Ground 3 24 - 72 7.5yr4/6 none sl 2msbk mfr 9w na .5 .6 elev. 1 4 72 -82 7.5yr4/4 none sl lmsbk mfi na na .4 .5 Depth to limiting factor +82" Remarks: Boring # 1 0 -9 10yr4 /3 none 1 2msbk mfr 9W 2f .5 1.6 2 ,;, 2 9 -37 10yr4/4 none s1 2msbk mfr gw if .5 .6 3 37 -78 7.5yr4/6 none sl lmsbk mfr na na .4 .5 Ground elev. 1 05.4 ] Depth to limiting factor +78" Remarks: CST Name.— Please Print Gary L. Steel Phone: 715 - 246 -6200 Address: 1554 h. Ave. New Richmond WI. 54017 Signature: Date: CST Number: 16— 6 ��- LL� rv 12 -22 -94 Cstm 0229 STEEL'S SOIL SERVICE Gary L. Steel Kevin Fleischaurer 1554 200th Ave. CSTM2298 NE4 NW4 S9- T31N -R19w New Richmond, WI 54017 MPRSW 3254 town of Somerset (715) 246 -6200 i N 1 =40 BM= top of SE lot survey stake at el. 100' l� e � � '�� � � �' — z•44 -s �J [ off '2 lo` Q Al /3 p T ►b T 2 5�' 3 3v' Gary L. Steel 12 -22 -94 _26 /NY A��� 4`8003 This instrument drafted by Brennan J. Cox Proj. No. 90- 24- 19.1 ApPR'nvFD 19g2� �= o JAN V 92 " '' 4 �M�S � di peels (.'.:'? YS�•' f?: c`. �; � '�3i' ^ fi:;r +i;'t�L•�J�t�19+K �c re r o ° H Bearings are referenced to the north to A) z line of the NWI of Section 9, w. ^' 1 li assumed to bear S89 ►r 00 t o 0 a �] - °E ~' C1 oro z � K 0 CD I s (+ r O c o+ < , �• rt S �• O rn a c 3C : a ° •n N tzj C C S to N• 1=G• e So Z � �• 1-• = C A� n o m 0 r+ . o o 3C = Cr • as o c c = 0 n d C) " m= M o o. rt 'n C+ r rt c T o s r• r m y rn n �' m rn O ►-r m rn fi d o �• Qt «, C/) LA D�' r+ dt' C �' <n '� d , � `."rte ��' `• , • ' I .: + � � � 0 'Cl S�Q0 1 59 660.20' 'y. ,.,,•,.., x;0.51 ;` _Road= Easement I IZ V `c ° 627. / CC* w .................... / IC. r •-.s 4LnK) I ro IN I� Z IZ Z roo� NMrM C1 cn °w �• ' m+ a o+ a oo �j w a IO IC t 1O o 0 IS II I — I I y° H a ►. - N ID tko IM cn t.0 I iZ ICJ o , rt = rt z Joint D ive Irn N � 1001 I Z trj 627.19 u , i M 0 I ' r y ° S00 660.20 :33.01-L g IL7 I 0 I� C71 f o a . — a -1 1 -1 (-h ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT f �. Owner Property Address City /State Legal Description: / "'� N G or Lot ,-' Block q4/, Subdivision/CSM # '/a ' /a, Sec. j , T,'2L`N-R aW, Town of So,,,,� �� e7` PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION !Tank manufacturer h Size ST/PC 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 - 2 Length Number of Trenches Setback from: House �xo Well --/, P/L 4,= Vent to fresh air intake ,7s ELEVATIONS Description of benchmark Elevation .-eo.« Description of alternate benchmark Elevation � �•- �/ Building Sewer , /��. �/ ST/HT Inlet 99-!5-i- ST Outlet &,-.2 - 2 PC Inlet PC Bottom Header/Manifold 91 - , , 9.;2 Top of ST/PC Manhole Cover ,ice_ P/ Distribution Lines () 91, R5/ () ( ) Bottom of System Final Grade Date of installation Z2 /i /4 Pe it number - State plan number Plumber's signature License number Date Inspector Complete plot plan Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Countx Safety and Buildings Division s CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitajyZpWr�t!Jo.: Personal information you provice may be used for secondary purposes [Privacy w, s.15.04 (1)(m)). Permit Holder's Name: ge ❑ Town of: State Plan ID No.: KYBERG, RON CST BM Elev.: Insp. BM Elev.: BM Description: Parceb'g�ND2102 -30 -000 0 0 0v " s TANK INFORMATION ELEVATION DATA A9800555 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic f s Benchmark o O � Oolding ation Bldg. Sewer Z 6)/Ht Inlet TANK SETBACK INFORMATION SO/ Ht Outlet TANK TO P/ L WELL BLDG. V to a ROAD Septic 7 ZZ� ZZ. NA ing NA Header / Man. 9 er — at ion NA Dist. Pipe Holding Bot. System V 9 � (P PUMP/ SIPHON INFORMATION Final Grade -;� 3 anufacturer and Cb �✓ s ay.P Model Nu M TDH I Lr n System TDH Ft orcemain Length Di a. H SOIL ABSORPTION SYSTEM BED TRENCH Width Length No. Of Tren he [T No. Of Pits Inside iquid Depth E I N a /9 1 DMItIENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STRE LE G Manu acturer: INFORMATION Type of / R mo Number: System: J �(U s /V OR UNIT DISTRIBUTION SYSTEM Header/Manifold " Distribution Pipe(s) �/ / x Hole Size x Hole Spacing Vent To Air Intake Length � Dia. Length � Dia. � Spacing b Z 7 Z -1 1 Z7 f 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 E] Yes ❑ No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) �� /'� /✓ e L/ LOCATION: SOME RSET 9.31.19,NE,NW 2276 44TH STREET — LO LY ACRES LOT 3 z�)�rd� w �✓ ��1. zz' 3� fi�rr. / PIan re�istbn requirek4� Yes ❑ No Use other side for additional information. Z L ou ( SBD -6710 (R.3/97) Da a Inspecto ignature Cert. No. Safety and Buildings Division Vi sconsi n SANITARY PERMIT APPLICATION 201 W. Washington Avenue In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less county than 8 1/2 x 11 inches in size. -W, • See reverse side for instructions for completing this application State sanitary Permit Numb Personal information you provide may be used for secondary purposes [:]Check it revision ro p. us& Lion [Privacy Law, s. 15.04 (1) (m)], State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Prope Owner Nqrme Property Location '1 /4 1 /4, S T , N, R 19k E (or)6T Property Owner's ailing��ss Cot Number Block Nurn e 1 It tate zip Code Phone Number Subdivision Name r C Nu er G ( ) S I. TYPE OF B IL ING: (check one) ❑ State Owned o Cit Nearest Road ❑ village L j66/ Public 1 or 2 Family Dwelling - No. of bedrooms yj Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. V- New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System ______System ________ System _____________ Tank Only______________ Existing ---- -- _________Exlstin�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 110 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit p� �( 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.1rich) Elevation �f / Feet Feet ci VII. Ca TANK in g t Site Total # of Prefab. Fiber_ Exper. INFORMATION g allons Gallons Tanks Manufacturer s Name Concrete con- Steel glass Plastic App New Tanks Existing structed T nks Septic Tank o I an 'C ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 01 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for ins4lation of the onsite sewage system shown on the attached plans. Plum s Nam : (Prin Plumber Si to o ps) MP /MPRSW No.: Business Phone Number: I Plumbers Address (Street, r State p Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssued Issuing Tit Signature (No Stamps) Approved [-]Owner Fee) Owner Given Initial /� Adverse Determinatio �V /� ; W-1 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber A A/� I \ i 1-2 UAS�: 0 gas- /91 •1lViscdhsln Department of Commerce SOIL AND SITE EVALUATION Division 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 8 112 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope Owner Property Location Govt. Lo j 1 f 114 F 1/4,S T N,R J E (orb Property Owner's Mtkiling Address, Lot # Block# Subd. Name or CSM# S Ci State Zip Code Phone Number Nearest Roams ❑ City ❑ Village Town New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate _ 7 bed, gpd /ft trench, gpd /ft Absorption area required bed, ft ft 2 Maximum design loading rate _bed, gpd /ft , 8 trench, gpd /ft Recommended infiltration surface elevation(s) // i�S 1S — ft (as referred to site plan benchmark) Additional design /site considerations 6. Parent material n - / Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system ZS ❑ U ZI S ❑ U d S ❑ U ®S ❑ U ❑ S Z U ❑ S ,® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground 8 / elev. Depth to limiting factor y -in. Remarks: Boring # r Ground 22- Zr _ elev. ft• ' Depth to limiting factor ZZLin. Remarks: CST Name (Pie a Print) , Signature Telephone No. L it - Address� Date CST Number 1 i Za % - i t ' / = I 3 0 39!,' ,oye a.45� -1 >�1 Witcgnsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of 3 Division of Safety and Buildings in acpordance with s. ILHR 83.09, Wis. 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 ST' CeOI X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ty rC ,Ev /A� �L EI S G > i4c1�� Govt. Lot ^/E, 1/4 NUI 1 /4,S 9 T 3 ,N,R / 9 E (or) Property Owner's Mailing Address Lot # I Block# Subd. Name or CSM# 2 5C6 15 T 4W • S.6 - 3 W 4 -l e - 4 I M�U — OR S�/3JJ �Eti�i o �- city State Zip Code Phone Number Nearest Road 50 5-1 16tuL MN 5SO 75. ( 40/2- y�D - i2P0 ❑city o ❑ village LLI' Town Z 3 0 'Y' E New Construction Use: esidential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate u bed, gpd/ft ti` trench, gpd /fl Absorption area required _ bed, ft 1�0 trench, ft l0 Maximum design loading rate N1k bed, gpd$ ' trench, gpd /ft Recommended infiltration surface elevation(s) s'e'w P - 3 ft (as referred to site plan benchmark) Additional design /site consi orations N S E T e EN S '- W Q (/ A` o.✓ e'O ti r D U le Parent material �CS Z Sn�T�� - 5'/ /7' ' ��'` Flood plain elevation, if applicable ft N S = Suitable for system Conventional Mound In- Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ U R ❑ U g❑ U 9 L❑ U ❑ S DW ❑ S SOIL DESCRIPTION REPORT AIIR = N o'r SAC CO M /4 s­' Pd;-77 Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft Texture Consistence Boundary Roots Bed ,Trench in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. /o Y 313 /a l w /-FS b,- 444 ,e rt S r f N�,P , 5 2- l0 . )5 / Y X S i l / .wr s�J� 4 'f fi 2 S / of .v , 6 Ground 3 S -y 7- YA elev. /S . 7 S Depth to limiting factor Remarks: Boring # )e 3/3 /a4w 4 S 5 /D '/ s i /, z,► 54,,r ,w►f�2 4. S Ufi -J : , G �G sye / ��►r fit' s N Ground - 7. S elev. Depth to limiting factor TV — Remarks: CST Name (Please Print) Signature Telephone No. 1 i 2!L/3K' icGrT 7 /5'` 3 . - R /A Address Date CST Number oC7 25'- I V F5 eje r41 X 41 6 Private Sewage Consultants Atrc n-us11 arl LOT 3 zu(3p I - 7 h S l 74,:., - wh // x P . = AWC eAve PITS / EV T <oJ = moo. d ' io 7 8 �0 Po 13 IEVA rIOA3 S L /02.12 h"IP f 1 - 111 S , � 3 /0 3 • PG (o Cr .�' UE SrS,J lo�4D� aq /0S;Gy • 2rsE a- r,�F v �r s - S ' � �t 5 ' f�s io y . y t-4 i T 1' -EAJc,4, 1 , � TI2 �tic Gt . ��•� I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 3 Property Address " �" T7 l c lz (Verification required from Planning Department for new construction) C l City /State �;,,,,��F,,� �6LT Parcel Identification Number LEGAL DESCRIPTION ((�� Property Location _ ' /o, d( ` /a, Sec. �, T R_2 2 Town of _% Yyw r Subdivision �� , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # _5_YQ 5Y-7 , Volume 13,-10 , Page # n(,Z Spec house ❑ yes 1� no Lot lines identifiable Vyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of e t e y expiration date. SIGNATURE OF PPPCANT 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 � ri Z e, by virtue of a warranty deed recorded in Register of Deeds Office. SI NATURE OF JPOCANT 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 3.28 ACRES WC. R/W N 142,946 SO. FT 3.09 ACRES EXC. R/W I N I8° 11' 43 "E 50.00 © U) 134.579 S0. Ft / U P W g 2 / 59 19 a W l V 1 09, I V. 02' p'! S89'291I5 "W 654.41' I _ca 3 W f 5 M� z 1 LL Nw 1 w +i 66' x O fV W ? EL VCL.1120, PG. W n z I 1 25 ` <1 - 18.20 ACRES INC. ESMT. Z I, All 11 ti 792,895 SO. FT. that C Wisco (DD 15.52 AC., EXC. ESMT. v of the N b 675,984 SO. FT. N U� bounds is c S89 07'01 "E 392.00' - -- � w NW1 �4 �I a Wiscon 77 o u� `, N D, g the no �$ of Lot Z the St 344.00 NW1 /4, ( sectio S co 2435 a Lot N00o52 D �� / PAGES 3 Lot 3; C feet t E line x descr Road) F 8 conta r G A S89 15 "W 33' WIDE 166a 12't H HWL 915.0 108.90 57.52' 33' W r Z N88 °33' 12 "E 259.00' V N Y U" W T 86' - M O IV Gj 4' I T cli in pX P O a Q Q Q ; a N rn u� o' y N88 0 33' 12 "E 556.03' ?ry S R 1 1 8 397.18' 73.83 5 . 275.00' 2